If you often find yourself tossing and turning in bed, waking up in the middle of the night, or generally struggling to get the sleep you need to be your best each day, you may be tempted to turn to over-the-counter (OTC) sleep aids. After all, if you can buy them in a drug store, they must be okay, right?
We hate to bring you bad news, but OTC sleep aids are often not the answer. Not only do they come with side effects and long-term health risks, they can also simply not work. But if you’re suffering with sleeplessness, there is something you can do about it.
Below, we’ll dive into the best over-the-counter sleep aids on the market, and explain why the natural options of sleep hygiene and circadian alignment are much better instead.
There are many different kinds of sleep aids on the market that you can buy without a prescription. Here are a few options:
Prescription sleep aids are known for their ugly side effects like dependence, withdrawal symptoms, and even increased dementia risk. But over-the-counter sleeping aids also come with their risks.
The common side effects of antihistamine sleeping aids include:
The common side effects of valerian root include:
The common side effects of melatonin include:
Even though they’re available to buy without a prescription, over-the-counter sleep medications still come with safety concerns.
Diphenhydramine has been linked with increased risk of cognitive decline in older adults. Plus, diphenhydramine is an anticholinergic drug, and anticholinergics have been linked to increased dementia risk.
Antihistamines have also been shown to have negative interactions with different kinds of medications, including acetaminophen (paracetamol) and aspirin.
The sleep you get from OTC sleep aids isn’t the best sleep for you either because it’s manufactured sleep. On the other hand, when you fall asleep with help from sleep hygiene alone (more on that soon), you get naturalistic sleep. According to Matthew Walker, the author of Why we Sleep, the sleep we get when we’ve taken a sleeping pill is architecturally different to normal, healthy sleep. Our deep-sleep brainwave activity doesn’t show the largest, deepest brainwaves we get with naturalistic sleep. Plus, your sleep may be even worse when you stop taking certain sleeping pills like Benadryl due to rebound insomnia
Natural sleep aids also have safety risks. The US Food and Drug Administration (FDA) classifies both valerian root and melatonin as dietary supplements. This means there are no strict rules on recommended doses and the amount in each supplement can vary from brand to brand.
In fact, a study looking at different brands of melatonin supplements found they contained from 83% less to 478% more than what their label said. A quarter of the supplements checked also contained the neurotransmitter serotonin.
Plus, they may not even help you get better sleep. One meta-analysis looked at 16 sleep studies on valerian root and found the research wasn’t robust enough to say for sure whether it improved sleep quality (although sleep scientists still don’t have an agreed upon definition for sleep quality).
The American Academy of Sleep Medicine says there’s a “lower degree of certainty” on whether to use melatonin, valerian root, and diphenhydramine or not to treat sleep problems and insomnia.
What’s more, there’s a lot we still don’t know about the long-term effects of using any of these sleep aids.
So, if you have trouble sleeping, what’s the best over-the-counter sleep aid to go for? We recommend drug-free options like sleep hygiene and circadian alignment (more on those below), but if you do want to go with something in a bottle, melatonin is your best bet.
Melatonin is a hormone your brain produces naturally two hours before your biological bedtime. It helps to prime your body and brain for sleep and makes you feel drowsy. And so supplements are useful for times when you want to sleep when your body isn’t producing high levels of melatonin.
These include when you’re:
In these times, melatonin has been shown to be safe for short-term use and effective at moving your circadian rhythm, or body clock. This helps you fall asleep earlier or later than you would naturally. You can’t overdose from melatonin and it’s non-habit forming.
If you’re pregnant, breastfeeding, or have underlying health conditions like diabetes or depression, speak to a doctor before taking melatonin.
Even if you’re suffering from chronic insomnia, the American Academy of Sleep Medicine recommends cognitive behavioral therapy for insomnia (CBT-I) in most cases, instead of turning to sleep aids. Cognitive behavioral therapy includes things like education on sleep hygiene (more on this soon), relaxation techniques, and sleep restriction — where you spend less time awake in bed.
Not only has CBT-I been shown to be effective, it may help you get to the root of the problem, meaning you can improve your sleep long term. Speak with a healthcare professional if you’re suffering with a sleep disorder to determine the best treatment options for you.
The American Academy of Sleep Medicine is currently investigating the safety of melatonin and is recommending those with insomnia avoid it for now.
There are ways to fall asleep faster and stay asleep all night without relying on sleeping pills. Here’s what to do for a good night’s sleep the natural way.
Sleep hygiene is a set of habits you can do throughout the day to help you get the sleep you need at night. Here’s what to do.
RISE can help keep your sleep hygiene on point by reminding you when to do 20+ sleep habits.
Your circadian rhythm is your internal body clock, or the roughly 24-hour cycle that dictates things like your energy levels, body temperature, and when your body makes certain hormones. So, as this dictates your sleep-wake cycle, there is a time when your body will naturally wind down and want to go to sleep.
To find the best time for you to go to sleep, look for your Melatonin Window in the RISE app. This is the time of night when your brain will be making the most melatonin it will all night. Go to sleep in this roughly one-hour window and you’ll find it much easier to fall asleep and stay asleep through the night. The timing of this window can change each night, but by keeping a consistent sleep schedule, you’ll find it changes less and less.
Tossing and turning at 3 a.m. is no fun, and sleep aids may feel like they’re helping in the short term, but they come with many health risks and side effects, and they can’t be relied on as a long-term solution.
Instead, you can turn to sleep aids that don’t come in a bottle: sleep hygiene and circadian alignment. RISE can help by reminding you when to do 20+ sleep hygiene habits and predicting the timing of your circadian rhythm each day. In those rare occasions when you do need a helping hand — like jet lag and moving your sleep schedule — the app can tell you the best time for you to take melatonin. All the above advice can help you get the sleep you need to feel and perform your best each day.
Melatonin is seen as the best sleep aid product as it has fewer side effects than other options, but it’s only a short-term solution and more suited towards shifting your sleep schedule than helping you sleep when you’d usually be trying to sleep. Improve your sleep hygiene and sync up with your circadian rhythm to improve your sleep long term.
Melatonin shouldn’t make you groggy in the morning, and if it does you can try taking a smaller dose earlier in the day. Completely natural sleep aids like improving your sleep hygiene, however, have no hangover effect the next day.
Sedating antihistamines are the strongest over-the-counter sleep aids, with doxylamine succinate tending to last longer than diphenhydramine.
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