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Sleep Aids: Safety, Side Effects, and What To Use Instead

Tempted by sleep aids to help you sleep? We share the safety, side effects, and how sleep hygiene and syncing with your circadian rhythm can help instead.
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Published
6/7/2022
Updated
13 MINS

Even though sleep is essential to our health and wellbeing, it can be hard to get enough of it.  And if you’ve ever found yourself struggling to drift off or waking up multiple times throughout the night, you might be tempted to reach for a sleep aid to help. 

However, prescription and over-the-counter (OTC) sleep aids come with many downsides, and so-called natural sleep supplements may not even work. The best way to help your body fall and stay asleep is through sleep hygiene and syncing up with your circadian rhythm. 

Below, we share everything you need to know about sleep aids, including their safety and side effects, and then cover how you can opt for the natural sleep aids of sleep hygiene and circadian alignment instead. 

 

What Are Sleep Aids?

Sleep aids are anything that help you sleep. Here are the common ones: 

  • Antidepressants: While they’re used to treat depression and anxiety, antidepressants can also be used to treat sleep problems as they’re a sedative.
  • Benzodiazepines: These include flurazepam (Dalmane) and temazepam (Restoril).  
  • Z-drugs: These include zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and zopiclone (banned in the US). 
  • Antihistamines: These are used to treat allergies, but they have a sedative effect, meaning they can also be used as sleep aids. You can buy these over the counter and you might see these as diphenhydramine (Benadryl and Tylenol PM) and doxylamine succinate (Unisom SleepTabs and NyQuil).

You can also find so-called “natural” sleep aids such as: 

  • Melatonin 
  • Magnesium 
  • Valerian root
  • Passionflower
  • L-theanine
  • Tryptophan
  • Cannabidiol (CBD)

They may be marketed as the safer option, but they’re not closely regulated by the Food and Drug Administration (FDA), meaning there are no strict guidelines on what’s included or even if the label correctly tells you what’s in these supplements. 

Not all sleep aids are made the same either. Not only do they all come with their own side effects and risks, they actually have different effects on you and your sleep. Some make you fall asleep faster, while others stop you waking up during the night. And then there’s melatonin which tricks your brain into thinking it’s sunset, making it wind down for sleep a few hours later, even if this is during the day.

What Are the Side Effects of Sleep Aids?

Prescription and over-the-counter sleep aids come with many side effects including: 

  • You can develop dependence on them to fall asleep  
  • Withdrawal symptoms, so need to slowly stop using them 
  • Sleepwalking 
  • Extra drowsiness the morning after (also called the hangover effect) 
  • Dizziness
  • Nausea 
  • Headache 
  • Dry mouth 
  • Constipation 
  • Allergic reactions
  • Muscle weakness  
  • Gastrointestinal problems 
  • Balance problems 
  • Impaired daytime performance 
  • Attention and memory problems 
  • Risk for long-term health implications like dementia, cancer, and early death 

Even natural sleep aids like melatonin, CBD, and magnesium come with potential side effects like: 

  • Headaches
  • Dizziness
  • Nausea 
  • Dry eyes 
  • Gastrointestinal issues 
  • Low blood pressure
  • Allergic reactions 
  • Confusion 
  • Sleepiness when you don’t want it 

 

Are Sleep Aids Safe?

Besides short-term side effects, sleep aids also have long-term health implications. 

One study found taking drugs such as doxepin hydrochloride for more than three years increases your risk of dementia. One meta-analysis looked at 10 studies on benzodiazepine and found nine of them reported an increased risk of dementia too. 

Another study found patients prescribed any hypnotic drug — think sleeping pills like zolpidem and temazepam — had an increased risk of dying than those who weren’t prescribed any, even if they were prescribed fewer than 18 pills a year. 

Even natural sleep aids come with their risks. Research into melatonin supplements found they contained from 83% less to 478% more than what was advertised on the label. What’s more, more than a quarter of supplements checked contained serotonin, a powerful neurotransmitter. So, you can never really be sure how much and what exactly you’re taking.

Plus, there’s still a lot we don't know about sleep medications, especially the effects of long-term use. There’s also a risk of drug interaction, where sleep aids negatively react with any medication you’re already taking. They’ve also been known to make some health conditions worse.

 

Do Sleep Aids Improve Your Sleep?

The short answer is no. While sleep aids do force your body to sleep, making it feel like you sleep better, it’s not natural shut-eye. 

Naturalistic Sleep Versus Manufactured Sleep 

When you fall asleep with help from healthy sleep hygiene that supports circadian alignment (more on that soon), you get what’s called naturalistic sleep. This is the best kind of sleep you can get — the kind that gives you plenty of energy the next day, boosts your mood and focus, and protects your health. 

The sleep you get from taking sleep aids, however, is manufactured sleep. According to sleep expert Matthew Walker, this kind of sleep is architecturally different to naturalistic sleep. When looking at your deep-sleep brainwave activity during these types of sleep, manufactured sleep doesn’t include the largest, deepest brainwaves you see during naturalistic sleep.

It’s not just deep sleep that’s affected, though. Benzodiazepine has been shown to reduce rapid eye movement (REM) sleep, which helps with learning and memory consolidation. 

Rebound Sleep Problems

The RISE app can work out your unique sleep need.

 The trouble doesn’t end when you stop taking sleeping pills, though. When you stop taking benzodiazepine, for example, you may spend longer in the REM sleep stage to compensate for not getting enough of it, but this may mess up your sleep patterns. 

REM sleep is also a light stage of sleep, meaning you’re much more likely to be woken up when in this stage compared to deeper sleep stages. If you are woken up, you’ll find it harder to meet your sleep need — the genetically determined amount of sleep you need each night. This leads to sleep debt, which is the amount of sleep you owe your body, measured over the last 14 nights. 

High sleep debt not only makes you feel tired the next day, it impacts your mood, productivity, and health. The RISE app can help you work out whether you’re carrying too much sleep debt. It can also calculate your unique sleep need so you have a number to aim for each night. Contrary to popular belief, not everyone needs 8 hours of sleep a night. 

You can also experience rebound insomnia, where you have trouble falling and staying asleep when you stop taking sleeping pills. This was shown in people who took benzodiazepine even for short periods of time. All this is to say that your sleep problems may be even worse than they were before you started taking sleep aids. 

Weak Evidence 

Natural sleep aids may not be as dangerous, but they also may not work. For example, CBD (cannabidiol) has become a popular sleep supplement, but it’s much more effective at reducing anxiety than helping you sleep.

And studies on other options simply aren’t robust enough. A meta-analysis looking at 16 studies on valerian root and concluded “valerian may improve sleep quality, but methodologic problems of the included studies limit the ability to draw firm conclusions. Sleep scientists also don’t have an agreed upon definition for sleep quality yet. 

It’s not just natural remedies, either. Guidelines from the American Academy of Sleep Medicine say many sleep aids — like suvorexant, zaleplon, and triazolam — have a “lower degree of certainty in the outcome and appropriateness” of using them to treat insomnia and sleep problems. 

Plus, many sleep aids aren’t meant to be taken long term, so you’re far better off addressing the root cause of your sleep problems. 

 

Should I Take Sleep Aids if I Have Insomnia?

Chronic insomnia is a whole new challenge when it comes to sleep problems. While many people are prescribed sleep aids or turn to over-the-counter options, they don’t always solve the problem, they come with potential risks and side effects, and you can’t rely on them long term. 

Even melatonin isn’t the answer. The American Academy of Sleep Medicine is currently investigating how safe melatonin is and, for now, it’s recommending those with insomnia do not use it. 

Instead, cognitive-behavioral therapy for insomnia (CBT-I) is recommended under most circumstances. CBT-I works by addressing the thinking and behaviors around sleep. This might include education on sleep hygiene (more on this soon), relaxation training, and sleep restriction — or reducing how long you spend awake in bed. 

CBT-I can often help you get to the root of the problem, improving your sleeplessness in a much safer way than turning to pills. You should speak with a healthcare professional to see if this can help you. 

How Can I Fall Asleep Without Sleep Aids?

Luckily, you don’t need to rely on sleeping pills to get a good night’s sleep. If you have trouble sleeping, there are lifestyle changes you can make to help you fall asleep, stay asleep, and have more energy the next day, all without popping a pill. Here’s how. 

Maintain Good Sleep Hygiene 

The RISE app can remind you when to do 20+ sleep hygiene habits.

Sleep hygiene is the name for the set of behaviors you can do throughout the day and night to improve your sleep. They’ll help you fall asleep faster and reduce how often you wake up in the middle of the night, therefore helping you get more sleep overall. 

If you’re getting CBT-I for insomnia, sleep hygiene will either be a part of it or it’ll boost its effectiveness if you’re trying other methods. But everyone — even good sleepers — can benefit from these good sleep habits.

Here’s what to do: 

  • Get natural light when you wake up: Light has the power to wake you up because it suppresses the production of the sleep hormone melatonin. In the mornings, this helps you overcome sleep inertia and sets up your circadian rhythm (or body clock) to make you feel sleepy come nighttime. 
  • Get natural light throughout the day: This may make you less sensitive to light in the evening. 
  • Avoid artificial light in the evenings: As light suppresses melatonin, getting too much light exposure near bedtime makes falling asleep much harder to do. Turn down the lights and put on blue-light blocking glasses 90 minutes before bed. 
  • Avoid caffeine, exercise, alcohol, and large meals too close to bedtime: All of these things can keep you up and disrupt your sleep. 
  • Take time to unwind: Spend time reading, listening to calming music, doing yoga, or journaling before bed to help your body and mind slow down. This is also great for stress and anxiety management, which both keep people up at night. You can also add a warm bath or show to your wind-down routine, which will counterintuitively help your body temperature drop, priming your body for sleep.
  • Keep your bedroom dark, cool, and quiet: Aim to make your bedroom between 65 to 68 degrees Fahrenheit and use blackout curtains, an eye mask, and ear plugs.  

We’ve covered more sleep hygiene tips here. RISE can help you maintain excellent sleep hygiene by telling you the exact times you should do 20+ sleep-boosting behaviors. 

Sync Up With Your Circadian Rhythm  

The RISE app can tell you when your Melatonin Window is.

Your circadian rhythm is your body’s internal clock that dictates when you feel awake and sleepy over a roughly 24-hour cycle. It can be disrupted by many things including food, exercise, and, the biggest of all, light. 

Once you’re practicing good sleep hygiene, aim to keep a consistent sleep schedule by going to bed and waking up at the same time each day, even on weekends. This’ll help regulate your circadian rhythm and you may start finding it easier to fall asleep at your desired time, rather than tossing and turning late into the night. 

You can also use RISE to check your Melatonin Window. This is the period of time when your brain will be making the highest amounts of melatonin it will all night. Go to sleep during this one-hour window and you’ll have a much easier time falling and staying asleep than if you went to sleep earlier or later. 

Consider Melatonin 

The RISE app can tell you when to take melatonin supplements.

 While we’re big proponents for natural sleep, there is one sleep supplement that can come in handy: melatonin. However, this still shouldn’t be a long-term solution to your sleep problems. Instead, we recommend turning to melatonin when you need to sleep when your body wouldn’t naturally have high melatonin levels. 

Melatonin is useful when: 

In these cases, you can use melatonin to shift the timing of your circadian rhythm earlier or later. Short-term studies suggest it’s safe and effective, and experts agree it doesn’t seem to be addictive like other sleep aids are. More research into long-term use needs to be done, though. 

We’ve covered how much melatonin to take here. If you do decide to turn to melatonin, RISE can tell you the best time to take supplements to help you drift off. 

Choose the Natural Sleep Aids of Sleep Hygiene and Circadian Alignment

It’s all too tempting to reach for sleep aids if you’re struggling to fall and stay asleep, but prescription and over-the-counter options come with great risks and side effects, and the so-called natural options aren’t much better. And while melatonin can help in certain cases, it should still be a short-term solution to help you get the sleep you need.  

Instead, turn to the best sleep aids for you: sleep hygiene and circadian alignment. Not only are they safe, they work long term, helping you fall asleep, stay asleep, and meet your sleep need night after night. The RISE app can help by reminding you when to do 20+ sleep hygiene behaviors and predicting your circadian rhythm, so you can sync up with it. Do these things and you may just find yourself snoozing more soundly than ever and having more energy each day, all without relying on sleep aids. 

Summary FAQs 

What is the best sleep aid at night? 

The best sleep aid at night is good sleep hygiene and syncing up with your circadian rhythm, both of which help you fall asleep naturally. Melatonin can help short term when adjusting to jetlag, shift work, or a new sleep schedule. 

Is it OK to take a sleep aid every night? 

No, it’s not OK to take a sleep aid every night. Experts agree sleep aids are designed for short-term use. Instead, turn to sleep hygiene to help you fall asleep each night. 

Why do I wake up after 2 hours of sleep? 

You may wake up after 2 hours of sleep due to light or noise in your bedroom; caffeine, alcohol, or large meals too close to bedtime; stress; or sleep disorders like sleep apnea. 

How can I sleep all night without waking up? 

To sleep all night without waking up, maintain good sleep hygiene like avoiding bright light before bed; not consuming caffeine, alcohol, or large meals too close to bedtime; and taking time to unwind and destress. 

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