Consider Medications
Misperceptions about sleep medicines — both prescription and nonprescription
— seem to persist. Some prescription sleep medications have been proven highly
effective and safe, while some other sleep aids such as melatonin melatonin and herbal remedies have gained popularity without adequate
data to support their safety or effectiveness.
In considering sleep medications, it is important to work closely with your healthcare provider,
to understand your options, to be aware of potential side effects, and to know what
questions to ask.
Read more below:
Prescription sleep medicines
Prescription sleep medicines fall into one of several classes, listed below. In
determining which sleep medicines may be right for you, your healthcare provider will take into
account such factors as your medical history, your insomnia symptoms, other medications
you are taking, and the way the medicine works in the body.
Types of sleep aids
NON-BENZODIAZEPINES. This is the newest class of sleep
medicines. The currently available products have a short half-life, which means
they are eliminated from the body quickly. Because of this, they are not likely
to cause daytime sleepiness. They are also “selective,” which means they
target specific receptors that are thought to be associated with sleep.
BENZODIAZEPINES. This class includes both long-acting medicines
(which can linger in the body and potentially cause daytime drowsiness) and short-acting
medicines (which do not stay in the bloodstream as long). Many benzodiazepines were
originally formulated to treat anxiety.
(See Non-Benzodiazepines).
BARBITURATES. These sedatives are rarely prescribed anymore
for insomnia, due to the risk of addiction, abuse, and overdose.
ANTIDEPRESSANTS. At times, healthcare providers will prescribe antidepressants
to promote sleep, although none of these medicines are specifically approved for
this purpose.
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In a 2002 poll, 15% of Americans surveyed reported that they used a sleep medication,
up from 11% the previous year.
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Nonprescription sleep medicines
Nonprescription sleep medicines usually contain antihistamines, which may induce drowsiness that lasts into the next day.
(Many cold and allergy medicines contain antihistamines, which is why they can make
you feel sleepy.)
It is important to check the ingredients label of any over-the-counter (OTC) treatment
— including those sleep aids designated as “nighttime” or “P.M.”
formulas — to see if it contains antihistamines. A common OTC antihistamine
is diphenhydramine hydrochloride.
OTC sleep medications can interact with other medicines you may be taking, so you
should consult your healthcare provider or pharmacist before using one of these sleep aids.
If an over-the-counter medication is not working for you, you may want to ask your
healthcare provider about prescription medications that might be right for you. (See above.)
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Other nonprescription treatments
Melatonin. Although melatonin is widely sold as a sleep aid, it remains controversial
in medical circles. Because melatonin (a hormone) is classified as a dietary supplement,
it has not undergone the rigorous clinical testing that medicines do. And with insufficient
data to support its claims, many experts question melatonin’s true effectiveness
and safety.
Herbal sleep aids. Herbal remedies for sleep problems include chamomile,
valerian root, hops, lavender, and passionflower. Like melatonin, these herbal remedies
have not undergone extensive testing, so their benefits are unproven. Herbal remedies
are generally considered safe; however, there are some that can be harmful under
certain circumstances. (Example: You should not use chamomile if you are pregnant
or if you are taking blood thinners.)
Important: While dietary supplements and herbal remedies may sound
harmless, they can have significant side effects or drug interactions. Moreover,
they are not clinically tested and approved by the FDA (Food and Drug Administration),
as are standard medicines. Before trying one of these alternative sleep aids, talk
with your physician.
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Questions to ask about sleep aids
You should discuss ANY sleep aid you are planning to take — whether prescription
or nonprescription — with your healthcare provider.
- Will this medicine help my particular sleep problems?
It is important to understand the nature of your insomnia.
For example, do you have trouble getting to sleep? Or is your main problem waking
up frequently? Some medicines may be most effective in helping you fall asleep initially,
whereas others may be better for preventing repeated wakings, or enabling you to
wake up feeling refreshed. (Click here for
a free sleep diary that can help you track your sleep patterns and identify problems.)
- Will I feel drowsy the day after taking this medicine?
Some medications remain in the bloodstream longer than others. This can potentially
make you drowsy even after you start your day.
- Could this medicine interact with medicines I’m taking for other conditions?
Make sure your healthcare provider is aware of all the medications you take. Important:
Include nonprescription medicines as well, such as cold medicines, pain relievers,
and drugs for indigestion.
- How long can I take this medication?
Before taking any sleep aid, it is important to speak with your healthcare provider about the
duration and frequency of its use.
Prescription sleep medicines are usually prescribed for 7 to 10 days. Your healthcare provider
may recommend that you use a prescription sleep aid for more than 10 days after
he or she reassesses your particular sleep problems.
- Am I at risk for becoming addicted to this medicine?
If taken as prescribed, sleep medicines usually do not cause dependence (addiction).
If you have been dependent on alcohol or other drugs in the past, you might have
a greater chance of becoming addicted; be sure to inform your healthcare provider of previous
dependence problems.
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Side effects
In general, the most common side effects of sleep medicines include dizziness, lightheadedness,
daytime drowsiness, diarrhea, and difficulty with coordination. With some prescription
medicines, however, the risk of these side effects is very small.
Here are some ways to ensure your treatment is as safe and successful as possible:
- Use only as directed. Follow your healthcare provider’s instructions about how, when, and
for how long to use the medicine.
- Never use alcohol while taking any sleep medicine.
- Tell your healthcare provider if you are taking any other medicines, including those you can
buy without a prescription.
- If you experience any unusual behavior changes or thought patterns after starting
on a medicine, contact your healthcare provider.
- When you first start taking any sleep medication, use extreme care while doing anything
that requires complete alertness, such as driving a car or operating machinery.
See whether the medicine has any effect on you the next day.
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