There are three types of sleep aids for insomnia: prescription medications, over-the-counter drugs, and dietary supplements. Before a prescription drug can be sold, it must be approved by the Food and Drug Administration FDA , which carefully reviews data from research studies about its effectiveness and safety. Once the drug is approved, a patient must get a prescription from their doctor in order to obtain the drug from a pharmacy.
Different classes of drugs cause sleepiness based on their chemical composition and how they affect the brain. Types of prescription drugs that are approved by the FDA for insomnia include:.
Drugs such as antipsychotics and anticonvulsants are occasionally used off-label for insomnia, but there is less data about their safety and effectiveness in treating sleep problems.
Over-the-counter medications can be purchased without a prescription. These pills do not go through the same level of FDA review as prescription medications, but they still must meet certain regulatory standards before they can be sold.
Over-the-counter sleep aids are composed of antihistamines. Antihistamines are frequently used to manage allergies, but because of their sedative effect, they are also marketed as sleeping pills. Antihistamine sleep aids may be sold as one-ingredient products, or the antihistamine may be combined with active ingredients for other issues such as cough, fever, or congestion.
Although people may use them for health reasons, dietary supplements are not formal medications. They do not have to be approved by the FDA , and there is considerably less oversight of sleep aids sold as dietary supplements. Natural sleep aids , such as melatonin, valerian, or kava, are examples of dietary supplement sleep aids. Brands can create sleep aids made of just one ingredient or a blend, which is why there is a huge diversity of these sleep aids available on the market.
Among the types of sleep aids for insomnia, dietary supplements tend to have the least amount of evidence from studies documenting their benefits and downsides. The primary benefit of most sleep aids is that they induce drowsiness that lets you get more sleep. By improving sleep in the short-term, many sleep aids can alleviate daytime drowsiness and impaired thinking from sleep deprivation.
They may help reset your sleep schedule, enabling you to start down a path toward consistent sleep. That said, most sleep aids are not meant for long-term use.
As a result, treatment for insomnia often combines a sleep aid with practical steps, such as improving sleep hygiene , that can help you get quality sleep every night without relying on sleep medication.
AASM organizes panels of sleep experts who review the existing research and make general recommendations about sleep aids. This is because certain sleep aids work quickly and wear off fast, and others start slowly and last a long time. AASM recommends against the use of over-the-counter sleeping pills and dietary supplements like melatonin and valerian. Potential side effects can vary based on the specific sleep aid and whether the person taking it has any other health problems or medications that they take.
In general, there are potential negative effects that can occur with almost all sleep medications, although the likelihood of these effects may be higher with some sleep aids. In addition to this general list of potential side effects, there are risks that exist only with some sleep aids. For example, some sleeping pills may have detrimental effects on other health conditions.
A number of sleep medications are tied to worsening symptoms of depression, and prescription sedatives can cause suppressed breathing that can exacerbate sleep apnea. Many sleep aids can be habit-forming. This may lead to the drug being taken for too long or at too high of a dose, increasing the risk of side effects.
Abruptly stopping the use of some sleep aids can trigger a resurgence of insomnia symptoms or other withdrawal symptoms. Because they are less carefully regulated, dietary supplements are more likely to have mislabeled dosage information or be tainted with chemicals not listed on the bottle.
Because of the possibility of side effects, it is important to talk with a doctor before starting to take any sleep aid. There is no sleep aid that is universally the safest. Depending on your personal health situation, certain drugs may be more or less risky than others.
But this determination should be made by a health professional who can review your situation and discuss the benefits and risks of specific sleep aids in your unique case.
Instead, the best sleep aid for insomnia is the one that is most tailored to your needs including the nature of your insomnia, your age, your overall health, and any other medications that you may take.
Taking these factors into account, you and your doctor can compare sleep aids and their potential benefits and downsides. In some cases, the best way to get better sleep may not involve a sleep aid at all. Improved sleep hygiene, including sticking to regular bed and wake times can be an alternative option for people struggling with sleep problems. When taken by healthy adults, sleep aids are usually safe for short-term use as long as they are used as directed. This means taking them at the right time and only with the recommended dosage.
Extra doses should be avoided even if sleeping problems continue. In addition, sleep aids should not be mixed with other sedatives, alcohol, or recreational drugs.
For certain people, there may be added risks of taking sleep aids for insomnia. Here's what you need to know about sleeping pills if you're considering them, and what steps you should take with your doctor before seeking a prescription. Because there are quite a few options for specific kinds of sleeping pills—the FDA lists 19 on their website—some sleeping pills serve different specific purposes, Janet Hilbert, MD , assistant professor at Yale School of Medicine and medical director at Yale Noninvasive Ventilation Program and Adult Sleep Medicine Program, tells Health.
But those are just the medications specifically indicated for insomnia—medications with other initial purposes may also be prescribed to treat sleeplessness. That's because the side effects of those medications often includes severe drowsiness, she says. Those include benzodiazepines Xanax, Klonopin , antidepressants Trazodone , and antipsychotics Seroquel. The FDA also lists over-the-counter drugs like Benadryl and Unisom as treatments for insomnia due antihistamines, which also cause drowsiness.
Experts Explain 10 Common Issues. One sleepless night does not warrant a sleeping pill prescription, and even those who suffer from acute insomnia may be better off exploring other options. Hilbert says. Additionally, trouble sleeping may be due to other sleep disorders like sleep apnea or restless legs syndrome , other medical or psychiatric disorders, medications taken for other problems, or poor sleep habits—and it's important to seek medical help to get a handle on any undiagnosed conditions.
Won adds that the evidence for the effectiveness of sleeping pills in the long run is generally poor. However, if a thorough medical evaluation doesn't show another underlying cause of sleeplessness, and CBTI isn't available or successful, that's a situation in which someone may benefit from sleeping pills, says Dr. If you think you might be a candidate for sleeping pills, the first step is speaking with your primary care doctor.
After that, you may be referred to a sleep center for a consultation with a sleep specialist which may include taking part in a sleep study , or to a clinical psychologist for CBTi. It has been used as a medicinal herb since the days of ancient Rome. Use of this flower, which looks like a daisy, also goes back thousands of years.
It's taken in pills as well as teas many people drink a cup of chamomile tea at bedtime. It is considered mild and safe to help you become drowsy. But some people have an allergic reaction to chamomile especially those who are allergic to ragweed. This supplement comes from a lab, not a plant. It's a synthetic version of the human hormone that helps regulate your sleep-wake cycle. But Dr. Epstein says it's not a sleep medication. Epstein advises taking one to three mg of melatonin two to three hours before bedtime, if you're trying to better align your sleep cycle because of jet lag or a night-shift job.
He says you can take melatonin safely for the long term. Benzodiazepines like lorazepam Ativan and temazepam Restoril target gamma-aminobutyric acid GABA , a brain chemical that reduces nerve activity and promotes sleep. These medications can be habit forming, may cause daytime sleepiness, and may be associated with dementia.
Nonbenzodiazepines — such as zolpidem Ambien and eszopiclone Lunesta — also work on GABA, but they leave the body faster and have fewer side effects, allowing for regular waking and daytime functioning the next day. However, they still increase the risk for sleepwalking and daytime sleepiness, which can lead to falls and injury. Melatonin-receptor agonists such as ramelteon Rozerem target melatonin receptors in the brain. They leave the body quickly and are not thought to be habit forming.
These medications are meant for short-term use only, under the direction of your doctor. But medications are just one option to treat insomnia. Behavioral therapy, which involves looking at your sleep habits and ways you think about sleep and routines, is equally effective," says sleep expert Dr.
Even though supplements are widely taken to help people sleep, we don't actually know if they work. Many supplements can have minor side effects, such as headache, dizziness, or nausea. Or they may increase the effect of alcohol or other drugs you're taking, such as other sleep medications. Perhaps the biggest concern is that the FDA doesn't regulate supplements, so there's no way to know if a pill contains what its manufacturer claims. If you want to take an over-the-counter sleep drug or a dietary supplement, speak with your doctor or pharmacist to make sure it won't interact with any medications you're taking.
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