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Are OTC Sleep Aids Safe To Take?


Those who have insomnia may have looked at the over-the-counter sleep aids at their local pharmacy to see if anything could help them quit tossing and turning. What about over-the-counter sleep aids? Do they pose any dangers? In that case, what is it that they do? Which do you believe would benefit you the most?

Over-the-Counter Sleep Aids—Can They Be Trusted?

While over-the-counter sleep aids pose few risks, they should be used cautiously. Daytime sleepiness is a common side effect of any over-the-counter sleep aid. Still, the blurred vision, confusion, and constipation caused by antihistamine drugs can be especially problematic for the elderly.

It's also a good idea to avoid combining them with other substances, as they can boost the effects of alcohol or other sleep prescriptions you might be taking. There is no link between tolerance and addiction. However, tolerance might lead to the need for higher doses. In no case should you take more of the sleep aid than is prescribed by the manufacturer.

Also, unlike conventional pharmaceuticals, supplements like melatonin, valerian, and CBD are not subject to the same stringent regulation from the FDA. That leaves no reliable way of knowing if the pill includes the ingredients listed on the bottle.

Over-the-Counter Medications

Over-the-counter (OTC) sleep aids, including Tylenol PM, Nytol, Sominex, ZzzQuil, and Unisom, are typical examples of products containing these active components. Allergy treatments like Benadryl and Zyrtec include the same active ingredient, antihistamine. Antihistamines prevent the release of a chemical in the brain, which can cause drowsiness and calmness. Users may be tempted to exceed the recommended dosage due to the rapid development of tolerance to these active components.

Antihistamines are the primary element in several over-the-counter sleep aids. The antihistamine diphenhydramine can be found in dosages ranging from 25 milligrams (mg) to 50 mg per pill in medications like Nytol, Sominex, and Unisom (blue capsule form).

In addition to melatonin, some OTC sleep aids like Unisom SleepTabs include the antihistamine doxylamine succinate at 25 mg per tablet.

These drugs have a calming effect because they inhibit the production of particular substances in the brain. They pose a minimal danger but do have some potential drawbacks. 

According to Dr. Epstein, "You tend to become tolerant of the impact very fast, so they stop working for you," and it is unclear what the effects of long-term use would be. Antihistamines may also have adverse effects, such as dizziness and clumsiness, in the elderly.

Another risk: some over-the-counter sleep aids contain other drugs. For example, Tylenol PM contains not just 25 mg of diphenhydramine but also 500 mg of acetaminophen, a pain reliever. You might miss that if you take medicine just for its sedative effects.

Do OTC Sleep Aids Truly Work?

The effectiveness of several sleep aids for insomnia was summarized in a 2017 article issued by the American Academy of Sleep Medicine (AASM). In the same year, there was a summary from the American Academy of Family Physicians (AAFP). Okay, so what did they say?

On average, taking diphenhydramine would cut down the time it took to nod off at the end of the day by 8 minutes. 

In addition, those who took it slept for an extra 12 minutes on average compared to those who took a placebo (dummy pill). Nonetheless, they did not see an enhancement in sleep quality over placebo.

Melatonin shortened the time it took to fall asleep by 9 minutes. The quality of sleep was marginally higher than with the placebo.

In comparison to diphenhydramine, research on the sleep aid doxylamine is lacking. The FDA has only authorized specific formulations (such as Unisom) for use as a sleep aid at night.

A Word of Caution for Its Risks

The effectiveness of sleep aid supplements is unknown, despite their widespread use.

Except for valerian root, "there is virtually little data on any of the herbal supplements that indicate benefit," Dr. Epstein notes.

Minor adverse reactions to supplements are expected, including headaches, dizziness, and nausea. Additive effects with other drugs like alcohol or tranquilizers are possible.

The fact that the Food and Drug Administration (FDA) doesn't keep tabs on supplements means there's no telling if a capsule has the ingredients the maker says it does.

Sleeping pills can cause you to have dry lips, urine retention, impaired vision, confusion, and constipation. "The usage of these medications is especially worrying in older or elderly persons," Dr. Patel said. 

People with heart issues and those taking heart medication should avoid decongestants containing pseudoephedrine (Sudafed) and allergy drugs ending in "D" (Claritin-D). Since the active ingredient reduces blood vessel diameter, it may increase cardiac workload with prolonged use. 

Some people may try them as a sleep aid because they include elements that make them feel sleepy. Something like this ought to be prevented. Antihistamines like diphenhydramine and doxylamine don't pose a significant risk to the cardiovascular system. By taking our Heart Age Test, you may find out how well your heart is doing.

In addition, the active ingredient for sleep is typically combined with additional drugs in sleep assistance pharmaceuticals. For instance, Tylenol PM contains acetaminophen, diphenhydramine, a sleep aid, and a pain reliever. You should check with your pharmacist to be sure that any other medications you take are compatible with any occasional sleep aids you might be considering using.

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