Best Over-the-counter Sleep Aids

How Do Over-the-counter (OTC) Sleep Aids Work?

Over-the-counter (OTC) sleep aids can offer relief to individuals struggling with insomnia or sleep disturbances linked to various conditions. These accessible remedies can facilitate better sleep without requiring a prescription. There are a range of options available, and individuals can explore different treatments to find what works best for them.

While OTC sleep aids can be helpful with some sleep problems, they may not be right for everyone. Each individual’s choice should be based on factors like underlying health conditions and medication interactions.

Who Uses Over-the-counter Sleep Aids?

Over-the-counter (OTC) sleep aids can help alleviate symptoms for individuals experiencing problems falling and staying asleep. Different OTC sleep aids are approved for specific patient populations. While adults commonly turn to these remedies, it’s important to approach their use in children cautiously by becoming informed.

Some OTC sleep aids are approved for pediatric use, such as melatonin, which may be recommended for children over the age of 3 under medical supervision. Always consult with healthcare professionals before giving any sleep aid to a child.

Are Over-the-counter Sleep Aids Safe?

Over-the-counter (OTC) sleep aids can offer temporary relief for individuals with sleep disturbances. While generally regarded as safe when used as directed, OTC sleep aids may pose risks if misused or overused. Common concerns include dependency, daytime drowsiness, and potential interactions with other medications.

Some ingredients may not be suitable for certain individuals, such as those with underlying health conditions, allergies, or the elderly. Read labels carefully, follow dosage instructions, and contact your healthcare provider if your sleep problems persist or you experience adverse reactions.

Can Over-the-counter Sleep Aids Be Used With Prescription Sleep Medication?

Combining over-the-counter (OTC) sleep aids with prescription sleep medication requires careful consideration due to potential interactions and heightened effects. While some individuals may find relief from combining these treatments, consult with a healthcare professional before doing so.

Mixing OTC and prescription sleep aids can lead to excessive sedation (drowsiness), respiratory depression (slowed breathing), and other serious complications. Certain ingredients in OTC sleep aids may interact with prescription medications. Interactions can change how effective these medications are and possibly amplify side effects. Do not use OTC and prescription sleep aids together unless directed by your healthcare provider.

Who Should Not Take Over-the-counter Sleep Aids?

Over-the-counter (OTC) sleep aids may not be suitable for everyone, and certain individuals should avoid their use altogether. Those with pre-existing medical conditions, such as liver disease, kidney problems, respiratory issues, or psychiatric disorders, should consult healthcare professionals before taking OTC sleep aids.

Pregnant or breastfeeding individuals should seek medical advice before using these remedies. Some ingredients may pose risks to the developing fetus or nursing infant. Individuals with a history of substance abuse or dependency should avoid OTC sleep aids containing ingredients that may contribute to addiction.

Can You Take OTC Sleep Aids While Pregnant or Breastfeeding?

Pregnant or breastfeeding individuals should use caution when considering the use of over-the-counter (OTC) sleep aids. While some OTC sleep aids may be deemed safe during pregnancy or lactation, certain ingredients in OTC sleep aids may pose risks to the developing fetus or nursing infant.

Melatonin supplements are generally considered safe during pregnancy and breastfeeding when used in moderation and under medical supervision. On the other hand, OTC sleep aids containing ingredients such as doxylamine succinate or diphenhydramine (common in some brands) may not be recommended during pregnancy or breastfeeding due to potential risks to the fetus or nursing infant. Always read labels carefully, seek medical advice, especially during pregnancy and breastfeeding.

Types of Over-the-counter Sleep Aids

There are many different kinds of over-the-counter (OTC) sleep aids, each with specific actions on the body that can assist with different aspects of sleep difficulties. Choose a sleep aid based on your needs and be mindful of potential interactions or side effects.

Commonly used over-the-counter sleep aids may include:*

• Sedating antihistamines: These include medications like diphenhydramine and doxylamine, which are often found in OTC sleep aids. They work by blocking histamine receptors in the brain, leading to drowsiness and aiding sleep.
• Melatonin: Melatonin supplements mimic the natural hormone produced by the body to regulate the sleep-wake cycle. They are widely used as OTC sleep aids to help individuals fall asleep faster and improve sleep quality.
• Valerian root: Valerian root is a herbal remedy believed to have sedative properties. It is commonly used as an OTC sleep aid to promote relaxation and alleviate insomnia. However, research on its effectiveness for improving sleep outcomes is mixed.¹
• Cannabidiol (CBD): Derived from cannabis plants, CBD is gaining popularity as a potential treatment for various conditions, including sleep disorders. Some individuals use CBD products as OTC sleep aids due to their purported ability to reduce anxiety and promote relaxation. However, more scientific evidence is needed to confirm its effectiveness and safety for sleep purposes.¹

*Dietary supplements (including vitamins, supplements, herbs, and natural medicines) are not regulated the same way as prescription medications by the FDA. Before being sold to the public, these products do not have the same clinical trials to determine their safety and efficacy. You should consult your doctor or pharmacist before starting any new dietary supplement.

Over-the-counter Sleeping Pills Compared

There are several choices when considering over-the-counter (OTC) sleeping aids. Melatonin, valerian root, sedating antihistamines, and CBD represent some common choices. Consider factors such as short-term or long-term use, potential side effects, and personal health considerations when selecting the most suitable OTC sleep aid.

The following table compares OTC sleep aid options on potential benefits, risks, and more^1,2:

Melatonin

Melatonin is a hormone naturally produced by the body’s pineal gland, primarily responsible for regulating the sleep-wake cycle.¹As an over-the-counter (OTC) sleep aid, melatonin supplements are commonly used to promote better sleep, particularly for those experiencing difficulties falling asleep or adjusting to new sleep schedules, such as shift workers or travelers experiencing jet lag.²

Melatonin supplements are available in various forms, including tablets, capsules, gummies, and liquids. While generally considered safe for short-term use, potential negative side effects of melatonin may include daytime drowsiness, headaches, dizziness, and nausea, especially if taken in excessive doses or for extended periods without medical supervision. Well-known brand names for melatonin supplements include Natrol, Nature Made, and NOW Foods, among others.

• How melatonin works: Melatonin works by signaling to your body that it’s time to sleep. Normally, the body produces melatonin in response to darkness, helping to regulate the sleep-wake cycle.¹ When taken as a supplement, melatonin may help adjust the body’s internal clock, making it easier to fall asleep.
• Effectiveness of melatonin: Melatonin may be effective in improving sleep quality and reducing the time it takes to fall asleep for individuals with sleep disorders like insomnia.² Studies have shown that melatonin supplementation can help reset the sleep-wake cycle and improve sleep patterns, especially when used in conjunction with behavioral interventions.¹ Individual responses to melatonin may vary, and its effectiveness may depend on factors such as dosage, timing, and underlying sleep conditions.
• Side effects of melatonin*: The top five side effects of melatonin include daytime drowsiness, headaches, dizziness, nausea, and irritability. These side effects are usually temporary and may subside once the use of melatonin is discontinued. However, it’s important to consult a healthcare professional if side effects persist or worsen.
• What else you should know about melatonin: Melatonin supplements may interact with certain medications, including blood thinners, immunosuppressants, and diabetes medications. Discuss potential interactions with a healthcare provider before taking melatonin.

Individuals with certain medical conditions, such as autoimmune disorders, depression, or epilepsy, should use melatonin with caution or avoid it altogether due to potential adverse effects. Pregnant or breastfeeding individuals should also consult a healthcare professional before using melatonin supplements.

*All medications, including OTC sleep aids, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Valerian Root

Valerian root is a herbal supplement derived from the roots of the valerian plant, known scientifically as Valeriana officinalis. It has been used for centuries as a natural remedy to promote relaxation and alleviate symptoms of insomnia and other sleep disorders. ¹

Valerian root is believed to enhance the production of gamma-aminobutyric acid (GABA), a brain chemical that helps shut down nerve impulses in the brain and nervous system. For some, this may lead to a calming effect.¹ This herbal supplement is available in various forms, including capsules, tablets, teas, and liquid extracts.

While generally considered safe for short-term use, valerian root may cause side effects for some individuals. Well-known brand names offering valerian root supplements include Nature’s Bounty, Gaia Herbs, and NOW Foods.

• How valerian root may work as a sleep aid: Valerian root is believed to exert its sleep-inducing effects by increasing levels of gamma-aminobutyric acid (GABA) in the brain. GABA is a brain chemical known for its calming and sedative properties. This mechanism helps promote relaxation and reduce anxiety, making it easier to fall asleep and improving sleep quality for some individuals.
• Effectiveness of valerian root: Research on the effectiveness of valerian root as a sleep aid has produced mixed results.² While some studies suggest that valerian root may help improve sleep quality and reduce the time it takes to fall asleep, other research findings have been inconclusive. A meta-analysis published in the American Journal of Medicine found that valerian root demonstrated modest improvements in sleep quality compared to a placebo. Evidence overall remains limited and further research is needed to establish its effectiveness.²
• Side effects of valerian root: Common side effects of valerian root may include headaches, dizziness, gastrointestinal discomfort, daytime drowsiness, and vivid dreams. These effects are generally mild and temporary, resolving once the individual stops taking valerian root supplements. Some individuals may experience more pronounced side effects, and long-term use of valerian root may lead to dependency or withdrawal symptoms upon discontinuation.
• What else you should know about valerian root: Valerian root may interact with certain medications, including sedatives, antidepressants, and antihistamines. These interactions may increase the risk of excessive sedation or other adverse effects.

Individuals with liver disease or other medical conditions should exercise caution when using valerian root, and pregnant or breastfeeding individuals should consult healthcare professionals before taking valerian root supplements due to limited safety data. Valerian root should not be used in conjunction with alcohol or other central nervous system depressants, and individuals experiencing persistent sleep disturbances should seek medical advice.

*All medications, including OTC sleep aids, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Sedating Antihistamines

Sedating antihistamines are a class of medications commonly used to treat allergies by blocking histamine receptors in the body. Their drowsiness-inducing effects make them useful as over-the-counter sleep aids.

These medications can help individuals fall asleep faster and stay asleep longer. They are available in various forms, including tablets, capsules, and liquid formulations. Well-known brand names of sedating antihistamines include Benadryl (diphenhydramine) and Unisom (doxylamine).

• How antihistamines may work as a sleep aid: Antihistamines used as sleep aids work by blocking histamine receptors in the brain. Histamine is a neurotransmitter involved in wakefulness, and blocking it may help calm the nervous system and make it easier to fall asleep.
• Effectiveness of antihistamines as a sleep aid: Antihistamines, such as diphenhydramine and doxylamine, may help some fall asleep faster and stay asleep longer. However, their effectiveness may diminish with prolonged use. They are not recommended for long-term treatment of sleep disorders due to potential tolerance and dependence issues.^1,2
• Side effects of antihistamines: Common side effects of antihistamines used as sleep aids may include drowsiness, dry mouth, blurred vision, constipation, and urinary retention. These effects are typically mild and temporary, resolving once the individual stops taking the medication. Prolonged use or high doses of antihistamines may lead to more severe side effects, including cognitive impairment and increased risk of falls, particularly in older adults.^3,4,5
• What else you should know about antihistamines: Use antihistamines as sleep aids cautiously and under the guidance of a healthcare professional. These medications may interact with other drugs, such as alcohol, benzodiazepines, and opioids, which may lead to excessive sleepiness and slowed breathing. Individuals with certain medical conditions, such as glaucoma, urinary retention, or prostate enlargement, should avoid antihistamines due to potential exacerbation of symptoms.

Pregnant or breastfeeding individuals should consult healthcare providers before using antihistamines, as safety data during pregnancy and lactation are limited. Antihistamines may not be suitable for individuals with certain allergies or sensitivities to their ingredients.

*All medications, including OTC sleep aids, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Cannabidiol (CBD)

Cannabidiol (CBD) is a natural compound derived from the cannabis plant. As a sleep aid, CBD is believed to interact with the endocannabinoid system in the body. CBD may have an effect on various bodily functions, including sleep-wake cycles.¹ CBD may promote relaxation and alleviate anxiety, contributing to improved sleep quality.¹ It is available in various forms, such as tinctures, capsules, gummies, and oils. Well-known brands offering CBD sleep aids include Charlotte’s Web, CBDistillery, and Green Roads.

• How CBD may work as a sleep aid: CBD is believed to influence sleep by influencing how the body regulates sleep-wake cycles. CBD may promote relaxation, reduce anxiety, and alleviate pain, all of which can contribute to improved sleep quality and duration.
• Effectiveness of CBD as a sleep aid: While there is growing interest in the potential of CBD as a sleep aid, research on its effectiveness is still in the early stages.² Some studies suggest that CBD may have helpful effects on sleep, including reducing insomnia symptoms and improving sleep quality. More robust clinical trials are needed to fully understand CBD’s efficacy as a sleep aid, dosages, and treatment recommendations.
• Side effects of CBD: Common side effects of CBD may include dry mouth, diarrhea, changes in appetite, fatigue, and drowsiness. These effects are generally mild and temporary, resolving once the individual stops taking CBD. However, high doses of CBD or long-term use may increase the risk of adverse effects, including liver damage and interactions with other medications. It’s important to start with low doses of CBD and gradually increase as needed, under the guidance of a healthcare professional.
• What else you should know about CBD: CBD may interact with certain medications, including blood thinners, antidepressants, and anticonvulsants, potentially altering their effects and increasing the risk of side effects. Individuals with liver disease or those who are pregnant or breastfeeding should exercise caution when using CBD, as safety data in these populations are limited.

CBD products are not regulated by the FDA, so quality and potency may vary among brands. It’s essential to purchase CBD from reputable sources and to consult healthcare professionals before starting CBD supplementation, especially if you have underlying health conditions or are taking other medications.

*All medications, including OTC sleep aids, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

How to Get Over-the-counter Sleep Aids

Over-the-counter (OTC) sleep aids are widely available, often found in local pharmacies, drugstores, supermarkets, and online retailers. OTC sleep aids can be purchased without a prescription, making them convenient options for those needing relief from sleep disturbances.

Use caution when considering the quality and legitimacy of the products purchased online. Inform your healthcare providers, including physicians, psychiatrist, or other healthcare professionals, about using OTC sleep aids. Your provider can assess potential interactions with other medications, risks to underlying health conditions, and how suitable each remedy is for your situation.

Which OTC Sleep Aids Work Immediately?

Sedating antihistamines such as diphenhydramine and doxylamine are OTC sleep aids that may start working quickly for some.^4,5 These medications are known for their fast-acting sedative effects.

While sedating antihistamines are not designed for long-term use, they are commonly used for short-term relief when having trouble falling asleep. Individual responses to OTC sleep aids may vary, and factors such as metabolism, dosage, and overall health can influence how quickly the medication takes effect. Always follow recommended dosages and usage instructions provided on the product label and consult healthcare professionals if sleep difficulties persist or worsen.

Using OTC Sleep Aids With Lifestyle Habits

Combining over-the-counter (OTC) sleep aids with stress management, sleep hygiene practices, and regular exercise can help improve sleep quality. Stress management techniques such as mindfulness, meditation, deep breathing exercises, and relaxation therapies can help reduce stress levels and promote a more relaxed state.¹

Maintaining a consistent sleep schedule, creating a comfortable sleep environment, and limiting exposure to stimulating activities before bedtime may also help. Following these practices optimizing the body’s natural sleep-wake cycle, which may make OTC sleep aids more effective. Engaging in regular physical activity, preferably earlier in the day, can also help regulate sleep patterns and promote overall physical and mental well-being.

How to Use OTC Sleep Aids Safely

While over-the-counter (OTC) sleep aids offer convenience, it’s important to recognize that they come with potential risks. To use OTC sleep aids safely, carefully read and follow the instructions on the product label, including recommended dosages and usage guidelines. Discussing the use of OTC sleep aids with a primary care provider can help you understand any potential interactions with other medications or risks to overall health.

Here are 6 tips for using OTC sleep aids safely: 

• Always follow the recommended dosage instructions provided on the product label to avoid exceeding the safe intake limits.
• Avoid combining OTC sleep aids with alcohol or other central nervous system depressants, as this may increase the risk of sedation and respiratory depression.
• Consult a healthcare professional before using OTC sleep aids, especially if you have underlying health conditions or are taking other medications, to identify potential interactions and risks.
• Use OTC sleep aids for short-term relief of occasional sleep disturbances and avoid prolonged or excessive use to prevent dependency and tolerance.
• Be aware of potential side effects associated with OTC sleep aids and discontinue use if you experience adverse reactions such as dizziness, daytime drowsiness, or gastrointestinal discomfort.
• Practice good sleep hygiene habits in conjunction with OTC sleep aids to optimize sleep quality and effectiveness of the medication.

What If OTC Sleep Aids Don’t Help?

If over-the-counter (OTC) sleep aids don’t provide the desired relief for insomnia or other sleep issues, alternative treatments may be more suitable. Prescription medications, cognitive-behavioral therapy for insomnia (CBT-I), and lifestyle modifications are all options to consider. Work closely with healthcare providers to identify the most appropriate treatment for you.

Alternative treatments for sleep issues may include¹:

• Benzodiazepines: Benzodiazepines are a class of medications that act as central nervous system depressants, promoting relaxation and sedation.They are sometimes prescribed off-label to treat sleep issues and while they can be effective for short-term relief of sleep disturbances, they are generally prescribed cautiously due to the strong risk of dependence and potential side effects. Other medications approved to treat insomnia may be used as well. Examples of these include Ambien (zolpidem), Lunesta (eszopiclone) , and Silenor (doxepin).
• Cognitive behavioral therapy for insomnia (CBT-I): CBT for insomnia is a type of therapy that addresses the cognitive and behavioral factors contributing to insomnia. This evidence-based therapy helps individuals modify thoughts and behaviors that hinder sleep, promoting healthier sleep patterns.
• Hypnosis for sleep: Hypnosis for sleep involves guided relaxation and focused attention to create a state of heightened suggestibility. Some individuals find hypnosis beneficial for improving sleep by reducing stress and promoting relaxation.
• Stress inoculation training (SIT): SIT is a form of cognitive-behavioral therapy that focuses on managing and reducing stress. If sleep issues are rooted in anxiety or stress, SIT may be employed to equip individuals with coping strategies and resilience against stressors, ultimately improving sleep.

Questions to Ask Your Healthcare Provider About OTC Sleep Aids

If you’re experiencing difficulty falling asleep or staying asleep, or if you’re considering using over-the-counter (OTC) sleep aids to manage occasional sleep disturbances, please consult your healthcare provider. Asking questions about OTC sleep aids can provide valuable information about safe and effective usage, especially if you have underlying health conditions, are taking other medications, or are uncertain about the potential risks and benefits.

Questions to ask your care team about OTC sleep aids include:

• How safe are OTC sleep aids?
• Will my sleep aid take effect the first time I use them?
• Am I at risk for more serious side effects from OTC sleep aids if I am already taking other medications?
• How long do I need to keep using OTC sleep aids, and are they safe to use long-term?
• Are there any lifestyle changes or habits I should consider alongside OTC sleep aids for better effectiveness?
• Can you recommend a specific OTC sleep aid based on my individual sleep concerns and health history?
• Are there any potential interactions between OTC sleep aids and other supplements or herbal remedies I’m currently taking?
• What are the most common side effects of OTC sleep aids, and how can I manage them?
• Should I avoid certain activities or medications while using OTC sleep aids?
• Can you provide guidance on tapering off OTC sleep aids if I decide to stop using them?
• Are there any other treatments or therapies for sleep issues that you would recommend exploring with or instead of OTC sleep aids?
• Are OTC sleep aids more effective than natural sleep aids?

How to Know if OTC Sleep Aids Are Right for You

Talking to your primary provider can help you determine whether over-the-counter (OTC) sleep aids are suitable for you.

First, assess your individual sleep concerns, including the frequency and severity of sleep disturbances, underlying health conditions, and any medications you’re currently taking. Next, weigh the potential benefits and risks of OTC sleep aids, considering safety, effectiveness, and potential side effects. Evaluate whether lifestyle changes, relaxation techniques, or alternative treatments may address your sleep issues without the need for medication.

Discussing your sleep concerns and treatment options with your healthcare provider can help you make an informed decision about whether OTC sleep aids align with your needs.