If it’s 3:00 a.m. and your mind is racing—making a grocery list, balancing your budget, or preparing your to-do list for tomorrow—your insomnia is probably nothing to worry about. However, if the condition persists for several nights, it may be reasonable to seek over-the-counter (OTC) sleep therapy.
If left untreated, persistent insomnia can lead to serious health problems, including an increased risk of high blood pressure, type 2 diabetes, and congestive heart failure. Even occasional insomnia can reduce productivity while increasing the risk of accidents and depression.
This article looks at four over-the-counter sleep remedies that may help treat occasional insomnia. Two are antihistamines, which can make you feel drowsy. The other two are natural remedies that are thought to help with sleep.
Causes of chronic insomnia
Diphenhydramine is an antihistamine commonly used to treat allergies. It is also the active ingredient in the over-the-counter cold and flu medication Benadryl.
Diphenhydramine has a sedative effect, which means it can make you drowsy and help you fall asleep. The effect can last up to seven hours.
There are several versions of diphenhydramine to choose from (including diphenhydramine citrate, diphenhydramine hydrochloride, and diphenhydramine tannin), none of which are inherently better than the other.
Simply Sleep, Nytol, Sominex, and 40 Winks are just a few of the OTC sleep aids that use diphenhydramine as the active ingredient. Generic versions are also available.
The recommended dose of diphenhydramine for adults and children 12 years of age and older is 50 milligrams (mg) at bedtime. Diphenhydramine citrate may take doses up to 76 mg.
Diphenhydramine should only be used in young children under the guidance of a pediatrician. It should not be given to children 2 years old or younger.
Diphenhydramine is unlikely to be addictive when taken as directed. If you find that you need to take a diphenhydramine sleep aid more than 3 times a week, talk with your healthcare provider about finding a more appropriate and effective treatment.
Side Effects and Risks
In addition to drowsiness, diphenhydramine side effects include nausea, headache, and dry mouth. Most side effects are mild and go away within 24 hours. If they persist or are severe, stop taking the medicine and tell your healthcare provider. You should also call your healthcare provider if you have trouble urinating.
If you are taking medication for anxiety or depression, get your healthcare provider’s approval before taking diphenhydramine. You should never take diphenhydramine with an antidepressant called a monoamine oxidase inhibitor (MAOI). Doing so can cause seizures, hallucinations, and a severe drop in blood pressure.
Diphenhydramine should not be used with alcohol. If you experience daytime sleepiness after taking diphenhydramine, do not drive or use heavy machinery until you are fully awake again.
Diphenhydramine is an antihistamine commonly used to treat allergies that have a sedative effect. It’s also found in over-the-counter sleep aids like Sominex and Nytol, as well as in the popular cold and flu medication Benedryl.
Safety of Antihistamines During Pregnancy
Doxylamine succinate is another antihistamine with sedative properties. Popular sleep aids that contain doxylamine succinate include Unisom SleepTabs, Wal-Som, and Nighttime Sleep Aid. It is also available in generic form.
The recommended dose of doxylamine succinate for adults and children over 12 years is 25 mg taken 30 minutes before bedtime. It should not be given to children under the age of 12.
Side Effects and Risks
In addition to drowsiness, doxylamine succinate side effects include nausea, chest congestion, nervousness, excitement, and dry mouth, nose, or throat. Let your healthcare provider know if these side effects are serious or persistent.
Call your healthcare provider right away if you have vision changes or trouble urinating.
Never take doxylamine succinate with alcohol or other medicines that cause drowsiness (such as cold and flu medicines). Doxylamine succinate should not be taken with MAOI antidepressants.
Doxylamine succinate is as effective as diphenhydramine, but tends to have a longer duration of action. For this reason, you should not take it the night before your busy morning schedule. You should also be careful not to drive or use heavy machinery until you are fully awake.
Contact your healthcare provider if you need to take doxylamine more than 3 times a week or if insomnia persists.
Doxylamine succinate is a sedative antihistamine that tends to last longer than diphenhydramine. It can be found in OTC sleep aids such as Unisom. Unlike diphenhydramine, doxylamine succinate should not be used in children younger than 12 years of age.
Melatonin is a naturally occurring hormone that helps regulate the sleep-wake cycle. This is a 24-hour mode consisting of approximately 16 hours of daytime wakefulness and 8 hours of nighttime sleep. The regular release of melatonin from the pineal gland stimulates drowsiness and sleep.
There are two types of melatonin sold over-the-counter: one is man-made, and the other is extracted from the pineal gland of animals.
The effectiveness of melatonin varies depending on who you talk to. Some people claim it works and leaves them feeling refreshed the next morning. Others don’t do any good.
According to published in 2013 PLoS One, The effect of melatonin on occasional insomnia is modest. There is some evidence that it can help people fall asleep faster and stay asleep a little longer.
On the downside, the longer you take melatonin, the less effective it seems to be. Therefore, it should only be used for short-term relief of insomnia when needed.
There is no recommended dose of melatonin. In general, higher doses produce better results. Most manufacturers recommend taking 0.5 mg to 3 mg 30 minutes before bedtime.
Due to a lack of safety studies, melatonin should not be given to children, pregnant women, or nursing mothers.
Melatonin is probably the safest over-the-counter sleep aid. Excess melatonin is quickly removed from the body and does not build up. Side effects are rare, but may include headache, nausea, and vivid dreams.
Melatonin is a sleep-stimulating hormone that is part of the sleep-wake cycle. It is the safest OTC sleep aid with few, if any, side effects. Even so, some people feel no effect after taking melatonin, while others do.
Valerian root (Valerian) has been used for centuries to treat insomnia.It contains a substance called valeric acid, which is believed to activate cells in the brain called gamma-aminobutyric acid (GABA) receptors. GABA is responsible for slowing down nerve signaling. By activating these cells, valerian root can provide a calming, sedative effect.
Despite its long-standing use in traditional cultures, the effectiveness of valerian root for insomnia is uncertain.According to a 2015 report Sleep Medicine Reviews, Valerian root has no apparent effect on insomnia.
There is no recommended dosage for valerian root. Most valerian supplements come in a dose range of 300 mg to 600 mg, and are considered safe within this range.
Due to a lack of safety research, valerian should not be taken by children, pregnant women, and nursing mothers.
Side Effects and Risks
Side effects of valerian root tend to be mild and may include headache, dizziness, itching, upset stomach, dry mouth, vivid dreams, and daytime sleepiness.
Although rare, liver damage can occur if valerian root is used in excess. This is especially true if “wild” valerian root is used, which can be contaminated with heavy metals, fertilizers, and other toxic substances.
Stop taking valerian root if you have signs of liver damage, including abdominal pain, nausea, clay-colored stools, dark urine, extreme fatigue, or jaundice (yellowing of the eyes or skin).
Valerian root is an herbal supplement thought to have sedative properties and aid in sleep. To date, there is little evidence that it can help with insomnia.
If you have occasional insomnia, it may be reasonable to use an over-the-counter (OTC) sleep aid containing the antihistamine diphenhydramine or doxylamine succinate.
Diphenhydramine is found in OTC sleep aids like Sominex and Nytol, while doxylamine succinate is found in OTC sleep aids like Unisom. Doxylamine succinate has a longer duration of action and, unlike diphenhydramine, cannot be used in children younger than 12 years of age.
The effectiveness of natural sleep remedies like melatonin and valerian root is less certain. Melatonin seems to work for some people but not for others. The evidence supporting the use of valerian root for insomnia is generally weak. Valerian root can cause liver damage if overused.
Insomnia doesn’t always require medication. In fact, improving sleep hygiene is often all it takes to get a good night’s sleep. This includes not eating before bed, turning off electronics at least an hour before bed, keeping the room temperature cool, and making sure the bedroom is as dark and quiet as possible.
If insomnia persists despite your best efforts, talk to your healthcare provider. When used correctly and under medical supervision, prescription sleep aids may help treat occasional insomnia.