If you’re struggling with insomnia, you might have checked out the over-the-counter sleep aid section in your local pharmacy and wondered if anything on those shelves might help put a stop to the tossing and turning. Are OTC sleep medications safe? What do they actually do? Which one might be best for you?

What Kinds of OTC Sleep Medications Are There?

Sleep medications that you can buy without a prescription include several categories:

  • Antihistamine-containing sleep aids. Try these if you have congestion and a cough from the flu or an upper respiratory infection. A product with doxylamine succinate will make you drowsy at night, but beware, it can also make you sleepy during the day and cause dry mouth, blurry vision, constipation, and trouble peeing.
  • Melatonin. OTC melatonin is a synthetic version of a hormone produced naturally by your body to regulate your sleep-wake cycle. Natural levels of melatonin in the body are highest at night. Research has found that melatonin can be helpful with certain kinds of sleep problems, especially for “night owls” who have a hard time falling asleep, and for people with jet lag. The evidence isn’t clear as to whether it helps with general insomnia. Side effects can include headache, dizziness, nausea, and drowsiness.
  • Valerian. Valerian is an herbal supplement that appears to act on certain receptors in the brain to slow down the nervous system and make you drowsy, although exactly how it works is unclear. It has few reported side effects other than drowsiness and dizziness.
  • CBD/cannabidiol.CBD, a derivative of the cannabis plant, is now found over-the-counter in many stores, including leading pharmacies. (It does not contain THC, the part of the plant that produces the “high” of marijuana.) CBD comes in multiple forms, including pills, edibles like gummies, patches, and creams. Because some studies have found that CBD relieves anxiety, a common contributor to insomnia and other sleep disorders, CBD is now being studied as a treatment for insomnia, but there is no conclusive data yet.

Are OTC Sleep Medications Safe?

Sleep medications that you can buy without a prescription are generally safe, but they do come with some risks. Daytime grogginess can happen with all over-the-counter sleep aids, and the side effects of the antihistamine medications, like blurred vision, confusion, and constipation, can be a particular problem for older adults. They can also increase the effects of, or interact with, alcohol or other sleep medications you may be taking, so it’s wise to avoid combining them with other substances. And while they don’t typically lead to dependency, over time your body can develop a tolerance to them, meaning you may need higher doses to get the same effect. Never exceed the recommended dose on the sleep aid’s packaging.

It’s also important to know that supplements, like melatonin, valerian, and CBD, are not regulated by the Food and Drug Administration as strictly as other medications. That means that there’s really no way to know for sure if the pill contains what it says on the label.

How Can OTC Sleep Aids Help Me?

Over-the-counter sleep aids are best for use in the short term, to overcome a brief bout of sleeplessness or to cope with jet lag. They are generally not useful for long-term chronic insomnia. If your sleep troubles last more than about a week, check with your doctor to see if there are underlying problems (like sleep apnea, stress, or anxiety). They may suggest additional interventions, like prescription sleep aids or cognitive behavioral therapy, which can help with insomnia. You may also be prescribed a sleep study, which evaluates your brain waves, movements, and breathing during sleep and can pinpoint problems you may not be aware of.

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