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Important facts about OTC sleep aids

Get help to sleep well

You haven’t slept well in weeks, and you’ve tried all the usual tricks — avoiding caffeine in the afternoon, skipping daytime naps, eating foods that help fight fatigue, keeping stress in check, and putting your phone away an hour before bed.

Americans in general are tired, and there’s a good explanation.

Before the COVID-19 pandemic upended our lives, millions suffered from insomnia External Site and poor sleep. Now, the chronic stress, anxiety, depression, and isolation caused by lockdowns, excessive screen time, disruption of daily routines and inconsistent schedules have led to more people experiencing sleep issues External Site — even if they slept fine before the pandemic.

So, if you’ve found yourself eyeing an over-the-counter (OTC) sleep aid at the pharmacy or grocery store, rest assured you’re not alone. However, it’s important to remember that while they might help temporarily, they’re not the best approach for the persistent lack of quality sleep.

What to know about over-the-counter sleep aids

While some might consider them to be helpful for chronic sleep issues, they’re most effective when used only occasionally. That’s because, according to the Mayo Clinic External Site:

  • Most contain antihistamines, which your body can quickly build up a tolerance to — meaning the longer you use them, the less you’ll feel the full effects.
  • They can leave you groggy the next day, depending on when you take them the night before.
  • There isn’t much known about their overall safety and effectiveness, and they could even interact with medications you’re currently taking.

Use OTC sleep aids with caution

According to the American Sleep Association External Site®, many people assume that because these medications are available without a prescription that they are safe and have mild side effects. However, you should take precautions. This includes:

  • Not using sleep aids for longer than two weeks (talk to your personal doctor if you’re still experiencing sleep issues)
  • Avoiding alcohol use
  • Avoiding activities that require alertness (like driving or operating heavy machinery)

If you haven’t tried an OTC sleep aid before, talk to your doctor if you have any questions or concerns. They can provide information about side effects, drug interactions, or the impact on underlying conditions, like asthma, sleep apnea, chronic obstructive pulmonary disease, severe liver disease and more.

What are my options?

So, you’ve decided to give over-the-counter sleep aids a try and have the green light from your doctor. The good news: They’re widely available in most grocery stores and pharmacies. The (somewhat) bad news: There are several different options to choose from. Store brands are nearly identical to their brand-name counterparts, so we’ve listed your top options by active ingredient first. Here’s what you might find.

over-the-counter sleep aids active ingredients

Active ingredient: diphenhydramine

You’ll find this sedating antihistamine in brands like Benadryl®, Aleve® PM, ZzzQuilTM, and others. It may cause you to feel sleepy the following day, and because it’s also an ingredient used to treat allergy symptoms, you may notice dry mouth and nasal passages. Other side effects can include blurred vision, constipation, memory problems, increased heart rate, and difficulty peeing.

Active ingredient: doxylamine succinate

Often recommended to pregnant women in combination with low doses of vitamin B6 to treat mild morning sickness, doxylamine succinate is also known as Unisom® SleepTabs® or Unisom® SleepGels®. Side effects are similar to diphenhydramine.

Active ingredient: melatonin

If you’re looking for something a bit less pharmaceutical, you could try the hormone melatonin, which helps keep your natural sleep-wake cycle in check and can potentially help reduce the time it takes to fall asleep. The effects are typically more mild than other OTC sleep aids. Though your body naturally produces melatonin, adding more can still produce side effects External Site like daytime sleepiness, dizziness, headaches, nausea, and irritability.

Important: safety considerations for adults 65 years or older

Elderly adults should not take External Site any OTC sleep aids with diphenhydramine or doxylamine succinate due to risk of confusion, dry mouth, constipation, and other adverse side effects. For more information about sleeping well over age 65, talk to your doctor. 

Alternatives to over-the-counter sleep aids

If you’ve tried sleep aids a few times and still aren’t feeling any relief, talk to your doctor. They may suggest cognitive behavioral therapy to help form new sleep habits or authorize short-term use of prescription sleep aids to help you get the relief you need.

If you don't have a personal doctor (someone you see regularly for your routine care) and you're a Wellmark Blue Cross and Blue Shield member, you can easily find one who's in your health plan network by using myWellmark®. Don't have a myWellmark account? Just go to Opens New WIndow and sign up in minutes to get access to tools that help you find care, know your coverage, keep tabs on claims and spending, and make informed decisions.