What are the best sleeping pills?
Sleeping pills may be sedatives or hypnotics, and they come in many forms. People can choose natural, prescription, or over-the-counter pills.
In this article, we will describe the types of sleeping pills and look at their uses and safety profiles.
Which sleeping pill is right for me?
A person can take a sleeping pill as a short-term solution if lifestyle adjustments have not worked.
Many people may not need sleeping pills.
By practicing good sleep hygiene, exercising, and avoiding alcohol and nicotine, an individual can often improve their sleep cycle and prevent insomnia.
Insomnia involves having trouble falling or staying asleep. People with insomnia may wake up too early or not feel refreshed upon waking.
If lifestyle adjustments do not work, for example when insomnia is severe, a sleeping pill may be a good short-term solution.
Avoid the long-term use of sleeping pills, because it can make insomnia worse, especially if a person stops taking the pills.
The range of sleeping pills includes supplements and over-the-counter (OTC) and prescription drugs. Anyone with ongoing insomnia should consult their doctor about the best approach.
The following are some of the most effective sleeping pills.
When it gets dark outside, the brain produces a hormone called melatonin. This regulates the sleep-wake cycle by telling the body that it is almost time for bed.
The brain makes less melatonin when it is light out and more when it is dark, such as during the winter. Age also plays a role — the older a person gets, the less melatonin they produce.
Many sleeping aids contain melatonin. They tend to be most effective for people with circadian rhythm sleep disorders, which are problems with the timing of sleeping or waking up.
Melatonin can be especially helpful for people:
- experiencing jet lag
- having trouble falling asleep at night
- coping with shift work
In recent years, manufacturers have marketed snacks and drinks that contain melatonin as "relaxation" products. Doctors do not know, however, if they are effective.
Melatonin supplements are available without a prescription from drug stores, supermarkets, and online shops. The pills tend to come in doses of 1–5 milligrams (mg), and a person should take them at bedtime.
Limited evidence suggests that melatonin can treat insomnia. However, though some findings have been mixed, most research indicates that it can reduce the amount of time it takes to fall asleep, including a 2017 meta-analysis published in the journal Sleep Medicine Reviews.
Sedating antihistamines can help people who have trouble falling or staying asleep.
Some OTC antihistamines, which people usually use to treat allergies, can cause drowsiness.
The following are sedating antihistamines:
- diphenhydramine, the active ingredient in Benadryl
- doxylamine, the active ingredient in Unisom
- cyclizine, the active ingredient in Marezine
Second-generation antihistamines are less likely to cause drowsiness. People use them to treat long-term allergy symptoms, and they are not effective as sleeping aids.
The following are nonsedating antihistamines:
- cetirizine, the active ingredient in Zyrtec
- loratadine, the active ingredient in Claritin
- fexofenadine, the active ingredient in Allegra
A doctor may recommend a sedating antihistamine, but only as a short-term solution. Though they are not addictive, the body gets used to them quickly, so they become less effective over time.
Valerian root is common in herbal supplements and can improve sleep quality.
Valerian is a plant. People have used the medicinal properties in the root since the times of ancient Greece and Rome.
Valerian root is a common ingredient in herbal supplements that people use to improve sleep, relieve anxiety, and support relaxation.
The supplements come in many forms, such as teas, liquids, and capsules.
Several clinical studies show that taking valerian can improve impressions of sleep quality in people with insomnia. However, not enough evidence is available to confirm whether valerian root is an effective sleep aid.
Valerian root-based sleep aids are available in drug stores, health food stores, and online shops.
Hypnotics are a group of sleeping medications only available by prescription.
A doctor may prescribe hypnotics to treat a number of sleep disorders, including insomnia. These medicines can also treat movement disorders that interrupt sleep, such as restless legs syndrome (RLS) and periodic limb movement disorder.
The most common hypnotic sleeping pills are:
Doctors tend only to prescribe hypnotics for insomnia that is long-lasting and bothersome because the drugs can have side effects.
Another class of sedative-hypnotics, called benzodiazepines, can also treat insomnia. These medications include:
Before prescribing a benzodiazepine, the doctor will usually first recommend a hypnotic. This is due to concerns about benzodiazepine dependence and its more severe side effects.
When to use sleeping pills
Always follow the instructions for OTC sleeping aids, including valerian products and antihistamines containing diphenhydramine or doxylamine.
The best time to take melatonin will depend on the nature of the sleep problem.
Sleeping pills for insomnia
A person with insomnia should take a sleeping aid just before or at bedtime.
Sleeping pills for jet lag
If tackling jet lag, take melatonin several hours before the intended bedtime every day throughout the trip and for a few days afterward. Doses of 0.5–5 mg tend to be sufficient.
Sleeping pills for shift work
For people with shift work, taking 2–3 mg of melatonin at the end of a shift can help prepare the body for bed.
Prescription sleeping pills
The right dosage and frequency will depend very much on a person's condition and the type of medication.
Always follow the doctor's instructions carefully.
Side effects and risks
People can feel tired and drowsy the day after taking sleeping pills.
Sedating medications, including antihistamines and hypnotics, can leave people feeling tired, drowsy, or groggy during the following day.
In older adults, using these pills can cause memory problems.
Some sleeping aids, when a person takes them to relieve insomnia, can make it more difficult to fall asleep without them.
No evidence suggests that using melatonin comes with serious risks. Researchers have yet to explore the long-term effects.
Do not take any sleeping aid before driving or operating machinery.
For many people, the risks of using prescription hypnotics outweigh the benefits. These medications are only suitable for short-term use. Most are habit-forming, meaning that they can be addictive, and they can also cause side effects.
Some side effects of prescription sleeping pills include:
- drowsiness or dizziness during the day
- problems with memory
- balance problems
In rare cases, they can cause people to perform actions, including driving, walking, eating, or making phone calls, while asleep.
Sleeping pills may also interfere with:
- remembering to take birth control pills regularly
- cimetidine for heartburn
- medications for fungal infections
The safety profile of valerian root is still unclear. Possible side effects may include headaches, dizziness, itchiness, and stomach problems. Some people feel groggy or drowsy in the morning after taking valerian root.
Also, people who have taken valerian root for extended periods then stopped suddenly may experience withdrawal symptoms. People who stop taking benzodiazepines after long periods may experience similar symptoms.
Because the medical community is still unsure of the effects, women who are pregnant and children under 3 years of age should not use valerian.
How to use sleeping pills safely
Always follow a doctor's instructions for using hypnotic sleeping medication.
The American Academy of Sleep Medicine advises the following for people taking sleeping pills:
- Never take a pill without a doctor's approval.
- Do not drink alcohol before using the medication.
- Take the first dose when you have planned no activities for the next morning.
- Do not operate a vehicle or heavy machinery after taking a sleeping pill.
- Dcontact a doctor right away if any complications occur.
People taking prescription sleeping pills should contact their healthcare team if they experience:
- confusion or extreme joy
- nervousness or anxiety
- problems focusing
- dependency on medication for sleep
- drowsiness in the morning
Older adults should also speak to their doctors if they experience any problems with concentration, thinking, or memory.
Sleeping aids can help a person get much-needed rest, but most are only suitable for short-term use.
Sleeping pills may contain an antihistamine or melatonin, for example. Some pills are only available by prescription.
The best type of pill will depend on the cause of the trouble sleeping and on a person's sleep patterns. People with insomnia may benefit from one medication, while those with jet lag experience the best results from another.
Only take sleeping pills when insomnia is more severe than occasional sleeplessness.
The risks of prescription sleeping pills sometimes outweigh the benefits, and doctors tend to only recommend them for people with severe sleep disorders.
What are the best natural ways to improve sleep?
Regular exercise is always good for maintaining healthy sleep habits. A person should engage in physical activity several hours before bedtime.
Begin to relax about 1 hour before bedtime and keep the bedroom dark, quiet and slightly cool to help you fall asleep quickly and stay comfortable. Maintaining the same sleep schedule, even on days off, as much as possible helps your natural sleep cycle in sync.
Avoiding caffeine, nicotine and alcohol for several hours before bedtime is always helpful in achieving restful sleep.Alan Carter, PharmD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.