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Sleep aids: Natural vs. over-the-counter vs. prescription pills

Trouble sleeping? Learn about your options for getting a better night's rest.

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Imagine cozying into bed and falling asleep within minutes -- and then staying asleep until the sun comes up or your alarm goes off. If you're one of those people, you're envied by many. 

If you're the opposite type of person, a.k.a. the kind who can't fall asleep in less than 30 minutes and is reeled into wakefulness at the slightest sound, you probably found yourself here as part of your quest to achieve normal sleep habits. 

As someone who struggles to sleep myself, I've browsed the internet and drugstore shelves for hours in an attempt to find a remedy. I've tried melatonin; I've tried herbal supplements (and suffered through subsequent allergy attacks); I've tried over-the-counter sleep medications. I've tried most things shy of prescription sleeping pills and here I'll outline all of the options you can try too. 

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If you're in the same boat, know that different sleeping remedies work for different people. You'll have to experiment (with caution, of course, and with a doctor's order for prescriptions) to find out what sleep aids out there will help you catch some much-needed rest. This list of sleep aids isn't exhaustive, but it's a good start.

Always consult with your doctor before taking any supplements or medications that can impact your sleep. If your inability to sleep is severely interfering with your ability to fulfill daily obligations or is accompanied by anxiety, panic, stress, depression or other mental health conditions, please talk to your doctor about possible root causes and treatments. 

Natural and herbal sleep aids

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For those just dipping their toes in the water, natural and herbal sleep aids are a good start. You can find oodles of products online and in stores that promise to help you sleep. Many natural sleep aids contain a combination of ingredients, while others contain just one ingredient. Here's a look at several common natural sleep aids. 

Melatonin: Melatonin is a hormone produced naturally in your body. In a perfect world, your body would produce more melatonin in the evening to prepare your body for sleep and less in the morning to help you feel alert. However, thanks to electricity and technology, many of us have wacky sleep schedules, thus wacky melatonin production. Supplementing may help (if you do it right). 

Magnesium: An essential mineral, magnesium can improve sleep because it helps in the regulation of melatonin. If you're hesitant to supplement melatonin directly, you could try supplementing magnesium first as a way to increase your body's natural production of melatonin. 

Valerian root: Nicknamed "nature's Valium," valerian root is available as an extract in pills and liquids. It gained its status as a sleep aid because of compounds that inhibit the breakdown of gamma-aminobutyric acid (GABA) in your brain. GABA is a chemical messenger, and low levels of GABA have been linked to poor sleep and anxiety. Because Valerian root inhibits the breakdown of GABA, more of it may remain in your brain, thus helping you sleep better.

GABA: Speaking of GABA, supplementing this chemical messenger directly is linked to improved sleep. Patients with insomnia have reported falling asleep faster after taking GABA supplements, but other research conflicts those findings. GABA may work better in combination with other ingredients.

Glycine: This amino acid is thought to improve sleep because it lowers your core body temperature. Your body does this naturally at night, and it's one of many indicators your brain perceives as a sign it's time to sleep. Glycine has been shown to reduce the time it takes to fall asleep and improve overall sleep quality.

L-theanine: Another amino acid, L-theanine is often included as an ingredient in combination sleep aids. It's mainly found in tea leaves and it's known to boost GABA, serotonin and dopamine levels in the brain. L-theanine may also reduce resting heart rate and inhibit stress responses, further promoting relaxation. 

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Cannabidiol (CBD) has become a popular natural sleep supplement.

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CBD: CBD was the unicorn of the late 2010s. People started using it for everything from pain relief to relaxation and, yes, sleep. Although it's unclear whether CBD can directly improve sleep in some physiological way, recent research does suggest that CBD reduces cortisol levels, which can alleviate stress and help you sleep. 

Lavender: Ever felt super relaxed after using lavender essential oil or lighting a lavender candle? It's not a placebo effect. Studies show that lavender really can promote sleepiness due to its effects on the nervous system. One study found that using lavender in combination with healthy sleep hygiene habits results in better rest than focusing on sleep hygiene alone. It's a simple addition to your bedtime routine that has potential to help a lot.  

Chamomile: Drinking chamomile tea or using an aromatherapy diffuser with chamomile essential oil may make it easier to fall asleep thanks to a compound called apigenin. This chemical compound binds to GABA receptors in your brain (are you sensing that GABA is a common denominator yet?) and induces relaxation.

One very important thing to note about natural and herbal sleep aids is that they're regulated as dietary supplements, not medications. This means they aren't subject to the strict safety and efficacy standards set forth by the Food and Drug Administration for medications. If you want to try one of the sleep aids described above, do thorough research on different brands before you buy. 

Over-the-counter sleeping pills

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When you head to the sleep aid aisle of a drugstore, you'll see dozens of different bottles with different names. Look closer, though, and you'll notice that most of the bottles contain one of the following two ingredients. 

Diphenhydramine: Found in Benadryl and other allergy medications, diphenhydramine is sold as a single ingredient or in combination with pain relievers, fever reducers and decongestants. As a sleep aid, it's typically sold alone. Brand names for sleep aids containing diphenhydramine include Aleve PM and Tylenol Simply Sleep. Most drugstores sell generic diphenhydramine as a sleep aid, too.  

Doxylamine: Used for short-term treatment of insomnia, doxylamine is another antihistamine that can cause drowsiness. You can find it in drugstores as a generic sleep aid, as well as under the brand names Unisom, Nytol and Nyquil.

As you can see, OTC sleep aids are just sedating antihistamines. People generally use these medications to treat allergy symptoms, but certain antihistamines (like the three described above) can make you sleepy. Second-generation antihistamines usually don't make you sleepy, and those are found in allergy pills labeled "non-drowsy."

Keep in mind that although antihistamines are generally considered safe, they may interact with other medications you're taking. Also, they're not intended to be taken for more than two weeks at a time, so they aren't a permanent solution to insomnia. 

Prescription sleeping pills

Like OTC sleeping pills, prescription sleeping pills go by dozens of names. Prescription sleeping pills fall into three categories, hypnotics, barbiturates and benzodiazepines. Below are some of the more common sleeping pills prescribed by doctors. 

Hypnotics: Hypnotics are a class of psychoactive drugs prescribed to induce sleep. They come with a lot of potential side effects, including headaches, nausea, depression, weakness, impaired coordination and nervousness. They may interact with other drugs you're taking and aren't recommended for use with alcohol, so be sure to talk to your doctor about those factors. 

Common hypnotics include: 

  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  • Eszopiclone (Lunesta)
  • Ramelteon (Rozerem)
  • Suvorexant (Belsomra)
  • Doxepin (Silenor)
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Prescription sleeping pills may cause dependency.

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Benzodiazepines: Benzodiazepines are typically used to treat anxiety, seizures and other mental health conditions, but they can also treat insomnia and are often prescribed for that purpose. These medications work by altering the activity of your nervous system, targeting neurons that trigger stress responses. There are several different types of benzodiazepines, and they all have potential side effects, some of which can be serious. Mixing benzodiazepines with alcohol or other sedating substances can be fatal. 

Common benzodiazepines include:

  • Alprazolam (Xanax)
  • Chlordiazepoxide (Librium)
  • Clonazepam (Klonopin)
  • Clorazepate (Tranxene)
  • Diazepam (Valium)
  • Estazolam (Prosom)
  • Flurazepam (Dalmane)
  • Lorazepam (Ativan)
  • Midazolam (Versed)
  • Oxazepam (Serax)
  • Temazepam (Restoril)
  • Triazolam (Halcion)
  • Quazepam (Doral) 

Barbiturates: Another sedative-hypnotic drug, barbiturates are a type of central nervous system depressant that quiets anxiety reactions and can treat insomnia and seizures. This class of medications can lead to emotional and physical dependence, and as such are classified as Schedule II drugs.

Common barbiturates include:

  • Amobarbital (Amytal)
  • Secobarbital (Seconal
  • Butabarbital (Butisol)
  • Pentobarbital (Nembutal)
  • Phenobarbital (Donnatal)
  • Butalbital/acetaminophen/caffeine (Esgic, Fioricet)
  • Butalbital/aspirin/caffeine (Fiorinal, Ascomp) 

Which kind of sleep aid should you try? 

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If you have trouble sleeping, talk to your doctor about possible treatment options.

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Natural, OTC and prescription sleeping pills all have pros and cons. For example, prescription medications are more likely to induce deep sleep, but they can also lead to dependence and side effects like sleepwalking or severe daytime drowsiness. 

Natural remedies aren't likely to be habit-forming, but because they're regulated as dietary supplements, it's hard to know what you're really getting in a bottle. As for OTC sleep aids, many people quickly develop a tolerance to them and they can cause side effects in some people, as well as interact with other medications. 

You should discuss sleep aids with your doctor if you think you could benefit from them. Ultimately, the "best" sleep aid is the one that helps you get the best rest without adverse effects. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.