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.
This article will describe the types of sleeping pills, then 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.
Generally, it is best to avoid long-term use, 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 and prescription drugs. Anyone with ongoing insomnia should consult their doctor about the best approach.
Some of the most effective sleeping pills include:
When it gets dark out, the brain produces a hormone called melatonin, which 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 we get, the less melatonin we 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 over-the-counter antihistamines, which people usually use to treat allergies, can cause drowsiness.
Though not all antihistamines have this effect, people sometimes use first-generation antihistamines, or sedating antihistamines, to promote sleep or relieve tension and anxiety.
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, there is not enough evidence 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 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 the more severe associated side effects.
When to use sleeping pills
Always follow the instructions for over-the-counter 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
For a person with insomnia, it is usually best to 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 taken to relieve insomnia, can make it more difficult to fall asleep without them.
There is no evidence that using melatonin comes with serious risks. It is worth noting, however, that 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 intended 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:
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 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, pregnant women and children younger than 3 years 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 people taking prescription sleeping pills to:
- never take a pill without a doctor’s approval
- do not drink alcohol before using the medication
- take the first dose when there are no activities planned for the next morning
- do not operate a vehicle after taking a sleeping pill
- contact 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 intended 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.