I’ve had problems sleeping most of my adult life. And I admit over the years I’ve tried using Benadryl (diphenhydramine) as a sleep aid now and then.
So I was interested when Consumer Reports recently published a warning that too many people are too frequently turning to over-the-counter sleeps aids.
A 2015 Consumer Reports national survey of 4,023 adults found a troubling trend: Of the 20 percent who took an OTC medication within the past year to improve sleep, almost 1 in 5 respondents, or 18 percent, said they took it on a daily basis. Most concerning: 41 percent told us they used the drugs for a year or longer.
The Food and Drug Administration (FDA) recommends taking over-the-counter sleep aids for no more than two weeks.
The article is a good reminder that just because you can buy sleep aids and other drugs without a prescription, it doesn’t mean they are safe for everyone.
And the directions are there for a reason; read them! Before taking an over-the-counter sleep aid, be sure you understand the drug’s side effects, and how it may interact with other drugs you are taking, or affect underlying health conditions you might have.
Over-the-counter sleep aids are just antihistamines
Diphenhydramine and the other common over-the-counter sleep aid ingredient, doxylamine, both belong to the class of drugs called antihistamines.
Basically, they’re allergy medications. But they work on the central nervous system and cause drowsiness, so they have also been approved by the FDA to treat short-term insomnia.
Do they work?
Not really. A journal reviewed 12 years of clinical trials looking at over-the-counter sleep aids and found:
Currently available literature suggests that commonly used OTC sleep agents, especially antihistamines, continue to lack robust clinical evidence supporting efficacy and safety in relevant populations.
Personally, I’ve found that diphenhydramine does cause drowsiness and makes me fall asleep more quickly, but I don’t stay asleep. Also, I don’t wake up feeling refreshed. Antihistamines have an 8-12 hour half life, which means the drug is still in your system after you get up in the morning. Feelings of sluggishness and memory impairment can linger several more hours. In healthcare we call this “Benadryl brain.”
For this reason, I don’t use Benadryl as a sleep aid anymore.
Safety concerns for over-the-counter sleep aids
What are the other side effects? The most common side effects other than drowsiness (which I guess isn’t really a side effect in a sleep aid!) are dizziness, palpitations, dry mouth, blurry vision, lack of coordination, constipation and upset stomach.
Who shouldn’t take antihistamines? Talk to your doctor or the pharmacist before using an over-the-counter sleep aid if:
- You’re pregnant or thinking of becoming pregnant
- You’re breastfeeding
- You’re taking other medications, especially high blood pressure meds
- You have glaucoma
- You have an enlarged prostate
- You have asthma or other breathing problems
- You have any health concerns and are unsure how an antihistamine will affect you
Buy generic, read the labels, and follow the instructions
For anyone buying an over-the-counter sleep aid I would recommend reading the labels and buying the cheapest generic.
Follow the dosing instructions and keep in mind that these drugs are not meant to be taken for more than two weeks.
The Consumer Reports article brings up a couple good points about the risks of long-term use.
- Although antihistamines are not considered addictive, the need to use a sleep aid or “crutch” to get to sleep at night could create a “psychological dependence.” Your body doesn’t need the drug, but your mind thinks you can’t sleep without it.
- More worrying, a 2015 study by the Journal of the American Medical Association (JAMA) linked frequent use of these first-generation antihistamines (NOT the newer allergy meds on the market) with an increased risk of dementia.
Consumer Reports—and most sleep specialists—recommend skipping the drugs and making lifestyle changes to improve sleep habits.
Here are a few of my previous posts on sleep, and more resources to improve quality of sleep.
For many of us, a good night’s sleep is as elusive as a unicorn, I know. But a natural night’s sleep, if possible, is far more rejuvenating than one induced with drugs.
These are my favorite books about sleep: