Over-the-Counter vs. Natural Sleep Aid Options

We all suffer from a restless night sleep every now and then, but for some, it happens more frequently. If you find yourself tossing and turning at 2am, night after night, it may be time to look into sleep aid options — but where do you start? A simple search online returns countless products claiming to help you fall and stay asleep, but it can be difficult to understand which product will work for you.

Sleep is an essential function for us to live our lives healthy and happy. Most adults require between seven and nine hours of sleep each night, but it is estimated 25% of American adults are regularly sleep deprived (sleep for less than six hours a night for at least 15 out of every 30 days) 1 and 35% of Americans report having a short-term episode of insomnia. 2

25% of Americans are sleep deprived. 35% of Americans have short-term insomnia episodes.

With nearly a third of American adults suffering from sleep deprivation and seeking a solution, the market has become saturated with endless options, and it can be difficult to decide which product might work for you. In this article we will be dividing sleep aids into two different categories – anticholinergics and natural types.

Anticholinergics include diphenhydramine types, which are mostly allergy medicines and over-the-counter sleep aids. Doxylamine is another type of anticholinergic and is used in similar products as diphenhydramines.

Natural types of sleep aids include melatonin, ashwagandha and passionflower.  

Diphenhydramine and Doxylamine

Diphenhydramine

Products containing diphenhydramine, like Benadryl, offer support to reduce the severity of cold or allergy symptoms, while also causing drowsiness, making them fall into the sleep-aid category. Medicines like this are meant to be used short-term while the users are experiencing cold and allergy symptoms. However, many people use these to self-treat symptoms of sleeplessness and insomnia, rather than for their intended purpose. Further, many products offering sleep assistance, like ZzzQuil, contain diphenhydramine.

15-20% of Americans will take an unprescribed sleeping pill in any given month

Dr. Bertisch. Assistant professor at Harvard Medical School, estimates that anywhere from 15-20% of Americans will take an unprescribed sleep aid in any given month. 2 Health professionals strongly advise against using these products long term as there are multiple health risks associated with long-term use, including a link to increased risk of dementia.

Below are common side effects from taking Benadryl and like products:

  • Sleepiness
  • Dry mouth
  • Weakness
  • Dizziness
  • Headache

If you have side effects that are severe or last more than a few days, contact your healthcare provider.

Doxylamine

Doxylamine is another antihistamine commonly used in allergy and sleep medicines such as Unisom Sleep Tabs. Both diphenhydramine and doxylamine are classified as anticholinergics. Products with doxylamine can relieve symptoms of allergy, hay fever and the common cold. While these medicines are generally safe with short term use, they should not be used long term. Using doxylamine products long term heightens your risk of for various health issues, including dementia.

Some users may experience mild side effects during use, including: 3

  • Drowsiness
  • Dizziness
  • Constipation
  • Upset stomach
  • Blurred vision
  • Decreased coordination
  • Dry mouth/nose/throat

Anticholinergics and Dementia

Link between anticholinergics and dementia/Alzheimers

A long-term study led by pharmacist Shelley Gray examined the relationship between Benadryl and dementia in 3,500 men and women aged 65 or older. These participants had previously participated in a long-term study, giving Gray access to information that relayed any medications participants had taken in the last 10 years, including both prescription medications and over the counter. Over the course of seven years, 800 participants developed dementia.

The results of the study showed that long-term users of anticholinergic medicines (taken for longer than three years cumulatively) showed a 54% increased risk of developing dementia than those taking the same dose for three months or less.4 Medical News Today calls out that “Researchers estimate that people taking at least 10 mg per day of doxepin, 4 mg per day of chlorpheniramine, or 5 mg per day of oxybutynin for more than three years would be at greater risk for developing dementia.” If you are taking medications that you are worried about, speak with your healthcare provider.

Many are unaware of the risks associated with anticholinergic medications – especially if used long-term as a sleep aid. Thankfully, there are other, more natural options to help with sleeplessness.

 

Natural Types of Sleep Aids

Melatonin

Melatonin levels naturally increase at night time.

Melatonin is a natural hormone that signals to our brain and body that it is time to go to sleep. Melatonin levels naturally rise two hours before bed but there are many environmental factors which may reduce its effectiveness. To take advantage of your body’s natural melatonin, follow these tips in the two hours leading up to bed: 5

  • Stop or reduce time on your tablets, phones and computers — they emit blue and green light which can decrease the effects of melatonin
  • If you are watching TV, stay at least six feet away
  • Turn off bright, overhead lights so the effectiveness of natural melatonin is higher

If you follow the above practices and still find that you need a melatonin boost, the natural hormone is available in the form of supplements and has shown to improve sleep quality and quantity. If you are suffering from a sleep cycle disruption such as jet lag or sleeplessness, melatonin is a great option to get your body clock back to normal. 

Melatonin dosage

Melatonin supplements come in all forms like capsules, liquid and gummies, which can be a great option as a sleep aid for children as there is research confirming that melatonin is safe for kids. 6 Research has shown the most effective dosage of melatonin to promote sleep is 0.5 mg up to 3 mg and should be taken an hour and a half before bedtime.7 As a hormone that’s in our body already, melatonin can be used as a natural sleep remedy for elderly without the negative side effects related to anticholinergic medications. Using a higher dosage can be ineffective and cause other side effects such as:

  • Increased daytime sleepiness
  • Reduced focus and concentration
  • Lower body temperature

Melatonin Dosage for sleep

  • Typical dosages for adults range from .5-5 mg to be taken an hour and a half before bed for sleep aid8
  • The AAP advises against dosages higher than 3-6 mg as a sleep aid for children and states that many young people respond to small doses of .5-1 mg9
  • Elderly and adults over the age of 55 are recommended to take the smallest dosage possible for effectiveness. Melatonin stays in older adults’ bodies longer and can cause daytime sleepiness8
  • If you are experiencing daytime sleepiness while taking melatonin, your dosage may be too high. It is recommended to take a smaller dose if you have daytime sleepiness8

Ashwagandha

Ashwagandha is an ancient medicinal herb that has long been used in Ayurvedic medicines, one of the oldest holistic healing systems in the world. It contains powerful anti-stress, anti-inflammatory and antioxidant effects. Research has shown that regularly using ashwagandha can help build resistance to stress, lower blood sugar and boost immunity.

Studies have shown that taking ashwagandha as a daily supplement can help improve overall sleep, especially for those with insomnia. Both groups show significant improvement in both quality and quantity of sleep, with insomnia patients showing greater improvement. 10,11 

It’s important to note that reaping the benefits of ashwagandha requires regular and daily intake. Some popular forms of ashwagandha are capsules, tablets, raw powder or in a drink. Traditionally, Ashwagandha is taken as “moon milk” — an ancient recipe that is once again growing in popularity.

Ashwagandha dosing for sleep 

  • Dosage for ashwagandha ranges from 250-600 mg per day, depending on the area of health you want to improve12
    • Adults should take 300 mg twice per day to help with restlessness and bouts of insomnia12
  • There is no evidence that ashwagandha poses health risks to children. Speak with your healthcare provider if you are considering giving your children ashwagandha 12

Passionflower

Native to the southeastern United States, and Central and South America, passionflower is a climbing vine that can be used to help sleeplessness. Passionflower may be taken as a tea, liquid extract, capsule or tablet. The supplement has shown to have sedative effects and relieve anxiety in multiple studies, some results finding that when treating anxiety, passionflower had similar results as antianxiety medications.

There is limited research on the effect passionflower has on sleep habits but there is evidence that the herbal supplement can shorten the time it takes to fall asleep and can increase the duration of sleep. 13

Passionflower Dosage 

  • Adults should take 400 mg twice daily14
  • Adults can also use liquid extract and take 45 drops each day14
  • If you are considering giving your children passionflower speak with your healthcare provider14

Some noted symptoms are:

  • Sleepiness
  • Dizziness
  • Confusion

 

Difficulty sleeping and low quality of sleep can be difficult to manage and can impact your daily life. If poor sleep is impacting you, it is important to seek out a solution that works for you.

 

 1Sleep Foundation  

2 Harvard Health

3 WebMD

4 JAMA Internal Medicine

5 Hopkins Medicine

6 Healthline

7 Cleveland Clinic

8 Sleep Foundation

9 Sleep Foundation

10 Cureus

11 ScienceDirect

12  NCBI

13Medical News Today

14 WebMD


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