Are you finding sleep elusive and considering taking something to help you get the shut-eye you need? If so, you’ve got lots of company. Nearly nine million Americans take a prescription sleep medication. Millions more use sleep aids that are sold over-the-counter (OTC).

But whether it’s a medication your health care provider prescribes or something you choose from the retail shelf, it’s important to know how sleep aids work. Some have side effects and can interact with other medications you may be taking. Others can lead to dependency if they are taken too often. Here’s a look at some of the more commonly used prescription and OTC sleep aids.

Prescription Sleep Medication

Prescription sleep medications are sedative-hypnotics. Ambien, Rozerem and Lunesta are examples. The main difference among these drugs is their half-life, or how long they remain in the body. Ambien has a half-life of 2 hours, Rozerem has a half-life of 1-2.5 hours and Lunesta has a half-life of 6 hours. Drugs with long half-lives can become habit-forming when taken nightly. They can also build up in the body, leading to side effects like irritability, problems with concentration, headache and heartburn. A greater risk of negative interactions with other medications is also a concern.

Over-the-Counter Sleep Medication

OTC sleep aids such as Nytol, Sominex and Unisom are generally found to be safe when used according to their directions. The Food and Drug Administration (FDA) has approved these medications to help relieve occasional sleepiness in people ages 12 and older. Antihistamines, which are used in many allergy medications, are often the active ingredient in OTC sleep aids. However, antihistamines can have side effects including constipation and difficulty with urination. They can also interact with certain medications that treat common conditions including high blood pressure, diabetes and glaucoma.

Natural remedies are another alternative for inducing sleep. Melatonin, which regulates the body’s circadian rhythm – the internal clock that controls the sleep-wake cycle – is one such natural sleep aid. Extracts of the chamomile, kava and valerian herbs are also marketed for their sleep-inducing abilities. However, “natural” does not necessarily mean “safe.” For example, melatonin can reduce the effects of immunosuppressant drugs and certain prescription medications that treat high blood pressure and depression. It can also sometimes cause effects that mimic depression. A list of medications that melatonin is known to interact with is available here. It’s also important to be aware that the FDA does not regulate the quality, dosing and formulation of melatonin and other supplements.

Consult your health care provider before taking any OTC sleep medication. Sleep medications should be used in the lowest effective dose, as a short-term solution and in combination with good sleep habits. How you go about preparing for sleep increases the likelihood of falling asleep quickly, staying asleep and reaping sleep’s many health benefits.

The LHSFNA’s Smart Medicine brochure includes a medication record to help you keep track of your prescription and OTC drugs and supplements. Keep this record up to date and bring it with you when you visit your health care provider. Visit our online Publications Catalogue to order this publication and other Fund materials that can help protect your health and safety.

[Janet Lubman Rathner]