People taking
sleep drugs
are as likely
to be in a
car crash as
those driving
with a blood
alcohol level
over the
legal limit.
some can worsen sleep apnea or other
health problems, or cause dizziness,
increasing the risk of nighttime falls,
especially in older people.
ADVICE Doctors may suggest a
prescription drug along with CBT-I for
chronic insomnia. In most cases, the
American Academy of Sleep Medicine
(AASM) recommends taking the lowest
dose for the shortest time possible.
Your physician should check in every
few months to see whether you still
need the sleeping pills.
No sleep drug should ever be takenwith alcohol, opioids, or any other
sedative, and older people in particular
should use them with caution. If you
use one, be sure to have at least 7 hours
available to sleep to reduce the risk of
next-day drowsiness.
Over-the-Counter Drugs
Sleep drugs sold over the counter
contain the antihistamine
diphenhydramine (Sominex and
others) or doxylamine (Unisom
SleepTabs), both of which trigger
drowsiness as a side effect.
RISKS OTC sleep aids can also trigger
next-day drowsiness, especially when
taken with other antihistamines or
alcohol, and may be habit-forming when
taken long-term.
ADVICE The AASM doesn’t recommend
these drugs for insomnia. If you opt
to try one, don’t take it longer than
recommended on the package, about
14 days. To avoid accidentally taking
too much, never combine it with other
drugs that contain antihistamines,
including allergy drugs, such as
Benadryl; nighttime pain relievers,
such as Advil PM; and cold drugs, such
as Robitussin Severe Multi-Symptom
Cough Cold + Flu Nighttime.
Melatonin
A 2018 CR nationally representative
survey of 1,767 Americans found that,
or diabetes, and blood thinners. And
there’s little evidence about its safety
beyond three months of use.
ADVICE The AASM says there’s not
enough evidence to recommend
melatonin. If you want to try it anyway,
especially for jet lag or shift work,
experts say to keep doses to less
than 10 mg. Check with your doctor
about interactions with other drugs
you may take.CBD
Cannabidiol, a compound found in
marijuana and hemp that doesn’t get
you high, is widely used to relieve pain
and anxiety, as well as to improve sleep.
In a 2019 nationally representative CR
survey of 1,018 Americans who had
tried CBD in the previous 24 months,
10 percent said they used it for sleep—
and most of those said it helped. CBD
might affect sleep by interacting with
receptors in the brain that govern
the body’s daily sleep-wake cycles,
according to a 2017 review in the journal
Current Psychiatry Reports. Some
research suggests that its effect on sleep
might lessen with extended use.
RISKS Side effects appear to be mild
(fatigue, diarrhea, and changes in
appetite) and it’s not addictive. But little
is known about its effect in older people
or pregnant women, or with long-term
use. Some evidence suggests that at
high doses it may interfere with certain
prescription drugs, including blood
thinners and antidepressants.
ADVICE If you want to try CBD, experts
recommend starting with modest doses.
And because CBD is inconsistently
regulated, it can be hard to know
whether a product has as much CBD
as its label claims, has more THC (the
psychoactive compound in cannabis)
than it should, or is contaminated.
For reassurance, ask the seller or
manufacturer for a product’s certificate
of analysis, which shows the results of
the company’s own tests.of those who had tried supplements for
sleep, 86 percent used melatonin. The
body naturally produces the hormone
as it grows dark to signal the brain that
it’s time for sleep. If you don’t naturally
produce enough of it, or if you’re
trying to go to bed at a different time
from normal—say, if you have jet lag or
work a night shift—studies suggest that
melatonin could help. It’s less likely to
help with other forms of insomnia.
RISKS Melatonin can cause next-day
drowsiness, headaches, dizziness, or
nausea. It can also interfere with certain
drugs used to treat high blood pressureFEBRUARY 2020 CR.ORG 35