Insomnia

This content was created by the National Sleep Foundation

Are Sleep Aids Right for You?

Many people find sleep aids helpful for insomnia. Your doctor may recommend that you take a sleep aid to help you fall asleep, sleep longer during the night, wake up less frequently, or improve the quality of your sleep. There are a few things to consider when you’re trying to decide if a sleep aid is the right approach for you:

  • Sleep aids may be a good idea if you’ve tried behavioral changes and other non-medical treatments, but insomnia continues to interfere with daily activities, productivity, or personal relationships.
  • If your insomnia is short-term, sleep aids may help. For example, if you’re having difficulty sleeping as the result of a temporary change to your work schedule, in the case of jet lag, or in advance of a special event or other cause of short-term anxiety and sleep loss.
  • If you and your doctor have determined the cause of insomnia, a particular sleep aid may be indicated for this cause.
  • Discuss with your doctor if your sleep difficulties are having psychological or health consequences.
  • Sleep aids can’t replace healthy sleep habits; good sleep practices are the foundation of proper treatment for insomnia. Especially if your insomnia is long-standing, it’s important to use non-medical approaches, such as proper sleep hygiene, and cognitive behavioral treatments for insomnia. For some, a combination of medical and behavioral treatments may be the best way to manage insomnia symptoms, and for others a sleep aid is used at the beginning of treatment and behavioral techniques take over as a long-term approach.

Some sleep aids are available by prescription only. This is because it’s important to work with a doctor to decide on the best type, dose, and plan for taking a sleep aid. Over-the-counter sleep aids work for some people, but it’s not a good idea to use these regularly for a long period of time. The best practice is to use a sleep aid with the input of your doctor.

How to Use Sleep Aids Safely

Consider these factors to make sure you’re using a sleep aid safely:

  • Consult with your doctor about which type to use, the proper dose, and the best treatment plan. Your doctor will take into account your age and other health factors, as well as the underlying cause of insomnia, if possible. All this information is important in using sleep aids properly.
  • Don’t forget non-medical approaches: If you take a sleep aid, it’s still key to use non-medical approaches, like cognitive behavioral treatments, relaxation exercises, and general sleep tips to establish healthy sleep patterns Multi-component approaches to facilitate sleep onset and maintain sleep is widely held as the best treatment approach.
  • Sleep aids can be very helpful, especially in providing initial relief for people with insomnia, but most doctors agree that they should not be used indefinitely. Your doctor will help you figure out how long to take a sleep aid (the goal being to take a sleep aid for the shortest duration that still provides you with the proper sleep benefits).
  • Over-the-counter sleep aids may help some people in the short term, but they are not intended for longer term use or as a comprehensive fix for insomnia.
  • Follow safety guidelines: It’s important to follow all the safety guidelines of each sleep aid. Read packaging material carefully and talk to your doctor about any precautions you should be aware of, especially as they pertain to your personal health.

FAQs About Sleep Aids for Insomnia

What Should Patients Try Before Taking a Sleep Aid?

  1. If, as in many cases, the insomnia is of recent onset and associated with stressful life experiences, it will likely resolve as the stress passes.
  2. Sleep Hygiene is always the first approach if the insomnia does not resolve spontaneously. For example, this includes eliminating caffeine intake for at least 6 hours before attempting to initiate sleep.  For more sleep hygiene tips, click here.

How Are Sleep Aids Chosen As Appropriate for Patients?

Usually the duration of the medication is matched to the pattern of the insomnia.  This is often a trial-and-error process.

Are Sleep Aids Addictive? What Are The Safety Concerns?

  1. Older prescription sleep aids still in use for treating insomnia are potentially addictive and toxic in overdose, and can lose effectiveness with regular use.  Others induce as much daytime as nighttime sedation, which affects waking performance and can contributes to automobile accidents, particularly when combined with alcohol.
  2. Over-the-counter sleep aids often include sedating antihistamines. These agents have limited effectiveness and often induce next day sleepiness after nighttime use, potentially leading to car accidents and poor school and work performance.  In the elderly, these agents can lead to confusion and falls.
  3. Newer prescription agents are safer, more effective, and less addictive.  Still, safety concerns include:
    • These agents induce sleep and should not be taken during waking activities. – In some situations (driving, going to a party, or talking on the phone) these agents can induce cognitive confusion and memory impairment.
    • All sleep aids should be used with caution in individuals with a history of addiction and addictive personalities.
    • In the elderly, due to the danger of nighttime falls, these agents should be used cautiously and at lower doses.

Are Some Insomnia Symptoms Easier to Treat Than Others?

Many insomnia symptoms are readily treated with interventions such as encouraging, teaching, and reinforcing healthy behaviors, as well as eliminating maladaptive behaviors that contribute to sleep difficulties.  A simple example: removal of technology from the bedroom and eliminating computer use one hour before sleep.  This is an example of identification of an issue, education on why it’s likely an unhelpful physiologic behavior, and teaching a change. The next step is execution.

What Are Some New Developments in Sleep Aids?

There are currently some medications working their way through the research process that target new and specific chemicals/hormones or receptor sites and hold promise.  Other non-prescription approaches include is the commercial development of other ‘aids’ that may contribute in some way to sleep improvement; for example, new bed designs, natural supplements and additives/scents.

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