Are sleep aids safe?

St. Joseph’s/Candler Clinical Pharmacy Specialist Kristen Pierce talks about over-the-counter and prescription sleep medications and ways to get a safe and good night’s rest

You feel like you do everything right – no caffeine leading up to bed time, relaxing before bed time, no screen time or electronics in the bedroom – yet you still have trouble falling or staying asleep.

Because over-the-counter (OTC) sleep medications and herbal supplements are so readily available, you may lean on them to get a good night’s sleep. But is that safe?

“Generally speaking, over-the-counter sleep aids are safe when used short term,” says Kristen Pierce, PharmD, BCACP, clinical pharmacy specialist in ambulatory care at St. Joseph’s/Candler. “Over-the-counter sleep aids are intended to be used a few times per week, and you really don’t want to use them for more than a few weeks.”

OTC sleep medications and even prescription sleep aids can come with side effects such as daytime drowsiness, dependency, confusion and sometimes even hallucinations, and they can interact with other medications you may be on, Pierce says. This is especially true for anyone on blood thinners and those over 65.

Pierce stresses the importance of talking to your doctor or pharmacist before starting any sleep medication, even OTC ones.

“Just because something is over-the-counter doesn’t mean it’s harmless to use,” Pierce says. “You can still take too much of an OTC medication such as Benadryl, for example. A lot of herbal supplements, such as melatonin or valerian, are not as strictly regulated by the FDA and can interact with your medications.”

Getting to the root of the problem

If you are having trouble sleeping, it is important to talk to your healthcare provider. As Pierce said, sleep aids can be helpful in the short term, but if you are consistently having restless nights, there may be an underlying problem.

One example is sleep apnea, a potentially dangerous sleep disorder where breathing repeatedly stops and starts while you sleep. Untreated sleep apnea has been known to lead to cardiovascular issues. Sleep apnea is treatable with lifestyle changes or the use of breathing assistance devices.

Related Article: What is obstructive sleep apnea?

Another example is nightmares. Maybe you experienced a life-altering event or have overwhelming stress in your life that is causing you to have nightmares or lose sleep at night. Your options to get help with that could be therapy or possibly prescription medications from your provider to help you relax before bed time, Pierce says.

“It’s always important to identify the underlying cause and fix that issue rather than becoming dependent on sleep aids,” Pierce says.

Why sleep is so important

Proper sleep – seven or more hours for adults – is important to our overall health. Studies show adequate sleep is key to productivity, brain function, decision making and our overall physical and mental health. Poor sleep quality is linked to a decline in productivity and cognitive function, as well as a host of chronic health problems including depression, obesity and hypertension.

“Sleep is necessary to properly function in life, so if you are having difficulty sleeping, it’s important to talk to your provider to prevent issues with day-to-day life,” Pierce says.

And the answer may not always be to pop a pill, even coming from a pharmacist. “I’m a pharmacist. I’m all about treating conditions with medications when they need to be treated, but you should consider non-medication options when possible.”

Pierce says the first line of defense is Cognitive Behavioral Therapy – Insomnia (CBT-I). This includes multiple components to basically train your brain and your body to sleep well by avoiding behaviors that are keeping you from getting a good night’s rest, Pierce explains.

Some examples can include:

• Maintaining good sleep hygiene
• Improving your sleep environment
• Relaxing, being in a calm mood before bedtime (meditation, reading a book)
• Avoiding the phone and television while in bed
• Going to bed and waking up the same time every day
• Avoiding naps during the day
• Only getting in the bed when you are sleepy
• Regular exercise

Related Article: Ways to get a better night’s sleep

“While it’s easy to grab a Benadryl or melatonin, you always want to try non-pharmacologic options first,” Pierce says. “Then if you are still having trouble sleeping, talk to your healthcare team before starting any over-the-counter medication.”

“Even though you can purchase them over the counter, there can still be harmful effects. They also can work really well for you, so it’s important to have that risk-benefit discussion with your provider and make sure that the agent you are choosing is appropriate, and you’re taking the right dose.”