What is the best OTC drug to use as a sleep aid?
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If you don't want to/can't go through the hassle of getting a prescription for something like Ambien, but you really need something to help you fall asleep (e.g. you are on a long redeye flight but aren't very tired, etc.), what should one take as a sleep aid?
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Answer:
The sleep-inducing agent in Nyquil is the doxylamine, which is available by itself, without the dextromethorphan (e.g. Unisom-2). Diphenhydramine is also very effective, available both as Benadryl (for anti-allergy) and Sominex (as a sleep aid). These two are widely considered the most effective OTC sedatives on the market. Both diphenydramine and doxylamine are antihistamines; both are very effective, and effectiveness and side-effects will vary from person to person. You'd need to see which one works best for your body chemistry. Some formulations of Nyquil contain small amounts of alcohol, which increases the sedative effect of antihistamines. Antihistamines sold as sleep aids specifically tell you NOT to do that; it can be so effective that you never wake up.
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Other answers
When I first went onto night shift as a nurse, I agonized over trying to sleep during the day. Night shift people, being as opinionated and chatty as they are, were more than happy to share their hints for sleeping during the day.They suggested earplugs and dark curtains and a/c on high, all of which helped. Still, I couldnât sleep.One fellow nurse suggested I take melatonin, an OTC supplement. He swore by it.Most nurses are very suspicious of the efficacy of drugsâmany of my friends only believed in ibuprofen for pain and zinc-based products for colds.Finally I took some, a relative small dose. I was indeed knocked out, and couldnât wake up when I DID wake up. My eyes were dry, my mouth was parched, and I was groggy. It was TOO effective for me.It DOES work for most people, but talk to your MD first, especially if you have any existing medical conditions.Hereâs the link to the WebMD page, which tells you a lot more.http://www.webmd.com/vitamins-supplements/ingredientmono-940-melatonin.aspx?activeingredientid=940
Anne Brown
You could always try an anti-histamine (obviously not the non-drowsy type) In the UK, there are lots available over the counter things:- Nytol, sleepeaze etc
Lou Davis
Unisom and Sominex are both great and are relatively cheap and OTC. Sominex will likely put you to sleep faster, and you can take a half dose easily. Unisom will likely keep you asleep longer, but in my experience doesn't have half doses. With either, avoid taking it more than three nights in a row and try to go 2-4 days between taking it. Otherwise it gets really tough to fall asleep.
Mischa Fierer
Here's my Rx for Ambien-free oblivion on long-haul flights. Hour 1 of flight: Double Bloody Mary. Hour 2: two Tylenol PM's or Bynadryl. Hour 3, watch movie. Hour 11 wake up (hopefully) from deep stupor at your destination. If you snore, alert your seat mates.
James Turley
I think that you may not be asking the best question. Perhaps you might consider discussing your difficulty sleeping with your family doctor. He/She might be able to identify the problem on his/her own, or refer you for a sleep study and consultation. The problem with OTC drugs is that they may act as depressants, possibly making things worse for those who can't sleep because of a depressive disorder. I tend to avoid prescribing OTC medications for sleep difficulty, often finding depression or anxiety as the cause. If so, your doctor can prescribe a suitable antidepressant with a strong side-effect of sleepiness to help with the problem. I use tiny doses of mirtazapine, low doses of trazodone or of amitriptylene to ease my patients' sleep problems.
Peter L. Herschman, M.D.
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