Short answer- Maybe but not much.
Indeed, 10 to 20 percent of Americans take over-the-counter sleep aids each year, according to the American Academy of Sleep Medicine.
That is a lot higher than I would have expected.
But what’s the evidence that supports these claims? “It’s quite lean,” says Andrew Krystal, who directs the sleep research program at Duke University.
Over-the-counter sleep aids work differently from prescription drugs for insomnia. Most are simply antihistamines in sheep’s clothing. (Yes, that’s a joke.) The majority of them — ZzzQuil, TylenolPM and Unisom SleepGels — contain diphenhydramine as the active ingredient, the same compound in Benadryl. (Unisom SleepTabs use doxylamine, another antihistamine.)
The clinical studies testing diphenhydramine for insomnia are minimal, Krystal says: There have been only two, which together involved 204 people. “That’s it. That’s all we have,” he says.
Basically you’re taking allergy pills an no one knows if they do anything other than make you groggy.
The first study included a comparison of the effects of diphenhydramine (50 milligrams, a typical OTC dose) with those of a placebo in 20 elderly people with insomnia. The participants reported slightly fewer nighttime awakenings with diphenhydramine than with the placebo, but no difference in how long they took to fall asleep, how well they slept or how long they slept.
So it also helped 20 old people get up and goto the bathroom less at night. WIN. I guess but anyone who has taken Benadryl knows if dries you out like a desert.
The second study tested 25-milligram doses of diphenhydramine against a placebo and an herbal preparation of valerian and hops in 184 adults with mild insomnia. Compared to a placebo, diphenhydramine improved sleep efficiency (the percentage of time in bed spent sleeping) based on participants’ feedback but not on automated readings of brain, eye and muscle activity. Neither did it affect sleep onset or total sleep time.
It also makes you pass out but you might not be sleeping. Same results as getting drunk right?
The valerian-hops combination helped, to some degree: People who took that mixture reported that it took slightly less time to fall asleep and that their insomnia was less severe.
The problem with valerian root is that there’s so much variety in the preparations, says Vivek Jain, who directs the Center for Sleep Disorders at George Washington University Hospital. You can’t be certain how much active ingredient you’re getting, he says, and because these products are regulated as supplements rather than drugs, their composition can vary from one maker to the next.
The bottom line is that the evidence has not shown more than modest effects of valerian, Krystal says.
What about melatonin? Jain says there is some evidence that it helps people fall asleep more quickly. A 2011 study of prolonged-release melatonin found that insomnia patients age 55 to 80 fell asleep 15 minutes sooner than with placebo, on average, but younger patients did not benefit.
There’s a larger reason why sleep aids don’t work, Jain says, and that’s because insomnia is not just a nighttime phenomenon. “It’s a 24-hour problem,” he says. Our wakeful state is akin to second or third gear in a car with a five-gear transmission. At night we drop into first gear or neutral.
“In insomnia, these gear shifts get unstable,” Jain says. Insomniacs spend their days in higher gears than most people, and they have trouble downshifting at night. “Patients don’t recognize the daytime problem. They just want to sleep more and more,” he says.
When considering sleep aids, he cites the lack of benefit and the risk of side effects and says, “There’s no good reason to take these. Ever.”
If you are going to use them, he says, “use them intermittently — not every night.”
And there is the takeaway for today. There’s no good reason to take these. EVER. Unless you are then try and just use them once in a while.
Well what can I do to fall asleep then?
I’ll have part 2 up for you tomorrow