Over-the-Counter Sleep Aids: Complete Guide

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    It’s no secret that healthcare costs in the United States are some of the highest in the world. One of the biggest medical drains on American wallets? Prescription drugs. According to a 2019 OECD report, about 12% of total healthcare costs in the country were dedicated to pharmaceuticals in 2018. That averages out to about $1,200 annually per household on medications.[1]

    What are U.S. citizens’ medical woes? For many, it’s sleep-related troubles. Experts estimate that U.S. citizens spent about $41 billion on sleep aids alone in 2015.[2] Considering prescription costs show no signs of declining any time soon, it’s no wonder people are turning to over-the-counter sleep aids.

    OTC vs Prescription Drugs

    Thoughtful pharmacist standing over the drugstore background; over-the-counter sleep aids versus prescription drugs concept.

    So, just how do over-the-counter supplements compare to their prescription counterparts? For starters, OTC supplements are not as heavily regulated. That can lead to issues with both labeling and safety. In other words, OTC drugs are prone to misleading or even outright false packaging and advertising. Even worse, because there’s no doctor’s note required for OTC sleep aids, many people don’t think about how these aids can interact with other supplements they’re taking, prescription or otherwise.

    This latter point can pose serious health risks. Just because a supplement is cleared for retail does not mean that it’s safe for everyone to use. Pregnant individuals, elderly people, or adolescents, for example, should exercise extra caution with OTC remedies. Furthermore, medications—both OTC and prescription—can have serious negative interactions with each other. These reasons are why it’s always important to consult with a healthcare professional before adding anything new to a diet, even OTC sleep aids.

    OTC drugs do have a distinct advantage over prescription alternatives, though: their price tags. For starters, the base costs for OTC remedies are often cheaper than, or at least as cheap as, prescription drugs covered by insurance. Without insurance, though, OTC remedies are far more affordable than prescription medications in the United States. These prices don’t even factor in the costs of going to see a doctor to get a prescription in the first place.

    Dangers of Sleep Deprivation

    Issues with falling and staying asleep can take a serious toll on someone’s mental and physical health. Specifically, experts say that consistent sleep deprivation or poor sleep quality can have serious consequences. Those who don’t get enough sleep are at an increased risk of conditions like stroke and diabetes. Unfortunately, about a third of U.S. adults don’t get enough sleep on a regular basis.[3] That makes sleep a serious health concern for the United States.

    Common Over-the-Counter Sleep Aids and their Efficacy

    There are plenty of over-the-counter supplements available on the market. However, not all of them work as well as they say they do. Some don’t even work at all. Below is a list of some of the most popular OTC remedies and what research says about their effectiveness in improving sleep quality.

    5-HTP (L-5-hydroxytryptophan)

    5-hydroxytryptophan (5-HTP, oxitriptan) antidepressant, molecular model. 5-HTP is used as an antidepressant, sleep aid and appetite suppressant. Atoms are represented as spheres.

    What Is 5-HTP?

    5-HTP is an amino acid that is necessary for producing the neurotransmitter serotonin. This neurotransmitter is involved in many important bodily functions, including regulating the sleep cycle and improving mood.

    How Effective Is 5-HTP?

    The truth is that there is currently not enough quality evidence to say one way or the other if 5-HTP supplements are effective as over-the-counter sleep aids.[4] Some research, though, suggests that 5-HTP may decrease levels of the neurotransmitters dopamine, norepinephrine, epinephrine.[5] Importantly, some stages of the sleep cycle require decreased levels of dopamine and norepinephrine. This research suggests that 5-HTP itself may only indirectly impact sleep, if it affects sleep at all.

    Other research seems to support this suggestion. For instance, one study looked into 5-HTP and its effects on sleep in rats. The findings suggest that 5-HTP itself is sleep inhibitive. However, this amino acid may still set off a chain of reactions that may overall still improve sleep.[6]

    Overall, experts are still uncertain what role 5-HTP plays in regulating sleep, if it’s involved in this process at all. More high-quality studies are necessary in order to determine if 5-HTP supplements can work effectively as sleep remedies.

    CBD (Cannabidoil)*

    CBD elements in Cannabis, Hemp oil. CBD as over-the-counter sleep aids concept.

    What Is CBD?

    CBD is a substance derived from cannabis plants. Notably, pure CBD does not contain tetrahydrocannabinol, or THC. THC is the compound that gives people a “high.” Importantly, the legality of CBD is in dispute across the United States since the federal government classifies cannabis as a Schedule I drug. In fact, the U.S. government specifically says CBD is not generally recognized as safe (GRAS).

    How Effective Is CBD?

    The U.S. federal government’s current position on CBD is that there is “insufficient evidence to rate [its] effectiveness” in improving insomnia.[8] In other words, there isn’t enough credible research to say whether CBD can safely improve the symptoms of insomnia. However, U.S.-funded research into cannabis is far more limited than other popular sleep aids; this lack of research isn’t surprising given the plant’s Schedule I status.

    Research outside the States, though, offers more insight into this potential sleep aid. Some, for example, suggest that CBD can cause side effects. Although, it is generally safer than many other alternatives. It’s worth noting that one of CBD’s side effects is tiredness.[9] This research therefore suggests that CBD may induce drowsiness in some individuals.

    Conversely, other research claims that CBD doesn’t really affect sleep itself. It may, however, help those suffering from anxiety.[10,11] This research may be relevant to those whose sleep quality suffers due to their anxiety. In other words, these findings suggest that CBD may alleviate anxiety symptoms. So, it stands to reason that those who lose sleep due to anxiety may get a sleep boost from CBD as a secondary effect of anxiety alleviation.

    Regardless of this oil’s efficacy, it’s notable that many CBD products in the U.S. are not heavily regulated. The result? Plenty of products that claim to be pure CBD actually contain some THC. Additionally, many products that claim to have CBD typically have less than they say—if they even contain CBD at all.[12] So, even if someone is interested in purchasing CBD-labelled products, they may not even get what they’re wanting.

    Chamomile Tea

    Chamomile tea. Camomile flower and cup of camomile tea.

    What Is Chamomile?

    Chamomile is a flower people have used in herbal medicine for thousands of years. The two main types of chamomile used in OTC remedies are German and Roman chamomile. Both are generally safe to use. One notable exception, though, is that pregnant individuals should avoid Roman chamomile.[13]

    How Effective Is Chamomile?

    Some small-scale studies suggest chamomile may help with anxiety and sleep. For example, one smaller study claims chamomile may help as a short-term remedy for sleeping issues in postpartum women.[14] However, there isn’t enough research to say definitively if this plant can help with any condition.[15,16]

    GABA (gamma-Aminobutyric acid)

    Chemical formula of GABA on blackboard

    What Is GABA?

    GABA is an inhibitory neurotransmitter. This means that GABA reduces brain excitability/activity.

    How Effective Is GABA?

    Research shows that GABA may be an effective sleep aid for some people. It’s not known quite how GABA impacts the sleep cycle, though. Because of this uncertainty, some people believe GABA supplements might just be placebos.[17]

    Other experts, though, are more optimistic about GABA’s role as a sleep aid. Some studies, for example, note that GABA intake correlates with positive changes in the early stages of sleep.[18] Others hypothesize that GABA may help with the production of melatonin, a key hormone that regulates the sleep-wake cycle.[18,19] So, when it comes to over-the-counter sleep aids, GABA has more research to back it up than many other options.

    Glycine

    Glycine (Gly, G) amino acid molecule. Skeletal formula.

    What Is Glycine?

    Glycine is an amino acid and, like GABA, an inhibitory neurotransmitter; it is incredibly important in the production of proteins. Glycine is also noted to have a sweet taste, making it a popular food additive.

    How Effective Is Glycine?

    Science says glycine intake can be a safe and effective way to potentially improve sleep issues.[20] Experts still don’t quite understand how it works as a sleep booster, though.[21]

    Lavender Oil

    Flat lay composition with lavender flowers and natural cosmetic on pink concrete background

    What Is Lavender?

    Lavender is a group of flowers in the mint family. English lavender (Lavandula angustifolia) is the most common source of lavender oil, which is often used in alternative medicine practices like aromatherapy.

    How Effective Is Lavender?

    Good news: lavender is generally safe to use. Bad news: there aren’t enough large-scale, high-quality studies to prove it is an effective sleep booster.[22]

    L-Theanine (L-γ-glutamylethylamide)

    L-theanine, amino acid found in green tea. Picture is with matcha tea, that contains up to five times as much L-theanine as regular green tea, therefore it is one of the best sources of theanine.

    What Is Theanine?

    Theanine is an amino acid; it is found in certain kinds of tea and mushrooms. Notably, the human body does not produce theanine.

    How Effective Is Theanine?

    Experts are divided on theanine. The U.S. FDA, for example, says theanine is GRAS. The European Food Safety Authority, though, does not recognize certain types of theanine for use as a science-backed sleep aid.[23] Some research suggests it can cause relaxation and mental alertness.[24] Conversely, one study says using L-theanine with GABA can be a great sleep booster.[25] Clearly, experts haven’t reached a consensus yet on this amino acid for use in over-the-counter sleep aids.

    Magnesium

    Pills with mineral Mg (magnesium) on a white background with an inscription from the chemical table.

    What Is Magnesium?

    Magnesium is an alkaline earth metal and necessary for some human biological functions. Having a magnesium deficiency may result in fatigue, among other symptoms.

    How Effective Is Magnesium?

    Magnesium intake may improve sleep quality, particularly for those who have low levels of magnesium. One study, for example, supports the idea that magnesium intake can improve sleep time and quality. Importantly, this study looked at elderly individuals suffering from primary insomnia.[26] Older people are notably more likely to have low magnesium levels compared to others.

    Melatonin

    Melatonin hormone molecule. In humans, it plays a role in circadian rhythm synchronization. Skeletal formula.

    What Is Melatonin?

    Melatonin is a hormone that helps regulate sleep. Pineal glands, located in the brain, produce this hormone.

    How Effective Is Melatonin?

    Research suggests that melatonin may help people fall asleep faster. However, it does not appear to increase the total amount of time someone is asleep.[27,28] So, those who have issues falling asleep might find melatonin supplements helpful. Those who have difficulties staying asleep, though, might not.

    Vicks NyQuil™

    Man sleeping in his bed and snoring loudly

    What Is Vicks NyQuil™?

    NyQuil is a well-known commercial medicine. It is designed to improve sleep quality during bouts of the cold or flu. Its active ingredients are the antihistamine doxylamine succinate, the painkiller acetaminophen, and the cough suppressant dextromethorphan.

    How Effective Is NyQuil?

    NyQuil can be incredibly effective as a sleep aid; it’s so effective, in fact, that it can even affect daytime alertness. This sleepy effect is due to some of its active ingredients. A side effect of dextromerthorphan, for example, is drowsiness.[29] Doxylamine, too, can promote sleepiness. In fact, it is an incredibly common short-term treatment for insomnia.[30]

    It’s important to note that emphasis on short-term treatment, though. The American Academy of Sleep Medicine does not recommend antihistamines for long-term insomnia treatment. Why? Because there currently is not enough information on their safety to endorse this practice.[31] Interested individuals can visit the official Vicks site to learn more about how to properly take NyQuil.

    Tart Cherry Juice

    tart cherry juice as an over the counter sleep aid

    What Is Tart Cherry Juice?

    Tart cherry juice is a sour juice made primarily from cherries. Raw, sour red cherries notably contain more vitamins and minerals than sweeter cherries.[32]

    How Effective Is Tart Cherry Juice?

    There currently is not enough research to say whether or not tart cherry juice is an effective sleep aid. Current research is either poorly planned and executed or too small-scaled to allow for meaningful conclusions. One pilot study, though, suggests there could be benefits in larger, more comprehensive studies into the effects of tart cherry juice on insomnia. This study notes that 15 older individuals who drank tart cherry juice noticed improvements in their insomnia.[33] Again, though, this sample size is too small to draw any generalization or definitive conclusions. However, it does suggest further research could prove fruitful.

    Valerian Root

    Valerian herb root and flowers with dropper bottle and mortar with pestle over oak background. Used as an alternative to valium in natural medicine; concept for valerian root as an over-the-counter sleep aid.

    What Is Valerian Root?

    Valeriana officinalis is a flowering plant. Like chamomile, people have long used valerian root in herbal medicine.

    How Effective Is Valerian Root?

    Currently, it is not exactly known how valerian interacts with the body. Some research suggests that it can reduce how long it takes to fall asleep.[34] However, these studies are often too small to mean much. At this point, more research is needed to determine if valerian root is an effective sleep aid.[35]

    Final Thoughts

    Prioritizing sleep is prioritizing overall health and well-being. Unfortunately, many people do not get enough sleep, which can increase the risk of serious health problems. Doubly unfortunate is the fact that healthcare costs continue to rise in the United States, which makes affording prescription medications difficult.

    That’s why many people are choosing over-the-counter sleep aids to help with their sleeping issues. However, not all sleep aids work as well as they say they do. That’s why it pays to research OTC remedies before purchasing anything.

    Terms

    • Active ingredient: The ingredient inside a supplement that causes change in the human body.
    • Amino acid: An organic compound that is notably involved in the processes of protein production, tissue repair, and nutrient absorption.
    • Antihistamine: A drug class that blocks the release of histamine. It may help with allergies, cold or flu symptoms, and other conditions.
    • Generally recognized as safe (GRAS): A label the U.S. Food & Drug Administration gives to items that research suggests is generally safe for human use.
    • Histamine: A compound that plays a role in the body’s immune response.
    • Inhibitory neurotransmitter: A neurotransmitter that prevents certain neurons from firing.
    • Organization for Economic Co-operation and Development (OECD): An international economic organization.
    • Primary insomnia: Insomnia not caused by another underlying medical condition.
    • Serotonin: An important neurotransmitter that serves several important functions, including improving mood and regulating the sleep cycle.
    • Tetrahydrocannabinol (THC): The compound in cannabis that gives people a “high.”

    References

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    [18]Balemans, M.G., Mans, D., Smith I., & Van Benthem, J. (1983). The influence of GABA on the synthesis of N-acetylserotonin, melatonin, O-acetyl-5-hydroxytryptophol and O-acetyl-5-methoxytryptophol in the pineal gland of the male Wistar rat. Reproduction, nutrition, development, 23(1):151-60. PMID: 6844712 

    [20]Bannai, M., Kawai, N., Ono, K., Nakahara, K., & Murakami, N. (2012). The effects of glycine on subjective daytime performance in partially sleep-restricted healthy volunteers. Frontiers in neurology, 3, 61. doi:10.3389/fneur.2012.00061

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    [29]National Highway Traffic Safety Administration. (2008). Dextromethorphan. Retrieved from https://web.archive.org/web/20080801054711/http://www.nhtsa.dot.gov/PEOPLE/injury/research/job185drugs/dextromethorphan.htm

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    [1]Organization for Economic Co-operation and Development. (2019). Health spending (indicator). Retrieved from https://data.oecd.org/healthres/health-spending.htm#indicator-chart

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    [32]U.S. Department of Agriculture. (2019). Cherries, sour, red, raw. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/173954/nutrients

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    [18]Yamatsu, A., Yamashita, Y., Pandharipande, T., Maru, I., & Kim, M. (2016). Effect of oral γ-aminobutyric acid (GABA) administration on sleep and its absorption in humans. Food science and biotechnology, 25(2): 547–551. doi:10.1007/s10068-016-0076-9

    *Legal Disclaimers: This article, its author, and site owners do not condone any illegal activity. This article is for reference purposes only; it is not designed to diagnose, treat, cure, or prevent any disease or condition. Any and all health questions should be directed toward a doctor or other licensed professional.

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