Thursday, October 30, 2014

Insomnia - Medications

Medications


About 20% or more of older American adults use some form of sleep aid, including prescription or over-the-counter drugs or alcohol. Many use such aids every night. Over-the-counter (nonprescription) medications make use of the drowsiness caused by some common medications. Prescription drugs used specifically for improving sleeping are called sedative hypnotics. These drugs include benzodiazepines and non-benzodiazepines.

Sedative hypnotics carry risks for withdrawal, dependency, and rebound insomnia. The chance of risk for these problems varies among different drugs.

Common Non-Prescription Sleep Medications

Brands with Antihistamines. Many over-the-counter sleeping medications use antihistamines, which cause drowsiness. Diphenhydramine is the most common antihistamine used non-prescription sleep aids.

Some drugs contain diphenhydramine alone (such as Nytol, Sleep-Eez, and Sominex), while others contain combinations of diphenhydramine with pain relievers (such as Anacin P.M., Excedrin P.M., and Tylenol P.M.). Doxylamine (Unison) is another antihistamine used in sleep medications. Certain antihistamines indicated only for allergies, such as chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), or hydroxyzine (Atarax or Vistaril) may also be used as mild sleep-inducers.

Unfortunately, most of these drugs leave patients feeling drowsy the next day and may not be very effective in providing restful sleep. Side effects include:

  • Daytime sleepiness
  • Cognitive impairment
  • Dizziness
  • Drunken movements
  • Blurred vision
  • Dry mouth and throat

In general, people with angina, heart arrhythmias, glaucoma, or problems urinating should avoid these drugs. They should not be used at the same time as medications that prevent nausea or motion sickness. Patients with chronic lung disease should also avoid some non-prescription sleeping aids, such as those containing doxylamine.


Review Date: 06/11/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)