Can’t seem to get a good night’s sleep? You’re not alone. Approximately 33% to 50% of the adult population suffer from symptoms of insomnia, with 10 to 15% having chronic insomnia.
So what exactly is insomnia and what can be done about it?
Defining Insomnia
Insomnia is defined as difficulty sleeping. This could be:
Difficulty falling asleep
Difficulty staying asleep
Waking up to early
A combination of the above
Additionally, insomnia can be classified by duration. These classifications are:
Transient insomnia – occurs over the course of less than 1 week and is usually caused from brief stress from environment or situation
Short term – occurs over the course of 1 week to 3 months and is often caused by a personal stressor
Chronic – occurs for a time period of greater than 3 months and the cause may not be identifiable
Other conditions may contribute to insomnia and include major psychiatric disorders, CHF, asthma, COPD, and chronic pain.
It is important to know that only transient or mild short term insomnia should be treated with over-the-counter options. If you are experiencing long term insomnia or over-the-counter options do not work for you, consult your doctor for further evaluation.
Consequences of Insomnia
Insomnia can impact the daily life of people affected about it. The sleep experienced by people with insomnia is often non-restorative and causes:
Fatigue
Mood disturbances
Occupation difficulties
Reduced quality of life
Additionally, long-term consequences of sleep deprivation include worsening cognitive function, impaired memory, and a higher risk of diseases such as diabetes mellitus, heart disease, and an overall increase in the risk of negative health outcomes.
Over-the-Counter Treatment of Insomnia
There are several options for treating insomnia that are available over the counter. However they should only be used for mild cases of insomnia and for short periods of times. There are 3 major options for treating insomnia with OTC medications: melatonin, antihistamines, and herbal supplements.
Melatonin – this is a hormone that is produced by the pineal gland in the brain that helps regulate the sleep cycle. A typical dose is 2 to 5 mg and common side effects are fatigue the next day. Melatonin has been shown to cause a small decrease in the time it takes to go to bed.
Antihistamines – this increases drowsiness and shortens the time it takes to fall asleep. The two options are diphenhydramine (Benadryl, ZZZquil) dosed at 25 to 50 mg at bedtime or doxylamine (Unisom) dosed at 25 mg at bedtime. There may be residual drowsiness the next day and tolerance to the medication may develop after 4 to 7 days. Additionally, taking this medication over the age of 65 increases the risk of falls and confusion.
Herbal Supplements – there are several herbal options for sleep that include:
Valerian Root – helps with sleep onset by increasing GABA – a neurotransmitter that has a calming effect on the body
Chamomile tea – might help with sleep onset
Kava – there is no clinical data to show that this supplement is better than placebo and can cause liver damage
CBD – while data is still lacking, it may help with sleep onset and maintenance.
As always, consult with doctor or pharmacist about potential drug interactions with over the counter medications or worsening of the condition.
Harbor Town Pharmacy is Here for You!
Come visit us and we can help you pick out the over the counter sleep aid that is right for you. We offer a wide variety of over-the-counter products, including many CBD options. We also offer traditional medication services should you need to fill a prescription for your sleep medication. See how our personalized approach to healthcare can improve your life today.
Written by Brittany Tipton, PharmD Candidate 2023
Reviewed by Kelsey Newell, PharmD
Sources:
1. DiPiro J, et al. Pharmacotherapy: A Pathophysiologic Approach. (eds),10th ed. McGraw Hill, New York, NY 2017.
(ISBN-13: 978-1259587481)
2. Katzung BG, et al. Basic and Clinical Pharmacology. (eds). 14th ed. Lange.
3. Sibler M. Chronic Insomnia. N Engl J Med. 2005; 353: 803-10.
4. Sateia MJ, Buysse DJ, Krystal AD et al. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic
Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med.
2017;13(2):307-349.