What’s the Best Over-the-Counter Sleep Aid? You Can’t Buy It

If you often find yourself tossing and turning in bed, waking up in the middle of the night, or generally struggling to get the sleep you need to be your best each day, you may be tempted to turn to over-the-counter (OTC) sleep aids. After all, if you can buy them in a drug store, they must be okay, right?

We hate to bring you bad news, but OTC sleep aids are often not the answer. Not only do they come with side effects and long-term health risks, they can also simply not work. But if you’re suffering with sleeplessness, there is something you can do about it. 

Below, we’ll dive into the best over-the-counter sleep aids on the market, and explain why the natural options of sleep hygiene and circadian alignment are much better instead. 

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There are many different kinds of sleep aids on the market that you can buy without a prescription. Here are a few options: 

• Antihistamine: These are used to treat allergies, but because of their sedating effects, antihistamines are also marketed as sleeping pills. You might see these as the active ingredients of diphenhydramine (Benadryl, Tylenol PM, Zzzquil, and Advil PM) or doxylamine succinate (Unisom SleepTabs and NyQuil). These are designed for short-term use and come with many risks and side effects. 
• Valerian root: This comes from the valerian plant, so it’s often marketed as a natural option that’s safer than synthetic sleeping pills. You might see this herbal supplement in pill form or as a tea. While it’s been used for centuries to help lull people to sleep, scientific research is torn on whether or not it’s actually effective. 
• Melatonin: Again, you’ll most likely see this marketed as a natural option as it’s a version of the hormone your body makes to help you fall asleep. Short-term use appears to be safe, but there’s still a lot we don’t know about long-term use. 
• Other sleep supplements: You might see other sleep supplements on the market like magnesium, chamomile, passionflower, and tryptophan.

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Prescription sleep aids are known for their ugly side effects like dependence, withdrawal symptoms, and even increased dementia risk. But over-the-counter sleeping aids also come with their risks. 

The common side effects of antihistamine sleeping aids include: 

• You can develop a tolerance to them 
• Daytime drowsiness
• Grogginess the morning after (the hangover effect) 
• Dry mouth
• Constipation 
• Blurred vision 
• Dizziness 
• Difficulty concentrating 
• Increased heart rate 
• Short-term memory loss 
• Confusion 
• Abnormal heart rhythms 

The common side effects of valerian root include: 

• Headaches 
• Daytime drowsiness
• Vivid dreams 
• Stomach upset 
• Heart palpitations 
• Brain fog 
• Anxiety 
• Itchy skin 

The common side effects of melatonin include: 

• Headaches
• Nausea
• Dizziness
• Anxiety 
• Depression 
• Joint pain 
• Tremors
• Unintended sleepiness — like during the day when you want to sleep at night

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Even though they’re available to buy without a prescription, over-the-counter sleep medications still come with safety concerns. 

Diphenhydramine has been linked with increased risk of cognitive decline in older adults. Plus, diphenhydramine is an anticholinergic drug, and anticholinergics have been linked to increased dementia risk.   

Antihistamines have also been shown to have negative interactions with different kinds of medications, including acetaminophen (paracetamol) and aspirin. 

The sleep you get from OTC sleep aids isn’t the best sleep for you either because it’s manufactured sleep. On the other hand, when you fall asleep with help from sleep hygiene alone (more on that soon), you get naturalistic sleep. According to Matthew Walker, the author of Why we Sleep, the sleep we get when we’ve taken a sleeping pill is architecturally different to normal, healthy sleep. Our deep-sleep brainwave activity doesn’t show the largest, deepest brainwaves we get with naturalistic sleep. Plus, your sleep may be even worse when you stop taking certain sleeping pills like Benadryl due to rebound insomnia 

Natural sleep aids also have safety risks. The US Food and Drug Administration (FDA) classifies both valerian root and melatonin as dietary supplements. This means there are no strict rules on recommended doses and the amount in each supplement can vary from brand to brand. 

In fact, a study looking at different brands of melatonin supplements found they contained from 83% less to 478% more than what their label said. A quarter of the supplements checked also contained the neurotransmitter serotonin. 

Plus, they may not even help you get better sleep. One meta-analysis looked at 16 sleep studies on valerian root and found the research wasn’t robust enough to say for sure whether it improved sleep quality (although sleep scientists still don’t have an agreed upon definition for sleep quality). 

The American Academy of Sleep Medicine says there’s a “lower degree of certainty” on whether to use melatonin, valerian root, and diphenhydramine or not to treat sleep problems and insomnia. 

What’s more, there’s a lot we still don’t know about the long-term effects of using any of these sleep aids. 

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So, if you have trouble sleeping, what’s the best over-the-counter sleep aid to go for? We recommend drug-free options like sleep hygiene and circadian alignment (more on those below), but if you do want to go with something in a bottle, melatonin is your best bet. 

Melatonin is a hormone your brain produces naturally two hours before your biological bedtime. It helps to prime your body and brain for sleep and makes you feel drowsy. And so supplements are useful for times when you want to sleep when your body isn’t producing high levels of melatonin. 

These include when you’re: 

• Recovering from jetlag 
• Adjusting to shift work 
• Changing your sleep schedule

In these times, melatonin has been shown to be safe for short-term use and effective at moving your circadian rhythm, or body clock. This helps you fall asleep earlier or later than you would naturally. You can’t overdose from melatonin and it’s not addictive.

If you do decide to use melatonin short term, you can use the RISE app to find the best time to take them to make sure you fall asleep 

If you’re pregnant, breastfeeding, or have underlying health conditions like diabetes or depression, speak to a doctor before taking melatonin. 

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Even if you’re suffering from chronic insomnia, the American Academy of Sleep Medicine recommends cognitive behavioral therapy for insomnia (CBT-I) in most cases, instead of turning to sleep aids. Cognitive behavioral therapy includes things like education on sleep hygiene (more on this soon), relaxation techniques, and sleep restriction — where you spend less time awake in bed. 

Not only has CBT-I been shown to be effective, it may help you get to the root of the problem, meaning you can improve your sleep long term. Speak with a healthcare professional if you’re suffering with a sleep disorder to determine the best treatment options for you. 

The American Academy of Sleep Medicine is currently investigating the safety of melatonin and is recommending those with insomnia avoid it for now. 

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There are ways to fall asleep faster and stay asleep all night without relying on sleeping pills. Here’s what to do for a good night’s sleep the natural way. 

Improve Your Sleep Hygiene 

Sleep hygiene is a set of habits you can do throughout the day to help you get the sleep you need at night. Here’s what to do.

• Get natural light first thing: Get at least 10 minutes of natural light as soon as possible after waking up. This will suppress melatonin, making you feel more awake and setting your circadian rhythm up to make it later in the day. 
• Get natural light during the day: This will make you less sensitive to light in the evening. 
• Avoid natural light before bed: Allow your brain to make all the melatonin you need by dimming the lights and putting on blue-light blocking glasses 90 minutes before bed. 
• Avoid sleep disruptors late in the day: These include caffeine, exercise, large meals, and alcohol — all of which can make it hard to fall asleep or may wake you up in the night. 
• Make a wind down routine: Set aside time to wind down for bed. This could include doing some yoga, journaling, listening to music, or reading. This’ll help prepare your body and mind for sleep and reduce stress, which could be keeping you up. 
• Make your bedroom dark, cool, and quiet: Aim for 65 to 68 degrees Fahrenheit, and use blackout curtains, an eye mask, and ear plugs to block out light and noise.  

RISE can help keep your sleep hygiene on point by reminding you when to do 20+ sleep habits. 

Sync Up With Your Circadian Rhythm 

Your circadian rhythm is your internal body clock, or the roughly 24-hour cycle that dictates things like your energy levels, body temperature, and when your body makes certain hormones. So, as this dictates your sleep-wake cycle, there is a time when your body will naturally wind down and want to go to sleep. 

To find the best time for you to go to sleep, look for your Melatonin Window in the RISE app. This is the time of night when your brain will be making the most melatonin it will all night. Go to sleep in this roughly one-hour window and you’ll find it much easier to fall asleep and stay asleep through the night. The timing of this window can change each night, but by keeping a consistent sleep schedule, you’ll find it changes less and less. 

The Best Over-the-Counter Sleep Aids? Sleep Hygiene and Circadian Alignment

Tossing and turning at 3 a.m. is no fun, and sleep aids may feel like they’re helping in the short term, but they come with many health risks and side effects, and they can’t be relied on as a long-term solution. 

Instead, you can turn to sleep aids that don’t come in a bottle: sleep hygiene and circadian alignment. RISE can help by reminding you when to do 20+ sleep hygiene habits and predicting the timing of your circadian rhythm each day. In those rare occasions when you do need a helping hand — like jet lag and moving your sleep schedule — the app can tell you the best time for you to take melatonin. All the above advice can help you get the sleep you need to feel and perform your best each day.