Should I Suggest OTC Sleep Aids?

New anxieties, remote job stress, and increased screen time all create an environment for reasons to stay up at night. More patients today are turning to their healthcare professionals for help as they suffer with sleep problems and the consequences of not getting enough rest. Many common OTC sleep aids are now being discouraged for some populations based on certain medical conditions, comorbidities associated with lack of sleep, and age group. While these products are relatively safe, PROs recognize OTC sleep aids should be reconsidered for some cases. 




Common OTC Sleep Aids

Over-the-counter (OTC) sleep aids were first made available more than 30 years ago and became popular because of their low toxicity rating and mild effects for occasional users. The most common OTC sleeping aids contain 1st generation antihistamines that work by interrupting normal brain receptor activity. This interruption provides a calming effect and slight dissociation from your waking thoughts to help users fall asleep easier or stay asleep longer. Long-term use of sleep aids is not advised and could result in a build-up of tolerance build-up or increased experiences of certain side effects.

Diphenhydramine




Side-Effects + Considerations:

DPH affects H1 receptors located throughout the body and has been shown to be prone to dependency and abuse by long-term users. Patients with various cardiac conditions should be advised against using this sleep aid because of the products effect on QT intervals and the associated risk of sudden cardiac death. DPH should also be reconsidered for aging populations as studies have shown an increased dementia risk associated with the use of sedatives of this class.
 

Doxylamine




Side-Effects + Considerations:

Doxylamine, another 1st generation antihistamine like DPH, is prone to abuse. Research studies about sleep-aid-dependent users report that users often continue using the product daily, and for an average of 6 months or more. Doxylamine has been significantly associated with reports of confusion, seizures, and even severe rhabdomyolysis for its users. PROs now confirm and review their patients' history of kidney disease or conditions causing fluid-retention as cases of syndrome of inappropriate antidiuresis (SIAD) have been repeatedly presented for long-term doxylamine consumers.

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