Beware of problems linked to sleep aids

In your search for a good night’s sleep, there is danger lurking in some over-thecounter drugs

In your search for a good night’s sleep, you might think the easy solution is one of those sleep drugs on store shelves -Advil PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom SleepMinis or perhaps the popular ZzzQuil, from the makers of NyQuil.

These drugs contain diphenhydramine, a decades-old antihistamine often used as a remedy for seasonal allergies, explains Consumer Reports. It works by blocking the histamine receptors in your brain that also control wakefulness -- so drowsiness is a side effect for some people.

Over-the-counter sleep aids that contain this drug (as well as doxylamine) might help you get to sleep. And what’s more, their packaging suggests that they are “non-habit-forming.”

But diphenhydramine can create a psychological dependence, says Carl W. Bazil, M.D., Ph.D., director of the Epilepsy and Sleep Division at Columbia University’s Department of Neurology. “The pills are not ‘addictive’ in the physical sense,” he says, “but there can certainly be a risk for a psychological depen-

dency.”

Side effects to take seriously

A 2015 Consumer Reports national survey of 4,023 adults found a troubling trend: Of the 20 percent who took an OTC medication within the past year to improve sleep, almost 1 in 5 respondents, or 18 percent, said they took it on a daily basis. Most concerning: 41 percent said they used the drugs for a year or longer.

That’s a problem because diphenhydramine can cause constipation, confusion, dizziness and nextday drowsiness, according to the drug’s FDA labeling. Another concern is the “hangover effect” -- impaired balance, coordination and driving performance the day after you’ve taken the drug, heightening the risk for falls and accidents. And in a January 2015 study in JAMA Internal Medicine, the frequent, long-term use of first-generation antihistamines, including diphenhydramine, was linked to an increased risk of dementia, including Alzheimer’s disease.

What to try instead

Should sleep problems persist beyond 14 days, it’s time to see your doctor. Insomnia can be due to an underlying condition, such as heartburn, depression or heart disease.

For those whose chronic insomnia is not so easily fixed, a new analysis by Consumer Reports Best Buy Drugs recommends cognitive behavioral therapy (CBT) instead of sleeping pills as a first-choice treatment. With CBT, you work with a licensed sleep therapist, learning about habits that may compromise your sleep. CBT also uses techniques like journaling to help you feel more optimistic about sleep. Studies suggest that CBT helps 70 to 80 percent of people with chronic insomnia, and effects are long-lasting, with few -- if any -- downsides.

If you still decide to take insomnia drugs, do so for only a few days at a time, at the lowest recommended dose. Never drink alcohol while taking them, and don’t take an extra pill to get back to sleep -- doing either can worsen the drug’s side effects. Avoid mixing them with other sleep drugs or supplements, including OTC nighttime pain relievers and antihistamines. Use caution if you drive the next day; you might still be drowsy.