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Over-the-counter sleep aids are intended to manage an occasional sleepless night, not chronic insomnia, which could signal a serious underlying problem (see Sleep Disorders: Insomnia). Taking an OTC sleep aid for more than 7 to 10 days is not recommended. (Many prescription sleep aids may be safer than OTC sleep aids, especially for older people.)
OTC sleep aids contain diphenhydramine or doxylamine , both antihistamines (see Over-the-Counter (OTC) Drugs: Antihistamines). These drugs tend to make people drowsy or less alert, although not everyone reacts that way. Asians seem to be less sensitive to the sedative effects of diphenhydramine than are people of Western European origin. Sleep aids should not be taken with alcohol, tranquilizers, or other drugs that also cause drowsiness and decrease alertness.
Diphenhydramine or doxylamine causes the opposite (paradoxical) reaction in some people, making them feel nervous, restless, and agitated. Older people, people with brain damage, and young children are apparently more likely to react this way.
Older people, pregnant women, and breastfeeding women should consult a doctor before they take any product that contains an antihistamine. This precaution also applies to people with angle-closure glaucoma, heart disease, constipation, or an enlarged prostate gland.
Last full review/revision February 2003
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