It doesn’t matter how much more you try to squeeze into your busy life, at the end of the day, sleep is nonnegotiable. Maybe that’s why there’s an entire industry focused on helping you achieve your ideal amount of shut-eye in the form of over-the-counter (OTC) medications. These sleeping aids come in liquid, gel capsule, and tablet options, like ZzzQuil and Unisom, and seem to work like magic, delivering fast, easy access to rest. But that convenience might come at a cost if you’re relying solely on these aids to fall and stay asleep. Even the bottles and packages they come in include labels warning that use is not recommended beyond 14 days without the supervision of a doctor.
To help better understand why, POPSUGAR talked with two sleep experts who agreed that constant use of OTC sleep aids is, by and large, not worth the risk. Read on for why, including what they’re made of, potentially harmful side effects, and interactions.
- What Are the Common Ingredients in OTC Sleep Aids?
- What Are the Potential Side Effects From OTC Sleep Aids?
- Do OTC Sleep Aids Interact With Other Medicines?
- What If I Take Other Medicines That Make You Sleepy as Sleeping Aids?
- So Is It Safe to Take OTC Sleep Aids Every Day?
- What to know about ibuprofen?
- Before You Take Ibuprofen, Try This
- Acetaminophen or aspirin
- Omega-3 fatty acids
- Thank you!
- Exercise and mindful movement
- More sleep (or coffee, in a pinch)
- ZzzQuil FAQ
- Q: How does ZzzQuil help you fall asleep?
- Q: What exactly is Diphenhydramine HCL?
- Q: What are the common side effects of ZzzQuil?
- Q: Can I use allergy medications in place of ZzzQuil to help fall asleep?
- Q: How is your ZzzQuil line different from PURE Zzzs?
- Q: Why do I have strange dreams on ZzzQuil?
- Q: How much ZzzQuil should I be taking?
- Q: Why do you have alcohol in your liquid sleep aids?
- Q: How are your ZzzQuil Liquicaps different from your ZzzQuil liquid?
- Q: Is ZzzQuil safe for children?
- Q: Is ZzzQuil safe to take while pregnant or breastfeeding?
- Q: Is there anyone else who shouldn’t take ZzzQuil?
- Q: How do I maximize the effects of ZzzQuil?
What Are the Common Ingredients in OTC Sleep Aids?
The top brands of OTC sleep aids contain one of two main ingredients: diphenhydramine and doxylamine. Both prescription and OTC medications that contain these drugs are called sedative hypnotics, and generally speaking, there’s not much difference between the two.
One glaring similarity is that helping restless individuals fall and stay asleep isn’t actually these ingredients’ main purpose. These drugs are antihistamines, which are intended to be taken for allergy relief. “The side effect of these medicines is they make you sleepy,” said Aneesa Das, MD, an assistant professor of sleep medicine at The Ohio State University Wexner Medical Center in Columbus, OH. “If you’re going to take them, you have to take caution, because they have a lot of side effects, so they’re not great as a long-term solution.”
What Are the Potential Side Effects From OTC Sleep Aids?
Some of those side effects include confusion, rapid heart rate, and increased risk for falls, Das said, adding that they’re also associated with blurred vision, dry mouth, bad breath, constipation, and urinary retention, which makes it difficult to go to the bathroom, especially for men. “There’s something called the Beers List, which is part of the American Geriatric Society, and it’s a list of medications that we have to be careful with. Why? Because all these drugs that make you a little sleepy come with a high rate of falls and fractures, especially in elderly patients. And all sedative hypnotics, OTC or prescription, are on that list,” said Rajkumar Dasgupta (Dr. Raj), MD, an assistant professor of clinical medicine at the Pulmonary, Critical Care and Sleep Medicine division of Keck Medicine at the University of Southern California in Los Angeles.
“Diphenhydramine has also been associated with early-onset dementia,” Dr. Raj said. “Those with memory concerns, especially older patients, should avoid OTC sleep aids containing diphenhydramine and doxylamine.”
Do OTC Sleep Aids Interact With Other Medicines?
If you’re taking anything else, prescription or otherwise, OTC medications to aid with sleep could react with those ingredients and lead to even more harmful side effects. “If you have underlying medical conditions, OTC sleep aid medications may have interactions or make those conditions worse,” Dr. Raj said. The National Institutes of Health links to a service where you can check drug-drug interactions, called Drug Interactions API, but you should consult a doctor.
Additionally, people should avoid combining OTC sleep aid medications with alcohol, the doctors say. “This would be extreme and it’s not common, but you can develop parasomnia,” Dr. Raj said, describing the diagnosis as abnormal occurrences while you sleep, like sleepwalking.
What If I Take Other Medicines That Make You Sleepy as Sleeping Aids?
Medicines like NyQuil, Tylenol PM, and Advil PM can make you sleepy because they include either diphenhydramine or doxylamine, but their primary use is not to serve as a sleeping aid but to treat other ailments, like pain and fever, with their other ingredients.
If you reach for these often to help you sleep, you might want to reconsider. “Any time you find yourself taking add-on medicines that you don’t need, there’s a major downside,” Dr. Raj said. That’s especially true when it comes to nonsteroidal medications, like ibuprofen, because they may cause gastro-intestinal upset or, ultimately, ulcers.
No problem, you’ll just have a glass of wine before bed, right? Think again. Although alcohol is a depressant and may have the initial effect of increasing drowsiness, consuming it may have the opposite effect in the long run. “While alcohol may sometimes help you fall asleep quicker, it actually increases sleep fragmentation in the second half of the night, so the net change with alcohol is that it decreases your sleep quality,” Das said.
So Is It Safe to Take OTC Sleep Aids Every Day?
If you decide to try OTC sleep aids to improve your sleep, know that they’re not intended to be used for more than two weeks at a time, at the very least to avoid masking the symptoms of a larger issue.
Even then, their use can come with risks, as mentioned above. A better option might be working on revamping your daily habits, like only using your bed for sleeping and sticking to the same wake-up time every single day.
Image Source: Unsplash / Kevin Grieve
Diphenhydramine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Antihistamines can cause drowsiness, which can aid in the treatment of occasional sleep problems (insomnia).
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen works by reducing hormones that cause inflammation and pain in the body.
Diphenhydramine and ibuprofen is a combination medicine used to treat occasional insomnia associated with minor aches and pains.
Diphenhydramine and ibuprofen is not for use in treating sleeplessness without pain, or sleep problems that occur often.
Diphenhydramine and ibuprofen may also be used for purposes not listed in this medication guide.
Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.
Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.
Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.
You should not use this medicine if you are allergic to diphenhydramine or ibuprofen, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.
Ask a doctor or pharmacist if it is safe for you to use this medicine if you have other medical conditions, especially:
- heart disease, high blood pressure;
- a history of heart attack, stroke, or blood clot;
- a history of stomach ulcers or bleeding;
- a breathing problem, such as asthma, emphysema, or bronchitis;
- liver or kidney disease;
- enlarged prostate or problems with urination; or
- if you drink 3 or more alcoholic beverages per day.
This medicine may be harmful to an unborn baby. Taking ibuprofen during the last 3 months of pregnancy may result in birth defects and prolonged labor and delivery. Do not use this medicine without a doctor’s advice if you are pregnant.
Diphenhydramine and ibuprofen may pass into breast milk and may harm a nursing baby. Antihistamines may also slow breast milk production. Do not use this medicine without a doctor’s advice if you are breast-feeding a baby.
This medicine is not approved for use by anyone younger than 12 years old. Always ask a doctor before giving an antihistamine to a child. Death can occur from the misuse of antihistamines in very young children.
What to know about ibuprofen?
Ibuprofen is not suitable for people who:
- are sensitive to aspirin or any other NSAID
- have, or have had, a peptic ulcer
- have severe heart failure
In 2015, the United States Food and Drug Administration (FDA) strengthened their warning about the increased risk of heart attack or stroke when taking higher doses of ibuprofen.
They call on people to be aware of this possible problem and to seek medical attention at once if they experience chest pain, breathing problems, sudden weakness in one part or one side of the body, or sudden slurred speech.
It should be used with caution if a person has, or has had:
- liver problems
- kidney problems
- mild heart failure
- hypertension, or high blood pressure
- angina, heart attacks (ischemic heart disease)
- narrowing of the arteries, known as peripheral arterial disease
- coronary artery bypass graft (CABG) surgery
- any experience of stomach bleeding
Patients should check with a doctor or a qualified pharmacist if they are unsure.
Possible adverse effects
The most common adverse effects of ibuprofen include:
- dyspepsia, involving upper abdominal pain, bloating, and indigestion
- pain in the stomach or intestines
Also possible, but less common, are:
- edema, or fluid retention
- hypertension, or high blood pressure
- stomach inflammation
- ulcers in the digestive system
- worsening asthma symptoms
Anyone who feels dizzy after taking ibuprofen should not drive or operate machinery.
Very rarely, a person may experience bleeding in the stomach, signs of which are:
- malaena, or black stools
- hematemesis, or vomiting with blood
Long-term use can lead to reduced fertility in some women, but this problem should stop soon after finishing treatment.
Share on PinterestIbuprofen is not recommended for those with asthma, as an allergic or asthmatic reaction could be provoked.
The United States (U. S.) Food and Drug Administration (FDA) warns that some people may be allergic to the ingredients of ibuprofen.
Allergic symptoms include:
- hives, red skin, blistering, or a rash
- facial swelling
- asthma and wheezing
Anyone experiencing these symptoms should stop using the drug.
In severe cases, anaphylactic shock may occur. The person will have difficulty breathing. This is life-threatening and needs immediate medical attention.
Ibuprofen should not be used in the last 3 months of pregnancy unless definitely directed to do so by a doctor, as it may affect the fetus or lead to problems during delivery.
Ask a health professional before using any medication while pregnant or breast-feeding.
Is ibuprofen addictive?
Some reports that suggest routine use of many pain relievers like Advil for migraine headaches may cause a rebound headache after the pain reliever wears off.
While this is not considered an addiction, it can create an annoying cycle that can be hard to break. Regular users of ibuprofen should be mindful of this.
Sometimes, one medication can interfere with the effects of another. This is known as drug interaction.
Drugs that may interact with ibuprofen include:
Antihypertensive medications: Drugs taken for high blood pressure, or hypertension. Ibuprofen can sometimes lead to a rise in blood pressure if used alongside antihypertensives.
Anti-inflammatory painkillers: Ibuprofen should not be taken with diclofenac (Voltarol), indometacin, or naproxen because there is an increased risk of stomach bleeding. Ibuprofen should not be necessary with these drugs, as they are already painkillers.
Aspirin: Ibuprofen and aspirin taken together significantly raise the risk of stomach bleeding. Patients taking low-dose aspirin for blood thinning should not take ibuprofen because the blood thinning effect will be diminished.
Digoxin: This is often used to treat atrial fibrillation. Ibuprofen and digoxin together can raise blood pressure levels.
Lithium: This drug is used for some mental disorders. Ibuprofen can make it harder for the body to eliminate lithium, resulting in potentially dangerous levels of lithium in the body.
Methotrexate: This is used to treat cancer and some auto-immune diseases. Ibuprofen can make it harder for the body to eliminate methotrexate. Potentially hazardous levels of methotrexate may build up in the body.
Tacrolimus: This drug is mainly used after an organ transplant, to stop the body’s immune system rejecting the new organ. Ibuprofen with tacrolimus can cause kidney damage.
Selective serotonin reuptake inhibitors (SSRIs): This type of antidepressant drugs, such as citalopram, fluoxetine, paroxetine and sertraline, taken with ibuprofen can increase the risk of bleeding.
Warfarin: An anticoagulant drug, or blood thinner, that stops the blood from clotting. Ibuprofen taken with warfarin can reduce the drug’s anticoagulant effects.
Anyone who is taking these or other medications should ask their doctor or pharmacist if it is safe to use ibuprofen.
As long as users adhere to the guidelines, ibuprofen can be used safely in a number of settings. It is not habit-forming or addictive.
Severe adverse effects normally occur only with long-term use.
In the face of the current opioid overdose epidemic, the Centers for Disease Control and Prevention (CDC) urge doctors and patients to consider non-opioid drugs, such as ibuprofen, before moving on to opioids as a treatment for pain.
Before You Take Ibuprofen, Try This
Plus, says Alban Latremoliere, a pain physiologist at Boston Children’s Hospital, NSAIDs don’t always work well—which could prompt people to take higher and higher doses when they should be turning to other treatments. “Instead of looking for a pill that works for every type of pain, we need to be thinking about combination approaches that treat the underlying problems,” he says.
If you’re concerned about the level of pain medicine you’re taking, here are a few things you might try instead.
Acetaminophen or aspirin
Unlike ibuprofen, over-the-counter acetaminophen has not been linked to heart problems. Nagda recommends it to some of her patients—especially elderly ones—who aren’t good candidates for anti-inflammatory medicines.
Still, the drug is not without its own risks. “We recommend it on an as-needed basis, rather than an around-the-clock regimen,” says Nagda. “People should still be careful about the doses, and if they need it somewhat regularly, they should talk to their primary care physician about having their liver function tested.”
Aspirin is another option. While it is an NSAID, studies of regular aspirin use suggest a protective cardiovascular effect, rather than increased risks. (It can, however, cause stomach bleeding and ulcers.) “If someone has regular pain and they’re planning on doing something more strenuous than normal, I might tell them to take an extra-strength aspirin beforehand,” says Nagda.
MORE: The New Bottom Line On Your Daily Aspirin
Omega-3 fatty acids
For arthritis and related conditions, studies show that omega-3 fatty acids—found in fish, fish oil supplements, nuts and seeds—may help reduce pain and inflammation. The Arthritis Foundation recommends taking fish oil capsules with at least 30% omega-3s.
Latremoliere says that following a diet rich in fish, fruits, vegetables and whole grains may also ease pain throughout the body, although it won’t likely take the place of pain medicines entirely. “If you make a habit of avoiding foods that promote inflammation and eating foods that help reduce it, it can definitely be helpful,” he says.
Despite a recent review that called into question the benefits of curcumin—the active compound in turmeric—Nagda says that people seeking pain relief may still want to try adding the yellow spice to their diet.
“It has anti-inflammatory properties, and there are some small studies that show benefits for patients with rheumatoid and other forms of arthritis,” she says. It’s safe in quantities used in cooking and flavoring food, so as long as you don’t mind the taste, there’s little downside.
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This traditional Chinese medicine technique may help reduce pain associated with back pain, neck pain, arthritis, headaches, fibromyalgia pain after surgery, according to research. Not everyone who tries acupuncture improves, says Nagda, but “when you look at risks and benefits compared to other methods like NSAIDs, acupuncture comes out on top with minimal risks.”
While acupuncture’s cost can be prohibitive for many pain sufferers, it is increasingly covered by health insurance—at least in part—as its benefits become clearer. Massage is another approach that’s been shown to to relieve chronic lower back pain.
Exercise and mindful movement
Regular exercise is a good way to ward off chronic pain and to reduce symptoms if it does develop. But certain types of movement may be more beneficial than others.
Tai chi has been shown to benefit people with fibromyalgia, for example, and yoga may help with back pain and arthritis. “Even if these techniques don’t necessarily decrease pain, they may help people cope with it better,” says Nagda.
Nagda also recommends swimming to many of her pain patients, as a way to stay active and flexible without stressing their joints. And for injuries, she stresses the value of using heat and ice and seeing a physical therapist, rather than masking pain with a pill.
In one 2016 study, people who practiced seated meditation for 20 minutes a day had less reaction to a painful stimulus than those who sat and read a book. The research didn’t include people with chronic pain, but the authors say meditation could have potential as an alternative to painkillers like opioid drugs. Other research has shown that mindfulness can reduce a person’s experience of physical pain (and emotional pain, too).
“If you meditate, you’re helping your brain relax and get into a state where some of its regions can be slowed down,” says Latremoliere. “That might help reduce focus on pain or attention to stimuli, so it makes sense that it might help people feel better.”
More sleep (or coffee, in a pinch)
Latremoliere’s own research in mice, published recently in Nature Medicine, has shown that chronic sleep deprivation can enhance pain sensitivity—and that a dose of caffeine can temporarily reverse those effects. Studies in humans have also suggested that staying awake for long periods of time can lower people’s thresholds for pain, and that the equivalent of a few cups of coffee before a workout can reduce perceived muscle pain.
“Our research suggests that if you have chronic pain and you’re not sleeping enough, your pain is probably greater because of that,” says Latremoliere. People should be wary of relying on caffeine to get by, however. “Coffee in the morning might help reduce pain and get you through the day,” he says, “but if you have it too late in the day it could make your sleep, and your pain, even worse.”
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Answers to your frequently asked questions about ZzzQuil
Q: How does ZzzQuil help you fall asleep?
A: ZzzQuil helps you fall asleep by introducing the ingredient Diphenhydramine HCL into your system. Diphenhydramine HCL is an antihistamine that has been shown to make you feel sleepy and help you relax with no lasting side effects. Unlike a more powerful prescription sleep aid, ZzzQuil is gentle and won’t force you to fall asleep; it will only help calm, soothe and guide you into sleep.
Q: What exactly is Diphenhydramine HCL?
A: Diphenhydramine HCL is a common antihistamine. Originally used to treat symptoms of allergies, such as mild rashes, itching, watery eyes, running nose and sneezing, it was soon discovered that Diphenhydramine HCL could help people fall and stay asleep. We’ve formulated our ZzzQuil products around this ingredient to give you the best sleep possible.
Q: What are the common side effects of ZzzQuil?
A: Most side effects of ZzzQuil are mild and will go away on their own. They include headaches, nausea and sleeplessness. While serious symptoms are extremely rare and usually the result of an overdose, if you experience seizures, extreme confusion or hallucinations, discontinue use and get help immediately. Click HERE for a complete list of possible side effects.
Q: Can I use allergy medications in place of ZzzQuil to help fall asleep?
A: Our Vicks ZzzQuil products have been carefully crafted to give you the best sleep possible. Unlike the Diphenhydramine HCL used to decrease symptoms of allergies, the only purpose of our Diphenhydramine HCL formula is for better sleep. Just like we don’t recommend using ZzzQuil to treat symptoms of allergies, we recommend that you do not use allergy medications for anything other than treating allergies, as it increases the risk of side effects and decreases the chance of successful results.
Q: How is your ZzzQuil line different from PURE Zzzs?
A: Our ZzzQuil line uses the active ingredient Diphenhydramine HCL. Our PURE Zzzs line uses the active ingredient melatonin, which is a hormone that occurs naturally in your body. While each have been shown to be safe and effective, you should choose the product that works best for you and your body. Click HERE to learn more about our PURE Zzzs line.
Q: Why do I have strange dreams on ZzzQuil?
A: Both ZzzQuil and PURE Zzzs help your body move from light sleep into the REM sleep cycle, which is your deepest and most restorative sleep, and also where you dream. The longer you stay in the REM sleep cycle, the more you’ll dream, and the more you’ll remember those dreams. However, while your dreams will likely be more vivid, you should not have terrifying dreams on ZzzQuil. If you do experience unwanted, frightening dreams, try practicing calming techniques before bed (link to “how to sleep better”). If you still experience unpleasant dreams, discontinue ZzzQuil use and talk to your health care provider about a sleep aid that will work for you.
Q: How much ZzzQuil should I be taking?
A: For our liquid products, adults and children over 12 years of age should take a single dose of 30 mL (measured in our provided cup) before bed. You should not have more than one dose in 24 hours. For our liquicaps, adults and children over 12 years of age should take two capules at bedtime and take only one dose in 24 hours. Children under 12 should not use any ZzzQuil product, but our PURE Zzzs Kidz product may be right for them. Click HERE to learn more (link the children melatonin page).
Q: Why do you have alcohol in your liquid sleep aids?
A: Some ingredients in our sleep aids don’t dissolve in water, but do dissolve in alcohol, so we formulate our products with it to keep the liquid smooth and consistent. The alcohol also helps keep the ZzzQuil formula stable, so it can last longer in your cabinet. There is minimal alcohol content in our ZzzQuil, so it’s safe for children over 12 to take, but if you would like an alcohol-free sleep aid, both our ZzzQuil Alcohol Free Of Liquid and ZzzQuil Liquicaps is are great options.
Q: How are your ZzzQuil Liquicaps different from your ZzzQuil liquid?
A: Both our ZzzQuil Liquicaps and our ZzzQuil liquids use the same active ingredient with different formulas, so you can choose how to take your sleep aid. They have exactly the same effect; we formulate them both ways so you can choose which one suits your taste and texture preference.
Q: Is ZzzQuil safe for children?
A: Yes, ZzzQuil is safe for children over 12 years of age. For children under 12 years of age, check with your health care provider or try our melatonin-based PURE Zzzs Kidz Melatonin Gummies.
Q: Is ZzzQuil safe to take while pregnant or breastfeeding?
A: You should not take ZzzQuil while pregnant or breastfeeding without first talking to your health care provider. While no serious side effects have been shown, there have been no long-term studies on the potential impact.
Q: Is there anyone else who shouldn’t take ZzzQuil?
A: Children under 12 should not take ZzzQuil unless instructed otherwise by a health care provider because the medication may be too powerful for them. The very elderly or those with neurologic disorders also should not take ZzzQuil because they are at a higher risk for confusion or other unwanted neurologic side effects.
Q: How do I maximize the effects of ZzzQuil?
A: Unlike powerful prescription medications, ZzzQuil will only help you get to sleep, it won’t force you to. To maximize your chance of getting a great night’s sleep with ZzzQuil, practice good sleep hygiene by removing all screens from your bedroom, getting light-blocking curtains, and turning on soothing ambient noise, like a fan or relaxing music. If you often feel stressed or anxious while falling asleep, try meditation techniques to help your ZzzQuil give you the most calming effect possible.