April Health Tip

Treating Insomnia with Over-the-Counter Sleep Aids

Prepared by:
Korakot Sayangbarp, Berlaine Benitez, Pharm.D. Candidates 2007
Preceptor: Nancy Borja, Pharm.D.

Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep or staying asleep, waking up too early, or feeling un-refreshed after sleeping. It causes a variety of daytime problems, including fatigue, moodiness, and anxiety about sleep.

Histamine is a chemical messenger in your brain that promotes wakefulness. Antihistamines typically produce drowsiness by suppressing the activity of histamine. Most FDA-approved Over-the-Counter (OTC) sleep aids contain an antihistamine such as diphenhydramine or doxylamine as the active ingredient. Before initiating any of these products, discuss your options with your physician or pharmacist.

FDA Approved Non-prescription medications for insomnia

The antihistamines in OTC sleep aids may produce side effects as the following:

• Daytime sleepiness
• Dizziness
• Fatigue
• Headaches
• Reduced alertness
• Vomiting
• Forgetfulness
• Constipation
• Urinary retention
• Blurred vision
• Dry mouth and throat
  

Important Information Regarding OTC Sleep Aids

• OTC sleep aids that contain antihistamine are approved by the FDA only for "occasional sleeplessness" by people who have trouble "falling asleep." These products are not intended to be used for more than a few nights or for severe cases of insomnia.
• The information accompanying an OTC sleep aid should be read carefully.
• OTC sleep aids are designed only for bedtime use.
• OTC sleep aids should be taken only as directed by a physician or according to the instructions that come with the medication.
• OTC sleep aids are not intended for use by children under the age of 12.
• OTC sleep aids should not be taken with alcohol or with a sleeping pill, sedative, tranquilizer, or another antihistamine.
• Pregnant or nursing women and individuals with breathing problems or glaucoma should consult their doctor before taking an OTC sleep aid.

Things you can do to help yourself

• Go to bed only when sleepy
• Establish a standard wake-up time
• Get out of bed whenever awake for more than 15-20 minutes
• Avoid reading, watching TV, or eating in the bed
• Refrain from daytime napping
• Exercise regularly
• Limit your intake of food right before bed
• Avoid alcohol and caffeine products at least 4 hours before bedtime
• Try to relax yourself before bedtime
• Have a warm bath just before you go to bed
• Talk to someone if you are worried, anxious or depressed
• If you have unresolved issues or problems that are causing stress, consult a counselor for help in making changes to your life.

References:

1. American Insomnia Association. Available at www.americaninsomniaassociation.org Accessed 3/13/07.
2. Treating Insomnia with Over-the-counter Sleep Aids, Herbal Supplements: AASM Position Statement. Available at www.medicalnewstoday.com Accessed 3/13/07.
3. Sleeping Pills and Sleep Medications for Insomnia. Available at www.helpguide.org/ Accessed 3/13/07.

Tips for Using Medicines Wisely

Medicines can be lifesavers. They can cure or control diseases. But if you use them the wrong way, they can be dangerous. Working together with your doctor can help you avoid problems. Follow the suggestions below for safe medicine use.

At Your Doctor’s Office
Bring your medicine bottles to your doctor’s office. You can also carry a list of the medicines you are taking. Make sure to include herbal products and over-the-counter medicines that you can buy in a grocery store or drugstore without a prescription. Know your drug allergies. Tell your doctor if you are pregnant or breastfeeding.

You should ask your doctor these questions:

• What is the name of this medicine?
• Why do I need to take this medicine?
• When and how do I take it? With or without food? With other medicines?
• How long do I have to take it?
• Are there any side effects?

You should also think about the cost of the medicine. Let you doctor know if the cost of the medicine is an issue. Make sure your doctor knows how you will pay for your medicines. Ask for the generic or less expensive choices. Tell your doctor if you want to treat your health condition without medicines, and ask if other treatments like weight loss or exercise are options.

At the Pharmacy
Read the label. Make sure it is the right medicine and make sure you understand the instructions on the medicine before you leave the pharmacy. You should be able to read the label clearly. Ask about how to store the medicine (for example, does it need to be kept in the refrigerator?). Do not leave medicines in your car because they can get too hot or freeze. Ask the pharmacist if the medicine should be okay to take with your other medicines. If you want a different language on the label, ask the pharmacist.

At Home
It is important to take your medicines the way your doctor tells you. If you don’t, you could get worse.  Here are some good tips:

• Use a pillbox
• Use a calendar
• Plan ahead if you are going to travel. Have enough medicine for your whole trip.
• Ask your pharmacist if you can get early refills so you do not run out of your medicine.
• Ask friends and family members for help if you need it.

Other Things That Can Help with Safe Medicine Use
If your medicine causes side effects you did not expect, or if you think you have an allergic reaction to it, call your doctor right away. If it is an emergency, call 911. Be sure to throw away old medicines, and do not share your medicines with other people. Always fill and refill all your prescriptions at the same pharmacy. Keep the phone number for the poison control center (1-800-222-1222) near your phone. Use www.medlineplus.gov to find information about your medicines.