Should I Take a Sleep Aid? What Works & What Doesn’t for Long-Term Sleep Health

Aug. 17, 2020

If you can’t seem to shake the feeling of being tired all the time, you might be desperately searching for a “magic” cure that’s going to solve all of your nighttime problems. Is it having a nightcap? Taking naps during the day to recover? Should you take a sleep aid? Before we cover what you should be doing, let’s take a minute to talk about why quality sleep is important.

Sleep helps our brain work properly, allowing it time to form new pathways to enhance learning, attention, and decision making. It plays a role in the healing and repair of our heart and blood vessels, which can help reduce the risk of heart disease, high blood pressure, and stroke. Adequate sleep can even help prevent us from gaining weight. But it’s not easy for everyone to get the recommended seven to nine hours every night. According to the National Institutes of Health, after several nights of losing sleep (even if it is just an hour or two per night), your ability to function is reduced to a point as if you haven’t slept at all for a day or two. When this happens, we often turn to habits that we think help us sleep better. However, many of these quick fixes might actually be hurting you in the long run.

Not All Sleep Aids Are Always Effective

A popular insomnia go-to for many is over-the-counter sleep aids. A study published in the American Journal of Geriatric Psychiatry found that about 22% of adults between 65 and 80 use an over-the-counter sleep aid occasionally to fall asleep. While these may help at first, many sleep aids contain antihistamines, which are easy to build a tolerance to. Therefore, the longer you take them, the less likely they are to make you sleepy. In addition, some of these medications can have unexpected side effects. Many of these sleep aids contain diphenhydramine, which is an anticholinergic medication. These medications block the activity of a chemical in the brain called acetylcholine, which can result in confusion, forgetfulness, and even delirium, especially in older adults. In addition, studies have shown that anticholinergic medications can cause a significant reduction in REM sleep (our most restful sleep). That’s kind of counterintuitive for a medicine you are taking to help you sleep. It may also lead to constipation and urinary retention — not things you want to deal with when all you want to do is rest. While over-the-counter sleep aids might initially be helpful, you might not be getting as much rest as you think.

The big exception is melatonin which is safe, non-habit-forming, and effective. Your body naturally produces melatonin, but taking melatonin over the counter has shown in some studies to help you fall asleep and stay asleep.

Don’t Turn to Alcohol

Another commonly used sleep aid: alcohol. According to the National Sleep Foundation, as many as 20% of Americans use alcohol to help them fall asleep. While alcohol might help you fall asleep quickly, it is actually detrimental to sleep as a whole. Normally when you sleep, you have wave patterns (called delta activity) which allows for learning and memory formation. When you drink alcohol, delta activity increases. Sounds good, right? But the problem is, these waves are joined by alpha activity, which normally don’t happen during sleep, but rather when you are resting. The alpha and delta waves together might actually limit restorative sleep. Alcohol also disrupts chemicals in your body which regulate the circadian rhythm, throwing off your sleep cycle. That’s why you tend to wake up in the middle of the night after a girls’ night out. Finally, alcohol blocks REM sleep, making you wake up feeling groggy and unfocused.

Taking a Nap Is Worse Than You Think

If you’ve had trouble sleeping, taking a quick nap during the day might help you get over that midday slump. However, while you might feel rested right after your nap, it might be a culprit in your sleep dysfunction. Napping for too long or too close to your bedtime might disrupt your sleep patterns and actually keep you up at night. This may cause grogginess the next day, necessitating a nap, and so the pattern continues.

If you’re having one of those days where you can’t get through without a little shut eye, the Mayo Clinic recommends keeping naps short (10 to 20 minutes), taking naps before 3 p.m., and creating a restful napping environment to get the most out of your time without disrupting your nighttime sleep.

What Does Work?

Get a New Mattress

Sometimes the reason you have a rough night is actually due to your bed. If your mattress is old, it can cause restless sleep and even back pain. Invest in a new mattress every seven years to help improve your sleep quality. If you are unable to afford one, try out a mattress topper which is an affordable solution to make your bed more comfortable for a cheaper price.

Exercise More

Dr. Charlene Gamaldo, medical director of Johns Hopkins Center for Sleep, reports exercise can help improve your sleep. She suggests at least 30 minutes of moderate aerobic exercise to increase restorative sleep. The reason exercise is helpful hasn’t been figured out, however, the timing of exercise may matter. Endorphins, yes, make you happy, but can also keep some people awake. Exercise can also raise your core body temperature, which signals the body clock that it is time to be awake and alert. This effect can last for 30 to 90 minutes, so it’s best to exercise at least one to two hours before bed.

Improve Sleep Hygiene

Sleep hygiene is a term for multiple habits that promote full and restful sleep. One example is being consistent with what time you go to bed and wake up each morning. This can keep your body in a natural rhythm and help you sleep better. In addition, creating a restful sleep environment is another way to get some Zzzs; make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature.

If falling asleep is your issue, remove electronic devices such as TVs, computers, and phones from the bedroom (or at least stop looking at them for a couple hours before bed). The blue light emitted from electronic screens can suppress melatonin, which is the chemical in your body that signals it’s time for sleep. This can shift your circadian rhythm by as much as three hours. That’s a lot of sleep to lose.

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