When using any over-the-counter medications and/or natural sleep remedies or supplements, there are several precautions to take.

See Addressing Pain and Medical Problems Disrupting Sleep

For example, prior to taking any non-prescription sleep aid, patients should follow the following steps:

Talk with your doctor. Even though a doctor’s prescription is not necessary to take an OTC sleep aid, it’s still a good idea. Of course, the most important thing to determine is that the sleep disruption is not due to something that might require medical attention such as sleep apnea. Once any serious medical condition is ruled out related to the sleep disruption, questions to ask the doctor about any OTC should include at least the following:

  • Will it interact with other medications?
  • Will it cause any problem with other underlying conditions or diagnoses?
  • What might be the best dosage?
  • How long should the sleep aid be used for?
  • What are warning signs that the aid should be stopped?

Keep precautions in mind. Diphenhydramine and doxylamine aren't recommended for people who have a number of conditions, including but not limited to:

  • Closed-angle glaucoma
  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Sleep apnea
  • Severe liver disease
  • Digestive system obstruction
  • Urinary retention

In addition, sleep aids pose risks for women who are pregnant or breast-feeding, and might pose risks to people over age 75, including the risk of stroke.

  • Take it one day at a time. Over-the-counter sleep aids are a temporary solution for insomnia. Generally, they're not intended to be used for longer than two weeks.
  • Avoid alcohol. Never mix alcohol and sleep aids. Alcohol can increase the sedative effects of the medication.
  • Beware of side effects. Side effects can be a warning sign to stop the medicine. Don't attempt activities that require alertness (such as driving) while under the influence of a sleep aid.

The reader may remember that several years ago many individuals used the substance tryptophan, an amino acid, to promote sleep. Dozens of individuals using this substance for sleeping were affected by a serious disorder called eosinophilia myalgia syndrome (EMS) due to a contaminant that entered the product during its manufacturing. Tryptophan has since been removed from the market in the U.S.


This is just one example of how products that are unregulated can be potentially harmful even though they are available for sale over-the-counter. Thus, when considering use of any of these types of products, be sure to consult a physician, research them thoroughly, and carefully consider the potential risks along with the benefits.

Dr. William Deardorff is a clinical health psychologist and specializes in providing psychological services to patients with chronic pain and spinal conditions. He has led a private practice for more than 30 years.