Sleep aids: Can antihistamines help me sleep?

With all the concerns about addiction and side effects associated with prescription sleep aids, is there anything wrong with just using over-the-counter antihistamines to treat insomnia?

- Antoni / New York

Answer

For occasional insomnia, over-the-counter (OTC) antihistamines, such as diphenhydramine, are somewhat effective as sleep aids but must be taken only as directed on the packaging. Antihistamines induce drowsiness by working against the central nervous system chemical histamine.

Just because a drug is available "over-the-counter" doesn't mean it is safe, especially if taken incorrectly. Talk to your doctor before taking any OTC sleep aids if you're currently taking any drugs for depression, psychiatric or emotional conditions, or Parkinson's disease. Also, antihistamines may not be safe if you have a history of glaucoma, heart problems or enlarged prostate.

Most over-the-counter products marketed as sleep aids contain antihistamines alone or in combination with pain relievers. Although these medications have some sedating effects, they also have other side effects that are undesirable and can even be deadly at high doses.

Persistent insomnia should be evaluated to identify underlying causes. Cognitive behavioral therapy is as effective, if not more effective, than sleep aids in the treatment of insomnia — with no side effects.

Occasionally, sleep experts will use a combination of cognitive behavioral therapy and prescription sleeping medications to treat insomnia. When used appropriately, prescription sleep medications generally are safe.

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