I was having trouble sleeping and started taking an over-the-counter sleeping pill; now I’m very drowsy during the day. Is there something else I can use to get some sleep?

September 26, 2016

Everyone experiences trouble sleeping from time to time. Usually it’s linked to something stressful that’s happening to you such as an illness or grief. Insomnia is also a common symptom of several health-related disorders such as depression, anxiety, or pain. Interestingly, while insomnia can be a symptom of depression, having chronic insomnia for at least a year can also lead to depression.

The definition of insomnia is fairly simple: difficulty falling asleep and/or difficulty staying asleep and/or awakening in the early morning without being able to return to sleep. It’s considered chronic insomnia if it causes you distress or prevents you from functioning normally during the day, occurs at least three times per week for at least three months, and isn’t related to any other factors, such as alcohol.

Treatment for insomnia can be tricky. So first see your doctor to rule out any mental health or physical conditions that could be causing your insomnia. You should also talk to your pharmacist about your drug history, as insomnia can be a side-effect of some kinds of medication, including prescription, over the counter, herbal or natural remedies, recreational, etc.

While drugs to treat insomnia work in the short term, their effectiveness isn’t maintained over time. Meanwhile, the side-effects – such as a “hangover” feeling the next day, confusion, lack of muscle control, dependence, withdrawal, and even rebound insomnia – stay the same. So the risks of taking drugs can outweigh the benefits.  

Changing your habits is a much more effective treatment for chronic insomnia and is safer over the long term, so it’s a good idea to always incorporate these options as part of your treatment plan:

  • Good sleep hygiene which includes going to bed only when you’re sleepy, keeping a regular sleep schedule (even on the weekend), avoiding naps, and only using the bed for sleep (and, well, you know…). And if you can’t fall asleep within 20 to 30 minutes, get out of bed.
  • Avoid stimulation such as caffeine (after noon), as well as exercise, nicotine, alcohol, and big meals (within two hours of your normal bedtime).
  • Try some relaxation techniques such as meditation, yoga, and deep breathing.
  • Aerobic exercise, even just brisk walking, can promote deeper and more restful sleep.

If you are struggling, it’s a good idea to keep a sleep diary to track your sleep patterns and your response to treatment. Keep in mind that these kinds of behavioural changes won’t improve sleep right away but are effective over time, so you have to persevere. If you find you’re still not getting the sleep you need, you can talk to your doctor to determine whether it’s appropriate to add a medication to your new habits. Most medications for sleep – even natural remedies –are only recommended for short-term use – two weeks at most. And over-the-counter antihistamines are not recommended at all.

So to go back to your question, the best thing you can do is stop the over-the-counter medication, establish a long-lasting healthy sleep routine, and speak to your doctor to determine whether using a medication as an additional treatment for a while would be right for you.