Over the counter sleep aids effectiveness
Pro Research Analysisby 
Searched over 200M research papers
Over-the-Counter Sleep Aids: Effectiveness and Key Ingredients
Common OTC Sleep Aids and Their Use
Over-the-counter (OTC) sleep aids are widely used by adults and older people to manage occasional sleep disturbances and insomnia. The most common ingredients in these products are antihistamines like diphenhydramine and doxylamine, as well as supplements such as melatonin and valerian. Many people use these products based on recommendations from friends or family, and often without consulting healthcare professionals, which can lead to misuse or inappropriate long-term use, especially among older adults 1578.
Effectiveness of Antihistamines (Diphenhydramine and Doxylamine)
Diphenhydramine, found in products like Benadryl and Panadol Night, is one of the most frequently used OTC sleep aids. Some studies show that diphenhydramine can improve sleep parameters such as sleep latency (the time it takes to fall asleep) and reduce the number of awakenings, with users often reporting feeling more rested the next morning compared to placebo 23. However, the overall clinical evidence supporting its effectiveness is limited, and side effects such as next-day drowsiness, cognitive impairment, and increased risk of falls—especially in older adults—are concerns. These products are recommended only for occasional, short-term use, not for chronic insomnia 125.
Effectiveness of Melatonin
Melatonin, a hormone that regulates sleep-wake cycles, is another popular OTC sleep aid. Research indicates that melatonin, particularly in prolonged-release formulations, can consistently improve sleep onset and sleep quality, especially in older adults with insomnia. Melatonin is generally well-tolerated and has a favorable safety profile compared to other OTC options 12. However, immediate-release melatonin and herbal supplements like valerian show less consistent benefits 1.
Effectiveness of Herbal Supplements (Valerian and Others)
Valerian and other herbal supplements are commonly found in OTC sleep aids, but the evidence supporting their effectiveness is weak. Most studies do not show significant improvements in sleep outcomes with valerian, and there is insufficient data to support the clinical use of other herbal mixtures for insomnia 126.
Safety and Risks of OTC Sleep Aids
While OTC sleep aids are generally considered safe for short-term use, there are important safety concerns, especially for older adults. Antihistamines can cause sedation, cognitive impairment, and increase the risk of falls. Melatonin is safer but should still be used with caution, as its long-term effects are not fully understood. Herbal supplements lack robust safety data, and their risk-benefit profile remains unclear 12567.
Special Considerations for Older Adults
Older adults are more likely to use OTC sleep aids inappropriately, such as taking them for extended periods. This increases the risk of adverse effects, including daytime sedation and cognitive problems. Experts recommend that pharmacists play a greater role in counseling older adults about the safe and appropriate use of these products 257.
Conclusion
OTC sleep aids like diphenhydramine and melatonin can offer some benefit for occasional sleep problems, with melatonin showing the most consistent positive effects and better safety. However, the overall evidence for the effectiveness of most OTC sleep aids is limited, and there are important safety concerns, especially for older adults. Herbal supplements such as valerian have not shown reliable benefits. Users should be cautious, avoid long-term use, and seek advice from healthcare professionals when considering OTC sleep aids.
Sources and full results
Most relevant research papers on this topic