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Over-the-counter sleep aids:
Get expert advice
Regardless of which OTC sleep aid you're considering, consult with a health-care practitioner. "Most people self-medicate," says Dr. Harvey Moldofsky, director of research at the Centre for Sleep and Chronobiology and president of the Toronto Psychiatric Research Foundation. "They go to the pharmacy and see all kinds of sleep aids, but they don't know that some of them can create problems."
In fact, numerous OTC sleep aids can have side-effects, including interactions with other medications. "Melatonin can interact with antidepressants," says Tara Maltman-Just, pharmacist and executive clinician at Vitality Integrative Medicine in Winnipeg. "Another common sleep aid contains an antihistamine that causes drowsiness; it should be avoided by people with narrow-angle glaucoma."
Even traditional sleep-promoting herbal remedies may have side-effects. "Calming herbals such as passionflower, lemon balm and valerian may be of benefit," says Maltman-Just, "but you should talk with a trained health-care professional to find what's best for you."
Use them sparingly
No matter the OTC sleep aid you choose, they're not intended for long-term or frequent use. If you consistently pop a pill to get some shut-eye, you may find that your usual dosage is no longer as effective as it once was—or that you can't get to sleep without it. "If you have to use OTC sleep aids for more than one or two weeks, it's time to look deeper," says Maltman-Just.
Dr. Moldofsky agrees: "Sleep aids have both immediate positive effects and negative effects. If you're getting into a habit, they're causing you harm."
Treat the cause
If you're regularly using an OTC sleep aid, you're treating a symptom of an underlying health issue, not the cause—and it's crucial to get help. "Sleep disturbance can be a sign of depression or anxiety, sleep apnea and hormonal imbalance in PMS, menopause and andropause," notes Maltman-Just.
Prescription sleep aids:
If you don't like the idea of taking sleep aids, remember that if your doctor has prescribed one, there's generally a good reason. Most doctors follow established guidelines for prescribing sleep aids, and they're aware of best practices for treating sleep disorders. "We don't ever recommend the indiscriminate use of medication for sleep problems," confirms Dr. Charles Samuels, founder and medical director at the Centre for Sleep and Human Performance in Calgary. "Short-term use of a sedative/hypnotic is what's recommended, in combination with a behavioural management program. We define short-term use as 10 to 14 days and, after that, intermittent use as one to two days a week."
If your doctor isn't monitoring your sleep-aid use closely, or if your dosage is increasing, it's time to seek out a sleep specialist. According to Dr. Samuels, family physicians might not always have the expertise to know when long-term use has become dependence or when a patient requires more detailed care.
Another red flag: not receiving treatment for the health issues behind the sleep disturbance. "There are good sleep aids, but they're for short-term use," says Dr. Moldofsky.
"If you're developing dependence, then you're not dealing with whatever is causing the problem." Examples of underlying conditions that may affect the quality and number of hours of sleep include sleep apnea, restless legs syndrome and unresolved emotional problems, such as anxiety or a major depressive disorder.
Check out these five bedtime rituals to help you sleep.
This story was originally part of "A Dose of Rest" in the November 2015 issue. Subscribe to Canadian Living today and never miss an issue!