Is it safe to take Unisom or other over-the-counter sleeping pills long-term?

Published: February 23, 2014 09:00 AM

No. You can buy the drugs without a prescription, but they’re not meant to be used for more than two weeks. That’s because long-term use can lead to dependence, rebound insomnia, and delirium. The active ingredients—diphenhydramine, found in products such as Benadryl, Nytol, and Sominex, and doxylamine, found in some Unisom products—can cause other side effects too, including next-day drowsiness, constipation, dizziness, and dry mouth.

For persistent sleeplessness, make an appointment with your doctor. Your insomnia could be due to an underlying condition or a medication you take. Conditions that can cause sleep problems can include Alzheimer’s disease, anxiety, depression, heart disease, or chronic pain.

If you take other medications, they can interfere with sleep too, and include allergy and cold medicine, beta-blockers for high blood pressure, some pain relievers, and steroids. In addition, alcohol, caffeine, and tobacco or other nicotine products can also cause insomnia.

For more information about insomnia, see our Consumer Reports Best Buy Drugs report.

If underlying conditions or medications have been ruled out as the cause, talk to your doctor about trying cognitive behavioral therapy. Studies have found it helps 70 percent to 80 percent of people with chronic insomnia—and several studies have found it to be more effective than sleeping pills alone. In other studies, a combination of the two has helped most.

One advantage of trying behavioral therapy is that there is no risk of medication side effects, plus you could experience long-lasting benefits, something pills won’t deliver since they only work when you take them.

If you and your doctor decide a prescription sleep medication is an option for you, consider zolpidem, the generic version of Ambien. It’s a Consumer Reports Best Buy drug. Our analysis found it’s the best initial prescription option for many people because of its efficacy, relative safety, and low price. But zolpidem and other prescription insomnia pills can still cause many of the same side effects as over-the-counter products, so be careful to use as low a dose as possible to help reduce the risk. And don’t take any sleeping pills for more than seven nights.

Editor's Note:

This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

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