Getting a good night's sleep plays a vital role in warding off illness, maintaining a healthy weight, and improving learning. But nearly a third of seniors don't get solid zzz's, according to a new University of Michigan poll of 1,065 adults age 65 and older. And more than a third (36 percent) report taking some type of sleeping medication, such as prescription drugs, over-the-counter aids, or supplements like melatonin, to help fix their sleep problems.

Prescription sedatives and some OTC sleep aids are risky, especially for older adults, says Leigh Ann Mike, Pharm.D., a clinical associate professor at the University of Washington’s School of Pharmacy. Side effects can include dry mouth, confusion, dizziness, next-day drowsiness, and impaired balance and coordination.

The good news is that there are safer ways to improve sleep—and according to the experts, they should be considered before starting any sleep medication. 

The Meds Cause Dangerous Side Effects

While ads for sleep medications might promise a safe, simple solution to that elusive good night’s rest, research suggests that the benefits are modest at best. A CR Best Buy Drugs analysis found that people taking sleep medications like Ambien (zolpidem and generic) or Lunesta (eszopiclone and generic) fell asleep only 8 to 20 minutes faster than people taking a placebo. 

Taking sleep meds may also cause dependency and increase your risk of car accidents, and more than double your risk of falls and fractures, common causes of hospitalizations and death in older adults, according to Consumer Reports’ Choosing Wisely campaign.

Because of these dangers, the American Geriatric Society includes the more potent prescription sleep drugs—eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien)—on its list of medications that adults age 65 and older should avoid.

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Compounding those dangers is the tendency for many people to use the medications for longer than is recommended. In a 2015 Consumer Reports survey of 4,023 U.S. adults, 41 percent of people who use over-the-counter sleep aids reported taking them for a year or longer. (Most of these drugs should be taken for just a few weeks.)

That's because a mounting body of evidence suggests that long-term use of certain sleep meds containing diphenhydramine, a common active ingredient found in OTC products such as Sominex, Tylenol PM, and ZzzQuil; antihistamines such as Benadryl; and some cold and cough medicines may increase your chances of developing dementia.

And although you might consider “natural” sleep remedies to be a safer bet, there's little research to suggest they work—and the supplements cause their share of side effects. For example, the popular herbal sleep aid melatonin can cause nausea and dizziness, and may interact with blood-pressure and diabetes medications.

Yes, Poor Sleep Is a Health Problem

In the University of Michigan poll, more than half (54 percent) of adults 65 and older said they believed poor sleep was a normal part of aging. But that's a harmful misconception, says Preeti Malani, M.D., chief health officer and a professor of medicine in the division of infectious diseases at the University of Michigan. What's more, only 26 percent of those polled spoke to their doctor about ways to improve their sleep. 

"If older adults believe that these changes are a normal, inevitable part of aging, they may not think of it as something to discuss with their doctor," Malani adds. "And not discussing it can potentially lead to health issues (related to sleep) not being identified and managed."

No matter your age, Malani recommends adding any concerns about sleep to the list of topics you discuss with your doctor during regular checkups. That way, he or she can rule out any underlying conditions that may be causing your lack of sleep, for example, anxiety, depression, restless legs syndrome, and even heart disease

Safer Ways to Fix Sleeplessness

If your doctor rules out other conditions that may be affecting your sleep, consider nondrug measures before popping a sleeping pill. Mike recommends first trying to improve your sleep hygiene: going to bed and waking up at the same time every day, avoiding that late-afternoon cup of coffee, limiting alcohol, and sleeping in a dark, peaceful bedroom (that means no smartphones and tablets in bed). 

For chronic insomnia, Best Buy Drugs recommends cognitive behavioral therapy (CBT) as a first-choice treatment. With CBT, you work with a licensed sleep therapist, learning about habits or attitudes that may compromise your sleep, and keeping a sleep diary. Studies suggest that CBT helps 70 to 80 percent of people with chronic insomnia, and effects are long-lasting, with few—if any—downsides.

Reserve sleeping medications for short-term bouts of sleeplessness, such as those caused by jet lag, anxiety after the death of a family member, or a job loss. Follow instructions closely, starting with the lowest recommended dose for only a few days at a time, and taking them only if you allow yourself at least 7 or 8 hours of sleep. Also, don't drink alcohol while taking sleep meds or take a sleep drug with other meds they might interact with dangerously, including antidepressants and certain antibiotics. Use caution if you drive the next day; you might still be drowsy.

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).