Sleep Aids: A Pill Primer

A comparison of the risks and rewards of popular prescription pills, over-the-counter drugs, and natural alternatives.

Photos courtesy of Wikimedia Commons
Eszopiclone (Lunesta)
Pros: Research shows it remains effective over time, unlike many other sleep aids.
Cons: It's been known to cause sleep-walking, -driving, -eating, -sex, -dialing, and other things better done awake; it can bring on hallucinations; and it can be habit-forming.
Zaleplon (Sonata)
Pros: It's short-acting (it lasts around four hours, half the norm) and is the best drug to take if you can't fall back asleep.
Cons: It won't knock you out for the night; it can cause the same trippy side effects as Lunesta; it can be habit-forming; and it may result in short-term-memory loss.
Ramelteon (Rozerem)
Pros: It's not habit-forming.
Cons: It doesn't work that well.
Antihistamines (Benadryl, Unisom, Tylenol PM)
Pros: No Rx needed for these antihistamine-based, nonnarcotic meds; the pain-relieving varieties ease aches and usher in sleep.
Cons: You'll probably be drowsy the next day.
Zolpidem (Ambien, Ambien CR)
Pros: It kicks in faster than other drugs (within a half-hour); Ambien CR, an extended-release med, helps you stay asleep longer.
Cons: It has the same potential side effects as the other "Z" drugs (such as eszopiclone and zaleplon), though they're often more intense.
Doxepin (Silenor)
Pros: Some research suggests it may be more effective and less addictive than "Z" drugs, and it helps you fall and stay asleep.
Cons: It can cause weight gain, so if you weren't depressed already, you might be after taking it.
Valerian Root
Pros: The herbal remedy comes in either tonic or supplement form.
Cons: It smells like a frat-house basement and tastes even worse.
Pros: It's not addictive. Melatonin is one of the hormones that can help reset your body clock and prep you for sleep.
Cons: There's no FDA regulation on melatonin, which means someone could be cooking it up in his garage and selling it to your local health-food store.
Magnesium and Calcium
Pros: The power combo (sold in supplement form; Tums work, too) can prevent sleep-disrupting nighttime reflux.
Cons: Excess calcium supplementation has been linked to heart-attack risk; taking more than 12 Tums a day can cause constipation and depression.
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