Chief of Urology and Director of Robotic Surgery at Virginia Hospital Center, Dr. Robert Mordkin surveys the nation's top doctors about men's health issues. Here, Mordkin talks to Dr. Amit Patel, a sleep specialist at the Pulmonary and Medical Associates in Arlington, Virginia, on getting a great night's rest.
Which over-the-counter sleep aids are effective?
Over-the-counter (OTC) remedies are not so intensely regulated by the FDA, leaving questions regarding the safety-side effect profile, differences in potency, and overall action specifically for sleep. One OTC remedy, melatonin, is a hormone secreted by our bodies to regulate our circadian rhythms and is used by sleep specialists to help shift certain sleep patterns. Research shows that even less than 1 mg is biologically effective and the main side effects are residual sleepiness and inadvertent shifting of sleep schedules. Valerian root extract is thought to act on the same receptor as some common prescription sleep medications, and there is research suggesting effectiveness, but more stringent testing is needed. L-Tryptophan was banned in 1989 due to rare side effects and the FDA has advised against kava, given the association with liver injury. 5-HTP has the potential to increase serotonin effects on the body, such as abdominal pains, bowel changes, and palpitations.
Anti-allergy medications (Benadryl), "PM" medications (Tylenol or Advil PM), and sleep aids (Sominex, Tranquil) carry a fairly extensive side-effect profile, including, but not limited to, daytime somnolence, mouth dryness, blurry vision, and confusion, and should not be used in persons with glaucoma, heart rhythm issues, and urinary retention. Though it is generally safe for occasional use in healthy individuals, continued use of this medication or any over the counter sleep aid for sleep purposes is not recommended. One should never take multiple sleep aids on the same night or in combination with alcohol.
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