Other side effects that can occur with diphenhydramine are constipation and urinary retention, Krystal says. What these studies did find with diphenhydramine was side effects, including dry mouth, dizziness and headache. Neither did it affect sleep onset or total sleep time. Compared to a placebo, diphenhydramine improved sleep efficiency (the percentage of time in bed spent sleeping) based on participants’ feedback but not on automated readings of brain, eye and muscle activity. The second study tested 25-milligram doses of diphenhydramine against a placebo and an herbal preparation of valerian and hops in 184 adults with mild insomnia. The participants reported slightly fewer nighttime awakenings with diphenhydramine than with the placebo, but no difference in how long they took to fall asleep, how well they slept or how long they slept. The first study included a comparison of the effects of diphenhydramine (50 milligrams, a typical OTC dose) with those of a placebo in 20 elderly people with insomnia. The studies looked at people with primary insomnia - meaning that their sleep problems were not the result of other medical issues such as depression, anxiety or pain.
(Other studies have looked at daytime sleepiness with the drug.) The clinical studies testing diphenhydramine for insomnia are minimal, Krystal says: There have been only two, which together involved 204 people. (Unisom SleepTabs use doxylamine, another antihistamine.) (Yes, that’s a joke.) The majority of them - ZzzQuil, TylenolPM and Unisom SleepGels - contain diphenhydramine as the active ingredient, the same compound in Benadryl. Most are simply antihistamines in sheep’s clothing. Over-the-counter sleep aids work differently from prescription drugs for insomnia. Companies marketing the herb valerian root and the hormone melatonin as over-the-counter sleep aids make similar claims.īut what’s the evidence that supports these claims? “It’s quite lean,” says Andrew Krystal, who directs the sleep research program at Duke University.Īnother reason why sleep aids don’t work: Insomnia is not just a nighttime phenomenon. The way they’re marketed, over-the-counter sleep aids sound very appealing: The new product ZzzQuil (yes, from the maker of NyQuil) promises “ a beautiful night’s sleep ” an ad says you’ll “ fall asleep faster and stay asleep longer” after using Unisom.
Indeed, 10 to 20 percent of Americans take over-the-counter sleep aids each year, according to the American Academy of Sleep Medicine. If insomnia visited me that often, I’d be tempted to pick up something at the pharmacy - something easy, something safe, something that didn’t involve making a doctor’s appointment. Thirty-three percent said they had experienced symptoms almost every night. In a 2005 survey of 1,506 Americans by the National Sleep Foundation, 54 percent reported at least one symptom of insomnia - difficulty falling asleep, waking a lot during the night, waking up too early or waking up feeling unrefreshed - at least a few nights a week over the previous year. I know the feeling - as do many other Americans. Every morning I am greeted by Facebook friends complaining of sleepless nights or awakenings.
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