OTC options: help for the sleepless - over-the-counter sleep aids - includes related articles on doxylamine and sleep techniques - Part 1 - Cover Story

FDA Consumer, Sept, 1994 by Marian Segal

Read the Label

Consumers can find out what ingredients are in an OTC drug product by reading the label. Unisom contains doxylamine succinate, for example, while Nytol contains diphenhydramine HCl. Some products, such as Sominex Pain Relief Formula and Bufferin AF Nite Time contain an analgesic for pain relief as well as an antihistamine. You may find that one works better for you than another. Because of the different product ingredients, the label warnings and directions for use vary.

Most OTC sleep-aid product labels caution patients with certain conditions to check with a doctor before taking the product. Such conditions include shortness of breath, asthma, emphysema, chronic pulmonary disease, glaucoma, and difficulty urinating due to enlarged prostate gland. The labels also warn against taking the product along with alcohol or other central nervous system depressants, such as sedatives or tranquilizers, because they heighten the depressant effect.

(Recently approved revisions in wording will appear on all labels by April 11, 1995: The words "breathing problems" will be used to describe shortness of breath and difficulty breathing related to obstructive pulmonary disease; "chronic bronchitis" will replace "chronic pulmonary disease"; and the word "asthma" will be removed. These changes will help consumers recognize respiratory distress symptoms more readily.)

Sleep-aids that contain aspirin must carry a warning to consult a doctor about Reye syndrome before giving the product to children and teenagers who have chickenpox or flu symptoms. Reye syndrome is a rare but serious disease that has been associated with use of aspirin in children with these conditions. This warning may also appear on products containing other salicylates. These drugs should not be given to children under 12, and they should not be used for more than two weeks unless under a doctor's direction. Pregnant and nursing women should check with a doctor before taking these products.

OTC nighttime sleep-aids can provide welcome relief from a night of wide-eyed wakefulness. OTC status does not, however, guarantee the product is hazard-free. Just like prescription drugs, OTC drug products must be used with care.

"The bottom line for all OTC drug products," says FDA's Benson, "is to read the label and follow the instructions."

(For more on insomnia, see "Why Aren't You Asleep Yet? A Bedtime Story" in the October 1989 FDA Consumer. Also, write to the American Sleep Disorders Association, 1610 14th St., N. W., Rochester, MN 55901.)

Tricks for the Tired

If you're having trouble sleeping, you may want to try modifying some behaviors that might be keeping you awake. The American Sleep Disorders Association suggests one or more of the following practices might help:

* Get up about the same time every day, regardless of when you go to bed.

* Go to bed only when sleepy.

* Establish relaxing pre-sleep rituals, such as a warm bath, light bedtime snack, reading, or watching television.

* Exercise regularly. Get vigorous exercise--such as jogging or squash--in the late afternoon, and mild exercise--such as simple stretching or walking--two or three hours before bedtime.