Journal of Sleep Disorders & Therapy
Open Access

Widely Used, Rarely Studied-the Over-the-Counter Sleep Aids.

Kathy Sexton-Radek Ph.D

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Editor Note

It is estimated that the some 18% of the population have taken anover-the-counter (OTC) sleep aid with some 41% using OTC sleep aidsfor more than one year [1].While the Federal Drug Administrationrecognizes OTC Insomnia drugs of Benadryl (diphenhydramine) andUnisom (doxylamine), the marketing of other products fill pharmacyshelfs and offerings from online mailings [2]. Insomnia has beenreported in some 30% of the general population based on large scale survey studies (Sleep In America Polls).Thus, the high need for atreatment to address the poor sleep quality of Insomnia is eminent.Measurements of OTC use of Sleep aids are survey are restricted to there porting’s of the usage but not the reasons and ways in which the OTC sleep aids are used. Further, the measurement of possible complicating factors such as interaction effects with other medicinesthe patient is taking, the effectiveness of the OTC counter sleep aid, the after effects of the OTC sleep aids, and habit forming behaviours arereduced to reporting’s rather than measurement.

Insomnia, by its nature, places a person in a diminished capacity to make decisions as the sleepiness subtracts attention, concentration and cognitive abilities. This perhaps, may be why decisions to take a little known and perhaps complicating substance for their sleeplessness maybe being made. However, this is why the Health Care Professional specializing in Sleep medicine needs to intervene. The assessment of all substances that they are taking, including OTC sleep aids, is necessary.It is an as much a part of the clinical picture of the patient as any other aspect about their demographic history. While little is known about the additive elements (both physiologically and psychologically) of OTC sleep aids, the frequency of usage increases.

The complicating factor of poorly researched substances places apatient at risk. More study of the usage patterns is needed, particularly since 41% are estimated to take not take the OTC sleep aid asdirected1.The interference with other medications the patient may be taking as prescribed, their nutritional health and presence of disease are necessary to assess. With the usage of OTC sleep aids the next day effects of sleepiness, dizziness, confusion and impaired balance are often reported1 but not studied. Further, it is uncertain which populations of patients are taking the OTC sleep aids. Recent reporting’s have identified the overuse of OTC sleep aids in the elderlyin reporting’s of studies linking OTC sleep aid use and dementia. These impactful findings need to be studied further and more rigorously.Variable such as tolerance and sensitivity to OTC sleep aids is unknown and such factors strongly determine patient reactions to substances.

Work to address these areas is to be multi component.Standardization of interview formats to include OTC (including sleepaids) usage patterns is necessary. Investigations in terms of pharmacology of the OTC sleep aid use that interactions with other medications and the classification of tolerance, sensitivity, addictive components of OTC sleep aids is necessary. The FDA specifies Sleep Disorder Information for prescribers, however, reporting of patient behaviours indicates alternative actions to those prescribed, measureand researched medications. At minimum, some universal evaluation methods of patient usage patterns and further study for patient safety is essential.

References

1. Thompson D (2016) Many misuse over-the-counter sleep aids.
2. FDA (2013) Sleep Disorder (Sedative-Hypnotic) Drug Information.

References