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Sleep Aid↕ | Type↕ | Mechanism↕ | Evidence Strength↕ | Key Risks↕ | Known For↕ |
|---|---|---|---|---|---|
Melatonin | Hormone supplement | Signals darkness to circadian system | Moderate (especially jet lag) | Grogginess, vivid dreams | Most popular OTC sleep supplement; more effective for sleep timing than insomnia |
Magnesium Glycinate | Mineral supplement | NMDA and GABA modulation | Limited but popular | Loose stools at high doses | Popular for relaxation and leg cramps; glycinate form best absorbed |
Ashwagandha | Adaptogenic herb | Reduces cortisol, anxiolytic | Moderate | GI upset, thyroid interaction | Ayurvedic adaptogen; KSM-66 extract most studied |
Valerian Root | Herbal supplement | GABA modulation | Mixed | Pungent smell, daytime sleepiness | Traditional European sleep herb since ancient Greece |
Chamomile | Herbal tea | Apigenin binds benzodiazepine receptors | Weak | Ragweed allergy cross-reaction | Gentle bedtime tea ritual; soothing placebo or mild anxiolytic |
L-Theanine | Amino acid | Increases alpha brain waves | Moderate for relaxation | Minimal | Green tea amino; promotes calm without sedation |
Diphenhydramine (Benadryl, ZzzQuil) | OTC antihistamine | H1 histamine blockade | Short-term effective, long-term problems | Next-day grogginess, dementia risk in elderly | Active ingredient in ZzzQuil and Tylenol PM; not recommended for chronic use |
Doxylamine (Unisom) | OTC antihistamine | H1 histamine blockade | Short-term effective | Next-day grogginess, anticholinergic effects | Unisom SleepTabs; also used for morning sickness in pregnancy |
Zolpidem (Ambien) | Z-drug hypnotic | Selective GABA-A modulation | Strong short-term | Parasomnias, dependence, sleep driving | Most prescribed sleep drug in US; sleep-walking and sleep-eating incidents |
Eszopiclone (Lunesta) | Z-drug hypnotic | GABA-A modulation | Strong | Metallic taste, dependence | Only Z-drug approved for long-term use; distinctive aftertaste |
Trazodone | Antidepressant (off-label) | Serotonin 5-HT2A antagonism | Moderate | Priapism (rare), orthostatic hypotension | Most common off-label sleep prescription; non-addictive alternative to Ambien |
Suvorexant (Belsomra) | Orexin receptor antagonist | Blocks wakefulness signaling | Strong | Next-day drowsiness, vivid dreams | Newer mechanism; targets wakefulness rather than forcing sedation |
CBT-I (Cognitive Behavioral Therapy for Insomnia) | Behavioral therapy | Sleep restriction, stimulus control, cognitive restructuring | Very strong | None; initially increased sleepiness | First-line treatment per AASM guidelines; more durable than drugs |
Ramelteon (Rozerem) | Melatonin receptor agonist | MT1/MT2 receptor agonist | Moderate | Dizziness, headache | Non-scheduled, non-addictive; prescription strength melatonin mechanism |
CBD (Cannabidiol) | Cannabinoid | Endocannabinoid modulation | Limited | Drug interactions, variable purity | Exploding wellness category; evidence for sleep weaker than marketing |
Weighted Blanket | Deep pressure stimulation | Calms autonomic nervous system | Limited but positive | None (except overheating) | Popular anxiety and sleep tool; 10-12 percent of body weight guideline |
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