Is taking a generic OTC sleep aid long term a bad idea?

In My Humble Opinion
1

Over the past six months I’ve been waking up during the night. This has nothing to do with having to go to the bathroom, and I have no problem falling asleep. About every two hours I’ve been waking up for about 15-20 minutes, and then finally falling back to sleep, only to repeat the process two hours later.

I’ve always been a good sleeper, but I’m 69 years old and it’s normal to need less sleep than when you were younger. The problem is I wake up at the same time every morning, so staying up later so that I’m more tired just means less sleep. I was getting 6 hours of sleep instead of a full 8 hours, and that meant I woke up tired. I started taking 5 mg of Melatonin before bed, but it didn’t help me to stay asleep through the night.

I recently researched OTC sleep aids and decided that something with Doxylamine Succinate was one of the safest, so I tried a generic 25 mg tablet. All I can say is WOW! Now I remember how I used to feel when I woke up in the morning. It knocks me out for almost the entire night, and I get 8-9 hours of good quality sleep.

Since I know there is no such thing as a free lunch, there must be some downside to taking Doxylamine Succinate I haven’t found yet. I read something about a possible link to Alzheimer Disease, which has me worried since AD runs in my family. I left a message for my doctor to see what he thinks, but I figured I’d throw it out to the masses. Is taking 25 mg Doxylamine Succinate nightly a bad idea?

2

Nightly? Beyond the advised usage instructions? I’d say Yes!

Let’s be clear, no, unless you have an unusual reaction, there’s little to no harm taking as advised, which is generally one dose daily, up to around a week. And I use the stuff to break cycles where I start falling asleep later and later and so forth. But never for more than 3 days.

But daily? For an extended length of time? I mean, it’s an Antihistamine, even with the regular dose, an extra glass of water before bed and an extra when I get up, I’ll be a touch groggy the morning after. I can’t image how bad it would get after a week.

Now of course, you may not, at 69 have anything you have to do the next morning, so that might be a worthwhile trade off. But I’d still suggest taking it per the on-label instructions. I wouldn’t be surprised that with a couple days usage to break the wakening cycle, you might be able to get more restful sleep.

The other reason to be careful is it might mask another, possibly more serious issue that’s causing the waking? Obstructed breathing, apnea, or any number of other issues could be causing the waking. And some of those may be made worse or more dangerous by drugging your way around them.

Still, I, and most parties (IANAD) consider them generally safe. But until you have a good handle on why the issue started, use as directed, and maybe consider a sleep study.

3

You may build up a tolerance to it if you use it all the time. If you take it once a week, it may work like this each time you take it. But if you take it every night, your body might eventually adapt to the drug and it might not produce the same drowsy effect. And you could build up a psychological dependency to it if you get too dependent on it. Even if it doesn’t produce a chemical dependency, you could feel anxious if you try to fall asleep without taking it. Even if you get great results with it, it’s probably best to just use it intermittently when you really need to get a full night’s sleep.

4

Thanks for the replies. I am retired, although I do work part-time two days a week, so I could just take it the night before my workdays to make sure I get a good night’s sleep, but that means that 5 out of 7 night I will have crappy sleep, which means feeling tired and cranky in the morning. I don’t want to take it every night, but I don’t want to feel crappy due to lack of sleep any day if I can avoid it.

I exercise regularly, and don’t suffer from sleep apnea, at least according to my wife. I do snore sometimes. I could try taking it every other night instead of nightly, and perhaps get down to 3-4 nights a week, but I guess I need to wait to hear from my doctor. As an aside, my wife takes two Benadryl every night to help her sleep, and has been doing so for the past 10 years. Her doctor knows she is taking it and doesn’t see it as a problem. BTW, her doctor is also my doctor. We live in a small town.

5

Seriously, I sympathize. I often sleep poorly, which is one of the reasons I use it. And I do have problems with waking up and failing to go back to sleep, but normally my biggest issue is the falling asleep part, so we differ in terms of priorities.

But so glad you’re taking this step. For that matter, it’s always good for your physician to know what OTC meds you’re taking regularly anyway, just in case they or a later specialist may need you to take something for a different condition, so any interactions are taken into account beforehand.

6

Does it make sense that only taking it periodically will somehow improve my overall sleep? Does taking one tablet help for more than one night? I assume that you take it nightly because you have to start the process over each night. Please correct me if I have that wrong, and if taking it every third night, for example, would be just as effective as taking it daily.

7

Happy to clarify.

So, in general, I have a tendency to stay up late. Normally though, I get in bed early enough to futz around long enough to fall asleep to get 7-8 hours of sleep, which is adequate, although not ideal.

But every once in a while (and OFTEN around transitional periods such as going on holidays, changing a work schedule, or Daylight Saving Time) it’ll keep drifting later, 15 minutes, then 30, then 45, which leads to sleep anxiety (I can’t fall asleep!) which makes the problems worse.

So after years of this, I started using OTC sleep aids as soon as the problem has gone on for more than 3 days (so generally when I’m at risk of losing a full hour of sleep). Normally, two days of taking the OTC sleep aid and getting a solid 8+ hours of sleep not only resets the sleep schedule, but having been rested, kills the sleep anxiety.

On the other hand, I have an IRL friend who has SERIOUS anxiety issues, which make me look like a frikkin’ rock by comparison. They too used OTC (at my advice), but as they got older, the OTC options were less efficacious, or the anxiety got worse. So they have prescription sleep and anxiety meds. Which, in their words, works like a light switch. No delays futzing around after taking one - you have X minutes and then you better be in bed. And he says when he takes them, it’s the most restful sleep he has ever had, waking up fully rested and with none of the grogginess / medicine head I associate with doxxy and other OTC options.

Of course, it’s prescription only and can be habit forming, so, different risks.

As for it working on an intermittent basis, it almost certainly depends on why your sleeping patterns changed. It could be something as simple as your mattress slowly giving out and not being able to get fully comfy again when you’re no longer as tired. It could be a medical issue. It could be something as (speaking from experience this time) a bedside fan starting to fail and spinning up/down at semi-regular intervals startling you awake.

Not being able to fall back to sleep, especially when you are as tired as described is another issue to identify. For me, it was a combination of anxiety (I only have x hours to fall back asleep before I have to get up for work) and the brain spinning up to being fully awake too quickly - which is still a problem for me.

One last thing that was suggested back when I was figuring out options was to (assuming your residence allows) try to fall asleep in a different bed, in a different room, and see if it made a difference. This is why I mention things like bed fans, sleep partners, and mattress quality. You can eliminate possible causes, but of course, you’re exposed to others.

OTC options are quick, reasonably cheap, and easy. If they work as described they’re great for a short term use. But if it is required all the time, likely something else is going on which ideally should be addressed. If nothing else, because while the cost is minimal, there’s always a risk that you’ll have a harder time getting up and responding if there’s a nighttime emergency.

8

Thank for your the sound advice. In my case it’s as much about quality as duration. Imagine waking up every 15 minutes throughout the night for only a minute or two. You would be exhausted in the morning even though you got “plenty” of sleep. Taking the OTC med insures I have good quality sleep, and that’s what counts as far as I’m concerned.

Like I mentioned before, I’ve always been a good sleeper, but now I’m waking up 4-5 times a night for no apparently reason. Maybe the dog jumped off the bed, maybe my wife snorted loudly, or maybe a large truck drove by, who knows. In the past I would either sleep through it or fall back to sleep so quickly I didn’t notice it. Now I lie awake for 15 minutes hoping to fall back to sleep, which I eventually do. With the OTC meds I either don’t wake up, or don’t remember waking up, and when I do finally get up I feel completely refreshed. If I could achieve that without having to take anything, like I used to be able to, life would be good. So far, I haven’t found a way to go back to before I started having these issues. I’ll let you know what my doctor thinks. I trust him.

9

OP: Do you drink alcohol?

One of the consequences of that is lighter sleep. You spend less or no time in deep sleep and what would otherwise be you rising up to the lightest level of sleep instead causes you to “surface” all the way to wakefulness.

The problem seems to get worse as we get older. So one drink with dinner that used to be no problem might now be a significant problem.

10

Not a drop. I was on Keto for 4 months earlier this year and got out of the habit of a glass of red wine or two, or a beer with dinner most nights, and I haven’t had any alcohol since. The fact that I usually wake up every few hours, at almost the exact same time every night, tells me it has something to do with my sleep cycle being interrupted by something. Perhaps a sleep study would be money well spent.

11

If it’s “always” the same clock time, but not the same time interval versus whenever you went to bed that night, I’d bet on an outside event. Like at 3am the streetsweeper goes by. Or that jerk with the loud motorcycle who closes down the bar every night.

12

I take different kinds. And not every night. For instance I take a Tryptophane supplement (it’s what’s in Turkey).

Some claim the drowsiness effect is an old wives tale, but it works for me. It does not knock me out, just kind of relaxes me.

I’ll also take ‘Calms’ another supplement (not at the same time) I don’t know what’s in those, but again it just sort of relaxes you a little. IMHO it’s best to mix it up a little bit so you’re not taking the same thing over and over and over again.

13

Thanks for the advice. I sometimes take tryptophan, and like you, it helps me fall asleep, but not stay asleep. As mentioned, I take melatonin, and it also helps me fall asleep, so I alternate between the two if I’m not sleepy at bedtime, which is rare. If there was a non habit-forming supplement that actually helped me stay asleep I would try it. Cost is no object, so any suggestions are welcome.

I don’t like the idea of taking doxylamine succinate nightly, and I stopped it until I hear back from my doctor, but it’s one of two things that guarantees me a good night’s sleep. The other is Costco’s brand of Tylenol PM, which contains diphenhydramine HCL as its sleep agent. Of course it has acetaminophen in it which is not good for your liver long term.

I know there are prescription meds you can get that will do the trick, but I really don’t want to knock myself out that way. I should hear from my doctor either Monday or Tuesday.

14

This is available as a standalone antihistamine. It’s most commonly known as Benadryl and is widely available as generic. You can use that if you don’t want the acetaminophen.

One thing you could do is take a Benadryl or Doxylamine Succinate pill when you wake up at night rather than before you go to bed. If you wake up at 2 am and feel that you might need help staying asleep, then take one at that time. I do that with Benadryl. If I wake up in the middle of the night and want to make sure I stay asleep till morning, I’ll take a single Benadryl. I usually sleep great for the rest of the night.

For years now, I’ve been waking up in the middle of the night. At first I’d have a lot of trouble going back to sleep, but it’s a lot better now. I still wake up pretty much every night, but I’m able to get back to sleep or rest in bed and feel good in the morning. Here’s some things I’ve learned. One is that just resting and being relaxed in bed can allow me to feel refreshed in the morning. Rather than worrying that I have to get back to sleep in order to feel good during the day, I just allow myself to be relaxed and not worry about being asleep. Another thing is that your perception of time when you are sleepy is not very good. I used to think I would be lying in bed awake for 3-4 hours after I woke up. Eventually I realized that I was actually slipping in and out of sleep during that time. The conscious part of my brain that keeps time was not aware of the time I spent sleeping, so it though it was awake the whole time. But I was actually in a sleep cycle and was getting good sleep even though I didn’t realize it. Now I only take a sleep aid if I have some pressing need the next day and I have to be sure I get a good night’s sleep. If you can try to maintain a relaxed mindset about your sleep, it can help you sleep better and make you need the sleep aids less.

15

I have dogs that need to be let out. They like to go out and bark at 2am. To let me know I get 50lbs of Border Collie on the bed and in my face. Happens about twice a night. So I guess they have trouble sleeping too.

It bugs me, but really they are doing their jobs. They hear something, they want to check it out. They have a doggie door, but we block them from it at night, cause they will just bark. I might have to change that and just let them have free range. When let out they have a 3000 sq ft 6’ tall fenced yard.

And, of course they get long walks. VERY high energy dogs. And Border Collies are bred such that need a job. Their job is to alert us to anything they don’t like. That’s a good thing, and protection for all. I don’t want to keep them from doing it.

16

I hadn’t considered this since I figured it would make be groggy in the morning, which I was trying to avoid, but I’ll try it.

Interesting idea, and well worth a try. I get anxious if I can’t go back to sleep, and this might help relieve that anxiety when I don’t readily fall back to sleep.

This sounds like it works for you, but may not work for me, but it’s worth a try. Thanks for your thoughts.

17

I have a Parson Russell Terrier (PRT) that naps throughout the day, and often wanders around the house at night, sometimes jumping on the bed, which wakes myself, but not my wife. If I’m not deeply asleep, I hear him walking around, going out the doggy door, and coming back in. I’m sure he does this almost every night, but if I am deep asleep I won’t hear it. However, I always feel him jumping on the bed, and it takes him a while to settle down and go back to sleep. I know that doesn’t help things, but there’s not much I can do about it. If I locked him out of the bedroom he would whine to come back in at night, which wouldn’t be much better.

The same is true for the PRT. I walk my dog at least 5 miles a day to wear him out. He’s 12-years-old, and you’d think he would be tired at night, but as I say, he naps during the day and gets plenty of sleep at night. Once he settles down, though, he’ll sleep for quite awhile.

18

Diphenhydramine has a half-life of 3.4 to 9.2hours. The drug’s time to peak, serum is 2 hours.

So, it tends to ‘max out’ in the bloodstream in 2hrs, and – depending on the person – tends to drop half its concentration in the bloodstream in that 3.4 to 9.2 hour range.

Meaning: if you’re going to take it in the middle of the night because you woke up … do it when nothing urgent awaits you four hours later … just in case. It’s good to find out how long it seems to stick around in your body.

And, JFTR,

Following oral administration of a single 25 mg dose of doxylamine succinate in healthy adults, mean peak plasma concentrations of about 100 ng/mL occur within 2- 3 hours after administration. The drug has an elimination half-life of about 10 hours in healthy adults.

SOURCE - 4pp PDF

19

If it is noise waking you, have you tried playing white noise of some kind in the bedroom? You’ll probably need your wife’s permission.
I can’t find the one I use, but here are some rain sounds:

20

Yes, and now you mention it I think it helps, at least until the dog jumps on the bed. I will try to get in the habit of playing it nightly, instead of just when I remember to, and see if that helps. Fortunately, my wife is fine with my playing white noise as long as I stick to “rain” and “waves lapping on the beach” sounds, which is fine with me.

And just so everyone knows, my dog has four different beds he sleeps in around the house, not to mention the living room couch which has a blanket on it he likes to sleep on. His favorite bed is in our bedroom closet and I often find him there in the morning when I wake up, assuming he hasn’t crawled under our bed covers because he’s cold.