Should I take supplements to help me sleep? A doctor explains

(CNN) — It’s long established that sleep plays a crucial role in health and well-being. Numerous studies have documented the relationship between health and the quantity and quality of people’s sleep. Anyone who has had a poor night of rest can attest to how they had less energy and were grumpier the next day.

Some 18% of American adults take a form of medication to help them sleep, including over-the-counter pills and prescription medications, according to a 2023 US Centers for Disease Control and Prevention report. Some 6.3% said that they take sleep medications every day and 2.1% took medication most days.

While medical treatments can help with sleep, are some forms more effective than others? Is there any danger in trying over-the-counter supplements such as melatonin? What about a recent social media sensation, “the sleepy girl mocktail”? What are nonpharmaceutical measures that can help with sleep? And why is it important to seek medical care for sleeplessness?

To help us with these questions, I spoke with CNN wellness expert Dr.
Leana Wen. Dr. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

CNN: How do we know that sleep is important for your health?

Dr. Leana Wen: The evidence is robust. For instance, studies have shown that people who regularly get fewer than seven hours of sleep per night have a higher prevalence of diabetes, obesity and high blood pressure, which are major risk factors for developing heart attacks and stroke. People with irregular sleep patterns also may have a higher risk for cardiovascular disease.

Sleep deficiency may impact immune system functioning and increase your chance of contracting diseases. In addition, lack of sleep can impair learning, problem-solving, decision-making and controlling emotion. And daytime drowsiness can be dangerous; it increases motor vehicle accidents and work-related injuries.

CNN: What kinds of medical treatments can help with sleep?

Wen: The US Food and Drug Administration has a list of medications, both prescription and over the counter, that are approved to treat sleeplessness and insomnia.

It’s important to note that many come with significant side effects, such as grogginess the next day, sleepwalking, confusion and dizziness. Some could be habit-forming and are not meant to be used long-term. Many have interactions with other medications. Anyone considering these treatments should speak with their physicians before starting them.

CNN: Are over-the-counter medications safer than prescription medications?

Wen: Not necessarily. For instance, some people take antihistamines like Benadryl to help them sleep. Antihistamines could cause dangerous overdoses if taken in large amounts or mixed with other drugs or alcohol. These medications also can cause sedation and impair someone’s function the next day. All this is to say, just because something is over the counter doesn’t mean that it’s safe in all instances.

CNN: What about melatonin? What is it, and does it work to help with sleep?

Wen: Melatonin is a hormone that the brain produces in response to darkness. It helps with regulating our circadian rhythm — our internal clock — and therefore is an important hormone for sleep.

Melatonin supplements are lab-made versions of this hormone. There is some evidence that melatonin supplements can help with jet lag. They may also assist shift-workers and people who have trouble falling asleep at a normal time at night. The research is mixed as to whether the supplements are useful for people with chronic sleep problems.

One issue to consider is that melatonin is a supplement and is not regulated by the FDA in the same way prescription medications are. The dose and purity can vary between brands. The same guidance applies for other supplements people may try as sleep aids. People should approach melatonin and other supplements with caution and, as with other over-the-counter drugs, discuss usage first with their primary care provider.

CNN: Which medications are more effective than others?

Wen: That depends on the individual. Just as with any other health condition, some people may respond best to one type of treatment and others to another.

Taking a step back, I think it’s essential for everyone considering a medication for sleep to first contact their health care provider. You should have an assessment to figure out what the cause of your sleep deficiency is.

Perhaps it’s a matter of simply not getting enough sleep. That’s different than if you are unable to fall asleep once you are in bed. In addition, some people are able to fall asleep but then awaken in the middle in the night.

Your provider may evaluate other aspects of your life. Drinking alcohol, for instance, may help some people feel like they can fall asleep faster but can actually increase nighttime awakening and reduce sleep quality. Certain medications could be stimulants and could be affecting your sleep. Perhaps you have an undiagnosed medical condition, such as sleep apnea or restless leg syndrome, which is waking you up. It’s important to get this evaluation done to find the root of the problem before starting medications.

CNN: There’s been a lot of chatter over TikTok and other social platforms about the “the sleepy girl mocktail.” What can you tell us about this trend and whether it is safe to try?

Wen: I had not heard of this, but you’re right — it is all over the internet. This is a recipe for a half of cup of tart cherry juice mixed in with a scoop of magnesium powder, topped off with soda water or prebiotic soda.

I think tart cherry juice was probably selected because it naturally contains some melatonin. It’s a small amount, but perhaps can have some impact on promoting sleep. Magnesium is a mineral that some studies suggest can help with relaxation and sleep. The soda water or prebiotic soda is probably for taste.

I’m not sure this concoction meets an evidence-based standard for treating sleeplessness, but it seems pretty safe, as long as the products are purchased from reputable places. Some people may be responding to it because of a placebo effect, but to that, I say, why not? If it helps someone achieve better sleep, and there isn’t harm, then they should keep it up.

CNN: What are other nonpharmaceutical measures that can help with sleep?

Wen: This is a key question and goes back to the issue of why someone is having sleep problems. Many people struggle because they don’t have enough time in bed, which is a first important component to good sleep. If the ideal sleep duration is at least seven hours a night, then try to allocate for at least eight hours in bed.

It’s best to aim to go to bed at around the same time every day, including on weekends. Avoid naps if possible. Sleep environment also matters. It’s best to slumber in a cool, quiet and dark place. Screens interfere with sleep, so try to avoid looking at your cell phone or watching TV right before bed.

Finally, there are other nonpharmaceutical measures, such as increased physical activity, yoga and acupuncture, that can help some people. Make sure to speak with your provider to diagnose any other issues and then try out different methods, in consultation with your provider, to see what works best for you.

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