What you should know before taking sleeping pills, supplements
September 3, 2026
By Renee Yan
A good night’s rest is often considered a panacea that brings a host of health benefits – from a stronger immune system and improved cognition to better stress and weight management. Quality sleep time can also lower your risk of heart disease and stroke.
Despite that, an estimated 50 million to 70 million Americans struggle with sleep or wakefulness disorders. It’s led many of them to search for remedies such as sleeping pills or supplements. In fact, about 13% of adults in the U.S. reported using sleep aids most days or every day over a period of 30 days in 2024.
And a casual glimpse of store shelves or online browsing will present you with a slew of choices – smartly labeled bottles promising hours of uninterrupted slumber. The flood of options begs a few questions: How do these pills work? Are they safe? And how often should you use them?
Safia Khan, M.D., Associate Professor of Family and Community Medicine and Neurology at UT Southwestern Medical Center specializes in sleep disorders and offers some guidance for patients who are hoping for better sleep. To start, she said, it’s generally safe to use sleep aids, but they shouldn’t be taken every day or without caution.
“Ideally, they should be taken as needed,” Dr. Khan said. “If you find yourself needing something every night, that’s your first clue you should speak with your primary care physician or ask about a sleep medicine expert.”
Here are a few things you should consider if you’re in need of a restful night’s sleep.
Common ingredients and OTC drugs for sleep
There’s no shortage of options when it comes to sleep aids, and it can be hard to decipher what differentiates one from another. For clarification, sleeping pills are medicines that help induce sleep, while supplements are non-regulated products said to promote relaxation and regulate your internal clock, making it easier to fall or stay asleep.
There are several commonly used ingredients or over-the-counter products you might find helpful:
- Melatonin is a hormone that helps regulate the body’s internal biological clock, including its sleep-wake cycle. Melatonin production and release ramps up in response to darkness and declines when the light is out. “It takes about an hour from the time that you turn off bright lights and electronics to when your brain begins to produce melatonin,” Dr. Khan said. “Melatonin is often the go-to recommendation for its safety profile.”
- Magnesium, an important mineral that functions in multiple ways throughout the body, promotes sleep by helping with muscle relaxation. “It is particularly useful for people who suffer from restless leg syndrome or muscle cramps,” Dr. Khan said. “However, taking too much can lead to diarrhea because of the way it draws water from the gastrointestinal tract and how it’s absorbed.”
- Gamma-aminobutyric acid (GABA) is an amino acid and neurotransmitter that inhibits certain brain activities, making it easier to fall asleep. Many prescription sleep medications target GABA receptors to stimulate the same effect, and some supplements list GABA among their ingredients.
- L-theanine, an amino acid found in tea leaves and certain supplements, has a calming effect that promotes relaxation. However, better data and rigorous studies are needed to determine its effect on sleep.
- Zinc is a mineral that indirectly affects sleep. “It helps with the production of melatonin,” Dr. Khan explained. “But like magnesium, it’s known to cause diarrhea as a gastrointestinal side effect. That’s why some people who suffer from constipation may also take these supplements.”
- Antihistamines, including doxylamine and diphenhydramine, are used to treat allergies. Because drowsiness is a common side effect, some might use them off-label as a sleeping aid. “But taking antihistamines can interfere with daytime alertness, and some patients describe it as a hangover effect,” Dr. Khan explained. “Antihistamines can also dry up your mucosal lining and cause constipation.”
- Valerian root is an herbal remedy extracted from the Valeriana officinalis plant native to Europe and Asia. It is generally considered safe to use although studies show its efficacy as a sleep aid varies. “Valerian and other herbal remedies like lavender and chamomile don’t directly affect your sleep, but they contain agents that promote relaxation, which makes it easier to fall asleep,” Dr. Khan explained.
Caution when using supplements
Supplements are not held to the same safety standards of the Food and Drug Administration (FDA) as medicine, and their results may vary. What’s more, with the growing popularity of cannabidiol (CBD) products and marketing claims touting their sleep benefits, it’s important to remember that federal law deems it illegal to add CBD to food or label it as a dietary supplement.
“Overall, many of the known sleep aids you find in the store today are considered safe, but I would advise patients to start with a lower dose in the beginning – maybe 2.5 or 3 milligrams each time – as a trial to see how it affects them,” Dr. Khan said. “Try that for a week or two as needed, and if you don’t experience any adverse effects, you may consider upping that dose to 5 milligrams if necessary.”
The script for sleep
In certain cases doctors may order a prescription for insomnia, which can offer a quick but also temporary fix. In 2024, the Centers for Disease Control and Prevention estimated that 5.2% of adults reported using prescription medications to help them fall or stay asleep. Some of the most used options belong to one of the main drug classes:
- Benzodiazepines work by enhancing the activity of GABA in the central nervous system and slowing brain activity. They are also prescribed for seizure disorders. Because of the risk of chemical dependence, potential cognitive dysfunction, and respiratory depression, benzodiazepines are only approved for short-term use.
- Z-drugs are nonbenzodiazepine sedatives so named because many of them begin or include the letter “z”. They also work by targeting GABA receptors and calming brain activity. However, they may cause altered mental status and abnormal sleep behaviors, such as sleepwalking or eating while not fully awake.
- Orexin receptor antagonists work by blocking the effects of orexin, a brain chemical that helps you stay awake and keeps you from falling asleep. Common side effects include dizziness and headaches.
- Melatonin receptor agonists mimic the effects of the body’s natural sleep hormone, but they may also cause headache, dizziness, and daytime drowsiness.
- Doctors might prescribe a low-dose antidepressant such as trazodone or doxepin off-label for its sedative effect. These are safe and non-addictive though some patients report morning grogginess, dry mouth, and thirst as potential side effects.
Notes on mixing medications and on moms-to-be
If you’re taking multiple medications or supplements, there is a chance of risky interactions. Magnesium can interfere with how other drugs are absorbed in the gastrointestinal tract. Melatonin, taken with blood thinners, may increase the risk of bleeding. And drinking alcohol or using valerian while taking sedatives such as benzodiazepines could lead to an overdose and impaired cognition and coordination. Not to mention, drinking can also reduce the effect of antidepressants.
“Because of all of these and countless other possible drug interactions, it’s best to check with your primary care physician before you decide to take anything,” Dr. Khan advised.
For pregnant people, the dilemma is just as tricky. Anything the mother drinks or eats affects the baby.
“For some of these supplements, there’s not enough data to guarantee their effects on pregnancy, and we try to avoid prescribing medications unless it’s medically necessary, especially in the first trimester,” Dr. Khan said.
Some evidence suggests melatonin is likely safe for pregnant people, but there’s still a need for comprehensive research. It’s recommended that patients consult their doctors before taking anything.
Best recommendations for insomnia
When patients seek help for insomnia, Dr. Khan said her first priority is to get a detailed personal medical history, including when symptoms began as well as recent habits or changes to routine.
“Usually it’s a stressful event that triggers insomnia: a death of a loved one, a loss of a job, or a move to a new city. That’s important to understand its impact on your physical and mental health,” she explained. “Talking to a therapist can help you process and regulate your emotional response, and research shows that cognitive behavioral therapy combined with medication therapy is the most effective approach.”
Keep a sleep diary
Information to track:
* Time you fall asleep
* Time you wake up
* Times you get up in the middle of the night
* Bedtime routines
* Medications
Dr. Khan also recommends keeping a sleep diary, including details of the approximate time you fall asleep, when you wake up, how frequently you get up in the middle of the night, your bedtime routines, and a list of any medications you use. All of this information goes toward painting a clearer picture and helping to identify what might get in the way of good sleep.
Another tip is to avoid taking sleep aids during or right before what’s known as “the forbidden zone of sleep,” which is typically one to four hours before bedtime when you are most alert. Taking a sleep aid during this period may render it ineffective. Instead, take it about an hour or 30 minutes before you sleep.
“Of course, there are other habits you can adopt if you’re really committed to improving your sleep,” Dr. Khan added. “Keep your screens out of the bedroom, wind down with relaxing activities, avoid big meals before bed, and the best nonpharmacological intervention I can recommend – exercising regularly during the day. Research shows exercise can regulate the body’s sleep-wake cycle and improve the quality of sleep.”
At UT Southwestern’s University Hospital Sleep and Breathing Disorders Clinic, physicians work with patients to identify habits that perpetuate insomnia and ways to address them. The clinic also evaluates patients for sleep apnea with on-site or at-home sleep studies.
“If you’ve been relying on sedatives or supplements for a long time, we can work with you to wean you off them if that’s an appropriate solution,” Dr. Khan added. “You may experience some sleep fragmentation as you go off them, but that’s to be expected. Having trouble sleeping is also a natural part of aging. It’s about understanding when that sleep fragmentation is normal versus abnormal.”
To make an appointment to talk with a provider, call 214-645-3900 or request an appointment online.
