To Sleep: Perchance To Take Lots of Pills
Testing over-the-counter sleep aids, herbal and non.
In my role as a Slate shopper, I have made many curious purchases. I've grown accustomed to questioning looks as the checkout guy rings up 30 toothpastes, or 28 toothbrushes, or 15 cases of beer ... OK, the beer wasn't for a story. Still, I was bracing for the most questioning checkout look of all as I approached a drugstore counter holding seven boxes of sleeping pills. I thought the kid at the register might refuse the sale, or refer me to a psych ward, or at least call over the manager. As it was, he never even blinked. Which is good, because now I can tell you all about over-the-counter sleep aids.
When it comes to OTC pills, you're basically looking at two options: 1) antihistamines; or 2) herbal remedies. Antihistamines use either diphenhydramine hydrochloride (brands include: Sominex, Compoz, Tylenol PM, and Unisom SleepGels) or doxylamine succinate (Unisom tablets, Equate). The two ingredients are pretty interchangeable. Each inhibits the same neurotransmitter to depress your central nervous system. These antihistamines are the same stuff you might take for allergies, which is why allergy medications make you so drowsy.
On the herbal side, there's valerian root, chamomile, passionflower, humulus lupulus, melatonin, and so on. Nobody seems to know how these work for sure. I've used melatonin once before (or, more accurately, misused it), and it gave me horrid dreams about metal hooks, so I'll never go back. But I was eager to try out some other crunchy solutions.
As for prescription sleep aids, I didn't go there. The most common are benzodiazepines (Xanax, Halcion), which work by boosting a neurotransmitter called GABA (didn't they do "Neurotransmitter Dancing Queen"?). Again, this slows down your central nervous system. A similar set of drugs includes Ambien and Sonata, which are not benzodiazepines but work in much the same way. You take these pills at night, just before you want to sleep, same as with the antihistamines and herbals. Some claim the benzodiazepines and, even more so, Ambien and Sonata, get out of your system quicker than antihistamines—meaning less "hangover effect" the next morning. But the prescription drugs can be more habit forming. And I wanted to stick with stuff I could buy right around the corner—to battle sudden bouts of sleeplessness—rather than set up a doctor's appointment as one would for chronic insomnia. I ended up trying out OTC pills in several different scenarios.
1. Jet Lag
Can sleep aids beat it? On a recent trip to Japan, I arrived in Tokyo in the afternoon, then needed to get a good night's sleep (despite a 14-hour time difference) and wake up for a 9 a.m. meeting. Basically, an impossible task. I took a Unisom Maximum Strength SleepGel (50 mg of diphenhydramine hydrochloride) in Tokyo at 11 p.m., when it felt like midafternoon for me, and it actually worked OK. I managed to stay asleep until 6:30 a.m., which was better than I'd hoped for, and I made it through the day. Thanks, Unisom!
The next night, still wickedly lagged, I took two Simply Sleep caplets (together, another 50 mg of diphenhydramine hydrochloride—same as the Unisom), but only managed to sleep until 5:45 a.m. I blame it on the sheer momentum of jet lag, not the pills.
On the third night, as a control, I took no pills and woke up at 4:30 a.m. Unacceptable. So I took two Simply Sleep caplets and managed to sleep until 9:30 a.m. Perfect. Except I should have taken one caplet—I might have avoided the severe grog that plagued me all day and made interaction with Japanese people an even greater effort.
Conclusion: These pills are not a bad way to deal with jet lag, in an emergency. Also, there's no chemical difference between Unisom Maximum Strength SleepGels and Simply Sleep, yet there are two important distinctions. 1) Unisom's "gel" is much nicer going down—the Simply Sleep actually caught in my throat half-dissolved and tasted so bad that I gagged. 2) You can't split Unisom Maximum Strength's dose—it's one gel that can't be cut in half—while Simply Sleep's two caplets give you more flexibility for a half-dose (25 mg) if you're scared of feeling out-of-it when you wake up.
2. Sacking Out
Sometimes you need to hibernate. I did not wish to be awake for any part of the 13-hour plane ride back from Japan—not even when they were showing America's Sweethearts. Could OTC pills do the trick? This time, I went herbal.
Calms Forté is a homeopathic sleep aid containing passionflower, humulus lupulus, chamomile, and a whole buttload of other ingredients. At least one Slatester swears by this remedy, and it's a well-known alternative treatment for insomnia (it also claims to treat attention deficit disorder and general nervousness). I took two Calms Forté caplets (recommended dosage: one to three) right after getting on the plane in Tokyo and promptly slept for the next 12 hours continuously. I woke up just before landing in New York, feeling quite rested and refreshed. The only way to fly! Of course, you need a solid 12 hours with nothing to do for this to work.
Seth Stevenson is a frequent contributor to Slate. He is the author of Grounded: A Down to Earth Journey Around the World.
Illustrations by Nina Frenkel.