The Best Sleep Aids, 2024

In the quest for great sleep, consumers face a dizzying selection of supplements and over-the-counter aids, each with bold and enticing promises of restfulness. But not all sleep remedies are created equal. This guide cuts through the marketing claims, using hard data from clinical research studies to determine the most safe and effective options available. We've put natural supplements and OTC sleep aids to the test, sifting through their claims and associated studies to recommend the specific products that actually deliver on their promises.

And the winners are...

Supplements vs. OTC drugs -- what's the difference?

In this guide, we’ve differentiated between dietary supplements and over-the-counter (OTC) drugs. Dietary supplements, including vitamins, minerals, and herbs, are less strictly regulated and aim to supplement the nutritional make-up of our diets. OTC drugs, which undergo more rigorous testing and regulatory approval by bodies like the FDA, contain active ingredients proven to treat or prevent diseases or disorders. Both supplements and OTC drugs have shown to be effective — to varying extents — at improving sleep quality. 

Melatonin: 81%* clinically effective, side effects rare and mild 

*percentage of clinical studies resulting in statistically significant sleep improvement

Melatonin is a hormone naturally produced by the body, and is widely recognized for its effectiveness in regulating sleep cycles and aiding sleep quality, without forming dependency.

Taken orally, melatonin helps to adjust your circadian rhythm and get you to sleep faster, while also lowering your core body temperature to promote better sleep throughout the night. It's particularly effective in improving sleep onset latency for anyone with insomnia or fitful nights of sleep.

The science supports Melatonin as a sleep aid

A comprehensive 2013 analysis in PLOS One, synthesizing data from 19 studies with 1,683 participants, revealed that melatonin supplements notably reduced the time to fall asleep by seven minutes and extended sleep duration by eight minutes. While these improvements might seem modest, they varied significantly among individuals. Importantly, researchers also observed that melatonin enhanced overall sleep quality, including the aspect of waking up feeling refreshed.

Studies show that a minimum effective doses of melatonin can start as low as 0.3 mg, taken an hour before bed time. While doses in studies have reached up to 10 mg/day, higher doses are not necessarily more effective. Research indicates that doses above 3 mg/day are generally more effective than lower doses, with prolonged release formulations outperforming immediate release.

What the experts think of Melatonin

Extended Release (ER) vs. Immediate Release (IR) -- which is better?

The choice between extended-release and standard dosage melatonin depends on the specific sleep issues one is trying to address, but generally research supports the use of extended release as a superior aid for sleep quality.

Extended-Release (ER) Melatonin: This form slowly releases melatonin into your system over a period of time. It's beneficial for people who have trouble staying asleep, as it can help maintain steady melatonin levels throughout the night. Extended-release is often recommended for those with Delayed Sleep Phase Syndrome (DSPS) and certain types of insomnia where night-time awakenings are a problem.

Standard (Immediate-Release) Melatonin: This type releases melatonin quickly into your system. It's ideal for people who have trouble falling asleep but do not necessarily wake up often during the night. Standard melatonin can help synchronize your circadian rhythm if you have irregular sleep patterns due to jet lag or shift work.

The small print: side effects and risks of Melatonin

Melatonin, in standard doses, is generally safe with infrequent and mild side effects such as daytime drowsiness, headaches, and nausea. Serious adverse effects are extremely rare and are typically associated with very high doses of melatonin supplementation. Critically, melatonin does not have addictive properties.

Antihistamines: a powerful sleep aid for occasional use 

Diphenhydramine HCl is the active ingredient in many over-the-counter sleep aids and anti-allergy products. It belongs to a class of drugs known as antihistamines, which work by blocking the action of histamine, a substance in the body that causes allergic symptoms.

When consumed, Diphenhydramine HCl also has a sedative effect, making it highly effective in helping you fall asleep. It's particularly useful for occasional sleeplessness, and is less typically used for long term applications. The sedative effect is a result of its action on the central nervous system, where it reduces the activity of certain neurotransmitters, leading to drowsiness.

Diphenhydramine HCl is the active ingredient in many over-the-counter sleep aids and anti-allergy products. It belongs to a class of drugs known as antihistamines, which work by blocking the action of histamine, a substance in the body that causes allergic symptoms.

When consumed, Diphenhydramine HCl also has a sedative effect, making it highly effective in helping you fall asleep. It's particularly useful for occasional sleeplessness, and is less typically used for long term applications. The sedative effect is a result of its action on the central nervous system, where it reduces the activity of certain neurotransmitters, leading to drowsiness.

Some studies of Diphenhydramine HCl indicated a small risk of next-day drowsiness. So it's generally recommended for short-term use and not as a solution for chronic sleep problems.

The small print: side effects and risks of Diphenhydramine, HCL

Diphenhydramine HCl, while effective as a sleep aid, does carry some potential side effects and risks. While these side effects are rare, the most include drowsiness, dizziness, dry mouth, blurred vision, and constipation. Users may also experience confusion or difficulty urinating, especially in older adults. Long-term use can lead to tolerance, diminishing its effectiveness as a sleep aid, and dependence. Additionally, it may interact with other medications and is not recommended for those with certain medical conditions, such as asthma, glaucoma, or an enlarged prostate. While Diphenhydramine HCl is highly effective as an immediate solution to poor sleep, we don't recommend it for regular or prolonged use.

Sleep aids -- precautions you should probably know

1. Consult a Healthcare Professional: Before taking any over-the-counter medications (sleep aids included), it's important to consult with your primary healthcare provider, especially if you have pre-existing medical conditions or are taking other medications.
2. Understand Potential Side Effects: Be aware of common side effects such as drowsiness, dizziness, dry mouth, or cognitive impairment, and understand how they might affect your daily activities. We have taken these reported side-effects into account in the recommendations we have made, but different medications can affect us all differently.
3. Avoid Long-Term Use: Most sleep remedies are intended for short-term use. Prolonged use can lead to dependency, tolerance, and potentially exacerbate sleep issues.
4. Be Cautious of Drug Interactions: Some sleep aids can interact with other medications, potentially leading to adverse effects. Always check for drug interactions, particularly if you're already taking prescription medications.
5. Adhere to Recommended Dosages: Follow the dosage instructions carefully. Taking more than the recommended dose can increase the risk of side effects and health complications.

The Bottom Line on Sleep Aids

The market offers a vast array of non-prescription sleep aids, many catering to different aspects of sleep disturbances. To us, melatonin stands out for its natural role in regulating the body's sleep-wake cycle, proving particularly beneficial for those struggling with irregular sleep patterns or circadian rhythm disorders. Diphenhydramine HCl, the active ingredient in over-the-counter antihistamines and sleep aids, is also highly effective in inducing drowsiness and promoting sustained sleep, making it a popular choice for occasional, acute sleeplessness. Both of these options, melatonin for its alignment with the body's natural sleep processes and Diphenhydramine for its sedative properties, offer distinct benefits in improving sleep quality without the need for a prescription.

Top Meta-Analysis Research Used for this Guide