Sleep Aids

Is Cannabis More Effective Than Other Sleep Aids?

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Over a third of adults in the United States don’t get the recommended 7 hours of sleep per night. Trusted Source Centers for Disease Control and Prevention (CDC) As the nation’s health protection agency, CDC saves lives and protects people from health threats. View Source With all that tossing and turning, over-the-counter (OTC) and prescription medications are popular options for improving sleep.

But more people appear to be turning to cannabis as an alternative sleep aid, according to a new 2023 study published in the journal Exploration of Medicine. Currently, 47 states and the District of Columbia have regulations allowing the medical and/or recreational use of cannabis. Trusted Source National Conference of State Legislatures View Source Yet, not much is known about its benefits for sleep. 

Researchers examined data from an extensive survey done by a Canadian medical marijuana data company on the use of cannabis among people who have problems sleeping. Participants included over 1,200 people who say they use cannabis to help them sleep. Most survey participants reported having sleep issues for over five years, including trouble falling asleep, feeling tired the next day, and waking up at night.

The researchers looked at the survey results to find out how cannabis affects participant’s sleep and how it makes them feel compared to prescription and OTC sleeping pills. They also looked at how the participants use cannabis and the type of cannabis they prefer to help them sleep. Two of the most well-known cannabinoids are tetrahydrocannabinol (THC), the compound that makes you feel high, and cannabidiol (CBD), which has a calming effect but doesn’t make you feel high.

Over 80% said that cannabis helps them sleep by relaxing their mind and body. More than half said it helps them sleep more deeply. Another 42% reported it allows them to sleep longer, and 36% reported it allowed them to sleep without waking. When asked about average sleep hours per night, 63% said they get 6-8 hours when only using cannabis, compared to 20% or less saying the same when using sleep medicines combined with cannabis, sleep medications alone, or no sleep aids. 

The survey found that most people prefer to smoke or vape cannabis compared to using oils or edibles. About 79% said they use THC for sleep, more than other forms like CBD or cannabinol (CBN). The majority (82%) said they don’t take any sleep medications currently, though half had used them in the past. People are more likely to use cannabis in place of sleep medications instead of using both at the same time, the study authors noted.

Cannabis can have side effects, including anxiety and irritability. Still, participants feel more focused and relaxed the next morning compared to taking other sleep aids. Sleep medications can come with side effects such as dizziness, daytime drowsiness, and difficulty concentrating or remembering things.  

This study adds to the current knowledge about the effectiveness of cannabis as a sleep aid relative to sleep medicines. For example, a 2022 study showed 39% of people stopped their sleep medication after they started using cannabis. And 71% of them said their sleep improved. Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source However, the study authors note that more research is needed, and their findings may help guide future, more objective and controlled studies.

The Best Natural Sleep Aids

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Sleep should be relaxing, but 35% of Americans1 struggle to get the recommended seven or more hours per night2 of shut-eye. Considering the serious consequences3 of not sleeping enough — including reduced performance, and increased risk of cardiovascular disease, cancer, diabetes, high blood pressure, and car accidents — it’s no surprise that many people turn to sleep aids to help them rest. While prescription and over-the-counter drugs are one option, natural sleep aids are also popular. According to one study, 1 in 5 Americans has tried a natural sleep aid4 in the past 12 months.

There is a staggering array of natural sleep aids available, all of which are rumored to offer the sleep you need. However, since the FDA does not review if supplements are safe or effective5, finding the most effective natural sleep aid can be difficult. Learning about the evidence supporting different supplements, as well as their potential effects and side effects, can make it easier to decide which natural sleep aid might be best for you.

However, it is important to consult your doctor before starting any new supplement. Natural does not always mean safe for everyone. Many supplements should not be taken by people who are allergic to the product, have certain conditions, or take certain drugs.

What Are Natural Sleep Aids?

Natural sleep aids are over-the-counter supplements intended to help you fall asleep faster or stay asleep throughout the night. They are usually plant-based, a vitamin or mineral already present in our diets, or supplemental amounts of something produced by the body. There aren’t strict guidelines surrounding the use of the word “natural” for supplements, and many natural supplements, such as melatonin6, tend to be synthetically derived.

Many customers prefer natural sleep supplements because they have fewer side effects7 than prescription sleep medications. They also appeal to people who prefer natural products, or are concerned about the addictive potential8 of prescription sleep aids.

Melatonin

Melatonin is a sleep-regulating hormone produced by the pineal gland in our brains9. It plays a significant role in organizing our circadian rhythms, the 24-hour sleep-wake cycles that govern when we wake up, feel alert, feel tired, and sleep.

A wide range of factors can suppress melatonin production10, particularly night-time exposure to light but also aging and some diseases. Since low melatonin levels can cause sleep disturbances, many people take supplemental melatonin in pill form. It is the fourth most popular natural supplement11 among American adults and is the second most used by children.

Melatonin is most often recommended for people with circadian rhythm conditions like delayed sleep-wake phase disorder12 or whose circadian rhythms are compromised by jet lag13. It is also used for some sleep disorders in children. Some people also find melatonin helps with shift work-related sleep disturbances or insomnia14, but the research is divided in terms of how effective it is for these problems. While there is also a prescription medication called a melatonin receptor agonist, this is different from supplemental melatonin.

While experts believe that melatonin is likely safe for adults15 taking standard dosages, there are potential safety concerns for children16. Additionally, allergic reactions are possible, and there is insufficient research about its use by pregnant or breastfeeding women. Side effects do not tend to be severe but may include dizziness, nausea, and headaches. Some people, particularly older adults, also report daytime drowsiness.
 Lavender

A popular fragrant garden and kitchen herb, lavender has long been thought to aid relaxation and improve sleep. Modern research seems to validate some of these traditional claims. The use of lavender oil, for example, has been shown to improve sleep quality among postpartum women17 and increase the effectiveness18 of good sleep hygiene. Lavender oil also seems to have a soothing effect19 and reduces anxiety and restlessness.

Most studies on lavender’s efficacy as a sleep aid have focused on lavender essential oil, though some people also use the dried herb as a tea or in their pillow. Essential oils should not be ingested except under a doctor’s supervision, as even lavender oil contains poisonous compounds20. Instead, the oil should be diffused into the air or diluted in a neutral cream or oil for use on the skin.

Lavender may be most appealing for people who struggle to sleep due to anxiety or racing thoughts. It is also popular among people who want an external sleep aid rather than something they consume. Short-term consumption of dried lavender or use of lavender essential oil is thought to be safe21, though potential side effects for the external use of lavender oil include skin irritation and allergic reaction.

Valerian

The pungent valerian plant — its smell has been compared to gym socks22 — has been prescribed for sleep problems since the 2nd century23. Though further research needs to be done, valerian appears to help people fall asleep faster, sleep better, and wake up less often. In some studies, patients taking valerian were 80% more likely to report sleep improvements than those taking a placebo24. Because experts haven’t located a single active compound, they speculate that valerian’s effect may be due to several compounds working together, or the amino acids GABA or glycine.

The roots and stems of the valerian plant are made into teas, tinctures, capsules, extracts, and tablets. While each type of preparation has its fans, the tea can have an unpleasant odor, and researchers generally use liquid extracts or capsules in their research. Valerian is usually recommended for people with insomnia or general problems with sleep quality. Most people report that it is more effective once they have been taking it for several weeks. However, further research is needed to determine how effective valerian is in treating insomnia.

Valerian is generally considered safe for adults and children over the age of three. Side effects are rare and tend to be mild but may include headache, dizziness, itching, and stomach upset.

German Chamomile

German chamomile has been used to treat sleep problems since ancient Egypt25. Despite this long history, there has been little research into its benefits. What we do know from smaller studies and meta-analysis is that German chamomile may soothe anxiety26 and improve sleep quality27, although researchers are not clear on why it might have these effects. On the other hand, it doesn’t appear to benefit people with insomnia.

The most common preparations of German chamomile are capsules, tincture, and tea. Although there is another variety called Roman chamomile, most research has focused on the German type.

Chamomile is generally regarded as safe when used as a tea or taken orally. It does have potential interactions with some drugs, including blood thinners, and there is little information on its safety for pregnant or breastfeeding women. Side effects are usually limited to mild nausea or dizziness, but allergic reactions are possible, particularly for people with allergies to related plants like ragweed and daisies.

Passionflower

The passionflower vine is native to the Americas and has historically been used as a sedative by multiple indigenous cultures28. There has been very little research into its benefits, though the existing research is encouraging, if limited. In one study focused on generalized anxiety disorder29, passionflower’s calming effects were comparable to a commonly prescribed sedative. Passionflower may also improve sleep quality30 and make it easier to fall and stay asleep31.

Extracts and tea are both common forms of passionflower people use. Both have been used in research settings, so choosing between them is a matter of preference. While research into this supplement shows potential benefits for anxiety and insomnia, there is no conclusive proof of its efficacy.

As with passionflower’s benefits, there is little research into its safety. However, daily doses of up to 800 milligrams have been used safely in studies lasting as long as two months. Side effects are usually mild and may include drowsiness, confusion, and uncoordinated movements. Pregnant women should not use passionflower, as it can induce uterine contractions. There is limited research into its safety while breastfeeding.

Hops

In addition to being the main flavoring in beer, the flowers of the hops plant are used by some people as a natural sleep aid. Like most natural supplements, the benefits of hops have not been researched enough to definitively state32 whether or not it might help people sleep better. However, there is preliminary evidence that hops supplements can help stabilize circadian rhythms33 and lessen the symptoms of shift work disorder. Dried hops flowers contain the acids humulone and lupulone, and their relationship with the body’s GABA receptors may be part of the reason34 for hops’ effects.

Hops is often combined with other natural sleep aids such as valerian. It can be taken as non-alcoholic beer or in dried form as a tea or dry extract. Different studies have used all three methods, and there is no evidence in favor of one form over another.

It is likely safe to consume hops in the form of non-alcoholic beer or tea, though supplemental use is only considered possibly safe due to the lack of research. Hops also has more potential side effects than some other natural sleep aids. Because it has weak effects similar to estrogen, hops can cause changes to the menstrual cycle and is not recommended for people who are pregnant or breastfeeding, or who have hormone-sensitive cancers or other conditions. Hops can also worsen depression. However, for most people, side effects are mild and may include dizziness or sleepiness.

Cannabidiol (CBD)

CBD is a chemical known as a cannabinoid that is present in the cannabis plant35.  Cannabis has over 100 cannabinoids36, and CBD is much different than the psychoactive delta-9-tetrahydrocannabinol (THC) cannabinoid. Most CBD is derived from hemp, which does not contain enough THC to be psychoactive.

Research into CBD has previously been limited due to cannabis regulations, but there are indications that it might help some people sleep better. To begin with, it appears to reduce the anxious symptoms37 of a broad spectrum of mental health conditions. It also seems that the body’s own cannabinoid system affects how we sleep38, making CBD more likely to have benefits. There has been some evidence39 that CBD can aid some sleep disorders and reduce excessive daytime sleepiness, but research is currently inconclusive.

Although CBD has been legal federally since 2018, it is not supposed to be sold as a dietary supplement. It is, however, widely available in forms such as tinctures, gummies, and oils. Because of this lack of regulatory oversight, one study found that 26% of CBD products had less CBD than they claimed, while 43% had much more. CBD appears to be largely safe40 with minor side effects such as tiredness, diarrhea, and changes to weight or appetite. However, its safety is unknown for pregnant or breastfeeding women. CBD may interact with medications and adversely impact certain health conditions.

Tart Cherry Juice

Juice from the tart cherry, also known as the sour cherry41, appears to raise melatonin levels42 and increase the availability of tryptophan43, an amino acid that may play a role in helping us fall asleep44. These are promising findings, and tart cherry juice may improve sleep quality and make it easier to fall asleep. However, some studies indicate45 that the effect on insomnia isn’t as strong as established treatments like cognitive-behavioral therapy.

Studies on the health benefits of tart cherries have had participants consume the equivalent of up to 270 cherries a day46, but there is no specific research into their safety. The juice, which can be very sour, is usually diluted in a small amount of water before drinking.

Magnesium

Magnesium is a dietary mineral47 naturally present in food and often added to processed foods. It is used throughout the body and is present in our bones, soft tissue, and blood. Older adults are more at risk for magnesium deficiency, and one of the mineral’s many roles is sleep regulation48. Some research suggests that supplemental magnesium may help reduce insomnia in older adults, either when used alone or with melatonin and zinc49. It may also reduce excessive daytime sleepiness50 in adults.

Since high levels of magnesium are available in foods like pumpkin seeds, it is easy to supplement by eating more magnesium-rich foods. Magnesium supplements are also available in pills and tablets, including multivitamins. Magnesium aspartate, magnesium citrate, magnesium lactate, and magnesium chloride are the easiest for the body to absorb51.

While magnesium is usually safe at ordinary dietary levels since the kidneys filter it out, high dosages can cause side effects like diarrhea, nausea, and abdominal cramping. Magnesium also interacts with some medication and other supplements, and very large dosages can lead to significant heart abnormalities including low blood pressure or hypotension, irregular heartbeat, and cardiac arrest.

GABA

Gamma-aminobutyric acid (GABA) is an amino acid and neurotransmitter52 that plays a vital role in regulating nervous system activity. In addition to being made by the body and present in food like tea and tomatoes, GABA is available in supplement form. While it was previously believed that GABA taken orally couldn’t pass the blood-brain barrier and was therefore not useful to the body, there is now some evidence to the contrary53.

Small trials of supplemental GABA have shown that it can reduce stress and may help people fall asleep more easily54. It is not currently known whether GABA’s effects on sleep might be due to stress reduction or another mechanism.

GABA naturally occurs in the body and in food, but there is little research into whether it’s safe to take as a supplement. However, most studies have shown no adverse reactions. GABA is available in pills and may be derived from natural or synthetic sources. Research is still ongoing as to whether synthetic GABA is as effective as GABA derived from a natural source.

Glycine

Like GABA, glycine is an amino acid and neurotransmitter55 made by the body and available in some foods. Glycine appears to affect sleep56 and pass the blood-brain barrier57, so it makes sense that glycine supplements may be beneficial. In fact, studies show that glycine appears to improve sleep quality58, potentially by lowering body temperature. Taking glycine before bed may also help reduce the performance impact of insufficient sleep, which may be due to improved sleep quality or another mechanism.

Supplemental glycine is available in capsule or powder form, and there is limited knowledge about what form might be most beneficial. While glycine is part of our diet, its safety is unknown when taken in the quantities usually found in supplements.

Sleep Aids to Treat Sleep Aids

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Sleeping problems are commonplace, and one of the most prevalent sleep disorders is insomnia, which affects between 10 and 30 percent of adults1 in the United States.

Insomnia occurs when a person has problems falling asleep (sleep onset) and/or staying asleep (sleep maintenance), and those problems cause sleepiness, slowed thinking, or other impairments during the day. Insomnia is often tied to sleep deprivation, which can have serious consequences for physical and mental health.

To address insomnia, many people turn to sleep aids. These include prescription drugs, over-the-counter medications, and dietary supplements. Every sleep aid for insomnia has potential benefits and downsides, and it’s important for individuals to be informed about their treatment options and talk with a doctor about the best option in their personal situation.

How Commonly Used Are Sleep Aids for Insomnia?

Sleeping pills or other sleep aids are a common component of treatment for insomnia. Studies have found consistently rising rates of sleep aid use with one study estimating around 19% of adults2 taking at least one sleep medication in the last month.

Data from the CDC shows that many adults take sleep aids frequently with more than 8% of adults3 using a sleep aid at least four times in the previous week. Use of prescription insomnia medications has increased among the elderly4, including among people without a formal diagnosis of insomnia.

This research also reflects a trend toward higher usage of over-the-counter (OTC) sleeping pills as well as dietary supplements such as natural sleep aids. A survey by Consumer Reports, for example, found that about 20% of adults said that they used a natural sleep aid in the past year.

How Do Sleep Aids for Insomnia Work?

Most sleep aids for insomnia work because they have a sedative effect, which means that they make you feel sleepy6. That sleepiness may happen rapidly to help you fall asleep or can have a prolonged effect to make it easier to sleep through the night.

The way that a sleep aid produces a sedative effect varies on its chemical composition. Depending on how they work and how they are regulated, sleeping pills for insomnia can be organized into several distinct types.
 

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What Are the Types of Sleep Aids for Insomnia?

There are three types of sleep aids for insomnia: prescription medications, over-the-counter drugs, and dietary supplements.

Prescription Drugs

Before a prescription drug can be sold, it must be approved by the Food and Drug Administration (FDA), which carefully reviews data from research studies about its effectiveness and safety. Once the drug is approved, a patient must get a prescription from their doctor in order to obtain the drug from a pharmacy.

Different classes of drugs cause sleepiness based on their chemical composition and how they affect the brain. Types of prescription drugs that are approved by the FDA for insomnia include:

  • Z Drugs: These medications slow down activity in the brain, which prompts a sedative effect.
  • Orexin receptor antagonists: These drugs block production of orexin, a chemical in the brain that makes you feel alert.
  • Benzodiazepines: Benzodiazepines are like Z drugs in that they decrease brain activity to induce sleepiness. These were among the first prescription drugs to be used for insomnia.
  • Melatonin receptor agonists: This type of medication increases the level of the hormone melatonin in the body, which promotes sleepiness.
  • Antidepressants: These drugs were first designed to treat depression but were later found to have a sedative effect. Only one antidepressant is formally approved by the FDA for insomnia.

Once a drug has been approved by the FDA for one use, doctors can prescribe it for other conditions, which is known as “off-label” use. Drugs such as antipsychotics and anticonvulsants are occasionally used off-label for insomnia, but there is less data about their safety and effectiveness in treating sleep problems.

Over-the-Counter Medications

Over-the-counter medications can be purchased without a prescription. These pills do not go through the same level of FDA review as prescription medications, but they still must meet certain regulatory standards 7before they can be sold.

Over-the-counter sleep aids are composed of antihistamines. Antihistamines are frequently used to manage allergies, but because of their sedative effect, they are also marketed as sleeping pills.

Antihistamine sleep aids may be sold as one-ingredient products, or the antihistamine may be combined with active ingredients for other issues such as cough, fever, or congestion. When added to other chemicals, OTC sleep aids are often labeled for “PM” use.

Dietary Supplements

Although people may use them for health reasons, dietary supplements are not formal medications. They do not have to be approved by the FDA8, and there is considerably less oversight of sleep aids sold as dietary supplements.

Natural sleep aids, such as melatonin, valerian, or kava, are examples of dietary supplement sleep aids. Brands can create sleep aids made of just one ingredient or a blend, which is why there is a huge diversity of these sleep aids available on the market.

Among the types of sleep aids for insomnia, dietary supplements tend to have the least amount of evidence from studies documenting their benefits and downsides.

What Are the Potential Benefits of Sleep Aids for Insomnia?

The primary benefit of most sleep aids is that they induce drowsiness that lets you get more sleep. They can accomplish this by helping you get to sleep and/or by increasing the chances that you’ll stay asleep through the night.

By improving sleep in the short-term, many sleep aids can alleviate daytime drowsiness and impaired thinking from sleep deprivation. They may help reset your sleep schedule, enabling you to start down a path toward consistent sleep.

That said, most sleep aids are not meant for long-term use. As a result, treatment for insomnia often combines a sleep aid with practical steps, such as improving sleep hygiene, that can help you get quality sleep every night without relying on sleep medication.

What Sleep Aids for Insomnia Work the Best?

Not everyone has the same reaction to a sleep aid, so there’s no hard-and-fast rule about which one works the best. Instead, doctors suggest insomnia treatments based on their patient’s specific situation, including their symptoms and their overall health.

To make these suggestions, doctors may draw on guidance from expert organizations like the American Academy of Sleep Medicine (AASM). AASM organizes panels of sleep experts who review the existing research and make general recommendations about sleep aids.

In the latest AASM guidelines for sleep aids for insomnia9, certain prescription drugs are recommended depending on whether a person’s problem is with sleep onset or sleep maintenance. This is because certain sleep aids work quickly and wear off fast, and others start slowly and last a long time. AASM recommends against the use of over-the-counter sleeping pills and dietary supplements like melatonin and valerian.

What Are the Potential Risks of Sleep Aids for Insomnia?

Potential side effects can vary based on the specific sleep aid and whether the person taking it has any other health problems or medications that they take. In general, there are potential negative effects that can occur with almost all sleep medications, although the likelihood of these effects may be higher with some sleep aids.

  • Lingering next-day effects: As many as 80% of people taking sleep aids10 say that the sedative effect may persist after they have woken up, creating excess drowsiness or slowed thinking when a person should be alert. This issue is most worrisome for people who drive in the morning and may be at a higher risk of auto accidents.
  • Confusion or loss of coordination: A strong sedative effect can make a person feel confused, dizzy, or unable to concentrate. As a result, they may be at risk for falls or other accidents right before bed or during the night.
  • Abnormal behavior: After taking sleep aids, some people engage in strange behavior while remaining partially asleep and unaware of their actions. This behavior can range from simple things like talking, to more complex actions like sleepwalking or trying to drive.
  • Allergic reaction: These responses are quite rare, but some people have allergic reactions to sleep aids.
  • Drug interaction: A sleep aid may interact with other medications and potentially change their potency or how they affect the body.

In addition to this general list of potential side effects, there are risks that exist only with some sleep aids. For example, some sleeping pills may have detrimental effects on other health conditions. A number of sleep medications are tied to worsening symptoms of depression, and prescription sedatives can cause suppressed breathing that can exacerbate sleep apnea.

Many sleep aids can be habit-forming. This may lead to the drug being taken for too long or at too high of a dose, increasing the risk of side effects.

Abruptly stopping the use of some sleep aids can trigger a resurgence of insomnia symptoms or other withdrawal symptoms.

Because they are less carefully regulated, dietary supplements are more likely to have mislabeled dosage information 11or be tainted with chemicals not listed on the bottle12.

Because of the possibility of side effects, it is important to talk with a doctor before starting to take any sleep aid.

What Are the Safest Sleep Aids for Insomnia?

There is no sleep aid that is universally the safest. Depending on your personal health situation, certain drugs may be more or less risky than others. But this determination should be made by a health professional who can review your situation and discuss the benefits and risks of specific sleep aids in your unique case.

What’s the Best Sleep Aid for Insomnia?

No sleep aid is a silver bullet, and there’s no one best sleep aid for everyone.

Instead, the best sleep aid for insomnia is the one that is most tailored to your needs including the nature of your insomnia, your age, your overall health, and any other medications that you may take. Taking these factors into account, you and your doctor can compare sleep aids and their potential benefits and downsides.

In some cases, the best way to get better sleep may not involve a sleep aid at all. Non-medical treatments for insomnia are often effective, and a doctor can review your options for both medical and non-medical treatments and help you decide what’s best given your circumstances. Improved sleep hygiene, including sticking to regular bed and wake times can be an alternative option for people struggling with sleep problems.

Are Sleep Aids for Insomnia Safe?

When taken by healthy adults, sleep aids are usually safe for short-term use as long as they are used as directed. However, given the potential for side effects, it’s always safest, regardless of the type of sleep aid, to take it under the guidance of a health professional.

To reduce the risk of negative effects, it’s important to take sleep aids safely. This means taking them at the right time and only with the recommended dosage. Extra doses should be avoided even if sleeping problems continue. In addition, sleep aids should not be mixed with other sedatives, alcohol, or recreational drugs.

For certain people, there may be added risks of taking sleep aids for insomnia. Examples include:

  • Older adults: Problems of disorientation and risk of falls from sedative medications make some sleep aids dangerous for older adults.
  • Children: Even at lower doses, children can have different reactions to drugs than adults. Given a child’s ongoing physical and mental development, those reactions can be detrimental to their health.
  • Pregnant and breastfeeding women: Depending on the sleep aid, there may be health risks13 for a woman or her child when these medications are taken during pregnancy or while breastfeeding.

People in these groups or those who have coexisting health conditions should carefully review their options for insomnia treatment with a doctor to determine whether there is a sleep aid that is safe for them to take.