If you occasionally find it difficult to fall asleep and stay that asleep, you are probably normal. If lack of sleep causes you to feel sleepy during the day, you have a problem.

Most prescription drugs for insomnia lose their effect with time, so you have to keep increasing the dose. After you take these drugs for several weeks, you have to taper doses slowly or you may not be able to sleep at all (1). You can buy melatonin over the counter without a prescription to help you fall asleep, but it will not help you to stay asleep (2,3). You may be buying a product that contains no melatonin at all. One researcher bought ten different brands of melatonin at the store and found no melatonin activity in most of them. Melatonin is sold as a food product and these products are unregulated.

If you suffer from insomnia, check with your doctor. If the cause is depression or anxiety, and you may benefit from taking antidepressive drugs such as Paxil, Prozac, Welbutrin, Buspar or Zoloft (4). If you are kept awake by restless legs, see report #G161. If no cause is found, try a regular exercise program and avoiding food before you go to bed. If you need temporary help to fall asleep, you can try taking melatonin, but we do not have good data on benefits or side effects.

1) MH Wiegand. Pharmacological treatment of insomnia. Nervenheilkunde 17: 6 (AUG 1998):240-247.

2) T Shochat, I Haimov, P Lavie. Melatonin - the key to the gate of sleep. Annals of Medicine 30: 1 (FEB 1998):109-114.

3) RL Sack, AJ Lewy, RJ Hughes. Use of melatonin for sleep and circadian rhythm disorders. Annals of Medicine 30: 1 (FEB 1998):115-121.

4) PP Chang, DE Ford, LA Mead, L Cooperpatrick, MJ Klag. Insomnia in young men and subsequent depression: The Johns Hopkins Precursors Study. American Journal of Epidemiology 146: 2 (JUL 15 1997):105-114.

Checked 12/9/18

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