What's the Best Sleep Aid? Natural, OTC & Prescription Options Compared

What's the Best Sleep Aid? Natural, OTC & Prescription Options Compared

Struggling to fall asleep? Getting the right amount of sleep is vital for maintaining optimal health, with poor quality sleep affecting everything from your alertness, energy levels and brain function to your immune system. 

Unfortunately, many people find it hard to get enough sleep. According to data from the Centers for Disease Control and Prevention, around 35 percent of American adults have a short sleep duration, meaning they sleep for less than seven hours per night.

Part of this is likely due to busy schedules. Another part is likely due to the reality that, for many people, simply falling asleep isn’t always easy. Every year, about a quarter of all Americans deal with insomnia, making achieving a full night’s sleep a serious challenge. 

Enter the sleep aid. From over-the-counter products sold at your local drug store to prescription medications, there are a variety of sleep aids available that promise a better night’s sleep and a quick, convenient end to insomnia.

Below, we’ve looked at the sleep aids that are currently on the market and dug into the science behind how each one works. Our list covers everything from herbal sleep aids to a wide range of over-the-counter and prescription drugs designed to make falling asleep easier.

If you frequently find it difficult to fall asleep, or if you’re simply looking for a safe, effective sleep aid to use after stressful days, you’ll find everything you need to know below.

Sleep Aids: An Overview

Search for sleep aids online and you’ll quickly come across thousands of different products with hundreds of different formulas, each promoted as the most effective option on the market.

Almost all of these sleep aids can be sorted into one of three categories: 

  • Natural sleep aids. These are usually herbal supplements that contain ingredients such as valerian root, lavender and passionflower. Sleep aids of this type are easy to buy from online shopping websites like Amazon and from your local health foods store.
  • Over-the-counter sleep aids. These are usually medications designed to improve sleep that don’t require a prescription. Popular over-the-counter sleep aids include doxylamine (Unisom® or GoodSense®) and melatonin.
  • Prescription sleep aids. These are sleep medications that require a prescription from a healthcare provider. Popular prescription sleep aids include zolpidem (Ambien®), doxepin (Silenor®) and ramelteon (Rozerem®). 

To make finding useful information easier, we’ve used these categories below when comparing the various sleep aids currently on the market.

Natural Sleep Aids

There are numerous natural sleep aids on the market, most of which are formulated with herbal ingredients. We’ve listed seven of the most popular below, ranging from classic sleep aids such as chamomile to newer products containing ginkgo biloba and cannabidiol (CBD). 

Chamomile

Chamomile, usually in the form of chamomile tea, is one of the oldest, most well known natural sleep aids. Mentions of chamomile tea being used for sleep and relaxation date back centuries.

This, combined with chamomile tea’s availability, have made it one of the most common natural sleep aids.

We dug into chamomile tea’s benefits as a sleep aid in our guide to chamomile tea and sleep

Overall, we found that the findings of scientific studies on chamomile tea’s benefits have been rather mixed, with some finding it effective and others identifying few or no benefits. Most of these studies indicate the need for additional research to be completed on chamomile. 

For example, a study from 2009 found that chamomile was helpful in reducing anxiety in people with mild to moderate generalized anxiety disorder. However, a 2011 study found that there was no significant difference in sleep for people with insomnia who were treated using chamomile. 

Another study from 2017 found that chamomile extract improved sleep quality in the elderly over a period of 28 days. 

You can find more study findings in our full guide to chamomile. Overall, chamomile’s low price and easy availability make it a popular natural sleep aid, even if the science behind its benefits for sleep is mixed. 

Valerian Root

Valerian root is also a popular herbal sleep aid. You can find valerian root sold on its own and used as an ingredient in a wide range of herbal sleep and relaxation supplements.

The valerian root used in these supplements is extracted from an herb native to certain parts of Asia and Europe. Like chamomile, the facts that valerian grows naturally and is widely available have made it one of the more popular natural sleep aids on the market.

Also like chamomile, the scientific evidence behind valerian is mixed, with some studies finding it effective and others recording few or no benefits for sleep.

For example, a study from 2000 found that valerian performed better than a placebo at helping sleep-disturbed people fall asleep, with valerian users falling asleep an average of 15 minutes faster than those given a non-therapeutic placebo (45 minutes vs. 60 minutes). 

However, a study from 2004 found no significant differences between valerian and a placebo on sleep quality in adults with sleep issues. A 2005 study reached a similar conclusion, finding that valerian was no more effective at improving sleep or anxiety than a placebo. 

In short, the scientific data behind valerian is mixed — a topic we’ve covered in more detail in our guide to natural sleep aids

Lavender

Commonly sold in capsules and as an essential oil, lavender is widely promoted in the natural health community as a safe, effective natural sleep aid.

Although there’s limited large-scale study data on lavender’s effects on sleep, the few studies that have been carried out have generally found that it may have mild sedative effects that can help to reduce anxiety and improve sleep quality.

For example, a 2014 study observed 79 people with self-reported sleep issues and found that, when paired with proper sleep hygiene, lavender essential oil improved sleep quality. Another study from 2005 found that the use of lavender aromatherapy was associated with increased deep or slow-wave sleep. 

It’s worth noting that both of these studies were quite small (the first involved 79 people, while the second only involved thirty-one). However, their findings are certainly of interest and could indicate that lavender may have certain benefits for improving sleep quality. 

Passionflower

Known as passiflora incarnata, passionflower is a common ingredient in herbal sleep aids that’s also sold on its own as a sleep supplement.

Like other herbal sleep aids, there’s only a small amount of research into passionflower’s effects on sleep. A study from 2011, which used self-reported data from participants, found that herbal tea containing passionflower was associated with higher sleep quality ratings. It’s worth noting that the study was small, with only 41 participants.

Another study from 2013 found that a combination of passionflower, valerian and hops was as effective as zolpidem (the active ingredient in Ambien) at reducing sleep latency and improving sleep time. 

However, more research needs to be completed to identify what the long term benefits are, as well as if there is a dependence liability with this combination and long term use. 

Ginkgo Biloba

A, herb from the Chinese maidenhair tree, ginkgo biloba is often used as an ingredient in herbal sleep supplements. It’s also available on its own as an all-purpose supplement that’s purported to help with everything from anxiety to heart health.

Despite being a popular herbal medicine, there’s little evidence to show that ginkgo biloba has any measurable effects on sleep.

One study from 2001 used polysomnogram (sleep study) data to compare the effects of ginkgo biloba and a placebo. The study, which notably only included 10 people, found that there were no significant differences in sleep quality between the group given the ginkgo biloba supplement and the group given the placebo.

Another study found that ginkgo biloba improved sleep efficiency when used with trimipramine, a tricyclic antidepressant medication. However, it’s difficult to draw any firm conclusions about ginkgo biloba from this study due to the participants’ concurrent use of trimipramine. 

Magnesium

Magnesium, an abundant mineral that’s important for everything from bone health to producing DNA, may also be a useful supplement for improving sleep

As an essential mineral, magnesium plays a key role in several processes related to sleep and wellbeing. Clinical trials of magnesium have shown that use can potentially improve symptoms of insomnia. 

For example, a 2012 study found that use of a magnesium supplement improved sleep time and sleep efficiency in the elderly. A 2011 study involving long-term care facility residents also found that magnesium, when used with melatonin and zinc, improved sleep quality scores . 

It’s worth noting that there’s only been a small amount of research carried out into the effects of magnesium on sleep, meaning nothing is conclusive yet. However, these studies seem to show that magnesium could potentially have real, noticeable benefits as a natural sleep aid. 

Cannabidiol (CBD)

If you’ve visited a natural health shop or simply read the news over the last few years, you’ve no doubt heard of CBD, or cannabidiol.

While hemp-derived CBD is legal on a federal basis, CBD’s precise legal status is still stuck in a gray zone in many parts of the country. 

Despite this, CBD has grown immensely in popularity over the last few years as a purported natural treatment for, well, just about everything.

CBD is commonly promoted as a natural treatment for insomnia. While evidence is limited, there is some data showing that it can be helpful for people with sleep difficulties.

For example, a study from 2019 involving 103 adults with anxiety or poor sleep found that more than half of the participants reported improvements in sleep after using CBD capsules. However, it’s worth noting that sleep scores improved within the first month in 48 patients (66.7 percent), but that it also fluctuated over time. 

Other studies, such as this study from 2010 and this study from 2019, have found that CBD may help to improve the symptoms of anxiety and post-traumatic stress disorder, both of which could cause difficulties maintaining healthy sleep habits.

However, it’s worth noting the research regarding CBD still needs a lot of work. In the latter study, for instance, patients were given CBD in conjunction with routine outpatient psychiatric care.

While there isn’t yet enough scientific evidence to say that CBD definitely works as a natural sleep aid, the research that has been conducted so far shows that it may have real potential. 

We’ve covered this topic in more detail in our full guide to CBD and anxiety

Over-the-Counter Sleep Aids

Beyond herbal sleep aids, a variety of over-the-counter medications are available that can help to treat insomnia and improve sleep. 

Unlike natural sleep aids, which are usually made from herbs or minerals, many of these OTC sleep aids contain pharmaceutical ingredients. You can typically buy these products from your local drug store, or occasionally from a supermarket or health foods store.

Below, we’ve listed four of the most common over-the-counter sleep aids, along with the data behind how each product works to treat insomnia and improve sleep. 

Melatonin

Melatonin is one of the most popular over-the-counter sleep aids available. It’s a key ingredient in our Sleep Gummy Vitamins, along with a variety of other naturally-occurring ingredients such as chamomile and L-theanine.

As a hormone responsible for regulating your sleep-wake cycle, your body naturally releases its own supply of melatonin as day turns to night and natural light levels begin to dip, signalling that it’s time for you to feel tired and go to sleep. 

The problem is, as we’ve explained in our full guide to melatonin and sleep, the human body is a little out of sync with modern technology. In a naturally lit environment, the body’s process for producing melatonin works well, causing you to feel sleepy late at night and alert in the day.

Add smartphones, computer screens, artificial lighting, shift work and late nights spent binging Netflix into the equation and the body’s natural method of regulating the sleep-wake cycle isn’t always enough to make you feel tired before midnight.

This is where melatonin supplements enter into the picture. 

A 2017 scientific review found that supplementing melatonin has been shown to improve sleep quality, reduce the amount of time required to fall asleep, increase total sleep time and regulate the body’s circadian rhythm. 

Other studies have found that melatonin may help to reduce the symptoms of jet lag in people who’ve traveled across time zones. 

L-5 Hydroxytryptophan (5-HTP)

L-5 hydroxytryptophan, or 5-HTP, is a serotonin-producing amino acid that’s made naturally by the body. Because serotonin is associated with sleep disorders, 5-HTP is often promoted as an over-the-counter sleep supplement.

There isn’t a lot of scientific research into 5-HTP’s effects on sleep. 

One small study (sample size of only 17) from 2010 found that a combined treatment consisting of GABA and 5-HTP caused patients to fall asleep faster, sleep longer and experience a higher quality of sleep compared to a placebo.

Unfortunately, there are few human studies that look at the effects of 5-HTP used on its own as a sleep aid. As such, the jury is still out on whether it’s truly effective as a non-prescription sleep treatment. 

Diphenhydramine (Benadryl®)

Diphenhydramine, the active ingredient in Benadryl (yes, the allergy relief medicine), is widely used as an over-the-counter sleep aid. 

Because diphenhydramine doesn’t require a prescription, it’s a common choice of sleep aid for people with insomnia that don’t want to see a healthcare professional or use prescription medication. 

Diphenhydramine is an antihistamine. It works as an insomnia treatment by blocking the uptake of the neurotransmitter histamine, which is responsible for the alertness and arousal part of your body’s natural sleep-wake cycle. 

Antihistamines like diphenhydramine may work well as sleep aids, meaning you should feel sleepier than normal after you take them. However, although you’ll find it easier to fall asleep, you might not wake up feeling as rested as you’d like.

This is because antihistamines like diphenhydramine can reduce the amount of time you spend in rapid eye movement (REM) sleep, the phase of the sleep cycle in which your brain activity is at its highest and your dreams are at their most intense.

We’ve covered this in more detail in our guide to Benadryl for sleep, which looks at the science behind antihistamines and sleep quality. 

Because of these effects on the sleep cycle, using antihistamines like diphenhydramine often is not recommended. However, it’s okay to use Benadryl or other drugs with diphenhydramine on an occasional basis if you find it difficult to fall asleep. 

Doxylamine

Doxylamine is an antihistamine. Just like diphenhydramine, it’s used to relieve allergy symptoms but may also be used as a short-term sleep aid. 

As with diphenhydramine and other antihistamines, using doxylamine often isn’t recommended as a sleep aid due to its effects on the sleep cycle.

Prescription Sleep Aids

For many people, natural sleep aids and over-the-counter sleeping pills are enough to drift off to sleep whenever the occasional bout of insomnia occurs. 

However, if you have persistent difficulty sleeping, over-the-counter medications may not be the most effective option. Some over-the-counter sleep aids, such as antihistamines, can also affect the quality of your sleep when they’re used over the long term.

For this reason, your healthcare provider may recommend a prescription sleep aid if you often find it difficult to fall asleep. 

Several different classes of medication are prescribed to treat insomnia. Early prescription sleep aids were mostly from the benzodiazepine class, which work by targeting receptors in the brain to produce a sedative effect.

You may have heard of drugs like lorazepam (Ativan®) and alprazolam (Xanax®), which belong to this class of mediations. These days, use of these drugs is generally discouraged for long-term sleep issues, as they have a high risk of causing the user to develop dependence. 

Today, most of the drugs prescribed to treat insomnia and other sleep difficulties are hypnotics or antidepressants. We’ve listed five of the most common prescription sleep medications below, along with the data on how they can help you treat insomnia and improve your sleep quality. 

Zolpidem (Ambien)

Zolpidem, the active ingredient in Ambien, is one of the most common sleep medications in the United States. 

Studies of zolpidem show that it’s highly effective as a treatment for insomnia. They also tend to show that, unlike many over-the-counter sleep aids, it continues to work over the long term.

One study from 2012 looked at the effects of nightly zolpidem use in people with insomnia. The patients were assessed over eight months, during which zolpidem significantly increased overall sleep time and sleep efficiency while reducing sleep latency (time required to fall asleep). 

A scientific review from 2011 reached similar conclusions, noting that zolpidem decreases sleep onset latency, improves sleep quality and reduces awakenings after sleep onset. 

In short, zolpidem works. However, like many other prescription medications used to treat sleep issues, it can cause side effects such as daytime drowsiness. It also is considered to have a high potential for dependence and overuse. For these reasons, zolpidem usually isn’t recommended for people who need to be highly active shortly after waking. 

Zaleplon (Sonata®)

Zaleplon, commonly sold under the brand name Sonata, is a hypnotic medication that’s used to treat insomnia. It belongs to the same class of medications as zolpidem (Ambien), but has a few key differences.

The biggest of these differences is its short half-life. Zaleplon has a half-life of just 30 minutes, which is much shorter than the two- to three-hour half-life of zolpidem

This means that a normal dose of zolpidem could last for up to three times as long in your body as the equivalent dose of zaleplon. 

Studies of zaleplon tend to show that it can reduce sleep latency and increase total sleep time in people with insomnia. 

For example, in this 1999 study, elderly patients with insomnia spent more time asleep and less time awake prior to sleep after treatment with zaleplon. 

Although zaleplon’s short half-life can be an advantage if you need to wake up early and have concerns about feeling tired with a longer-lasting medication, it could also make zaleplon less effective if you’re prone to waking up during the night. 

Eszopiclone (Lunesta®)

Eszopiclone, sold under the brand name Lunesta, is another type of hypnotic medication used to treat insomnia. 

The key difference between eszopiclone and other sleep medications is its half-life. Eszopiclone has a half-life of six hours — up to six times as long as that of zaleplon and two to three times as long as the half-life of zolpidem.

Because of this long half-life, eszopiclone may be more effective as a treatment for sleep issues in people who frequently wake up during the nighttime. 

Doxepin (Silenor)

Doxepin is a prescription medication that belongs to the tricyclic antidepressant class. It’s used for a range of purposes, including as an insomnia treatment. 

Clinical studies of doxepin show that it has positive effects on sleep maintenance and total time spent asleep. Interestingly, these studies also show that low doses of doxepin tend not to cause the next-day residual effects that are a common issue with many other sleeping pills. 

For instance, one such study of elderly people with insomnia from 2014 found that doxepin is effective as an insomnia treatment even at very low doses. However, it’s also worth noting that the improvements were observed into the last third of the night, and they did not significantly affect sleep onset.

Considering doxepin as an insomnia treatment? Our comprehensive Doxepin 101 Guide explains how doxepin works to make sleeping easier, as well as how it compares to other drugs on the market as an insomnia treatment. 

Ramelteon (Rozerem)

Ramelteon is a hypnotic medication that’s used to treat insomnia, particularly cases of insomnia that involve difficulty falling asleep. 

More specifically, ramelteon is a melatonin receptor agonist. Experts believe it works by binding to the body’s MT1 and MT2 melatonin receptors, which are responsible for regulating the body’s sleep-wake cycle. 

Polysomnography studies of ramelteon show that it produces a faster onset of persistent sleep than placebo. Separate studies from 2006 and 2007 have also found that ramelteon can lower latency to persistent sleep in people with insomnia.

In short, ramelteon can help people with insomnia falling asleep faster. Interestingly, studies of ramelteon also typically show that it doesn’t produce any next-day residual effects, meaning it may be less likely to cause morning drowsiness than other prescription sleep aids. 

We’ve dug into the science behind ramelteon, as well as its benefits as a sleep medication, in our complete guide to ramelteon and its effects

What’s the Best Sleep Aid?

With such a large variety of sleep aids and medications on the market, working out which one is the most suitable for you isn’t always an easy process.

There’s no “best” sleep aid for everyone. Depending on how often you find it hard to fall asleep and the severity of your sleep issues, you may benefit from an over-the-counter treatment or a more effective prescription medication.

If you have trouble sleeping and want to do something about it, the best approach is to talk to a healthcare provider. They will be able to prescribe a safe, suitable treatment based on your symptoms and needs.

Not quite ready to use medication for better sleep? Our guide to science-backed ways to get a better night’s sleep lists habits and lifestyle changes that you can make to enjoy higher quality, more refreshing sleep. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.