insomnia sleepless menopause sleeping pills, diphenhydramine

Sleeping pills are big business. That is especially true for over-the-counter drugs. Millions of people take “PM” pain relievers regularly because they fear they may not fall asleep easily. Diphenhydramine is the most common ingredient. But another hard-to-pronounce sedating antihistamine can also be found in OTC sleeping pills. It is doxylamine. This reader describes a confusing situation with this sleeping pill. Her health professionals did not agree about the safety of doxylamine.

A Sleeping Pill and Memory Problems:

Q. You have written that diphenhydramine in “PM” pain medications can be risky for older people. I take a medication that contains doxylamine.

No pharmacist has ever told me that this might be a problem. However, a psychologist specializing in memory problems told me that I would be better off with a prescription sleeping pill. What do you think?

A. Both doxylamine and diphenhydramine are sedating antihistamines. They have anticholinergic effects that can cause problems for older people. Acetylcholine (ACh) is a brain neurochemical that is essential for memory and many other neurological functions. Anticholinergic drugs can interfere with the action of ACh.

Although many older people use such products to help them sleep, both drugs are considered potentially inappropriate for the elderly (International Journal of Clinical Pharmacy, Aug. 2017).  When senior citizens purchase an OTC sleeping pill, there is no warning about age or memory problems.

Here is a message from Linda about her sleeping pill and brain fog:

“I have been taking doxylamine succinate for years. It helps me sleep well. I am 74 years old and am experiencing ‘brain fog’ more recently. I was assuming it was a part of my aging process.

“After listening to your radio show on this issue I am beginning to wonder if the sleep-aid is actually causing the problem. If it is, can the damage be reversed? I plan to stop taking the pills immediately. I have tried natural sleep aids but they don’t seem to work for me. I am very worried about this.”

Chandra offers this comment about doxylamine as a sleeping pill:

“I have long lectured myself about taking the common over-the-counter antihistamine doxylamine succinate for sleep. I just saw the physician’s assistant on Monday to extend my CPAP machine prescription and raised the issue. ‘Don’t worry about it,’ he said.

“Well, I’m going to worry about it! Time to get off, once and for all. What is a puzzle to me is that I have researched negative side effects before and haven’t found the anticholinergic connection. Now, a Google search brings that up immediately. I repeat (and at least I know I’m repeating): Thanks for this alert! It’s just what I needed to clean up my act.”

Is Zolpidem a Safe Sleeping Pill Alternative?

Unfortunately, some prescription sleeping pills such as zolpidem may affect memory and balance and put people at risk for falls and fractures (Expert Review of Clinical Pharmacology, Jan. 2014).  As a result, they may not be a great substitute for doxylamine.

You can learn more about medications that may be dangerous for senior citizens from our Guide to Drugs and Older People. Anyone who would like a copy, please send $3 in check or money order with a long (no. 10) stamped self-addressed envelope:

  • Graedons’ People’s Pharmacy, No. O-85
  • P. O. Box 52027
  • Durham, NC 27717-2027.

It can also be downloaded from this website.

Here is a list of drugs with anticholinergic activity. You can also listen to the free podcast of our show on this topic at this link.

Share your own story about sleeping pills in the comment section below.

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  1. barbara
    Matthews, NC

    After many years of insomnia and using various types of over the counter preparations that did not work, I tried CBD oil from the health food store. It works. I take it before bedtime (1tsp) and again when I wake in the middle of the night. It takes about 20 to 30 minutes to work and all told I am getting six or seven hours sleep a night. Doing without sleep all those many years caused brain fog and other health problems.

  2. Cindy

    I’ve commented on this before but it bears repeating. I’ve had insomnia all my life, mainly due to the fact that I’m high-strung and have bipolar tendencies — not full-blown bipolar, just the traits.

    To get sleep, I combined all kinds of stuff — melatonin, herbs and supplements like tryptophan, homeopathics, 5-HTP, etc. Various combinations of all this stuff would work for awhile and then not so much, so I’d keep changing up the combinations…

    This went on till I started reading about STRESS and how it activates CORTISOL, and how very bad all this is for health and longevity. This got me looking into ADAPTOGENS — supplements that fight cortisol and reduce stress. Some e.g.’s are: Ashwaganda, Rhodiola, Holy Basil and others. Well, for the last 4 years or so I’ve been taking the 3 that I just mentioned (the 2nd two have to be taken on an empty stomach so I take them 1st thing in the a.m.).

    And guess what?! I’m realizing that I no longer have any sleep problems! I’ve got many bottles of various sleep aids that I just no longer need or take. Even if I have to get up and pee, I can go right back to sleep. And now if I take a sleep aid, even a very natural and “safe” one, I find it hard to get up in the morning! So I’m basically a happy camper now. (I do use cherry juice as well, and I’m sure that helps too.)

    PS: Adaptogens have no side-effects that I’ve been able to determine; they are very safe, natural and user-friendly. CB sez: check ’em out!

  3. Dorothy

    I had been taking Tylenol PM for several years but wasn’t getting more than 6 hrs a night. Then, I found out I could buy diphenhydramine for next to nothing so I skipped right to the ingredient that should help me sleep.

    I hadn’t been taking that more than a month before I noticed my fingernails were getting paper thin with longitudinal ridges. I quit the diphenhydramine and slowly my nails began to recover but have never gotten completely smooth again.

    Then, I looked up kidney disease and found the nails looked like a symptom of kidney disease. Kidneys can be affected by that drug. Beware.

  4. Odell M

    I have been taking a 1 mg Xanax, 3 mg Melitonin, and about a table spoon of vicks nite time to help me go to sleep.

    Can’t shut my thought train off to go to sleep . I am 86 and know I have to sleep, drink lots of water. How bad is this for my mind? I know this is bad but how bad?

  5. Barbara
    Chicago, IL

    After Taking Melatonin Nature’s Bounty, Dual Spectrum, Melatonin 5mg for 2-3 months, and I had become very, very confused about everything and it got so bad it scared me.

    So, I took note of the newest culprit and that happened to be the Melatonin. Immediately I stopped taking it completely but it took up to 3 full months for me to resume normal decision making but at the time it was an ordeal not to make any simple decision, it was so very frightening!

  6. Sara
    Tampa, FL

    I recently tried cherry juice and medical marijuana and after 10 years of not sleeping I am now sleeping all the way through the night. I started with 8oz of cherry juice in the evening and morning. Then after a week I went down to 4oz 2x a day, then after a few more days I went down to 4oz only at bedtime.

    After a few more days I used 2ml of indica drops, I have my medical marijuana license. I am finally on a regular sleep schedule after fighting with myself over this issue with no lasting results and it took me 10 years to figure it out. I now go to bed around 11pm and wake up around 8am for about 9 hours of sleep, and I do get up once a night to go to the bathroom. It is wonderful to finally sleep.

  7. Joan
    Baltimore MD

    I absolutely had severe short-term memory loss while using a drug that combined an anti-anxiety drug with diphenhydramine when I was experiencing a severe bout of insomnia several years ago. I read about the memory-loss effects in People’s Pharmacy and immediately stopped the medication. I did recover from the memory loss very quickly. However, I was disappointed to have to discontinue the medication because it was so effective for me, AND it was very inexpensive. But I’d rather have my memory in tact.

  8. Larry

    I have some memory and balance problems too. Happens with low dose Trazadone and/or sleeping too long.

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