OTC And Prescription Sleeping Aids

Last Updated: June 10, 2020

Authored by Nena Messina, Ph.D.

Many over the counter sleeping pills are useful for insomnia and can also help reduce the effects of a hangover. In the same way, prescription sleeping pills can provide specific solutions to lack of sleep with more prolonged effects. In classifying sleeping aid prescriptions, one many need to look at various characteristics and mechanisms of action to understand what category each medication falls into.

Sleeping pills prescription is very high in the United States and continues to grow at a significant rate. The manufacturing of generic prescribed sleeping pills makes it easier to gain access to these medications. Otc sleeping aids are easily purchased at a local drug store and require no medical prescriptions.

Whether it’s over the counter sleep medication or a prescribed drug, sleep aids can be classified in many ways in clinical practice, most times according to the structure of the active ingredient, the anatomical components affected by the mechanism of action of the drug, and the spectrum of therapeutic action.

OTC Sleeping Pills

As the name implies, Otc sleeping pills are medications obtained over the counter without a prescription from a medical professional. Over the counter sleeping aids are the most common types and can come in various names and brands. Some nature made sleeping aid can also be purchased over the counter and are known to be perfectly safe. However, they still may have some side effects and can cause allergic reactions.

Getting OTC Medications

Often one might wonder why it is so easy to get sleeping pills otc even though there are also other forms of sleep aids that can only be administered on prescription. Rx sleeping pills can be purchased from various vendors online and offline without the need or the hassle of securing a prescription. What makes sleeping pills over the counter different from other forms of sleep medications which have strict doses?

Here is a list of over the counter sleeping pills:

  • Nytol
  • Tylenol
  • Excedrin
  • Benadryl
  • Doxylamine succinate

An over the counter sleeping aid may have a shorter half-life than its counterpart. The best over the counter sleep medication may have minimal side effects with a longer half-life and is quite sufficient for insomnia and other secondary health issues.

Many drugs can cause sedation, but not all can be categorized as over the counter sleeping pill due to their various applications, classes, psychological effect, and other potentials.

Strongest OTC Aid

The strongest over the counter sleeping pills are the Diphenhydramine. This class of sleeping pills majorly acts on histamine receptors located in the CNS to invoke sedation. The duration of strong sleeping pills over the counter may last as long as 4 to 6 hours or longer in some cases. The peculiarity of its side effects is limited to daytime drowsiness and difficulty in urinating, which may be experienced in the elderly. Diphenhydramine is also used as an allergy relief medication and is usually administered to people with mild cases of insomnia.

woman sleeping in bed

Prescription Sleeping Pills

There are many cases of insomnia, and the cause of the sleep disorder determines the levels or potency of sleep aid recommended by the physician. A prescription sleeping pill may be recommended for cases that may be severe or chronic. What is the difference between prescribed sleep medication and those that can be purchased without a prescription? The significant difference between sleeping pills over the counter and those that are prescribed is that prescribed sleep pills have primary functions which involve CNS activities and can present with more dangerous side effects.

Here are the names of prescription sleeping pills and how they function:

Tricyclics (Antidepressants)

The tricyclic prescription sleep medication acts by binding to brain receptors to cause neurological effects. Even though its mechanism is not well studied and its duration of effect may vary, it is one of the most effective prescribed sleep aids. Its side effects may be extreme, with symptoms such as difficulty urinating, extended painful erections, and possible cardiac arrhythmias. This is why the medication should only be used on prescription. Examples of tricyclics are:

  • Desyrel, Oleptro, Trazorel, Trittico, Molipaxin, Trialodine (Trazodone)
  • Adapin, Doxal Gilex, Sinequan, Deptran, (doxepin)
  • Elavil, Lentizol, Saroten, Laroxyl, Tryptomer, Endep (amitriptyline)
  • Stangyl, Surmontil, Rhotrimine (Trimipramine)


Benzodiazepines must be only administered on prescription as the drug is extremely potent and can lead to dependency and addiction if abused. Its mechanism of action involves binding to GABA receptors in the CNS. Benzodiazepine is one of the strong prescribed sleeping pills, and its effects can last between 4 to 24 hours or more depending on the drug. Some extremely potent Benzodiazepine types such as Diazepam has a half-life of about 20 to 100 hours.

Here is a Benzodiazepine sleeping pill prescription list:

  • Xanax (alprazolam)
  • Sonin, Dormonoct, Havlane (Loprazolam)
  • Insoma, Nitrados, Nitrosun, Paxadorm, Somnite, Ormodon, (Nitrazepam)
  • Valium (Lorazepam)
  • Alepam, Serax, Serepax, Purata, Medopam, Murelax, Opamox, (Oxazepam)
  • Klonopin, linotril, Rivotril (Clonazepam)
  • Restoril, Tenox, Nortem, Remestan, Temtabs, Normison, (Temazepam)
  • Dalmadorm, dalmane (Flurazepam)

man looking at the bottle with pills

Sleep Cycle Modifying Medication

This is a category of drugs with a relatively shorter half-life. Actually, there is only one widely used med with such action: Rozerem (Ramelteon). Although were found to present with similar health issues as benzodiazepines, in the long run, their mechanism of action involves altering CNS activities, especially at regulation point. The medication stimulates receptors of melatonin in the brain which alters sleep cycles. The duration of effect may last for 4 to 6 hours.

Selective GABA Medications

As the name implies, this category of drugs target GABA receptors in the brain and are very precise in their actions. They specifically cause sleepiness by binding to a specific GABA receptor and can last for about 6 to 8 hours. This medication is strictly on prescription as side effects may be extreme. The prescription sleeping pill names are:

  • Ambien (Zolpidem tartrate)
  • Sonata (Zaleplon)
  • Ambien CR (Zolpidem tartrate extended-release)
  • Lunesta (eszopiclone)

Taking Sleeping Aids Safely

There are many categories of sleep aids ranging from non-narcotic to narcotic forms with different mechanisms of action. Medical practitioners use the classification of sleep drugs in recommending the strongest otc sleeping pills as well as prescribed medications for patients suffering from sleep disorders.

Prescription sleep drugs, when abused, can lead to dependency and distort CNS functions which often lead to major health issues. One should talk to a medical expert before taking sleep aids. Substance abuse detox is usually the first line of action when a person develops addictions to sleeping drugs.

There are many facilities today that support substance abuse treatment planning for addicts. The best drug rehab centers provide both inpatient and outpatient services with detox, cognitive behavioral therapy, medication therapy, and others, to help mitigate the effect of addiction to sleep medications.

Page Sources

  1. Sleep Disorder (Sedative-Hypnotic) Drug Information. U.S. Food And Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/sleep-disorder-sedative-hypnotic-drug-information
  2. Surprising View of Insomnia and Sleeping Pills. Sleep. 2013 Aug 1; 36(8): 1127–1128. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3700708/

Published on: September 17th, 2019

Updated on: June 10th, 2020

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.


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