OTC Sleep Aid Comparison: Evidence, Dose and Risks
Compare 19 non-prescription sleep aids, including antihistamines, melatonin, herbals, magnesium and cannabinoids, by dose, evidence, risks and interactions.
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What it covers
This reference puts 19 non-prescription sleep aids side by side. It includes OTC antihistamines (diphenhydramine, doxylamine), melatonin, herbal and botanical products (valerian, hops, chamomile, passionflower, lavender, lemon balm, ashwagandha, kava, tart cherry), minerals and amino acids (magnesium, glycine, L-theanine, tryptophan and 5-HTP), and cannabis products (THC, CBD, CBN). It is a companion to the Non-Prescription Sleep Aids chapter.
What each card shows
Every agent has a card with its category, an evidence grade, and five rows: mechanism, typical dose, onset and duration, key risks, and interactions. Examples of the points it records: diphenhydramine and doxylamine carry rapid tolerance, next-day carryover and anticholinergic risk; melatonin timing matters more than dose and label content varies widely; kava carries serious hepatotoxicity and is not recommended for sleep; magnesium accumulates in renal impairment; tryptophan and 5-HTP carry serotonin syndrome risk with serotonergic drugs; CBD inhibits CYP3A4 and CYP2C19.
| Evidence grade | Meaning in this tool |
|---|---|
| Low–moderate | Low-to-moderate controlled human data (melatonin, magnesium) |
| Low | Low strength of controlled human data |
| Minimal | Minimal or preliminary data |
| Not supported | Not supported or recommended against (kava, CBN) |
Filtering and sorting
Search across names, mechanisms, risks and interactions (for example "anticholinergic", "CYP" or "withdrawal"). Filter by category or by minimum evidence grade, and sort by category, name or evidence. A checkbox flags agents to avoid or use with caution in adults 65 or older: diphenhydramine and doxylamine (Beers criteria), magnesium (renal accumulation) and THC.
Limitations
Evidence grades reflect controlled human data for a direct sleep effect and are deliberately conservative. Doses are typical literature ranges, not individualized recommendations. Supplement content is not FDA-verified and varies widely. CBT-I remains first-line for chronic insomnia. The tool is educational decision support and has no scoring or report output; confirm details against current references and the full medication list.
About PsychoPharmRef
PsychoPharmRef is a free clinical psychopharmacology reference built by Jerad Shoemaker, MD for psychiatrists, residents, and medical students. All tools are evidence-based and designed for point-of-care clinical decision support.
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