Getting enough restful sleep and maintaining a regular sleep schedule is important for overall health, just as maintaining a nutritious diet and regular exercise program. Studies show that insufficient, disrupted sleep negatively impacts cognitive functions such as attention, learning, and memory, as well as physical and mental health.
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The National Heart, Lung, and Blood Institute has highlighted that sleep deprivation and untreated sleep disorders are associated with increased incidence and prevalence of a variety of long-term health conditions, including heart disease, high blood pressure, stroke, diabetes, obesity, and certain cancers.1 Shape2 According to the Sleep Foundation, this study shows the clinical benefits of healthy sleep patterns.
Although everyone experiences sleep problems occasionally, many people in the US experience insomnia on a regular basis. Insomnia involves having trouble either falling asleep or staying asleep, or periodically waking up early despite spending enough time in bed. Symptoms of insomnia include daytime fatigue, dissatisfaction with sleep, difficulty concentrating, and feelings of depression, anxiety, or irritability.3 It can be acute or chronic and has a significant impact on health and quality of life, leading to reduced productivity, increased accident risk, and increased irritability, anxiety, and daytime fatigue.4 According to the American Academy of Sleep Medicine, chronic insomnia can be detrimental to physical, mental, and emotional health, negatively affecting overall health and daily functioning. Additionally, chronic insomnia may increase the risk of depression, anxiety, substance abuse, work-related accidents, Alzheimer's disease, and type 2 diabetes.3
News and recent clinical data about sleep and insomnia
According to a recent survey conducted by the American Academy of Sleep Medicine, 12% of Americans are struggling with chronic insomnia. The online survey was conducted between May 16 and 24, 2024, involving 2006 adults. The results showed that men were slightly more likely to be diagnosed with chronic insomnia than women, with the most prevalent rate of diagnosis observed in individuals aged 25 to 44 years.5
In May 2024, the National Sleep Foundation published a consensus statement that included a comprehensive review of the current evidence on the impact of screen use on sleep health across different age groups. The consensus statement stated that screen use generally impairs sleep health in children and adolescents, particularly when digital devices are used before bedtime. The panel of experts also noted that behavioral strategies and interventions can help reduce these adverse effects, such as limiting screen time and teaching children about technology use and its impact on sleep.6
About the Author
Yvette C. Terry, BSPharm, RPh, is a consulting pharmacist and medical writer in Haymarket, Virginia.
A study published in BMJ Open Sport & Exercise Medicine Studies have shown that taking a break for body-weight resistance exercise activity in the evening has the potential to improve sleep duration and total sleep time.7 Specifically, the study data showed that interrupting sedentary time with 3 minutes of light to moderate intensity body weight resistance exercise every 30 minutes in the evening increased free-living time spent sleeping by 27 minutes. It had no disruptive effects on other sleep elements and 24-hour physical activity patterns in healthy adult participants.7
In a study diabetes The study showed that unhealthy sleep patterns, whether too little or too much, significantly increases the risk of type 2 diabetes in diverse adult populations.8 The investigators evaluated long-term trajectories of sleep duration and diabetes incidence in 22,285 black adults and 13,737 white adults. Analyses revealed that the most suboptimal sleep trajectories were consistently correlated with diabetes incidence across all socio-demographic subgroups.8
Over-the-counter sleep aids
The primary goal in treating insomnia is to find and address any underlying causes, enhancing the patient's sleep quality, daytime functioning, and productivity when possible. The use of OTC sleep aids is often the first line of treatment for insomnia. These products are available in various dosage formulations and usually contain diphenhydramine or doxylamine, although some products contain melatonin and other herbal supplements for sleep.9 OTC sleep aids are not suitable for patients who suffer from long-term insomnia, medical consultation is recommended for such patients.9
Pharmacists are well positioned to ascertain the appropriateness of self-treatment strategies and can adequately guide patients in deciding on an appropriate agent. An important role is to check for potential therapeutic duplication (diphenhydramine can also be found in some cold and allergy medications) or drug-drug interactions and contraindications and to instruct patients to seek further medical evaluation from their primary health care provider. Self-treatment may sometimes be inappropriate, particularly in pediatric patients, older adults, and people with chronic comorbidities who are taking other medications.
Pharmacists can also evaluate patients and identify specific medical conditions, such as arthritis, heartburn, hyperthyroidism, and sleep apnea, that may impact or disrupt sleep quality and duration. Pharmacists should also identify pharmacological agents such as antidepressants, antihypertensives, and sympathomimetic amines that are commonly associated with insomnia and make patient-centered clinical recommendations accordingly.9
Recommendations
Pharmacists should advise patients that over-the-counter sleep-inducing medications are only appropriate for short-term use, and if insomnia continues or worsens after 7 to 10 days of using these medications, patients should consult their primary health care provider for further guidance.9 Patients should also be instructed to follow the manufacturers' recommended dosage and duration of treatment and to be aware of potential adverse drug reactions such as morning sickness, xerostomia, constipation, and blurred vision, as well as drug interactions and warnings. Pharmacists can also remind patients that to improve sleep, it may be beneficial to establish a regular bedtime routine, limit naps to 20 to 30 minutes, avoid heavy meals and stimulants before going to bed, discontinue electronic device use before bedtime, and create a relaxing sleep environment. Through effective patient education initiatives, pharmacists can be helpful in treating insomnia by advising patients, recommending available treatments, monitoring for adverse drug reactions, promoting sleep hygiene, and encouraging further medical evaluation when appropriate.