Difficulty in the onset of sleep, insufficient total sleep time, frequent awakenings during sleep, or poor quality of sleep are often termed sleep disorders. If these signs occur once in a while, then they might be considered sleep disturbances, due to lifestyle changes. However, if these signs occur repeatedly or persist for more than three days, then they should be considered as sleep disorder or insomnia.

Usually, these sleep disturbances are coped with by simple lifestyle modifications and by taking a proper balanced diet. At times, though, these measures are not sufficient and sleep disorder persists. If an individual faces a problem in sleep patterns and sleep quality even after taking ample measures in his lifestyle and diet, then it is necessary to take the help of sleeping aids to overcome insomnia.

Primarily, these sleeping aids are of two types depending on their availability. These are:

• Over-the-counter sleeping aids (OTC)

These are the sleeping aids that are easily available at any medical store, and you do not need any medical prescription to buy these aids. They are basically antihistaminic drugs, melatonin-rich compounds, or herbal products. These are commonly available under the trade name Nytol, Sominex, Sleepinal, Compoz, Unisom, Nighttime sleeping aid, and Valerian.

• Prescription sleeping aids

As the name suggests, these are the drugs that are prescribed by a medical/healthcare professional to treat insomnia. These prescription drugs are often known as ‘sedative hypnotics.’ They are usually benzodiazepines, non-benzodiazepines, melatonin-mimicking drugs, or antidepressant drugs. These are commonly available under trade names Prosom, Dalmac, Doral, Restoril, Helicon, Sonata, Ambient, and Rozerem.

There are diverse outlooks on the comparative effectiveness of prescription sleeping aids and over-the-counter sleeping aids, but the basic difference between both of them can be comprehended by comparing them over a few parameters:

1. Indication

OTC sleeping aids are indicative of acute insomnia. They are used by individuals suffering from occasional insomnia (persisting for less than a week).

Prescription sleeping aids are indicative of chronic insomnia, i.e., insomnia that persists for more than three weeks.

2. Mode of action

OTC sleeping aids work by inducing drowsiness, but their effect does not last after frequent use, as the body develops tolerance to their sedative effect; hence, they are not advisable for long-term use.

Prescription sleeping aids work by depressing the central nervous system, thereby, inducing tranquility and sleep. These drugs work very quickly and their effect lasts longer. Hence, they induce sleep soon and improve the overall sleep duration.

3. Efficacy

OTC sleeping aids are effective in treating infrequent insomnia, but they cannot be used to treat chronic persisting insomnia as tolerance to its sedative effects develops very easily.

Prescription sleeping aids are very effective even after long-time usage. Clinical studies have proved that these drugs can sustain their sedative effect even after a long duration of usage.

4. Safety

OTC sleeping aids are neither enough studied for their usage in conditions like insomnia, nor are there sufficient clinical studies that support their usage as sleeping aids. Many medical professionals strongly disapprove of their usage as sleeping aids. Such sleeping aids are often taken without medical supervision; hence, their dosage is not controlled and, at times, this leads to adverse reactions.

Prescription sleeping aids are taken under medical supervision; therefore, they are relatively safer. The overall effectiveness of these drugs is also proven by various clinical studies conducted on insomnia.

5. Side effects and risk factors associated

Taking OTC sleeping aids is usually followed by side effects, such as developing drug tolerance, drowsiness during day time, dizziness, and medical interaction with other drugs. Along with this, taking these sleeping aids for a prolonged time might mask the underlying condition associated with insomnia.

Prescription sleeping aids usually have very less side effects and risks, but long-time usage of these aids may result in drug dependency; also, weaning off from these medicines may cause withdrawal symptoms and may worsen insomnia.

There are a variety of sleeping aids available in the market. The efficacy of these sleeping aids varies from person to person and the best sleeping aids are those that work best for that particular person.