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NIOSH Training for Nurses on Shift Work and Long Work Hours

Sleep Aids and Stimulants (Continued)

If you are not sleeping well, you may decide to try an over-the-counter (OTC) medication for sleep. Most OTC sleeping aids are antihistamines, such as diphenhydramine. Because they have a long period of action, they can make you feel drowsy for several hours after you awaken. Also, they lose their effectiveness over time. Thus, it may be better to see a health care provider for an assessment and advice.

Your doctor can prescribe a medication that fits your specific sleep problem. Three typical problems are difficulty going to sleep, difficulty staying asleep and waking up too early. The newer prescription medications target each of these problems specifically, with different mechanisms and durations of effect.12

You might be tempted to have a glass of wine or other alcoholic beverage to help you fall asleep. Although drinking alcohol can quicken sleep onset, researchers strongly recommend against this because it causes arousals and awakenings. As a result, you may not feel refreshed on waking.

Melatonin, a hormone, has become popular as an OTC sleeping aid. It is sold as a nutritional supplement in the United States and is not regulated as a drug by the FDA. Therefore, the FDA has no oversight on its purity or accuracy of dosage. Some experts have expressed concern about the melatonin products sold in the United States.12,13 In addition, two expert sleep panels have published cautions about the use of melatonin to promote adjustment to shift work, stating that more research is needed in this area.12,14

Normally, the body increases melatonin level in the evening 1 to 2 hours before usual bedtime. Melatonin level peaks in the body around 2-4 a.m. and then decreases until morning, when production ceases. If you take melatonin to sleep, it must be taken at the right time, or else it could shift the circadian clock in the wrong direction or have no effect. It may be difficult for shift workers to determine the right time to take melatonin because their changing sleep schedules and exposures to light likely change the time when their body will be sensitive to melatonin.

Module: 6, Page 10 of 20