6 Sleeping Pill Alternatives for a Good Night's Sleep
While sleeping pills may provide a short-term solution, these natural sleep aids are better at improving overall sleep health
It's 2 a.m. and you're still up. Frustrated, you grab a sleeping pill. While effective in the short term, sleeping pills can cause memory problems, muscle weakness and drowsiness, among other side effects.
Fortunately, natural sleep aids can be as effective, or more effective, than sleeping pills. A recent study in Sleep Medicine Reviews outlined six alternatives: acupuncture, taking a hot bath, manual therapy, CBT, therapeutic exercise and limbic neuromodulation.
To understand each, we talked to two sleep health experts.
As we get older, our relationship with sleep shifts. Some of the most common changes include:
- Going to bed earlier
- Less deep sleep
- Disruptions in the circadian rhythm
- Lower melatonin levels
- A higher risk for certain sleep disorders, such as sleep apnea and restless leg syndrome
Age is also a risk factor for many conditions that cause chronic pain, making it difficult to fall and stay asleep. These conditions include but are not limited to multiple sclerosis (MS), fibromyalgia and arthritis.
"There's a difference between your sleep when you're on a sleeping medication, versus natural sleep."
In response, doctors often prescribe sleep medication. The CDC estimates 8.4% of Americans take sleeping pills, with higher use among adults over 45. While sleeping pills can increase time asleep, at least in the short run, they don't improve sleep quality.
"There's a difference between your sleep when you're on a sleeping medication, versus natural sleep," says Luis Buenaver, PhD, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine. Taking a sleeping pill can increase time asleep, he explains, but the real fix is to develop habits to improve sleep quality as well as duration.
Sleeping pills also have a variety of side effects, including being groggy the next day and having slower reaction times. Buenaver adds that people often build up a tolerance to sleeping pills, meaning the medication can be less effective the longer someone takes it.
Natural Sleep Aids to Consider
"Our bodies are designed to sleep and given the right strategies and skills people can, in general, learn to sleep without sleeping aids," says Katie Siengsukon, PhD, a professor of physical therapy at the University of Kansas Medical Center.
"Our bodies are designed to sleep and given the right strategies and skills people can, in general, learn to sleep without sleeping aids."
The necessary strategies and skills are often determined by the underlying problem, such as physical pain, stress or poor sleep hygiene. Natural sleep aids address one or more of these issues and may be used independently or together.
Many can even be used alongside sleeping pills if someone wants to use medication in the short term.
1. Manual therapy
When trying to improve sleep health, physical therapy (PT) may not be the first thing to come to mind, but there is a strong link between PT and sleep. One of the most studied PT interventions is manual therapy.
"Manual therapy is any therapy where the therapist is using their hands," says Siengsukon. This often includes massages and stretches facilitated by a physical therapist.
Typically, manual therapy treats chronic pain that makes it difficult to fall or stay asleep. A physical therapist or another health care professional should diagnose the underlying problem before choosing a manual therapy modality.
2. Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) can treat multiple conditions, including insomnia. CBT is a non-medication treatment that addresses behaviors in a talk therapy format. It also addresses racing thoughts, which can keep people up at night.
"A regular exercise routine can improve someone's sleep quality."
Buenaver has found CBT sessions specifically geared around sleep habits and anxieties to be successful at treating insomnia. Usually, his patients undergo six sessions and receive mindfulness practices they can do independently. After treatment, his patients have seen a marked improvement in sleep for up to two years.
3. Taking a Bath
Many habits are touted to promote good sleep hygiene, but one of the most research-backed is taking a bath. "A warm bath or shower can heat the body passively," explains Siengsukon. This heating process allows the body to naturally cool as we fall asleep, helping with melatonin production and stress relief.
While effective, baths are best used with other strategies as opposed to a standalone intervention.
4. Therapeutic exercise
"A regular exercise routine can improve someone's sleep quality," says Buenaver, so long as the exercise doesn't happen too close to bedtime.
There's an array of sleep-healthy workouts, such as pilates, aerobic exercise, functional strength training, yoga and Qigong, to name a few. The key is to find an enjoyable routine suitable to someone's abilities, says Buenaver.
Underlying conditions also impact which exercise works best. A 2016 study found that moderate-intensity aerobic exercise helped participants with MS reduce daytime sleepiness while walking and stretching helped those with MS improve sleep quality. However, those same exercises may not work for other conditions. A physical therapist or other health care professional can help you create an optimal exercise routine for your needs.
5. Acupuncture
Acupuncture, a traditional Chinese medicine where needles are stuck into the body, promotes better sleep health by relieving stress and physical pain. The practice relaxes the body which may help someone fall asleep faster and stay asleep, explains Siengsukon.
"An excellent first step is to see a primary care physician."
6. Limbic neuromodulation
Limbic neuromodulation is a series of therapies, medications and mindfulness practices aimed at regulating the limbic system, the part of the brain responsible for emotional and behavioral responses.
These practices lower anxiety and stress levels, leading to better sleep. They may also play a role in relieving emotional stress and sleep disturbances caused by chronic pain. In one 2019 study, limbic neuromodulation made it easier for patients with fibromyalgia to sleep.
While the practices above, and many others, are effective at improving sleep, they won't work for everyone. Many physical and mental health conditions impact sleep quality, meaning a treatment plan should work for the specific underlying condition.
"An excellent first step is to see a primary care physician," recommends Siengsukon. A primary care doctor can assess symptoms and refer a patient to a pulmonologist if there's a sleep disorder, a psychologist for insomnia, or a physical therapist for pain interrupting sleep.
Along with medical intervention, good sleep hygiene, such as sleeping in a quiet room or turning off screens an hour before bedtime, can also help. Sleeping pills may be a temporary fix, but natural sleep aids and good sleep hygiene improve sleep quality for years to come.
