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You’ve followed the usual tips for getting enough sleep — sleeping on a regular schedule, avoiding caffeine and daytime naps, exercising regularly, and managing stress. Still, it’s been weeks and a good night’s sleep remains elusive. Is it time for an over-the-counter sleep aid? Here’s what you need to know if you’re considering medication to help you sleep.

Sleep aids: Not a magic cure

Over-the-counter sleep aids can be effective for an occasional sleepless night. There are a few caveats, however. Most over-the-counter sleep aids contain antihistamines. Tolerance to the sedative effects of antihistamines can develop quickly — so the longer you take them, the less likely they are to make you sleepy. In addition, some over-the-counter sleep aids can leave you feeling groggy and unwell the next day. This is the so-called hangover effect. Medication interactions are possible as well, and much remains unknown about the safety and effectiveness of over-the-counter sleep aids.

Yes, lack of sleep can affect your immune system. Studies show that people who don’t get quality sleep or enough sleep are more likely to get sick after being exposed to a virus, such as the common cold. Lack of sleep can also affect how fast you recover if you do get sick.

During sleep, your immune system releases proteins called cytokines, some of which help promote sleep. Certain cytokines need to increase when you have an infection or inflammation, or when you’re under stress. Sleep deprivation may decrease production of these protective cytokines. In addition, infection-fighting antibodies and cells are reduced during periods when you don’t get enough sleep.

So, your body needs sleep to fight infectious diseases. Long-term lack of sleep also increases your risk of obesity, diabetes, and heart and blood vessel (cardiovascular) disease.

How much sleep do you need to bolster your immune system? The optimal amount of sleep for most adults is seven to eight hours of good sleep each night. Teenagers need nine to 10 hours of sleep. School-aged children may need 10 or more hours of sleep.

But more sleep isn’t always better. For adults, sleeping more than nine to 10 hours a night may result in poor quality of sleep, such as difficulty falling or staying asleep.

A growing number of studies suggest that use of electronic media, such as computers, TVs, mobile phones or video games, especially before bedtime, is tied to later bedtimes and less sleep for children and adults.

There are many possible explanations for this link. People might simply be using time previously spent sleeping to use electronic media. Or use of electronic media might be displacing physical activity, which generally promotes quality sleep. Another possibility is that the increased physiological and mental arousal caused by electronic devices makes it hard for people to fall asleep.

Some researchers believe that exposure to light at night from electronic media sources can interfere with melatonin, a hormone that helps control the natural sleep-wake cycle. It’s also possible, however, that people who have trouble falling asleep might tend to use electronic media before falling asleep. Obviously, further research on this topic is needed.

In the meantime, if you’re concerned about the impact of electronic media on your sleep, pay attention to good sleep hygiene. For example, maintain a regular sleep schedule and avoid stimulating light and noise — such as from a TV or computer — around bedtime. If you use your phone or tablet in bed, it might help to turn down the brightness and hold the device at least 14 inches (36 centimeters) away from your face to reduce the risk of sleep disruption.

Results from several small or short-term studies indicate that valerian — a tall, flowering grassland plant — may reduce the amount of time it takes to fall asleep and help you sleep better. However, not all studies have shown valerian to be effective, and there may be some dangers.

Before you decide to take a valerian supplement for insomnia, consider the following:
•Medication may not be the answer for insomnia. Cognitive behavioral therapy — for instance, replacing worries about not sleeping with positive thoughts — may be more effective and safer than medications for dealing with chronic insomnia.
•Product claims may be misleading. Be a smart consumer and do a little homework. Don’t just rely on a product’s marketing. Look for objective, research-based information to evaluate a product’s claims. Of the many valerian species, only the carefully processed roots of the most widely studied species, Valeriana officinalis, are known to contain the most effective mix of active compounds.
•Dosage is unclear. Valerian seems to be most effective after you take it regularly for two or more weeks. Since there have been relatively few rigorous studies involving valerian, it’s not clear what dose is most effective or for how long you should take a particular dose.
•Possible side effects exist. Although valerian is thought to be fairly safe, headache, dizziness, gastrointestinal problems and sleeplessness can occur. Valerian may not be safe if you’re pregnant or breast-feeding. If you have liver disease, avoid taking valerian.
•Drug interactions are possible. Valerian may increase the effects of other sleep aids. It also increases the sedative effect of other depressants, such as alcohol and diazepam (Valium). Check with your doctor if you’re thinking of taking a valerian supplement to make sure that it won’t interact with any other medications you’re taking.

Ultimately, persistent insomnia indicates a problem, such as a medical or psychological condition or poor sleep habits. If you have persistent insomnia, talk to your doctor about possible causes and treatment strategies or consider getting an evaluation at a sleep medicine center that’s accredited by the American Academy of Sleep Medicine.

Stress symptoms may be affecting your health, even though you might not realize it. You may think illness is to blame for that nagging headache, your frequent insomnia or your decreased productivity at work. But stress may actually be the culprit.

Common effects of stress

Indeed, stress symptoms can affect your body, your thoughts and feelings, and your behavior. Being able to recognize common stress symptoms can give you a jump on managing them. Stress that’s left unchecked can contribute to health problems, such as high blood pressure, heart disease, obesity and diabetes.

Common effects of stress …

… On your body … On your mood … On your behavior
•Headache
•Muscle tension or pain
•Chest pain
•Fatigue
•Change in sex drive
•Stomach upset
•Sleep problems
•Anxiety
•Restlessness
•Lack of motivation or focus
•Irritability or anger
•Sadness or depression
•Overeating or undereating
•Angry outbursts
•Drug or alcohol abuse
•Tobacco use
•Social withdrawal

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