Understanding the Side Effects and Risks of Taking Sominex for Sleep

Understanding Sominex and Its Side Effects

Sominex is an over-the-counter sleep medication that contains the active ingredient diphenhydramine. It is used to help people who have occasional sleep difficulties fall asleep and stay asleep. While Sominex can be effective for short-term insomnia relief, it does come with potential side effects that users should be aware of.

What Is Sominex?

Sominex is the brand name for products containing the antihistamine diphenhydramine as the active ingredient. Diphenhydramine blocks the effects of histamine in the body, causing drowsiness. Besides being used as a sleep aid, diphenhydramine also has anticholinergic properties, meaning it blocks the neurotransmitter acetylcholine in the nervous system. This helps induce relaxation and sleepiness.

The maximum recommended dosage of diphenhydramine for adults and children over 12 years old is 50 mg taken 30 minutes before bedtime. The effects of Sominex generally last for 4 to 6 hours. While diphenhydramine begins working relatively quickly to initiate sleep, it is only meant for short-term or occasional insomnia relief. It is not recommended for long-term treatment of sleep disorders.

Side Effects of Sominex

While diphenhydramine in Sominex can help you fall asleep, it also comes with some potential side effects to be aware of. These may include:

• Daytime Drowsiness: The sleep-inducing effects of diphenhydramine can persist into the next day, causing continued drowsiness, slow reflexes, and impaired cognitive and motor performance. This can make it dangerous to drive or operate heavy machinery.
• Dry Mouth: Diphenhydramine has anticholinergic properties that can reduce saliva production, leading to an uncomfortable dry mouth sensation.
• Dizziness: Some people may feel lightheaded or dizzy after taking diphenhydramine, which can increase the risk of falls or accidents.
• Urinary Retention: Diphenhydramine can make it more difficult for the bladder muscles to fully relax and empty, potentially causing urinary retention issues.
• Constipation: Slowed gastrointestinal motility is another possible anticholinergic effect of diphenhydramine that can lead to temporary constipation.
• Confusion: Especially in older adults, diphenhydramine has been associated with paradoxical excitation, including increased confusion, agitation, and even delirium-like symptoms.

Risk of Dependence and Abuse

While not common, there is also a risk of developing psychological and physical dependence on diphenhydramine with long-term, high-dose use of Sominex. Tolerance can develop over time as well, meaning increasing doses are required to get the same sleep-inducing effects. Attempting to abruptly stop high dose diphenhydramine use can also cause withdrawal symptoms like anxiety, tremors, nausea, and trouble sleeping.

Who Should Avoid Sominex?

Though generally considered safe for short-term use, the following groups should use caution with or avoid Sominex products containing diphenhydramine:

• Young children
• Older adults
• Pregnant women
• Nursing mothers
• People with glaucoma
• People with breathing issues like COPD
• People with bladder obstruction disorders
• People taking monoamine oxidase inhibitors (MAOIs)

Those with existing medical conditions need to be especially careful about potential drug interactions and exacerbation of health problems with anticholinergic medications like diphenhydramine. It's always best to consult your doctor before taking Sominex.

Risk of Next-Day Impairment

One of the most significant risks with Sominex is the potential for next-day drowsiness and impairment. The sleep-inducing effects of diphenhydramine can last longer than the night, which makes driving or operating machinery dangerous. Studies have found residual effects of diphenhydramine on motor and cognitive function lasting over 10 hours after ingestion.

This diphenhydramine hangover effect poses risks like:

• Slowed reaction times
• Difficulty concentrating and paying attention
• Impaired hand-eye coordination
• Dizziness/lightheadedness
• Dangerous drowsiness

To avoid next-day impairment, it's best to use Sominex only occasionally and make plans that don't involve driving or hazardous activities for the next morning.

Interactions With Alcohol and Other Depressants

Combining Sominex or other diphenhydramine products with alcohol or central nervous system (CNS) depressants like opioid painkillers, sedatives, tranquilizers, etc. can enhance drowsiness and sedation to dangerous levels. This exponentially increases risks like:

• Extreme drowsiness
• Breathing difficulties
• Impaired coordination
• Cognitive dysfunction
• Unconsciousness
• Coma
• Death

It is never safe to mix diphenhydramine-containing sleep aids with other substances that slow down the body's systems. Doing so can have severe, even fatal, consequences.

Potential for Dementia Risk

Some research indicates regular long-term use of anticholinergic sleep medications like diphenhydramine may increase the risk of developing dementia. However, study findings are still inconclusive at this point.

For instance, a 2019 study published in JAMA Internal Medicine found a significant association between anticholinergic drug use for more than 3 years and increased dementia risk. However, another 2019 study found long-term insomnia itself increased dementia risk, not necessarily the medications used to treat it.

While more research is still needed, those concerned with brain health in older age may want to be cautious with use of anticholinergic sleep aids like Sominex until more definitive evidence is available.

Increased Fall Risk

Between the potential for daytime drowsiness, dizziness, and cognitive impairment, diphenhydramine use can increase risks for instability and falls. This is especially concerning for elderly populations already at higher fall risk.

One study found taking more than 4 mg of diphenhydramine daily increased the chances of hospitalization due to an injury by nearly 50%. The cognitive effects on top of sedation seem to have an impact on balance and motor coordination that may result in more falls.

Safer Use of Sominex

When used occasionally and as directed, Sominex can help relieve temporary insomnia safely and effectively. But it is always best to take precautions like:

• Following dosage guidelines carefully.
• Only using for short periods (1-2 weeks maximum).
• Allowing for full nights of sleep after taking it.
• Avoiding alcohol and other CNS depressants.
• Speaking with your doctor first if you have medical conditions or take other medications.

While side effects are possible, Sominex is relatively safe if used responsibly and with awareness of the potential risks. Being properly informed allows making the best decisions for your health when considering use of this common over-the-counter sleep aid.

Treating Insomnia Long-Term Without Medications

For chronic insomnia lasting more than a few weeks, experts recommend relying on non-drug treatments rather than medications like Sominex. Some evidence-based alternatives may include:

Cognitive Behavioral Therapy for Insomnia

CBT-I works to improve sleep by targeting anxiety-provoking thoughts, behaviors, and beliefs about sleep. Trained therapists provide tools to help change sleep-disruptive habits and address the underlying causes of insomnia versus just managing symptoms.

Sleep Hygiene

Improving sleep hygiene involves making simple lifestyle and environment changes like:

• Establishing a regular bedtime and wake time
• Limiting naps during the day
• Making the bedroom dark, cool, and quiet
• Avoiding stimulating screens and activity before bed
• Exercising regularly, but not too close to bedtime
• Following a relaxing pre-bed routine

Relaxation Techniques

Learning and practicing relaxation methods like deep breathing, visualization, progressive muscle relaxation can help reduce anxiety and racing thoughts that interfere with sleep.

Cognitive Distraction

This involves keeping the mind occupied with a repetitive, unstimulating cognitive activity until sleepy. Counting backwards from 100 and repeating words/phrases are examples.

For insomnia lasting longer than a month, these types of approaches address the root causes and establish healthy long-term sleep habits. They also avoid the risks and side effects of medications.

Know the Signs It's Time to Seek Professional Help

While occasional short-term use of Sominex can be appropriate, chronic insomnia or excessive daytime sleepiness may indicate an underlying sleep disorder or health issue. It's important to consult a doctor or sleep specialist if you experience symptoms like:

• Difficulty sleeping or staying asleep at least 3 nights per week for over a month
• Feeling unrested during the day despite adequate sleep time
• Frequent strong urges to take naps during the day
• Difficulty paying attention, concentrating, or remembering
• Ongoing fatigue or low energy
• Mood changes like depression or irritability

A sleep study may be recommended to check for issues like sleep apnea, restless leg syndrome, or hormonal disorders contributing to insomnia. An underlying condition needs to be addressed for long-term healthy sleep.

The Bottom Line

Sominex can help occasional insomnia, but regular long-term use carries risks like daytime drowsiness, confusion, increased fall risk, and potential dementia concerns. It is also not a substitute for treating chronic insomnia through cognitive and behavioral changes. Understanding the side effects and when it's time to see a doctor allows making informed decisions about use of this common OTC sleep medication.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.