Common Over-the-Counter Sleep Aids for Flying
For many travelers, over-the-counter (OTC) options are the first consideration for achieving some rest during a flight. The most widely available options typically contain sedating antihistamines or the hormone melatonin. However, it's crucial to understand their specific properties, as they are not all created equal.
Sedating Antihistamines
Diphenhydramine and doxylamine are two common sedating antihistamines found in many OTC sleep aids. They work by blocking histamine, a compound that helps activate wakefulness in the brain.
- Diphenhydramine: Available under various brands, this medication is a potent sedative that can effectively induce drowsiness for a single night. However, a significant drawback is the potential for next-day grogginess, often described as a "hangover effect". This can be particularly disruptive if you need to be alert upon arrival.
- Doxylamine: Doxylamine also acts as a sedating antihistamine. It has a similar side effect profile to diphenhydramine, including the risk of dry mouth and lingering grogginess. Due to its longer duration of action (up to eight hours), it's best reserved for longer flights where sufficient sleep time is available to avoid feeling sluggish.
Melatonin
Melatonin is a hormone naturally produced by the body to regulate the sleep-wake cycle. As a supplement, it signals to your body that it's time for sleep but does not act as a strong sedative like other sleep aids. It is particularly effective for resetting your internal clock and minimizing jet lag.
- Usage for jet lag: For eastward travel, where you need to shift your clock earlier, melatonin may be taken at your new destination's bedtime. For westward travel, where you shift your clock later, it may be taken in the morning. Starting with a low strength is often recommended.
- Considerations: Since melatonin is a dietary supplement, FDA regulations are less strict compared to prescription medications. Always consult a doctor, especially if you have pre-existing conditions.
Prescription Medications for In-Flight Sleep
For severe sleep difficulties or anxiety, a healthcare provider might recommend a prescription sleep aid. These are generally more powerful and carry higher risks than OTC options.
Z-drugs (Non-Benzodiazepine Sedative-Hypnotics)
This class includes medications like zolpidem, eszopiclone, and zaleplon. They work by slowing brain activity to induce a very deep sleep.
- Zolpidem: A powerful sedative, zolpidem is effective but carries significant risks, including sleepwalking, memory loss, and poor coordination. It is crucial to have at least 6 to 7 hours for sleep to allow the drug to metabolize, and it should never be combined with alcohol. High altitudes can also exacerbate its side effects.
- Eszopiclone and Zaleplon: These work similarly to zolpidem but may have different durations of action. Some, with a shorter duration, may be suitable for shorter flights (5-6 hours).
Benzodiazepines
Medications such as temazepam and alprazolam are central nervous system depressants often prescribed for anxiety, including severe fear of flying.
- Serious Risks: Many health experts advise against using benzodiazepines on flights due to risks like reduced awareness, impaired reaction times, increased risk of deep-vein thrombosis (DVT) from immobility, and paradoxical agitation. The combination with alcohol is especially dangerous.
Other Prescription Options
Ramelteon: This prescription medication acts as a melatonin receptor stimulant and is less aggressive than Z-drugs. It helps regulate the body's sleep-wake cycle with fewer sedative side effects like sleepwalking or memory loss.
Important Safety Considerations for In-Flight Medication
Regardless of which medication you consider, safety is the top priority, especially given the unique circumstances of flying.
- Trial Run at Home: Always test a new sleep medication at home before your flight to understand how your body reacts. This helps you avoid unexpected side effects at 30,000 feet.
- High Altitude Effects: Reduced cabin pressure can exacerbate the side effects of sedative-hypnotic medications, worsening drowsiness and impairing motor skills.
- Deep-Vein Thrombosis (DVT): Sleeping too soundly can increase the risk of DVT, especially on longer flights. Sedatives can cause a person to remain immobile for too long. If you use a sleep aid, get up and move around periodically to promote blood circulation.
- Avoid Alcohol: Combining alcohol with sleep aids can intensify side effects and increase vulnerability. Alcohol itself disrupts normal sleep cycles and causes dehydration, which is already an issue on planes.
- Emergency Situations: Taking strong sedatives may impair your ability to react appropriately during a rare but possible in-flight emergency.
Non-Pharmacological Strategies for Better Flight Sleep
For many, non-medication strategies are the safest and most effective way to improve in-flight rest. These tips involve creating an optimal sleep environment and adjusting your schedule.
- Create Your Comfort Kit: Pack essentials like a high-quality eye mask, noise-canceling headphones or earplugs, and a comfortable neck pillow.
- Mind Your Diet: Avoid caffeine and large, heavy meals, especially closer to bedtime. Instead, opt for herbal teas or light, potassium-rich snacks like bananas to aid relaxation.
- Adjust to the New Time Zone: Align your sleep schedule with your destination's time zone before and during your flight. Set your watch immediately upon boarding to psychologically acclimate.
- Optimize Your Seat: A window seat offers a wall to lean against, reducing jostling from other passengers. Reclining your seat slightly (if possible) and using a footrest can also help improve comfort.
- Stay Hydrated: Drink plenty of water to combat the low humidity in the cabin, which can affect overall comfort and dehydration.
Comparison of Common In-Flight Sleep Aids
| Medication/Supplement | Type | Primary Action | Best For | Potential Side Effects |
|---|---|---|---|---|
| Melatonin | OTC Hormone | Regulates circadian rhythm | Reducing jet lag, mild sleeplessness | Headache, nausea, daytime sleepiness |
| Diphenhydramine | OTC Antihistamine | Induces drowsiness (sedative) | Occasional, short-term sleeplessness | Grogginess, dry mouth, next-day hangover effect |
| Doxylamine | OTC Antihistamine | Induces drowsiness (sedative) | Long flights (8+ hours), occasional sleeplessness | Grogginess, dry mouth, hangover effect |
| Zolpidem (Ambien) | Prescription Sedative | Forces deep sleep | Severe insomnia, needs sufficient sleep window | Memory loss, sleepwalking, high-altitude risks |
| Ramelteon (Rozerem) | Prescription Agonist | Stimulates melatonin receptors | Long-term use, jet lag adjustment | Fewer side effects than Ambien, rapid onset |
Conclusion
When considering what medicine helps you sleep on a plane, the best approach is to start with the safest, least intrusive options first. For many travelers, non-pharmacological methods and melatonin for circadian rhythm adjustment can provide sufficient rest with minimal risk. OTC antihistamines are another option for occasional use but can cause next-day grogginess. Prescription medications are potent but should be reserved for those with severe sleep issues and used only after consulting a doctor and understanding all associated risks, particularly when flying. Always prioritize safety, test medications at home, and avoid combining them with alcohol. A well-prepared and cautious approach will ensure your journey is as restful as your destination.
