What Can I Take to Make Me Sleep: Melatonin & More

Melatonin is the most widely used and studied sleep supplement, and it does work, though its effects are more modest than many people expect. A meta-analysis of 19 trials found that melatonin helped people fall asleep about seven minutes faster and added roughly eight minutes of total sleep compared to placebo. Beyond melatonin, a range of other supplements, over-the-counter medications, and prescription drugs can help with sleep, each with different strengths, tradeoffs, and levels of evidence behind them.

Melatonin and Why Timing Matters More Than Dose

Melatonin is not a sedative in the traditional sense. It works by signaling to your brain that it is time for sleep, essentially nudging your internal clock. That distinction matters because it means when you take melatonin affects how well it works at least as much as how much you take. The meta-analysis that found modest improvements in sleep latency and total sleep time also noted that trials using higher doses and longer treatment durations showed greater effects.¹ But a more recent dose-response analysis found that melatonin’s benefits peak at around 4 mg per day and that taking it about three hours before your desired bedtime produces better results than the typical approach of swallowing a pill 30 minutes before bed.²

This earlier timing makes sense when you consider how melatonin works. Your body naturally starts producing melatonin a couple of hours before sleep, and taking a supplement earlier in the evening mimics that pattern more closely. In people with delayed sleep phase syndrome, where the body’s clock runs late and sleep onset is pushed far past a normal bedtime, melatonin taken five hours before the body’s natural melatonin rise shifted sleep onset earlier by about an hour and a half and significantly reduced the time it took to fall asleep.³ Meta-analyses have consistently found the strongest evidence for melatonin in reducing sleep onset latency, particularly in people with primary insomnia and delayed sleep phase syndrome.⁴

The practical takeaway: if you have been taking melatonin right before bed and feeling like it does nothing, try a lower dose earlier in the evening. Many store-bought melatonin products come in 5 or 10 mg tablets, which is often more than needed. Starting at 1 to 3 mg and working up if needed, taken two to three hours before your target bedtime, is a reasonable approach. Melatonin is also useful for jet lag and shift work, where timed doses can help reset your clock to a new schedule.⁵

Magnesium

Magnesium supplements have become a popular sleep aid, and there is some evidence behind the trend, though the research base is still relatively small. In elderly individuals, eight weeks of magnesium supplementation increased sleep duration, reduced the time it took to fall asleep, and improved blood markers related to sleep regulation, including melatonin and cortisol levels.⁶ A crossover trial in adults with poor sleep found that a magnesium supplement significantly improved sleep quality, sleep duration, deep sleep, and sleep efficiency compared to placebo.⁷

A trial of magnesium bisglycinate, one of the more popular forms marketed for sleep, showed a modest benefit over placebo in reducing insomnia symptoms after four weeks, though the effect size was small.⁸ The honest read on magnesium is that it likely helps somewhat, especially if you are not getting enough through your diet (and many adults are not), but the improvements are modest. It is unlikely to be a standalone fix for serious insomnia.

Valerian Root

Valerian is one of the oldest herbal sleep remedies, and the research on it is genuinely mixed. An early meta-analysis found that across six studies measuring whether sleep improved or not, people taking valerian were about 1.8 times more likely to report improved sleep than those on placebo, though there were signs of publication bias inflating that number.⁹ A broader systematic review of 40 studies using valerian found results split roughly down the middle: 13 studies found it effective, while 10 found no significant benefit over placebo.¹⁰

A more recent randomized trial did find that a standardized valerian extract significantly improved sleep quality scores, sleep latency, actual sleep time, and sleep efficiency compared to placebo, with benefits appearing as early as day three and continuing through the eight-week study.¹¹ Valerian’s advantage is its mild side-effect profile. Its disadvantage is inconsistent results across studies, which may partly reflect differences in the plant preparations used. If you try it, give it a few weeks rather than expecting one-night results.

L-Theanine

L-theanine, an amino acid found naturally in tea, has gained attention as a calming supplement that may support sleep. A meta-analysis covering 12 studies found that L-theanine significantly improved overall subjective sleep quality, reduced perceived time to fall asleep, and improved daytime functioning. The authors noted, however, that many of the studies used L-theanine in combination with other ingredients, and more research on L-theanine alone is needed.¹² A separate systematic review of dietary supplementation trials confirmed that beneficial effects have been reported on both objective and self-reported outcomes, including measures of sleep latency, sleep efficiency, and feelings of refreshment on waking.¹³

L-theanine seems to work less by making you drowsy and more by reducing the mental chatter that keeps you awake. That makes it a reasonable option for people whose sleep problems stem from anxiety or a racing mind at bedtime, though the evidence, while encouraging, is still emerging.

Over-the-Counter Antihistamines

Diphenhydramine (the active ingredient in many “PM” branded products) is one of the most commonly used OTC sleep aids in many countries. It does cause drowsiness, and an expert consensus review confirmed that it can be useful for short-term insomnia. But the same review noted that tolerance to its sedative effects tends to develop by around day three.¹⁴ That means diphenhydramine can help for a couple of rough nights, but it is not a good ongoing sleep strategy. Side effects include dry mouth, constipation, and next-day grogginess. In older adults, anticholinergic medications like diphenhydramine carry additional risks including confusion and falls, which is why geriatric guidelines flag them as potentially inappropriate for people over 65.¹⁵

Prescription Sleep Medications

When OTC options and supplements are not enough, several classes of prescription drugs are available. The most commonly prescribed are the “Z-drugs” (zolpidem, zopiclone, eszopiclone, and zaleplon), which act on the same brain receptors as older benzodiazepines but tend to be shorter-acting. A large network meta-analysis of 153 randomized trials found that non-benzodiazepine hypnotics added roughly 22 to 25 minutes of total sleep time and shortened the time to fall asleep by about 10 to 12 minutes compared to placebo, depending on whether sleep was measured subjectively or objectively. They also reduced time spent awake after initially falling asleep.¹⁶ Despite their widespread use, systematic reviews comparing Z-drugs to each other and to benzodiazepines have found few consistent differences between them.¹⁷

Dual orexin receptor antagonists (suvorexant, lemborexant, daridorexant) are a newer class that works differently. Rather than increasing sedation, they block the brain’s wakefulness signals. The literature suggests they are effective, and they offer an alternative approach for people who do not respond well to the older classes or have concerns about dependence.¹⁸

Off-label options are also common. Trazodone, an older antidepressant, is one of the most frequently prescribed sleep aids in practice even though it is not officially approved for insomnia. Doxepin at very low doses is another option. A retrospective comparison of the two in psychiatric inpatients found no significant difference between trazodone at a higher dose and doxepin as step-up therapy when an initial trazodone dose was not enough.¹⁹

Next-Day Effects and Driving Safety

One of the most important practical concerns with any sleep medication is whether it impairs you the next morning. This is not a minor issue: on-the-road driving studies have shown that benzodiazepine hypnotics and zopiclone significantly impair driving ability the morning after a bedtime dose, and sometimes even into the afternoon.²⁰ The degree of impairment depends heavily on the drug’s half-life and dose.

A network meta-analysis of randomized driving trials found that after a single dose, most sleep medications performed similarly to placebo. But several stood out as worse: zopiclone, higher-dose zolpidem (especially when taken in the middle of the night), mirtazapine, and triazolam all significantly impaired driving compared to placebo. On the safer end, lemborexant and suvorexant at standard doses were associated with lower impairment than zopiclone.²¹ Reassuringly, with repeated use over days, most medications caused fewer residual effects than after the first dose, though flurazepam (a long-acting benzodiazepine) was an exception. A dedicated driving study on suvorexant found no clinically meaningful next-morning impairment on average at 20 or 40 mg, though some individual participants, particularly women, did show noticeable effects.²²

Rebound Insomnia When You Stop

A fear many people have about sleep medications is that stopping them will make sleep worse than it was before they started. This phenomenon, called rebound insomnia, is real, particularly with shorter-acting benzodiazepines. Classic research identified that drugs with short to intermediate half-lives, like triazolam and nitrazepam, caused rebound insomnia even after only a few nights of use, while longer-acting benzodiazepines like diazepam and flurazepam did not.²³

Research on rebound insomnia after stopping hypnotics in outpatients found that the sleep worsening was not just a brief blip: it persisted at varying levels throughout the entire post-treatment monitoring period in some patients, with considerable night-to-night variation.²⁴ This unpredictability can drive people back to the medication, creating a cycle that feels like dependence even when the original insomnia might have improved on its own. Not all medications carry the same risk: melatonin and the orexin antagonists have not been linked to significant rebound insomnia, which is one reason clinicians increasingly favor them for longer-term use.

Why a Placebo Can Improve Your Sleep

Here is a genuinely surprising finding from sleep research: the placebo effect in insomnia trials is enormous. A meta-analysis of polysomnographic data (objective brain-wave measurements, not just self-reports) found that people in the placebo arms of insomnia drug trials showed small-to-moderate improvements in virtually every sleep measure, including time to fall asleep, total sleep time, and sleep efficiency. The analysis estimated that roughly 64% of the drug response in insomnia trials was already achieved by placebo alone.²⁵ A separate meta-analysis comparing placebo to no treatment at all confirmed a reliable placebo effect on perceived time to fall asleep, total sleep time, and global sleep quality.²⁶

This does not mean insomnia is “all in your head” or that medications do nothing beyond placebo. It means that the act of taking something you believe will help, combined with the structured bedtime routines that clinical trials impose, produces genuine physiological changes in sleep. It also means that the real-world benefit of a supplement with thin evidence might partly be a ritual effect, and that is not necessarily a bad thing.

Cognitive Behavioral Therapy for Insomnia

Any honest discussion of what you can take for sleep has to mention the option of not taking anything. Cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line treatment by most sleep medicine guidelines, and the evidence for it is strong. A systematic review of comparative effectiveness studies found that CBT-I typically improved sleep latency by 30 to 45 minutes and total sleep time by 30 to 60 minutes, with sleep efficiency improving by 8 to 16 percent. Long-term follow-up studies consistently favored CBT-I over both benzodiazepines and Z-drugs, and the effects of CBT-I tended to last after treatment ended while the benefits of medication faded.²⁷

Even digital CBT-I programs, delivered through apps rather than in-person therapy, show durable improvements. A study comparing digital CBT-I to medication found that the medication’s benefits leveled off between months one and two and even worsened after four to five months, while CBT-I outcomes improved steadily during the first three months.²⁸ CBT-I is not always easy to access, and it requires more effort than swallowing a pill, but for chronic insomnia it delivers bigger and longer-lasting improvements than any medication studied to date.

Alcohol and Sleep Medication Interactions

Using alcohol to fall asleep is common but worth flagging because it interacts dangerously with nearly every sleep aid discussed in this article. Alcohol enhances the sedative effects of benzodiazepines, Z-drugs, antihistamines, and many other medications that act on the central nervous system, and combining them can lead to extreme sedation, impaired breathing, and in serious cases, death from overdose.²⁹ The interaction is pharmacodynamic, meaning alcohol amplifies the drug’s brain effects rather than just changing how the drug is processed by your liver.³⁰ Even OTC supplements like valerian and melatonin are generally advised against mixing with alcohol, though the risks are less severe than with prescription sedatives. If you are taking anything for sleep, treating alcohol as incompatible with your sleep routine is the safest approach.

CBD and Cannabis

Cannabidiol (CBD) products are widely marketed for sleep, and the evidence is at an early stage. A systematic review of 34 studies found that all reported at least some participants experienced improvement in insomnia symptoms. Among studies that performed statistical testing, roughly half of the CBD-dominant arms and three-quarters of the combined CBD-THC arms found significant improvements. However, only two of the 34 studies actually focused on patients diagnosed with insomnia, many used unvalidated self-report measures, and most lacked objective sleep measurement.³¹ The honest assessment is that CBD may help some people sleep, but the science has not caught up to the marketing. If you try it, you are essentially running a personal experiment with limited guidance on dose, timing, or which formulation works best.

What You Eat and When

Diet is not the first thing people think of when they cannot sleep, but meal composition and timing can influence sleep onset. A controlled study found that a high-glycemic-index carbohydrate meal eaten four hours before bedtime roughly halved the time it took to fall asleep compared to a low-glycemic-index meal at the same timing. Interestingly, the same high-GI meal eaten just one hour before bed did not produce the same benefit, suggesting that the body needs time to process the meal’s metabolic effects before they translate into sleepiness.³² The proposed mechanism involves tryptophan availability in the brain: high-GI foods trigger insulin, which clears competing amino acids from the bloodstream and allows more tryptophan to reach the brain, where it is converted into serotonin and eventually melatonin.

That said, the relationship between dietary glycemic patterns and sleep across a whole diet, rather than a single controlled meal, is less clear. A randomized trial comparing low- versus high-glycemic Mediterranean eating patterns found no significant differences in sleep quality or daytime sleepiness between groups over the course of the study.³³ So a strategically timed starchy snack a few hours before bed might help you nod off, but overhauling your entire diet around glycemic index is unlikely to fix a sleep problem on its own.

Older Adults and Medication Risks

Sleep medication choices change with age, and not just because of reduced metabolism. The American Geriatrics Society’s Beers Criteria, a widely used list of medications best avoided in people over 65, includes many popular sleep drugs: benzodiazepines, Z-drugs, and first-generation antihistamines like diphenhydramine all appear on the list due to increased risks of falls, confusion, and cognitive impairment in older adults.¹⁵ For older adults, the safer pharmacological options tend to be low-dose melatonin, low-dose doxepin (which is actually approved for insomnia at very low doses), or the newer orexin antagonists. CBT-I remains effective across age groups and avoids medication risks entirely. Magnesium supplementation has shown particular promise in older populations, with improvements in both sleep duration and sleep latency documented in elderly participants.⁶