If you are or were recently taking a prescription monoamine oxidase inhibitor (an antidepressant known as an MAOI), you should ask your doctor before taking OTC sleep aids or supplements. The same goes for anyone taking any medications for Parkinson's disease, depression, or any psychiatric or emotional problems. And be careful with the combination sleep aide Tylenol PM because it contains acetaminophen, which can be dangerous if consumed in high-enough doses and is also found in many pain relievers and combination cold, allergy, and sinus medications. And Advil PM, in a class of drugs called nonsteroidal anti-inflammatory medications, or NSAIDs, carries its own risks. Also, there's no evidence that OTC sleep aids are helpful to people when taken over long periods of time for insomnia, Sateia says.
If OTC medications and nondrug approaches like CBT aren't enough, there are also prescription drugs that can help improve sleep and may be appropriate for people with acute insomnia, says Sateia. Newer-generation sleep aids include zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata), temazepam (Restoril), and ramelteon (Rozerem), which Sateia says are generally safe. They're recommended for short-term use, but some research suggests people may be able to use them over a longer period of time without suffering harmful side effects or becoming dependent. Takeda Pharmaceuticals North America, which makes Rozerem, says that there is no scientific evidence that the drug causes dependence or abuse. Ongoing use of certain other sleep aids, however, can lead to chemical dependence.
Nevertheless, anyone taking these medications should be followed closely by a doctor, especially since some of the medications have been linked to rare episodes of strange behavior, including sleep eating, sleep driving, and making phone calls or having sex while asleep.
And as for taking propofol—the anesthesia medication implicated in Michael Jackson's death: No way, says Sateia. It's not a recommended treatment for insomnia and should never be used outside of a hospital.