Diphenhydramine works very well to lessen allergy symptoms and is used not only as the sole ingredient in Benadryl but as all or part of the makeup of some 300 mostly over-the-counter medicines.
Diphenhydramine crosses into the brain and makes us drowsy. This “side effect” has caused it to become a widely used sleeping aid. Most OTC sleep aids have diphenhydramine (or doxylamine, a very similar product) as their active ingredient.
The problem with using these older antihistamines for allergy relief is that they are sedating and may make users too drowsy to safely drive or do other tasks requiring attention. They can be especially problematic for older adults and have been linked to falls and auto accidents. Regular use has also been linked to risk of dementia.
They can also be a problem with small children, causing extreme sedation and even coma. Also, oddly enough, in some children they have a paradoxical effect of causing agitation.
For allergy relief three newer antihistamines are available: loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra). These do not get into the brain and are much less likely to be sedating.
How about for sleep?
For very occasional use, diphenhydramine and other older antihistamines are probably OK. Like most sleeping pills, the sleep induced by antihistamines is not natural, with little REM sleep, and the sedation can linger well into the next day. It is not dissimilar to the sleep you get after drinking too much alcohol.
Better choices are melatonin or chamomile, which work immediately, or magnesium, which must be taken regularly and build up in your system. If you find yourself using an antihistamine to sleep more than 2-3 times a month, ask your doctor about alternatives.
So, yes, it is probably time to say adios to diphenhydramine, doxylamine and all the older antihistamines. Be sure to read the labels on OTC products before you buy them.
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