Are you taking a drug from this “forbidden” list?

Insomnia can be miserable. Lying awake at night, and being exhausted during the day, is not only, well, exhausting, it can be potentially fatal.

So, what’s a person to do? For most, the answer comes in the form of a pill.

I’ve written previously about the risks of prescription sleep aids known as benzodiazepines, particularly if you’re over 65. Daytime grogginess, sleep walking and other physical symptoms often accompany the use of these medications.

But what about over-the-counter sleep aids? They’re OK, right?

Not necessarily.

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Night time cold medicine can lead to dementia

In 1991, geriatrician Dr. Mark Beers created the Beers Criteria. It identifies medications that are potentially dangerous for older adults. The Criteria has been updated in 1997, 2003, 2012 and 2015.

Anticholinergics are among the types of drugs on the list. They act on neurotransmitters to inhibit signals being sent to various parts of the body. Anti-Parkinson’s drugs and many drugs for hypertension are included on this list.

So is diphenhydramine, the active ingredient in over-the-counter sleep aids like Tylenol PM and Benadryl. If you’re between 65 and 80, there’s a one-in-three chance you’ve used one of these products to help you sleep.

The criteria states that anticholinergics could result in dry mouth and constipation. More importantly, though, they could cause confusion in older adults that can lead to dangerous behaviors.

Recent research has taken this a step further, showing that this class of drug could be linked to dementia.

University of Washington School of Pharmacy Professor Shelly Gray found a strong link between long-term, steady use of anticholinergics and the development of dementia and Alzheimer’s disease.

Her 2015 study followed 3,434 people for seven years. These people did not have dementia, and took anticholinergics regularly.

After seven years, 23.2 percent had developed dementia, with 79.9 percent of those cases being Alzheimer’s.

One drug leading to more and more

Jennifer Schroeck, a clinical pharmacist with the U.S. Department of Veterans Affairs Western New York Healthcare System, raises a different concern about the side effects of over-the-counter cold medicines in seniors.

She points out the likelihood of a “cascade effect” in terms of prescribing more and more medications.

For example, in men with prostate conditions, anticholinergics can lead to difficulty urinating. A man with this symptom may not associate it with his sleeping medicine. If he doesn’t mention the fact that he’s taking OTC sleep aids, his doctor will prescribe a bladder medicine.

“That new drug may have side effects too, so then something else is added to manage those,” says Schroeck. It doesn’t take long for those side effects to pile up.

Alternatives to OTC sleep aids

Fortunately, there’s a lot you can do to help yourself get to sleep before turning to medications, even over-the-counter ones.

As usual, food and nutrition can play a big role. Here are some suggestions for high “sleep index” foods and nutrients from my colleague, Dr. Isaac Eliaz.

For many people, melatonin, with its many other health benefits, is the solution.

Still others find success with essential oils that relax the senses and calm the body before sleep.

And, let’s not forget that daily exercise can make you more prepared to fall asleep at night.

Of course, if your problem is severe and persistent, you will want to talk with your doctor.