Carolyn Dean, MD, ND, Medical Advisory Board Member, Nutritional Magnesium Association
Do You Use Advil PM to Fall Asleep?
We have a pill for this, a pill for that, one to help this, one to not do something else, and on and so forth. Life is complicated, and we often try to take shortcuts. What if some of these shortcuts are silent killers? Taking an Advil PM in and of itself doesn't seem like much. If you take it every night, however, there may be a bigger underlying problem.
Taking Advil PM presents real health risks, and many good reasons not to take it exist. It's probably best to avoid using it unless there are health benefits that outweigh the risks. Learn more about what Advil PM does, when you can take it, and considerations to keep in mind if you do.
When Might You Take Advil PM?
If you aren't able to sleep because of minor aches and pains in your body, taking Advil PM can help you during those occasional instances. It'll help you fall asleep and stay asleep. It's not supposed to be consumed to treat consistent sleep issues or sleeplessness without body pain.
How Much Advil PM Should I Take?
- Ages 12+: Take 2 caplets at bedtime. The manufacturer states to not take more than 2 during each 24-hour period.
- Under 12 years: Do not take Advil PM.
Stop using it and ask a doctor if:
- your pain gets worse or persists more than 10 days.
- sleeplessness continues for longer than a 2-week period.
Can You Become Addicted to Advil PM?
Like any drug, Advil PM can cause addiction problems. While the drug itself is not considered to be "addictive", the association between it and sleep can cause people to depend on it. If you equate being able to sleep with Advil PM, or if you use Advil PM as a way to "escape" from the night, it isn't a stretch of the imagination that people could obsess about Advil PM each night, similar to the way addicts may focus on other drugs.
A tolerance to the sedative effect can develop quickly, so please don't take Advil PM for more than three or four nights in a row. If you feel you need a sleep aid every night, you should talk to your doctor to see the options available to you.
Interactions and Warnings
- If you develop a dependency on it, it can lead to a tolerance for the ingredients—this means you'll need to keep increasing the dose to get the desired result.
- When you stop taking Advil PM, you may experience “rebound insomnia”, which is when you find it difficult to get to or keep sleeping because you suddenly stopped taking it. As you can imagine, this can worsen sleep apnea.
- Sleep aids can cause impairment the next day, especially if you’re older. It can increase the risk of falls, fractures, and other accidents—even if you don’t feel drowsy. Of course, poor sleep itself can impair your coordination and lead to accidents as well.
Learn more about the effects of and alternatives to Advil PM below.
What Are the Side Effects of Advil PM?
Advil PM is a drug with two active ingredients:
- Ibuprofen: Potential side effects are stomach irritation and bleeding.
- Sleep Aid (Diphenhydramine Citrate, or DC): Potential side effect is drowsiness.
While the primary side effects are not that serious, other side effects could be more severe: such as chest pain, shortness of breath, mood changes, decreased urination, other side effects. See what could happen as a result of taking Advil PM from less serious to severe.
- Medication Dependency. What is of greatest concern is not the medical side effects but the emotional side effects and risk of medication dependency. If you're using Advil PM to artificially do what your body isn't doing, there may be something significantly wrong. One or two pills as directed may be good for occasional use. Eventually, though, two pills won't work—so you'll try three. Once three pills don't work, you're taking four. Your body will start adjusting to the medication. Think about it: Your body is wound up and fighting to stay awake. You're trying to turn it off. You start throwing more drugs at it, and your body tries to fight harder.
- Stomach Upset. While taking Advil PM, you can experience an upset stomach as a result. The symptoms that can be had are nausea, vomiting, constipation, or diarrhea. To prevent having these happen, consider eating a light snack or meal before taking the medication.
- Grogginess. The antihistamine (diphenhydramine) can make you feel groggy when you wake up the next morning.
- Gastrointestinal Bleeding. Ibuprofen, an ingredient in Advil PM, is an NSAID that has been associated with an increased risk of gastrointestinal bleeding. This is one good reason not to exceed the recommended dosage. If you start throwing up blood or notice blood in your stool, stop taking Advil PM and contact your doctor immediately.
- Increased Risk of Falling. The likelihood of Advil PM increasing your chances of falling if you already have a history of falling, are over 65 years old, or are consuming other drugs that make you drowsy or dizzy.
- Heart Failure. Advil PM, as it contains ibuprofen, can increase the risk of fluid buildup and limb swelling. This development can worsen heart failure, so the American Heart Association recommends that older people with heart failure or reduced heart function do not take this medication. You're at a higher risk of heart failure if you're over 65 years old and have high blood pressure, heart disease, or kidney disease.
- Dementia. Taking Advil PM for three years is linked to about a ten percentage point increase in the probability of dementia or Alzheimer's. The study compared this to not taking any Advil PM at all.
- Heart Attack or Stroke. The ibuprofen in Advil PM can lower the effect of low-dose aspirin in people who take it to keep heart attacks or strokes at bay. If you do take aspirin every day, take Advil PM more than eight hours before you take it. Also, take it at least half an hour after you take the aspirin to lower the risk of heart attack or stroke. Heart attack or stroke risk can increase as early as the first weeks of NSAID use, and the risk may increase with longer NSAID use. The risk appears to be greater at higher doses. Also, a large number of studies show that patients with or without heart disease or risk factors for heart disease are at increased risk for heart attack or stroke. Patients are at increased risk for heart failure with NSAID use.
Dr. Carolyn Dean, a medical doctor and naturopath, comments, " It’s not just the people with heart disease that are at risk but anyone can suffer a heart attack or stroke when they take NSAIDs. Despite these warnings, the current message being sent to the public about NSAIDs is that because you can buy these drugs in a convenience store then you probably think they must be safe. Recent studies add to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously, and used only after consulting a healthcare professional."
How Does Advil Work With Your Body?
1. Can you take Advil PM caplets with alcohol?
No. Avoid drinking alcohol with Advil PM, as the latter contains diphenhydramine, which leads to drowsiness. Alcohol can intensify this effect temporarily. Additionally, the combination of the two increases the risk of stomach bleeding. If you have high blood pressure, it's not recommended to take Advil PM because it can make your body retain fluid and raise your blood pressure.
2. Is Advil PM Safe for Your Liver?
The good news is that ibuprofen rarely affects the liver. Most non-steroidal anti-inflammatory drugs (NSAIDs) are absorbed completely—the way they are metabolized makes liver toxicity a rare occurrence. However, if you take too much over a period of time, it can cause a problem with kidney function. The good news is that it is reversible if you stop taking them.
3. Watch Out for the Advil and Coffee Routine!
With Advil PM and possible dependency on a sleep aid comes a potential caffeine addiction. We knock ourselves out in the evening and try to perk ourselves up at the start of the day. Over and over again, we enter this cycle of drugging ourselves to sleep and then drugging ourselves awake. Where does it end?
At some point, your body can only take so much. If you're needing to take an Advil PM at night followed by caffeine in the morning, chances are you're running on empty. Fatigue, exhaustion, dehydration, and other factors become increasingly risky for you.
4. Advil PM and Pregnancy
- Before Pregnancy: Using NSAIDs (such as Advil) before pregnancy—after your last menstrual period—was found to increase the risk of miscarriage.
- During Pregnancy: Don't take ibuprofen during the last three months of pregnancy. Since Advil PM contains this ingredient, avoid it to prevent birth defects, prolonged labor, and a longer delivery. Make sure to your ask your doctor.
- After Pregnancy: Even after pregnancy, diphenhydramine and ibuprofen may get into the breast milk and can harm a nursing child. Make sure to get your doctor's advice if you are breastfeeding.
What Are Alternatives to Advil PM?
If you're not sleeping at night, there are plenty of non-drug related solutions you can try.
- Change Your Schedule. Chances are, your schedule is landing you at bedtime rushed and stressed. It is important to take some time to ease into sleep. Don't be working on a presentation for work or school at 11 pm and try to turn the lights out at 11:05 pm. You'll likely be awake until midnight as your body needs to unwind and find its rhythm.
- Exercise. Don't do this right before bed, but a few hours before or during the day. Exercise is good for all sorts of things, but it is especially beneficial for sleep. A sore, tired body will look for rest. If you free up your schedule to ease your mind, your mind will ease gently to sleep. Doing aerobic physical activity, along with knowledge about how to create conditions conducive to sleeping, was found to be an effective treatment approach to improve sleep quality in older adults with chronic insomnia
- Diet Is Key. Don't eat a big meal and try to fall asleep. Not only are you fighting a sugar rush and trying to digest everything, but it can also be uncomfortable if you're full, gassy or bloated. Eat at least an hour or two before bed-time.
- Do Nothing (Unless Sleep Is Impossible). Keep relaxed, as this is the quickest way to return to a state of full sleep. If you wake up in the middle of the night and the temptation to distract yourself by doing something strikes, quell it! It can actually get you more awake to do something than nothing. However, if you absolutely can’t sleep, there is nothing wrong with getting up and doing some "mindless" chores like folding laundry.
- Don't Check the Time. When you look at the clock, it's probably going to end up with you calculating how many hours you have left before you need to wake up. Does that ever lead to peaceful thoughts? Not really. Keep your eyes away from the time to keep anxiety at bay.
- Drink Caffeine-Free. Don't just avoid caffeine at night: Try something without it that can also help you fall asleep! Natural teas, such as chamomile and rooibos, don't contain caffeine and also offer many benefits that can boost your overall health, which then contributes to helping you fall asleep. Chamomile contains a flavonoid called chrysin that is partially responsible for the tea's sleep-aid reputation. A study of the relationship between a standardized chamomile extract and sleeping results in insomniacs led to the discovery that chamomile gave benefits relative to placebo in adults with chronic primary insomnia.
- Keep It Dark. Leaving the bed to use the restroom, turn on a television show, or checking tomorrow's weather will have two disadvantages: You'll lose more sleep time and throw off the circadian rhythms that drive your sleep. The melatonin levels rise in your body in response to darkness, which helps prepare your body and mind for sleep. If you expose yourself to light during the evening, it suppresses your body's natural melatonin production. Try not to turn on the lights and instead, use a nightlight or something less obtrusive.
- Try Magnesium. The natural sleep mineral "magnesium" is depleted from the body by Ibuprofen and other NSAIDs. This is another reason why these drugs tend to create a dependency and here is why: Magnesium regulates melatonin (sleep hormone) production, relieves the muscle tension that can prevent restful sleep, and activates GABA, the main inhibitory neurotransmitter of the central nervous system—activation of GABA(A) receptors favors sleep. When magnesium is depleted, insomnia and sleeplessness result, increasing the need for something that will help with sleep. It's important to note that not all forms of magnesium are easily absorbed by the body. Magnesium citrate powder is easily absorbed, can be mixed with water, and sipped throughout the day and especially in the evening for a deep and restful sleep.
- Consider Melatonin: It's a hormone found naturally in the body—the synthetic form is used as medicine to reset the body’s internal clock. If you want to fight jet lag, have an unusual work schedule that makes it hard for you to fall asleep, or a circadian rhythm disorder, melatonin can be a good supplement to use. However, it should not be taken for general insomnia. According to a 2001 study from the Massachusetts Institute of Technology, the optimal amount to take is 0.3 milligrams. However, most pills and supplements often contain 10 times the amount in a single dose. This can cause a “hangover” effect that leaves you groggy the next morning. It's alright to take it every so often. If you do, just take a small dose two hours before you sleep and create an environment conducive to sleep: low to no light, no blue light from screens, and relaxation.
This article is for informational purposes only and is not meant to treat or diagnose. Please talk to your doctor or pharmacist about your specific situation to determine what is best for your health and wellbeing.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Layla W on September 19, 2019:
Sleep is the best thing you can choose for yourself, even over food. While asleep, the body naturally heals itself:).