Can't sleep? You're not alone.
Google Search trends for "sleep supplements" continue to rise as people reach for remedies—from melatonin to magnolia bark tea—to help them get a better night's rest. Roughly one in three U.S. adults report short sleep duration, and about one in 10 meet the criteria for chronic insomnia. Americans now spend billions each year on over-the-counter sleep aids and supplements—often with little evidence to show which ones work, which don't, and which might even cause harm.
So how can someone safely navigate this crowded marketplace of pills, teas, and supplements to find something that actually helps?
A new study, led by Richard Schwab, MD, Penn Medicine's chief of Sleep Medicine, and Michael Perlis, PhD, director of Penn's Behavioral Sleep Medicine program, seeks to provide some long-needed answers. The research team is studying how well different medications work and developing guidelines to help doctors treat insomnia, one of the most common and often misunderstood sleep problems.
Unlike most previous studies that focused on a single drug or highly controlled lab conditions, this trial will rely on a comparative effectiveness research (CER) model—meaning it will test how medications perform under real-world conditions. That's important, because insomnia is most often diagnosed and treated in primary care settings, not sleep clinics.
The trial will compare five medications—trazodone, zolpidem (Ambien), doxepin, melatonin, and diphenhydramine (Benadryl)—against a placebo in more than 1,000 patients recruited from primary care practices across the University of Pennsylvania Health System.
Participants who do not respond to these medications will then have the opportunity to receive cognitive behavioral therapy for insomnia (CBT-I) at no cost. The study's ultimate goal is to provide clear, evidence-based guidance to help both physicians and patients make better choices about insomnia treatment.
