Health authorities are raising red flags about the misuse of over-the-counter sleep aids by potentially millions of Americans, a trend that could result in long-term dependency and serious health issues.

A 2023 survey conducted by the American Academy of Sleep Medicine (AASM) revealed that approximately 22 percent of adults in the United States regularly or occasionally turn to over-the-counter sleep aids such as Tylenol PM, NyQuil, or ZzzQuil. This marks a significant increase from the findings of a 2020 report by the National Center for Health Statistics (NCHS), where 8.4 percent of U.S. adults reported using medication to help them sleep most nights or every night.

Dr. Castel Santana, a board-certified family medicine physician and medical director at 10X Health System, shared with the Daily Mail that there is a growing unease within the medical community regarding the misuse of products like NyQuil and Tylenol PM. Tylenol PM, in particular, remains one of America’s best-selling nighttime pain relievers, generating nearly $1 billion in annual sales.

Dr. Santana noted alarming instances of extreme misuse, stating, “I’ve come across cases where people are taking excessively high doses of Tylenol PM, and even reports of it being snorted. Such dependency can heighten the risk of turning to other drugs, including illegal substances like heroin.”

It’s important to remember that Tylenol PM is intended for the temporary relief of occasional sleeplessness due to minor aches and pains, not as a remedy for chronic insomnia. Similarly, NyQuil and ZzzQuil are designed as short-term sleep solutions linked to colds and the flu, not for ongoing sleep disorders.

Tylenol PM is marketed for the temporary relief of occasional sleeplessness that occurs alongside minor aches and pains, not for treating chronic insomnia. Similarly, NyQuil and ZzzQuil are marketed as short-term sleep aids related to colds and the flu – not for chronic sleep problems.

Tylenol PM contains two active ingredients: acetaminophen, a pain reliever and fever reducer, and diphenhydramine, an antihistamine that causes drowsiness. 

In 2024, Vicks, the maker of NyQuil and ZzzQuil (which contains diphenhydramine but no pain reliever), launched PainQuil PM, a pain reliever with the same ingredients as Tylenol PM but in a liquid form.

Tylenol PM is marketed for the temporary relief of occasional sleeplessness that occurs alongside minor aches and pains

Diphenhydramine is used in many over‑the‑counter medications under different brand names, including Benadryl, Sominex, Simply Sleep and more. 

Dr Santana told the Daily Mail that research has shown it is the diphenhydramine component that has ‘potential for psychological dependence.’ 

Psychological dependence occurs when a person feels a strong emotional or mental craving for a substance, believing they need it to function or cope with stress. 

It is characterized by intense thoughts about the drug, anxiety, irritability or restlessness when it is not available. Physical dependence, on the other hand, involves the body adapting to the substance, so that sudden discontinuation produces withdrawal symptoms such as nausea or heart palpitations. 

‘Although acetaminophen… doesn’t generate the classic euphoria of opioids, misuse still occurs when people begin to rely on the product nightly for sleep or pain, and increase dose or frequency beyond label directions,’ Dr Santana said.

While Johnson & Johnson originally owned Tylenol as part of its consumer health division, it spun off that division in August 2023 into a separate publicly traded company called Kenvue Inc.

Kenvue now owns and markets Tylenol independently, along with other brands like Band-Aid, Listerine, Benadryl and Neutrogena. 

The Daily Mail has contacted Kenvue and Vicks for comment.

Dr Santana also highlighted that the misuse of any medication ‘reflects an underlying vulnerability (insomnia, pain, stress, mental health issues, reward pathway dysregulation), which could increase risk for other substance use.’

He added that, ‘for example, someone who uses Tylenol PM nightly might escalate to stronger sedatives, or use alcohol or other substances to sleep. If there is a substance-use vulnerability [mental health, pain disorder, trauma, genetics] then there is definitely an increased risk of other addictions.’

Vicks, the maker of cold relievers and sleep aids NyQuil and ZzzQuil, has launched a new product called PainQuil PM

NyQuil and ZzzQuil are marketed as short-term sleep aids related to colds and the flu – not for chronic sleep problems

The recommended dose for Tylenol PM for adults is one to two caplets at bedtime, and no more than two caplets in 24 hours.

Each caplet contains 500mg of acetaminophen and 25mg of diphenhydramine. 

A class action lawsuit filed against Johnson & Johnson, which previously owned Tylenol, alleges that the company misrepresented its Tylenol PM product as ‘non habit-forming,’ despite evidence suggesting otherwise. 

The lawsuit, initiated on November 13, 2024, by Sirreon Goodson from California, claims that the diphenhydramine can lead to dependency as frequent use can cause some people to feel they cannot sleep without it. 

According to the class action suit, diphenhydramine triggers a ‘cocaine-like pattern of stimulation of dopamine transmission’ that can result in users becoming dependent on medications that contain the ingredient.

‘Tolerance can develop in as little as one to two weeks, requiring users to take larger and larger doses for the same sedating effect, and causing dependency in users who find they need diphenhydramine to fall asleep,’ the case reads. 

‘The result is habitual use.’

The complaint states that Goodson purchased the product in November 2023 in Sacramento after relying on the ‘non-habit-forming’ label.

The suit alleges that, despite following the directions, Goodson ‘developed a habit’ of using the product.

The lawsuit, which remains ongoing, seeks restitution for consumers who purchased Tylenol PM sleep aids containing diphenhydramine within the applicable statute of limitations period.

On social media, users who were not connected to the lawsuit have also claimed to have battled dependencies on Tylenol PM. 

On Facebook, Cassidy Joyner (pictured) from Georgia revealed that she had been using the drug for two-and-a-half years and couldn’t sleep without it

In March, Cassidy Joyner from Georgia revealed on Facebook that she couldn’t sleep without taking Tylenol PM or another sleep aid for more than two years. 

What began as a quick fix for restless nights gradually turned into a nightly ritual that she came to rely on completely.

‘For about two and a half years straight, I couldn’t fall asleep on my own,’ she explained, describing how she believed she needed something to make her drowsy before bed.

Joyner later came to realize that her struggle wasn’t purely physical – it was deeply emotional. She said stress and a toxic environment were at the root of her sleeplessness. 

Surrounded by negativity, she often felt unsafe, uneasy and constantly on edge. 

‘My heart would race before I went to sleep,’ she recalled, adding that she lived in a state of alertness, unsure what each night would bring.

But after removing herself from those circumstances and rebuilding her life around positivity and supportive people, Joyner said she finally broke free from her Tylenol PM dependency. She now sleeps peacefully without any medication. 

‘It’s definitely an improvement for me, and so much healthier,’ she wrote, encouraging others to eliminate negative influences to restore balance and well-being instead of turning to drugs.

Stress can cause sleep issues because it activates the body’s fight-or-flight response, increasing levels of stress hormones like cortisol and adrenaline. These hormones raise heart rate, alertness and muscle tension, which make it harder to relax and fall asleep. 

Christopher Schisel (pictured) from Wisconsin said his dependency on Tylenol PM led to a 13-year addiction to THC and Benadryl, which he said he is still undergoing treatment for

After years of battling addiction to hard drugs, Ohio native Kayla Cooley wrote in a Facebook post that she found herself dependent on Tylenol PM. 

Cooley described waking up each day feeling she needed the medication, comparing the compulsion to her former dependence on heroin. 

‘If my body didn’t ache, my head would be pounding,’ she wrote. ‘I’d take Tylenol PM just to get to sleep.’

About seven months ago, Cooley said she made the decision to stop taking the pills, and wrote that her life has transformed since. 

She now sleeps soundly, feels calmer and experiences more peaceful dreams. 

‘Even when I’m in pain, I’d rather pray through it and deal with it on my own,’ she wrote, describing a newfound sense of strength and serenity.

For Cooley, the change wasn’t just physical, it was spiritual. She believes her recovery came through faith rather than pharmaceuticals. After overcoming heroin addiction, she realized she didn’t need what she calls ‘man-made pills’ either. 

In her view, society’s reliance on medication is driven by profit, not healing. 

For almost 13 years, Christopher Schisel from Wisconsin has been battling a similar dependence. 

He wrote in a Facebook post that what started in 2012 with nightly doses of Tylenol PM gradually developed into an addiction to Benadryl and THC, a struggle that he said has shaped much of his adult life.

‘It all started with Tylenol PM,’ Schisel wrote. ‘It’s been a struggle ever since.’ 

Kayla Cooley (pictured) from Ohio compared her reliance on Tylenol PM to her heroine addiction. ‘If my body didn’t ache my head would be pounding,’ she wrote on Facebook

Despite multiple rounds of treatment and participation in 12-step programs, he has admitted that breaking free from the addiction has been incredibly difficult: ‘I can’t seem to kick it.’

Schisel wrote that he now lives in a supportive housing program, where staff help monitor his well-being. He continues to search for a path to recovery, this time turning to SMART Recovery meetings online, an evidence-based approach focused on self-empowerment and cognitive-behavioral tools.

He wrote that he decided to share his story publicly in hopes of finding others who understand what he is going through. 

‘I just needed to get this out there to see if anybody else knows about this kind of addiction,’ Schisel explained, describing his post as both a confession and a call for connection.

Santana told the Daily Mail that it is best to ‘address the underlying causes of insomnia and pain rather than turning to over-the-counter drugs from the get-go.’ 

‘For sleep, evaluate sleep hygiene (bedtime routine, light exposure, screen use, stimulation) and see if there are cortisol issues or sleep apnea that can be addressed,’ he said.

Some of the alternative remedies he suggested for insomnia include cognitive-behavioral therapy, meditation before bed, limiting caffeine intake later in the day and experimenting with magnesium supplementation.