Is Taking Tylenol PM Every Night Safe? Long-Term Side Effects and Dangers

“It should not be used for treating chronic insomnia,” says Carla Podgurecki, MD, a family medicine physician with Texas Health Fort Worth.

Here’s a closer look at Tylenol PM, its recommended use, and potential side effects.

What’s in Tylenol PM?

• ‌Acetaminophen‌ is an analgesic (painkiller) and fever reducer that cools the body and changes the way the body senses pain. It can be used to relieve discomfort from problems like headaches, muscle aches, cramps, sore throat, and toothaches.

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• ‌Diphenhydramine‌ is an antihistamine that has sedative effects. In addition to relieving allergy symptoms like itching, a runny nose, and irritated or watery eyes, diphenhydramine acts on the central nervous system to cause drowsiness, making it easier to fall asleep and stay asleep.

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If you’d like help sleeping but don’t have pain, it’s best to take medication without a pain reliever. Ask your doctor which sleep aid best suits your needs.

How Often Can You Take Tylenol PM?

Tylenol PM is intended to be used for short-term relief from temporary sleep problems caused by pain, not as a treatment for insomnia.

“If you are using it for more than three consecutive nights, then you should discuss your sleep issues with your doctor,” says Podgurecki.

Long-Term Effects of Taking Tylenol PM

1. It May Mask an Underlying Sleep Problem

It’s not uncommon to have sleep struggles here or there, but needing a medication like Tylenol PM to fall asleep every night could mean that you have an underlying problem that isn’t being addressed.

“To improve sleep, it’s important to know why falling asleep or staying asleep is difficult, because the treatment options are specific to the cause,” Podgurecki says.

Tylenol PM can also be the cause of sleep problems, because the medication may suppress REM sleep, leading to further sleep deprivation.

2. It Can Become Less Effective Over Time

“Quality of sleep becomes worse, and the person may have grogginess the next day,” says Podgurecki. “And in some people, it can paradoxically stimulate the central nervous system, which can result in difficulty sleeping.”

3. It Can Lead to Liver Damage

“There’s an increased risk of acute liver damage with taking chronic high doses if someone consumes more than three alcoholic drinks per day,” says Podgurecki.

Mixing sleep aids like Tylenol PM with alcohol or other sedatives can also increase the risk of overdosing and death.

4. You May Experience Insomnia or Withdrawal When You Stop Taking It

You may also experience symptoms of withdrawal.

“Abrupt cessation of high doses can cause acute withdrawal symptoms manifested by high fever, hypertension, and bowel and bladder incontinence,” Podgurecki says.

Who Shouldn’t Take Tylenol PM?

Adults over 65 shouldn’t take medications containing diphenhydramine at all. “[People over 65] metabolize medications slower and are more likely to have medication interactions,” says Podgurecki.

If you are on medications or have any health conditions, talk to your doctor before taking Tylenol PM.

Alternatives to Taking Tylenol PM

It’s important to talk with your doctor if you regularly have trouble sleeping. Together, you can determine the underlying cause and decide on a treatment that’s safe and effective. Your doctor may recommend that you try these practices:

• ‌Focus on sleep hygiene.‌ Getting exercise during the day, sticking with a regular bedtime routine, limiting the use of electronics before bed, practicing relaxation techniques, and avoiding caffeine and alcohol are go-to first steps for getting a better night’s sleep, Podgurecki says. If you don’t want to stop drinking coffee or alcohol entirely, try avoiding these drinks when it’s close to bedtime.
• ‌Try cognitive behavioral therapy (CBT).‌ A proven treatment for insomnia, CBT teaches behavioral strategies that may make it easier to fall asleep without the need for medications.

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• ‌Schedule a sleep study.‌ If your doctor suspects that you have an underlying medical problem such as sleep apnea or restless legs syndrome, a sleep study can confirm the diagnosis so that you can start treatment.

The Takeaway

• Tylenol PM can be used for temporary sleep issues such as pain or jet lag, but it should not be used for more than three consecutive nights.
• Prolonged use can lead to decreased effectiveness, potential liver damage from acetaminophen, and withdrawal symptoms, and it may hide underlying sleep disorders that require a different treatment.
• Certain groups, including adults over 65, those who are pregnant or breastfeeding, and people with specific health conditions, should avoid diphenhydramine.
• For chronic sleep problems, alternatives like good sleep hygiene, CBT for insomnia, and consulting a doctor for a sleep study are recommended.