Should you just knock yourself out?

A fair question that deserves a straight answer.

Here's a piece of feedback we get on our product, and it's fair: “it didn't knock me out.”

We understand it. Being knocked out is the most obvious proof that something worked — you took a thing, you fell asleep, done. But two different things are being measured: how quickly you lost consciousness, and how much of the night restored you. Only the second decides how you feel tomorrow, and a sedative can deliver the first while reducing the second.

Start with the nightcap, the most widely used sleep aid not sold as one. It does two separate things to your night, at two different times. While alcohol is in your system — roughly the first half of the night — it directly suppresses REM. That's a drug effect on the brain systems that produce REM; it happens while you're still asleep and has nothing to do with waking up. Then your body finishes processing the alcohol, and the second effect arrives: your nervous system rebounds and the rest of the night turns shallow and broken. That's the 3 a.m. wake-up people blame on stress. Both effects start showing up in the research at around two drinks, and drinking closer to bedtime makes them worse.

Cannabis surprises people because the experience is convincing: you fall asleep quickly and are less aware of the night, which feels like good sleep. THC suppresses REM directly, so your impression of the night improves while its restorative content goes down. Tolerance builds with regular use, and people who stop after months of nightly use usually sleep worse for a while before it settles.

Drugstore sleep aids are the biggest sellers in the category. They're antihistamines — allergy medicines that sedate — which is why the first night usually works. The sedative effect fades within days, many people wake up foggy, and if you're prone to restless legs they can make it worse. The biggest share of the aisle runs on the weakest evidence in it.

Prescription sleep drugs deserve care in both directions. Most work by amplifying GABA, the brain's main calming signal, and they aren't all alike — some newer drugs are considerably gentler on deep and REM sleep than the ones they replaced. A meta-analysis of the data drug companies submitted to the FDA found the z-drugs shorten time to sleep by about twenty-two minutes by laboratory measure, with a placebo response nearly as large as the drug effect. They carry real risks of dependency and significant side effects including next-day impairment. This is a decision to make with a doctor, and never one to stop abruptly on your own.

How to judge whether something worked

Not by how fast you went under. Judge it by the morning: whether you woke up feeling restored, whether words came easily, whether your workout felt normal. If you wear a sleep tracker, watch your deep and REM trends over a couple of weeks rather than your time to fall asleep. Falling asleep sooner is a real result — it just isn't the one that decides how tomorrow goes.