The Sleep Medication You Should Avoid Taking If You Have Prostate Problems

As men age, their prostate naturally grows larger. What starts around the size of a walnut can expand to the size of a lemon by the time they reach 60. An enlarged prostate — also known as benign prostatic hyperplasia (BPH) — is pretty common, affecting about one-third of men over 65, according to the National Institutes of Health. When the prostate enlarges, it can press against the urethra, leading to urinary issues like a weak stream, discomfort while urinating, or frequent nighttime trips to the bathroom.

On top of that, aging itself can make it harder to get a good night's sleep, prompting some men to turn to sleep aids. But if you have an enlarged prostate, certain sleep medications, like Unisom, should be avoided, says men's health urologist Justin J. Houman, MD, FACS, in a Health Digest interview.

"Unisom, like many over-the-counter sleep aids, contains diphenhydramine or doxylamine, which are antihistamines with anticholinergic properties," Houman said. "These medications can worsen urinary retention in men with BPH by relaxing the bladder muscle while tightening the prostate and sphincter." In severe cases, this can lead to acute urinary retention, which is not only painful, but may also require a catheter to relieve.

Before you pick up another sleep aid, look at the list of ingredients for diphenhydramine or doxylamine. Benadryl and ZzzQuil are two sleep medications with diphenhydramine. Houman recommends melatonin because it works with your natural sleep/wake cycle without affecting your prostate or bladder symptoms. Magnesium can also help your body relax to improve your sleep quality. You can also try some of these tricks to help you fall asleep.

If these over-the-counter sleep aids don't help you sleep, you could consult your doctor about a prescription sleep aid such as zolpidem (Ambien). A 2011 study in the Central European Journal of Urology looked at 35 men with nocturia (frequent nighttime urination) and lower urinary tract symptoms linked to an enlarged prostate (BPH). The men took tamsulosin to relax the prostate and help with urine flow, but some of the men were still experiencing sleep disruptions due to nocturia. These men were given zolpidem to help with sleep and tamsulosin for their urinary symptoms. After two weeks, the men reduced their nighttime trips to the bathroom and improved their sleep quality.

Look at the ingredient labels of your cough and cold medicines and avoid medications with doxylamine. Diphenhydramine is often found in allergy medications, so you can take second-generation antihistamines such as Allegra, Claritin, or Zyrtec for your allergies if you have BPH. Decongestants can affect the muscles of the bladder, making urination more difficult. You should avoid oral decongestants with pseudoephedrine or phenylephrine as well as inhaled medications such as Afrin and Vicks VapoInhaler. An alternative for nasal congestion may be nasal strips.

Motion sickness medications often have antihistamines that can aggravate your BPH symptoms, so consult your doctor about prescribing a motion sickness patch. Medications for hemorrhoids that have phenylephrine can restrict blood and urine flow similar to decongestants. Local anesthetics that have pramoxine or benzocaine may be safer alternatives for hemorrhoids. (Try these foods to boost your prostate health.)

Houman says to avoid certain muscle relaxers (e.g., cyclobenzaprine) and tricyclic antidepressants (e.g., amitriptyline) because they have anticholinergic properties that can affect your bladder and prostate. Diuretics treat high blood pressure, heart failure, and edema by helping you remove excess water from your body through urination. If you're already experiencing problems urinating due to BPH, you should avoid taking diuretics.