Factors associated with the use of over-the-counter sleep aids containing diphenhydramine (Panadol Night) among University Students in Lebanon: A cross- sectional study

Sleep is a fundamental human need, yet for many, it remains elusive. When the night stretches on without rest, people often turn to the most accessible solution available: over-the-counter medications found on pharmacy shelves without a prescription. These products are widely perceived as safe because they do not require a doctor's visit, but this ease of access can lead to complex behaviors. Among the ingredients in these sleep aids, diphenhydramine is a common active component. It is an antihistamine, a type of drug originally designed to treat allergies, which happens to cause drowsiness as a side effect. Because it is sold freely, it is frequently used by young adults to manage sleeplessness, sometimes without medical guidance. The question of how this practice affects university students, who face high levels of stress and irregular schedules, is a matter of public health. Understanding who uses these aids, why they choose them, and what happens to their sleep quality is essential for ensuring that a quick fix does not become a long-term problem.

In Lebanon, researchers set out to investigate this specific issue among university students. They focused on a popular sleep aid called Panadol Night, which contains both a pain reliever and 25 milligrams of diphenhydramine. The team, led by scholars from the Holy Spirit University of Kaslik, wanted to know how common the use of this medication was, what factors drove students to take it, and whether it actually helped those who struggled with sleep. To find the answers, they conducted a study involving 402 university students aged 18 to 30. The researchers distributed an anonymous online questionnaire that asked participants about their demographics, their sleep habits, their health, and their history with sleep medications. They used a standard, validated tool called the Pittsburgh Sleep Quality Index to measure how well students slept, categorizing anyone with a score indicating significant trouble as a "poor sleeper." The study also looked at whether students had been diagnosed with insomnia by a doctor, if they experienced pain that kept them awake, and where they got their advice on taking these medications.

The results revealed a clear picture of how these students interact with sleep aids. Nearly one in five students, or 18.7 percent, reported having used Panadol Night at some point in their lives. More specifically, 8.0 percent had used it within the month before the survey, and 4.7 percent were current users. The study found that these users were not a random group; they shared distinct characteristics. Students who were slightly older, between the ages of 22 and 30, were significantly more likely to have used the medication in the past month compared to those aged 18 to 21. Furthermore, students who believed the medication was safe were twice as likely to use it. Perhaps most telling was the link between the medication and the quality of sleep. Students who used Panadol Night in the past month reported significantly worse sleep quality than those who did not. In fact, among those classified as poor sleepers, 11.7 percent had used the medication recently, whereas only 0.7 percent of good sleepers had done so. This suggests that the medication is often a response to severe sleep difficulties rather than a casual habit for those sleeping well.

The investigation also uncovered the reasons behind the decision to take these aids. A history of being diagnosed with insomnia by a doctor was a strong predictor of use, with diagnosed students being more than four times as likely to have taken the medication recently. Pain that disturbed sleep was another major factor; students who experienced sleep disruption due to pain were more likely to turn to the drug. When the researchers looked at how students decided to take the medication, they found that self-reliance was the dominant force. Among those who had ever used the product, nearly three-quarters of the recent users had made the decision to take it on their own, without a recommendation from a doctor or pharmacist. Social media played a surprisingly large role as well; students who received a recommendation from social media were far more likely to be recent users than those who did not. Conversely, recommendations from doctors were not a significant driver of recent use. The study also highlighted that many users experienced side effects. Among those who reported side effects, such as fatigue, drowsiness, or a racing heart, 70 percent were recent users, compared to only 24 percent of those who had never experienced side effects.

The researchers concluded that the use of Panadol Night among Lebanese university students is deeply intertwined with sleep problems, pain, and the perception that the drug is safe. The data indicates that older students and those who feel confident in the safety of the medication are the most likely to use it, often making the choice themselves rather than following medical advice. The findings suggest that while students turn to these aids to solve their sleep issues, the users are actually experiencing poorer sleep quality than their peers. This pattern points to a need for better education regarding the appropriate use of over-the-counter sleep aids and a greater focus on identifying and treating the underlying causes of sleeplessness, such as insomnia and pain, rather than relying on self-directed medication. The study serves as a reminder that just because a remedy is easy to find does not mean it is the right solution for every sleepless night.