What are the over-the-counter (OTC) treatments for excessive daytime sleepiness (EDS)?

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From the Guidelines

Over-the-counter treatments for excessive daytime sleepiness include caffeine as the most accessible option, typically found in coffee (80-100mg per cup), tea (30-50mg per cup), or supplements (100-200mg tablets). For optimal results, take caffeine early in the day, limiting consumption to 400mg daily and avoiding it after 2pm to prevent sleep disruption 1. B vitamins, particularly B12, may help with energy levels; a B-complex supplement containing 2.4mcg of B12 daily can be beneficial. Some people find relief with herbal supplements like ginseng (200-400mg daily) or rhodiola (200-600mg daily), though their effectiveness varies. Addressing sleep hygiene is crucial alongside these treatments—maintain a consistent sleep schedule, limit screen time before bed, create a comfortable sleep environment, and exercise regularly. If excessive sleepiness persists despite these measures, consult a healthcare provider as it may indicate an underlying condition like sleep apnea, narcolepsy, or a medication side effect requiring professional evaluation and treatment. It's essential to note that while modafinil has been shown to be effective in treating excessive daytime sleepiness, it is a prescription medication and not available over-the-counter 1. Additionally, other treatments like pitolisant may be effective, but more research is needed to fully understand its effects, particularly in pediatric populations 1.

Key Considerations

  • Caffeine is the most accessible over-the-counter option for treating excessive daytime sleepiness
  • B vitamins and herbal supplements may also be beneficial, but their effectiveness varies
  • Addressing sleep hygiene is crucial for optimal results
  • If excessive sleepiness persists, consult a healthcare provider to rule out underlying conditions

Treatment Options

  • Caffeine: 100-200mg tablets, limit consumption to 400mg daily
  • B vitamins: B-complex supplement containing 2.4mcg of B12 daily
  • Herbal supplements: ginseng (200-400mg daily) or rhodiola (200-600mg daily)

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Over-the-Counter (OTC) Treatments for Excessive Daytime Sleepiness (EDS)

There are no specific over-the-counter (OTC) treatments for excessive daytime sleepiness (EDS) mentioned in the provided studies.

Prescription Treatments for EDS

  • The medications available to improve daytime wakefulness include:
    • Amphetamines
    • Methylphenidate
    • Pemoline
    • Modafinil 2
  • Wakefulness-promoting agents such as modafinil, stimulants such as methylphenidate and amphetamines, and newer agents specifically designed to improve wakefulness are used to treat EDS secondary to central disorders of hypersomnolence 3
  • Modafinil is approved for use in patients with excessive sleepiness associated with narcolepsy, obstructive sleep apnoea/hypopnoea syndrome (OSA/HS) or shift work sleep disorder (SWSD) 4
  • Stimulants are used to treat excessive sleepiness 5
  • Amphetamine-like central nervous system stimulants or modafinil and its R-enantiomer, armodafinil, wake-promoting compounds unrelated to amphetamines are used to treat EDS 6

Treatment Approach

  • Determining the cause of daytime sleepiness is the first step in treating it 2
  • Treatment of EDS should focus on targeting the primary disorder when excessive sleepiness is secondary to other conditions 3
  • Treating the primary cause, whenever identified, is the approach for treating excessive sleepiness 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Pharmacologic management of daytime sleepiness.

The Journal of clinical psychiatry, 2004

Research

Excessive Daytime Sleepiness: A Clinical Review.

Mayo Clinic proceedings, 2021

Research

[Excessive daytime sleepiness].

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 2005

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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