The Hidden Dangers of Prolonged Diphenhydramine Use

Written by Nguyenjessica 

Published on July 19 2025

Diphenhydramine — a name you’ll find on countless pharmacy shelves under brand names like Benadryl, Unisom, and countless store-brand sleep aids. It’s been a go-to solution for allergies, seasonal sniffles, and sleepless nights for decades. Because it’s sold over the counter, many Americans assume it’s entirely safe to use as needed — even every night.

But here’s the truth: Diphenhydramine was never designed for long-term daily use.

Behind its familiar pink capsules lies a medication with side effects that can sneak up on you, especially when taken continuously over weeks, months, or even years. Whether you’re using it for chronic allergies or as a nightly sleep crutch, prolonged use carries risks that could affect both your physical and cognitive health.

In this article, we’ll dive deep into what diphenhydramine does, why people fall into the habit of using it long term, and — most importantly — the short-term and long-term side effects that every user should know.

Key Points

Diphenhydramine is intended for short-term, occasional use.

Prolonged use can impair memory, attention, and cognitive performance.

There is a significant risk of tolerance, dependency, and rebound insomnia.

Older adults face increased risks of confusion, falls, and dementia.

Safer alternatives are available for both allergy relief and sleep support.

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Table of content

What Is Diphenhydramine and How Does It Work?

Why Do People End Up Using It Long Term?

Common Side Effects of Prolonged Use

Serious Health Risks: What Science Says

Special Risks for Older Adults

What Is Diphenhydramine and How Does It Work?

Diphenhydramine belongs to a class of drugs called first-generation antihistamines. These medications work by blocking histamine receptors in your body — the same receptors responsible for allergic reactions like sneezing, watery eyes, and runny nose.

But diphenhydramine also crosses the blood-brain barrier, a natural defense that usually protects your brain from foreign substances. Once inside, it causes sedation and drowsiness — effects that some people use intentionally to help them fall asleep.

This dual action explains why diphenhydramine is found both in allergy medications and in over-the-counter sleep aids.

Why Do People End Up Using It Long Term?

Chronic Allergy Management
People with year-round allergies — to dust mites, pet dander, or pollen — may start taking diphenhydramine daily, often thinking it’s the simplest way to control symptoms.

Sleep Aid Dependency
Millions of Americans report using diphenhydramine-based products like Unisom nightly to combat insomnia, believing it's a safer alternative to prescription sleep meds.

Habitual Use for Anxiety or Stress
Some turn to diphenhydramine for its calming effects during high-stress periods, even though it’s not approved for this purpose.

The problem? Diphenhydramine is habit-forming in the sense that your body quickly develops tolerance, leading you to take higher doses for the same effect — increasing risks along the way.
 

Common Side Effects of Prolonged Use

Even at regular doses, taking diphenhydramine continuously can trigger a range of unwanted effects:

Daytime Drowsiness & Brain Fog
Residual sedative effects may leave you feeling sluggish, unfocused, and mentally foggy during the day.

Dry Mouth, Dry Eyes & Dry Skin
Its anticholinergic properties can severely dry out mucous membranes, increasing the risk of cavities, bad breath, and eye discomfort.

Constipation & Urinary Retention
Chronic users often report trouble with bowel movements or difficulty emptying the bladder fully — which can become a serious medical issue.

Blurred Vision & Dizziness
Impaired vision and balance problems can put users at risk of accidents or falls.

Weight Gain
Some studies suggest antihistamines may contribute to weight gain due to their impact on metabolism and appetite regulation.

Serious Health Risks: What Science Says

Cognitive Impairment & Memory Loss
Diphenhydramine is known for its anticholinergic load — meaning it blocks acetylcholine, a neurotransmitter critical for learning and memory. Long-term use may impair cognitive function, particularly in older adults.

Dementia Risk
A 2015 study published in JAMA Internal Medicine linked long-term use of strong anticholinergic drugs like diphenhydramine to an increased risk of dementia. The risk increased with cumulative dose.

Rebound Insomnia
Ironically, chronic use for sleep can backfire. When you stop taking it, you may experience worsened insomnia, leading to a vicious cycle of dependence.

Heart Rhythm Disturbances
In some cases, diphenhydramine may prolong the QT interval — a heart rhythm irregularity that can lead to serious complications, especially in people with heart conditions.
 

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Special Risks for Older Adults

Older adults metabolize medications differently, making them more sensitive to the effects of diphenhydramine.

Confusion, Delirium & Hallucinations
Regular use can cause acute mental status changes, leading to hospitalizations.

Falls & Fractures
Sedation and dizziness contribute to a higher risk of falls — a major cause of disability and death in seniors.

Increased Dementia Vulnerability
The aging brain is particularly susceptible to anticholinergic-related damage, amplifying the long-term risk of cognitive decline.

For these reasons, The American Geriatrics Society strongly advises against the use of diphenhydramine in older adults.

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