Nighttime pain relief is wide awake and going strong

Ahh … sleep. Is there a better feeling than waking up completely refreshed after a good night’s sleep? Webster’s Dictionary defines sleep as “a natural, regularly recurring condition of rest for the body and mind.”

Unfortunately, for many people sleep does not always come so naturally. In 2009, economic uncertainties, fear of new influenza strains, and pain are contributing to problems with sleeplessness experienced by many among the U.S. population. Temporary sleeping problems can cause a tired mind and lead to bothersome headaches. Similarly, body aches and pains often lead to lack of sleep, further perpetuating the cycle.

Nighttime pain relievers are useful in these situations because they can provide short-term relief of the occasional headaches and minor aches and pains that can accompany sleeplessness. According to Information Resources, Inc. (IRI), the nighttime pain-relief segment of the health, beauty, and wellness industry generated more than $156 million spent at food markets, drugstores, and mass outlets (excluding Wal-Mart) during the 52 weeks ending January 25, 2009.

This represents 6 percent of the overall internal analgesics category and a 1.5 percent increase over the same period last year. In addition, in terms of units sold, three nighttime pain relievers currently rank among the top 50 internal analgesics. Who uses nighttime pain relievers and why?

According to the National Institutes of Health, about 70 million people suffer from a chronic sleep disorder or intermittent sleep problem. Intermittent sleep problems can be caused by many factors, one of which is pain. Headaches, backaches, muscle aches, minor arthritis pain, and menstrual cramps are common types of pain keeping people awake at night.

A new poll released by the National Sleep Foundation shows that only 32 percent of Americans who admit to having sleep problems report them to their physicians. Those who choose to deal with their problems themselves have the option of using OTC sleep aids.

Individuals experiencing both pain and sleeplessness may choose a nighttime pain-relief medication. Regular OTC sleep aids typically contain diphenhydramine hydrochloric acid, an antihistamine with sedating properties. Most major brands of nighttime pain relievers, however, also contain an analgesic such as ibuprofen, acetaminophen, naproxen, or aspirin. Instead of taking two pills, consumers just need one.

A need for speed

Products offering rapid relief are becoming increasingly popular across many categories, and pain relief is no exception. In a shopper’s decision-making process, these forms figure differently from regular caplets and tablets. Advil was the first major brand to introduce a liquid-capsule version of its product in the nighttime pain-relief segment.

Soon after, Tylenol brought to market a rapid-release product with holes specially designed to release medicine quickly. New technology continues to propel both the internal analgesics category and the nighttime pain-relief segment.

Nighttime pain relievers for women

IRI numbers show that women’s pain relievers generated 2.5 percent of total revenue in the internal analgesics category during the 52 weeks ending January 25, 2009.

In March, Midol, a leader in the segment of women’s pain relief, introduced a nighttime reliever of menstrual pain. Premium-priced niche products like these have the potential to drive incremental sales and increase retailer margin.

Natural relief

One potential drawback to the use of nighttime pain relievers is the morning-after drowsiness antihistamines can cause.

Natural products such as valerian root and melatonin have been used for a long time to induce sleep without side effects, but they have typically not contained pain relievers.

MidNite, a natural herbal sleep remedy, recently unveiled MidNite PM. Like the original MidNite, it contains a blend of lemon balm, lavender, chamomile, and melatonin; however, MidNite PM also contains bromelain, a natural pain reliever derived from pineapples. When an adult awakens in the night, these pills can be taken without the side effect of morning drowsiness, as long as at least three more hours can be devoted to sleep.

Merchandising

Though regular OTC sleep aids such as Sominex and Simply Sleep are often placed near analgesics, retailers should resist the urge to position all the nighttime pain relievers together. Brand awareness ranks high on the consumer decision tree, so the pain-relief display should be divided into brand blocks.

The decision to purchase a nighttime product comes later in the decision process, so a nighttime section should be contained within each brand block. These nighttime sections can be positioned near each other when feasible.

Information for pharmacists

When nighttime pain-relief medications contain an antihistamine, short-term use is best. Although there is no risk of addiction as there is with prescription sleep aids, the body can develop a tolerance to diphenhydramine.

Though the diphenhydramine will continue to work as an antihistamine, the body may adapt to the side effect of sleepiness, which can confuse the user into thinking that doses of increasing strength are necessary. Pharmacists should advise users to read product labels carefully and be cautious until they know how the products will affect them.

Top 10 nighttime pain relievers (IRI-ranked by dollar sales) for the 52 weeks ending January 25, 2009

• Advil PM (ibuprofen diphenhydramine citrate) caplet, nonprescription strength, 20 ct.

• Tylenol PM (acetaminophen/diphenhydramine HCl) Rapid Release Geltab, Extra Strength, 20 ct.

• Tylenol PM (acetaminophen/diphenhydramine HCl) Geltab, Extra Strength, 24 ct.

• Tylenol PM (acetaminophen/diphenhydramine HCl) Caplet, Extra Strength, 24 ct.

• Advil PM (ibuprofen diphenhydramine citrate) Caplet, nonprescription strength, 40 ct.

• Tylenol PM (acetaminophen/diphenhydramine HCl) Rapid Release Geltab, Extra Strength, 40 ct.

• Tylenol PM (acetaminophen/diphenhydramine HCl) Geltab, Extra Strength, 24 ct.

• Tylenol PM (acetaminophen/diphenhydramine HCl) Caplet, Extra Strength, 24 ct.

• Tylenol PM (acetaminophen/ diphenhydramine HCl) Rapid Release Geltab, Extra Strength, 20 ct.

• Advil PM (ibuprofen diphenhydramine citrate) Caplet, nonprescription strength, 40 ct.

Jennifer Johnston is with Hamacher Resource Group Inc. (www.hamacher.com), a provider of category management, marketing communications, and retailing strategies to the health, beauty, and wellness industry.