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Sleep Aids - US - November 2010

This report explores the market for non-prescription, over-the-counter (OTC) sleep aids. Many Americans have trouble falling asleep or staying asleep. Despite their sleep troubles, however, most Americans have not tried a prescription, OTC or homeopathic sleep aid.

This report explores the reasons why adults are reluctant to use sleep aids, and presents areas of opportunity—especially in light of product recalls of Johnson & Johnson/McNeil Consumer Healthcare brands Tylenol PM, Simply Sleep and others.

This report explores ways to build brands, innovate product forms and marketing, expand the category, and engage and educate consumers about the advantages of non-prescription sleep aids and remedies over traditional prescription medications.

Analysis and insights include:

  • Market drivers and opportunities for innovation, both in product form and the market as a whole
  • Competition in the marketplace among products and treatments, as well as behavioral adjustments that are designed to help people sleep
  • Innovation and innovators among leading companies in the category
  • Advertising and promotional strategies and/or themes
  • Consumer opinions and behavior, including data on consumers who have purchased or are willing to purchase non-prescription, OTC sleep aids
  • Cluster analysis to identify the consumer groups most likely to be attracted to these products
  • Custom consumer group analysis with an in-depth review of attitudes toward sleep aids by age group and gender

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Table of contents

  1. Scope and Themes

    • What you need to know
      • Definition
        • Data sources
          • Sales data
            • Consumer survey data
              • Advertising creative
                • Abbreviations and terms
                  • Abbreviations
                    • Terms
                    • Executive Summary

                      • Sales growth of 22% between 2005 and 2010 masks recent problems in the market
                        • No shortage of sleep problems…
                          • … yet most have never tried a sleep aid
                            • Competitors seek the Holy Grail
                              • Private label share exceeds that of the leading brand manufacturers
                                • Drug store share of sales is slipping
                                  • Reimbursement for OTC sleep aids problematic for some adults
                                    • Media spending lags behind other OTC healthcare categories
                                      • Most adults get too little sleep, and lose time trying to sleep
                                        • Sleep difficulties most common among adults 18-24 and women 18-34
                                          • Lack of confidence in sleep aids
                                            • Doctors take a back seat to family members/friends with younger adults
                                              • A motivated few will “try anything”
                                              • Insights and Opportunities

                                                • Promote importance of sleep to overall health
                                                  • Recall presents a unique opportunity
                                                    • Strengthen store brands
                                                      • Lose the analgesic
                                                        • Leverage sleep hygiene tools
                                                        • Inspire Insights

                                                            • Trend: Mood from Food
                                                            • Market Size and Forecast

                                                              • Key points
                                                                • Sales rollercoaster
                                                                  • Private label sales strong
                                                                    • Sales and forecast of OTC sleep aids
                                                                      • Figure 1: U.S. FDMx sales of OTC sleep aids, at current prices, 2005-15
                                                                      • Figure 2: U.S. FDMx sales of OTC sleep aids, at inflation-adjusted prices, 2005-15
                                                                    • Fan chart forecast
                                                                        • Figure 3: FDMx sales and fan chart forecast of sleep aids, at current prices, 2005-15
                                                                      • Walmart sales
                                                                      • Market Drivers

                                                                        • Majority of Americans have trouble sleeping at least occasionally
                                                                          • Figure 4: U.S. population aged 18 or older, 2010-15 and troubles sleeping regularly or occasionally, by gender and age, July-August 2010
                                                                        • Insomnia
                                                                          • Figure 5: Insomnia/sleep disorder prevalence in last 12 months, by gender and age, April 2009-June 2010
                                                                        • Worry and sleep
                                                                          • Figure 6: Sleep concerns and the impact of lack of sleep, by gender, July-August 2010
                                                                          • Figure 7: Sleep concerns and the impact of lack of sleep, by age, July-August 2010
                                                                        • Innovation
                                                                          • Figure 8: Sleep aid new product launches, by private label and branded, 2004-10
                                                                        • Flexible Spending Accounts OTC rules change
                                                                          • Other illnesses cause sleep problems
                                                                            • Figure 9: Prevalence of selected diseases/disorders among adults aged 18+, 2006 and 2009
                                                                        • Competitive Context

                                                                            • Sleep hygiene
                                                                              • Figure 10: Never tried a sleep aid, by type of aid, July-August 2010
                                                                            • Prescription medications
                                                                              • Figure 11: Total U.S. revenue and prescriptions of leading prescription brand & generic sleep aids, at current prices, 2008-09
                                                                            • Prescription sleep aids used
                                                                              • Figure 12: Prescription sleep aid usage, by gender and age, July-August 2010
                                                                            • Many ‘off-label’ alternatives
                                                                              • Figure 13: Type of sleep aids used, currently and in past, July-August 2010
                                                                            • ‘PM’ medications
                                                                              • Figure 14: FDMx brand sales and market share of PM versions of internal analgesics in the U.S., rolling 52 weeks ending July 12, 2009 and July 11, 2010
                                                                            • Private label alternatives
                                                                                • Figure 15: FDMx retail sales of private label sleep aids at current prices, 2005-10
                                                                              • A plethora of sleep remedies
                                                                                • Myriad sleep apps
                                                                                • Segment Performance

                                                                                  • Key points
                                                                                    • Natural, homeopathic sleep aids gain converts
                                                                                      • Private label sales strong
                                                                                        • Snore remedies fading
                                                                                          • Sales of sleep aids, by segment
                                                                                            • Figure 16: U.S. FDMx sales of OTC sleep aids, segmented, by type, 2009-10
                                                                                        • Segment Performance—Diphenhydramine HCl Sleep Aids

                                                                                          • Key points
                                                                                            • Sales of branded Diphenhydramine HCl shrinking
                                                                                              • Sales and forecast of diphenhydramine HCl sleep aids
                                                                                                • Figure 17: FDMx retail sales of Diphenhydramine HCl, at current prices, 2005-15
                                                                                            • Segment Performance—Natural Sleep Aids

                                                                                              • Key points
                                                                                                • Natural sleep aids provide calm in the storm
                                                                                                  • Fewer negative perceptions of natural sleep aids
                                                                                                    • Sales and forecast of natural sleep aids
                                                                                                      • Figure 18: FDMx retail sales of natural sleep aids, at current prices, 2005-15
                                                                                                  • Segment Performance—Doxylamine Succinate-based Sleep Aids

                                                                                                    • Key points
                                                                                                      • Sales of Doxylamine Succinate-based products declined 14% since 2005
                                                                                                        • Sales and forecast of Doxylamine Succinate-based sleep aids
                                                                                                          • Figure 19: FDMx retail sales of Doxylamine Succinate-based sleep aids, at current prices, 2005-15
                                                                                                      • Segment Performance—Snore Remedies

                                                                                                        • Key points
                                                                                                          • Snore remedy sales tank
                                                                                                            • Sales and forecast of snore remedies
                                                                                                              • Figure 20: FDMx retail sales of snore remedies, at current prices, 2005-15
                                                                                                          • Segment Performance—Homeopathic Remedies

                                                                                                            • Key points
                                                                                                              • Homeopathic sleep remedies are up and coming
                                                                                                                • Fewer negative perceptions of homeopathic remedies
                                                                                                                  • Sales and forecast of homeopathic remedies
                                                                                                                    • Figure 21: FDMx retail sales of homeopathic remedies, at current prices, 2005-15
                                                                                                                • Retail Channels

                                                                                                                  • Key points
                                                                                                                    • Drug stores share of sales is slipping
                                                                                                                      • Supermarkets and other channels hold their own
                                                                                                                        • Sales of sleep aids, by channel
                                                                                                                          • Figure 22: U.S. FDMx sales of non-prescription sleep aids, by retail channel, 2009-10
                                                                                                                      • Retail Channels—Drug Stores

                                                                                                                        • Key point
                                                                                                                          • Drug stores asleep at the wheel
                                                                                                                            • Drug store sales of sleep aids
                                                                                                                              • Figure 23: U.S. sales of OTC sleep aids, at drug stores, 2005-10
                                                                                                                          • Retail Channels—Supermarket and Other

                                                                                                                            • Key points
                                                                                                                              • Supermarkets and other channels increase sales 14% since 2005
                                                                                                                                • Supermarket and other store sales of sleep aids
                                                                                                                                  • Figure 24: U.S. sales of OTC sleep aids, at supermarket and other stores*, 2005-10
                                                                                                                              • Natural Channel/SPINS

                                                                                                                                  • Key points
                                                                                                                                    • Sales of sleep aids in the natural channel
                                                                                                                                      • Figure 25: Natural supermarket sales of sleep aids, at current prices, 2008-10
                                                                                                                                      • Figure 26: Natural supermarket sales of sleep aids, at inflation-adjusted prices, 2008-10
                                                                                                                                    • Natural channel sales by segment
                                                                                                                                      • Figure 27: Natural supermarket sales of sleep aids, by segment, August 2008 and August 2010
                                                                                                                                    • Leading brands
                                                                                                                                    • Leading Companies

                                                                                                                                      • Key points
                                                                                                                                        • Leading manufacturers realized sales decline of almost 15%
                                                                                                                                          • Leading manufacturers do not have natural offerings
                                                                                                                                            • Manufacturer sales of sleep aids
                                                                                                                                              • Figure 28: FDMx select manufacturer sales of OTC sleep aids in the U.S., 2009-10
                                                                                                                                          • Brand Share—Diphenhydramine HCl Sleep Aids

                                                                                                                                            • Key points
                                                                                                                                              • Unisom leapfrogs Simply Sleep
                                                                                                                                                • Manufacturer and brand sales of Diphenhydramine HCl sleep aids
                                                                                                                                                  • Figure 29: Select FDMx brand sales and market share of Diphenhydramine HCl sleep aids in the U.S., 2009-10
                                                                                                                                              • Brand Share—Natural Sleep Aids

                                                                                                                                                • Key points
                                                                                                                                                  • MidNite romp
                                                                                                                                                    • Melatonin plus
                                                                                                                                                      • Manufacturer and brand sales of natural sleep aids
                                                                                                                                                        • Figure 30: Select FDMx brand sales and market share of natural sleep aids in the U.S., 2009-10
                                                                                                                                                    • Brand Share—Snore Remedies

                                                                                                                                                      • Key points
                                                                                                                                                        • Snore remedy sales fading away
                                                                                                                                                          • Manufacturer and brand sales of snore remedies
                                                                                                                                                            • Figure 31: Select FDMx brand sales and market share of snore remedies in the U.S., 2009-10
                                                                                                                                                        • Brand Share—Homeopathic Sleep Aids

                                                                                                                                                          • Key points
                                                                                                                                                            • Homeopathic brands trying to break through
                                                                                                                                                              • Manufacturer and brand sales of homeopathic sleep aids
                                                                                                                                                                • Figure 32: Select FDMx brand sales and market share of homeopathic sleep aids in the U.S., 2009-10
                                                                                                                                                            • Innovation and Innovators

                                                                                                                                                              • Key points
                                                                                                                                                                • New product introductions wane
                                                                                                                                                                  • Figure 33: Pace of innovation—new product introductions in U.S., 2004-10
                                                                                                                                                                • Environmentally-friendly packaging claims strong in 2010
                                                                                                                                                                  • Figure 34: Claim trends in new OTC sleep aid product launches, 2004-10
                                                                                                                                                                • 2010 U.S. product introduction highlights
                                                                                                                                                                  • Homeopathic remedies
                                                                                                                                                                    • Natural sleep aids
                                                                                                                                                                      • Private label sleep aids
                                                                                                                                                                      • Marketing Strategies

                                                                                                                                                                        • Overview
                                                                                                                                                                          • Figure 35: U.S. media spending—sleep aid brands, 2006-09
                                                                                                                                                                        • Advertising themes
                                                                                                                                                                          • Advertising approaches
                                                                                                                                                                            • McNeil—Tylenol PM/Simply Sleep
                                                                                                                                                                              • Figure 36: McNeil Consumer Healthcare/Tylenol PM television ad, November 2009
                                                                                                                                                                            • Chattem—Unisom
                                                                                                                                                                              • Figure 37: Chattem/Unisom SleepMelts television ad, May 2010
                                                                                                                                                                              • Figure 38: Chattem/Unisom Sleep television ad, December 2009
                                                                                                                                                                            • Concepts in Health—MidNite
                                                                                                                                                                              • Figure 39: Concepts in Health/MidNite Pills television ad, September 2010
                                                                                                                                                                            • Pharmavite—Nature Made Sleep
                                                                                                                                                                              • Figure 40: Pharmavite/nature made sleep television ad, May 2010
                                                                                                                                                                          • Sleep Habits

                                                                                                                                                                            • Key points
                                                                                                                                                                              • On average, Americans get just seven hours of sleep during the week
                                                                                                                                                                                • Americans try to pay down sleep debt on the weekend
                                                                                                                                                                                  • Figure 41: Average hours of sleep—weeknights and weekends, by gender and age, July-August 2010
                                                                                                                                                                              • Sleep Troubles

                                                                                                                                                                                • Key points
                                                                                                                                                                                  • Most adults have trouble sleeping at least some of the time
                                                                                                                                                                                    • Figure 42: Sleep troubles, July-August 2010
                                                                                                                                                                                  • Most adults have trouble falling asleep at least occasionally
                                                                                                                                                                                    • Figure 43: Trouble falling asleep, by gender and age, July-August 2010
                                                                                                                                                                                  • Adults who have trouble falling asleep spend 1.5 hours trying
                                                                                                                                                                                    • Figure 44: Hours spent trying to fall asleep among those with trouble falling asleep, by gender and age, July-August 2010
                                                                                                                                                                                  • Waking up and not being able to get back to sleep is also quite common
                                                                                                                                                                                    • Figure 45: Waking up in the middle of the night, by gender and age, July-August 2010
                                                                                                                                                                                  • Almost half of adults 18-34 regularly feel tired during the day
                                                                                                                                                                                    • Figure 46: Tired during the day, by gender and age, July-August 2010
                                                                                                                                                                                • Sleep Aid Usage

                                                                                                                                                                                  • Key points
                                                                                                                                                                                    • The majority of adults with sleep issues have never tried a sleep aid
                                                                                                                                                                                      • Figure 47: Sleep aid usage, by form, July-August 2010
                                                                                                                                                                                  • Attitudes Towards Sleep Aids

                                                                                                                                                                                    • Key points
                                                                                                                                                                                      • Most adults who take a sleep aid do not believe it is effective or reliable
                                                                                                                                                                                        • Figure 48: Attitudes towards sleep aids, by type, July-August 2010
                                                                                                                                                                                      • Women worry more about OTC sleep aid risks
                                                                                                                                                                                        • Figure 49: Attitudes towards OTC sleep aids, by gender, July-August 2010
                                                                                                                                                                                      • Men more likely to agree that prescription sleep aids are effective; have fewer worries
                                                                                                                                                                                        • Figure 50: Attitudes towards prescription sleep aids, by gender, July-August 2010
                                                                                                                                                                                      • Women much more likely than men to feel herbal sleep remedies are effective
                                                                                                                                                                                        • Figure 51: Attitudes towards herbal sleep aids, by gender, July-August 2010
                                                                                                                                                                                    • Selecting Remedies

                                                                                                                                                                                      • Key points
                                                                                                                                                                                        • Personal referrals are key to reaching the most troubled sleepers (adults 18-34)
                                                                                                                                                                                          • Figure 52: Sources consulted when selecting sleep remedies, by age, July-August 2010
                                                                                                                                                                                      • Motivation to Try Sleep Aids

                                                                                                                                                                                        • Key point
                                                                                                                                                                                          • About one in 10 adults are always looking for something to help them sleep
                                                                                                                                                                                            • Figure 53: Interest in trying/identifying new sleep aids, by gender, July-August 2010
                                                                                                                                                                                        • Impact of Lack of Sleep

                                                                                                                                                                                          • Key points
                                                                                                                                                                                            • Lack of sleep is costly
                                                                                                                                                                                              • Figure 54: Impact of lack of sleep, by gender, July-August 2010
                                                                                                                                                                                            • Young adults most greatly affected by sleep loss
                                                                                                                                                                                              • Figure 55: Sleep concerns and the impact of lack of sleep, by age, July-August 2010
                                                                                                                                                                                          • Race and Hispanic Origin

                                                                                                                                                                                            • Key points
                                                                                                                                                                                              • Black adults most likely to get six or fewer hours of sleep
                                                                                                                                                                                                • Figure 56: Average hours of sleep—weeknights and weekends, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                              • Hispanics most likely to have trouble falling asleep regularly
                                                                                                                                                                                                • Figure 57: Trouble falling asleep, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                              • Among troubled sleepers, blacks take longest to fall asleep
                                                                                                                                                                                                • Figure 58: Hours spent trying to fall asleep among those with trouble falling asleep, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                              • About four in 10 Hispanics regularly feel tired during the day
                                                                                                                                                                                                • Figure 59: Tired during the day, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                              • Sleep aid use low based on race or Hispanic origin
                                                                                                                                                                                                • Figure 60: Sleep aid usage, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                              • Blacks least likely to agree that prescription sleep aids are effective
                                                                                                                                                                                                • Figure 61: Attitudes towards prescription sleep aids, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                              • Attitudes towards OTC sleep aids are consistent
                                                                                                                                                                                                • Figure 62: Attitudes towards OTC sleep aids, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                            • Cluster Analysis

                                                                                                                                                                                                • Unworried, but Occasionally Troubled
                                                                                                                                                                                                  • Characteristics
                                                                                                                                                                                                    • Opportunity
                                                                                                                                                                                                      • Alertness-focused Sleepers
                                                                                                                                                                                                        • Characteristics
                                                                                                                                                                                                          • Opportunity
                                                                                                                                                                                                            • Tired Users
                                                                                                                                                                                                              • Characteristics
                                                                                                                                                                                                                • Opportunity
                                                                                                                                                                                                                  • Characteristic tables
                                                                                                                                                                                                                    • Figure 63: Troubled sleeper clusters, August 2010
                                                                                                                                                                                                                    • Figure 64: Average hours of sleep, by troubled sleeper clusters, August 2010
                                                                                                                                                                                                                    • Figure 65: Sleep troubles, by troubled sleeper clusters, August 2010
                                                                                                                                                                                                                    • Figure 66: Hours spent trying to fall asleep, by troubled sleeper clusters, August 2010
                                                                                                                                                                                                                    • Figure 67: Sleep aid usage, by form, by troubled sleeper clusters, August 2010
                                                                                                                                                                                                                    • Figure 68: Sleep concerns, the impact of lack of sleep, and interest in new products, by troubled sleeper clusters, July-August 2010
                                                                                                                                                                                                                  • Demographic tables
                                                                                                                                                                                                                    • Figure 69: Troubled sleeper clusters, by gender, August 2010
                                                                                                                                                                                                                    • Figure 70: Troubled sleeper clusters, by age, July-August 2010
                                                                                                                                                                                                                    • Figure 71: Troubled sleeper clusters, by household income, July-August 2010
                                                                                                                                                                                                                    • Figure 72: Troubled sleeper clusters, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                                                  • Cluster methodology
                                                                                                                                                                                                                  • Custom Consumer—Gender by Age

                                                                                                                                                                                                                    • Key points
                                                                                                                                                                                                                      • Half of women aged 18-34 experience difficulty sleeping on a regular basis
                                                                                                                                                                                                                        • Figure 73: Trouble falling asleep, by gender and age, July-August 2010
                                                                                                                                                                                                                      • Women aged 35-54 most likely to wake up and not be able to get back to sleep
                                                                                                                                                                                                                        • Figure 74: Waking up in the middle of the night, by gender by age, July-August 2010
                                                                                                                                                                                                                      • Men aged 18-34 spend 1.75 hours trying to fall asleep
                                                                                                                                                                                                                          • Figure 75: Hours spent trying to fall asleep among those with trouble falling asleep, by gender by age, July-August 2010
                                                                                                                                                                                                                        • Despite sleep troubles, young adults no more likely than all adults to regularly use sleep aids
                                                                                                                                                                                                                          • Figure 76: Sleep aid regular usage, by form, by age and gender, July-August 2010
                                                                                                                                                                                                                        • Women aged 18-34 consult spouse, friends or online sites rather than their doctor
                                                                                                                                                                                                                          • Figure 77: Sources consulted when selecting sleep remedies, by age and gender, July-August 2010
                                                                                                                                                                                                                        • Women aged 18-34 worried about using sleep aids
                                                                                                                                                                                                                          • Figure 78: Attitudes towards OTC sleep aids, by age and gender, July-August 2010
                                                                                                                                                                                                                        • The lives of 18-34s are negatively impacted by lack of sleep
                                                                                                                                                                                                                          • Figure 79: Impact of lack of sleep, by age/gender, July-August 2010
                                                                                                                                                                                                                      • Key Household Purchase Measures—SymphonyIRI Group Builders Panel

                                                                                                                                                                                                                          • Sleep remedies
                                                                                                                                                                                                                            • Sleep aid tablets—consumer insights on key purchase measures
                                                                                                                                                                                                                              • Brand map
                                                                                                                                                                                                                                • Figure 80: Brand map, selected brands of sleeping aid tablets buying rate, by household penetration, 2009
                                                                                                                                                                                                                              • Brand leader characteristics
                                                                                                                                                                                                                                • Key purchase measures
                                                                                                                                                                                                                                  • Figure 81: Key purchase measures for the top brands of sleeping aid tablets, by household penetration, 2009
                                                                                                                                                                                                                              • Appendix—Other Useful Consumer Tables

                                                                                                                                                                                                                                  • Figure 82: Attitudes towards OTC sleep aids, by age, July-August 2010
                                                                                                                                                                                                                                  • Figure 83: Attitudes towards prescription sleep aids, by age, July-August 2010
                                                                                                                                                                                                                                  • Figure 84: Attitudes towards herbal sleep aids, by age, July-August 2010
                                                                                                                                                                                                                                  • Figure 85: Sources consulted when selecting sleep remedies, by gender, July-August 2010
                                                                                                                                                                                                                                  • Figure 86: Sleep concerns and the impact of lack of sleep, by age, July-August 2010
                                                                                                                                                                                                                                  • Figure 87: Attitudes towards herbal sleep aids, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                                                                  • Figure 88: Sources consulted when selecting sleep remedies, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                                                                  • Figure 89: Interest in trying/identifying new sleep aids, by race/Hispanic origin, July-August 2010
                                                                                                                                                                                                                                  • Figure 90: Sleep aid occasional usage, by form, by age and gender, July-August 2010
                                                                                                                                                                                                                              • Appendix—SymphonyIRI/Builders Panel Data Definitions

                                                                                                                                                                                                                                  • SymphonyIRI Consumer Network Metrics
                                                                                                                                                                                                                                  • Appendix—Trade Associations

                                                                                                                                                                                                                                    Companies Covered

                                                                                                                                                                                                                                    • American Academy of Sleep Medicine (AASM)
                                                                                                                                                                                                                                    • American Pharmacists Association (APhA)
                                                                                                                                                                                                                                    • BOIRON SA
                                                                                                                                                                                                                                    • Centers for Disease Control and Prevention
                                                                                                                                                                                                                                    • Chattem, Inc.
                                                                                                                                                                                                                                    • Consumer Healthcare Products Association (CHPA)
                                                                                                                                                                                                                                    • CVS Caremark Corporation
                                                                                                                                                                                                                                    • Food and Drug Administration
                                                                                                                                                                                                                                    • GlaxoSmithKline (USA)
                                                                                                                                                                                                                                    • Green Pharmaceuticals Inc
                                                                                                                                                                                                                                    • Johnson & Johnson
                                                                                                                                                                                                                                    • McNeil Consumer & Specialty Pharmaceuticals
                                                                                                                                                                                                                                    • National Institutes of Health
                                                                                                                                                                                                                                    • National Sleep Foundation (NSF)
                                                                                                                                                                                                                                    • Novartis Pharmaceuticals Corporation
                                                                                                                                                                                                                                    • Pharmavite LLC
                                                                                                                                                                                                                                    • PhRMA Pharmaceutical Research and Manufacturers of America
                                                                                                                                                                                                                                    • Roundy's, Inc
                                                                                                                                                                                                                                    • U.S. Consumer Product Safety Commission
                                                                                                                                                                                                                                    • World Self-Medication Industry

                                                                                                                                                                                                                                    Sleep Aids - US - November 2010

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