Hi Lloyd: With an underlying condition that hampers sleep, the best first approach is typically to address the underlying condition. But you likely know that. As for sleep meds, all the experts advise using the only under supervision of a sleep expert or other physician because — as you suspect — they're not as effective as marketed, and they can be downright dangerous. The experts I've spoken to, and the research I've looked into, categorically suggests trying all the other sleep remedies (exercise, diet, and more than a dozen others) before even considering sleep meds (OTC or prescription). I've written about it: https://medium.com/wise-well/the-dangerous-truth-about-sleeping-pills-79dc85f9b261