Insomnia is the chronic inability to sleep or to remain asleep through the night. The condition is caused by a variety of physical and psychological factors. These include emotional stress, physical pain and discomfort, disturbances in brain function, drug abuse and drug dependence, neuroses, psychoses, and psychological problems that produce anxiety, irrational fears, and tensions. Conventional medical treatments may include giving sedatives, tranquilizers or hypnotics, psychotherapy, and exercise. However, there are also a variety of natural substances, which may help. These are discussed below.
Melatonin is a hormone produced by the small, pea-shaped pineal gland located in the brain. During daylight hours, light entering the eye stimulates neurons to transmit impulses to the pineal gland that inhibit melatonin secretion. But at night, the pineal gland is able to release melatonin, which causes relaxation and initiates the sleep cycle.
As the body ages, it produces less melatonin—which may explain why elderly people often have difficulty sleeping1 and why melatonin supplements improve sleep in the elderly.2 This does not mean that the use of melatonin should be limited to the elderly. Other research has shown that non-elderly adults with insomnia can also have lower melatonin levels.3 Also, research has demonstrated that melatonin even helps facilitate sleep in young adults.4 An appropriate dose would be 3–6 mg melatonin taken one hour before bedtime.
VALERIAN ROOTValerian root is considered by many to be the "granddaddy" of all sleep-promoting herbs, and is the leading herb for insomnia in modern herbal medicine. Valerian root makes getting to sleep easier and increases deep sleep and dreaming. Valerian does not cause the morning "hangover" which is a common side effect of prescription sleep drugs and melatonin in some individuals.5,6 By itself, a valerian root supplement (standardized for percent of valerenic acid), in doses of 300–400 mg can be taken thirty minutes before bedtime. Also, Valerian may be combined with other herbs. For example, one German study compared the effect of a combination product containing an extract of valerian root (320 mg at bedtime) and extract of lemon balm, Melissa officinalis, with the sleeping drug Halcion®.7 After monitored sleep for nine nights, the herbal duo matched Halcion in boosting the ability to get to sleep as well as in the quality of sleep. However, the Halcion group felt hung over and had trouble concentrating the next day, while those taking the valerian/lemon balm combination reported no negative effect.
HOPSHops have a history of use as nature's best sleep "inducer." Though many natural substances are more effective at keeping one asleep, Hops is often considered best at inducing sleep. The German Commission E recommends Hops for anxiety or insomnia.8
PASSION FLOWERPassion flower has been, and continues to be an extremely popular herb in Europe where it is often used to induce relaxation and sleep. In the United States, however, medical use of the herb did not begin until the late nineteenth century when passion flower was used to treat nervous restlessness and gastrointestinal spasms—the belief being that passion flower worked primarily on the nervous system, particularly for anxiety due to mental worry and overwork.9 Research has demonstrated that the flavonoids in passion flower are the primary constituents responsible for its relaxing and anti-anxiety effects.10
SCULLCAPScullcap has been used historically and in modern times as a sedative for people with nervous tension as well as for insomnia. Unfortunately, very few studies have been conducted on Scullcap. However, one double-blind, placebo-controlled study11 of healthy subjects demonstrated noteworthy anxiolytic (anxiety-reducing) effects from Scullcap. Also, one of Scullcaps constituents known as scutellaria has been shown to have mild sedative and antispasmodic actions in animal research.12
GRIFFONIA SIMPLICIFOLIA (5-HTP)
5-Hydroxy-L-Tryptophan (5-HTP) is a natural peptide, which the human body uses to make the neurotransmitter serotonin. Serotonin is important for normal nerve and brain function, and plays an important role in sleep. In fact, your body can convert serotonin into melatonin.13 The concept is that by taking supplemental 5-HTP your body should be able to make serotonin, which ultimately, should help promote sleep. In fact, in one placebo-controlled trial 5-HTP was able to improve the duration and depth of sleep in individuals with insomnia.14 In addition, 5-HTP was able to improve sleep quality in a preliminary trial of people with fibromyalgia.15 Commercially, 5-HTP can be derived from the seeds of a West African plant called Griffonia simplicifolia. Some Griffonia extracts are standardized to 10 percent 5-HTP.
Gamma-Amino Butyric Acid (GABA) is a natural peptide, which is manufactured from the amino acid glutamine and glucose. In the central nervous system, GABA exerts anticonvulsant, sedative, and anxiolytic effects at the cellular level.16,17 GABA supplements appear to promote relaxation and sleep.18 GABA itself does not cause drowsiness. Instead, by easing anxiety, it simply makes it easier to fall asleep.
DIET AND/OR OTHER CONSIDERATIONS
For many insomniacs, avoiding caffeine may be an absolute necessity. After all, caffeine is a well-known stimulant, which can keep you awake.19 Now if you're thinking, "Fine, I'll just make sure not to have any coffee in the evening," you may be in for a disappointment. The effects of caffeine can last up to twenty hours,20 so you may need to stop drinking coffee altogether. Now besides regular coffee, black and green tea, cocoa, chocolate, some soft drinks, and many over-thecounter pharmaceuticals also contain caffeine, so be sure to limit or avoid the intake of these items as well. Another dietary consideration is that eating high-carbohydrate food before bedtime, such as a slice of bread or some crackers, can significantly increase serotonin levels in the body—and the neurotransmitter serotonin is known to reduce anxiety and promote sleep.
Non-dietary considerations include stress and smoking. Insomnia can be triggered by, or exacerbated by psychological stress. Dealing with that stress through counseling has helped in many studies.22 Another method of intervention, which has helped is listening to relaxation tapes.23
In addition, research has shown that smokers are more likely to have insomnia than non-smokers,24 which is one more good reason for smokers to quit.
Another non-dietary approach to insomnia can include lavender oil. The volatile or essential oil of lavender contains many medicinal components, including perillyl alcohol, linalool, and geraniol. The oil is calming25 and thus can be helpful in some cases of insomnia. One study of elderly persons with sleeping troubles found that inhaling lavender oil was as effective as tranquilizers.26 The German government approves lavender for people with insomnia.27
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- Blumenthal M, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines (1998) Austin: American Botanical Council and Boston: Integrative Medicine Communications, pp. 147.
- Foster S, Herbs for Your Health (1996) Interweave Press, Loveland, Colorado, pp. 68–9.
- Meier B, Zeitschrift Phytother (1995) 16:115–26.
- Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers. Alternative therapies in health and medicine 2003; 9(2):74-8.
- Foster S. Herbs for Your Health. Loveland, CO: Interweave Press, 1996, 86–7.
- Guyton AC, Hall JE. Textbook of Medical Physiology, 9th ed. Philadelphia: W. B. Saunders, 1996.
- Soulairac A, Lambinet H. Etudes cliniques de líaction du precurseur de la serotonine le L-5-hydroxy-tryptophane, sur les troubles du sommeil. Schweiz Bundschau Med (PRAXIS) 1998;77(34a):19–23.
- Puttini PS, Caruso I. Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a 90 day open study. J Int Med Res 1992;20:182–9.
- Kalant H, Roschlau WHE, Eds. Principles of Med. Pharmacology. New York, NY: Oxford Univ Press, 1998.
- Bloom FE, Kupfer DJ. Psychopharmacology: The Fourth Generation of Progress. New York, NY: Raven Press, Ltd., 1995.
- GABA. WholeHealthMD.com. Accessed on December 1, 2005 from http://www.wholehealthmd.com/refshelf/substances_view/1,1525,10027,00.html.
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- Morin CM, Culbert JP, Schwartz SM, Am J Psychiatr (1994) 151:1172–80.
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- Phillips BA, Danner FJ, Arch Intern Med (1995) 155:734–7.
- Buchbauer G, et al, Z Naturforsch [C] (1991) 46:1067–72.
- Hardy M, Kirk-Smith MD, Stretch DD, Lancet (1995) 346:701 [letter].
- Blumenthal M, et al, (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines (1998) Austin: American Botanical Council and Boston: Integrative Medicine Communications, pp. 159–60.
Gene Bruno, MS, MHS
Gene Bruno is the Dean of Academics and Professor of Dietary Supplement Science for Huntington College of Health Sciences (a nationally accredited distance learning college offering diplomas and degrees in nutrition and other health science related subjects. Gene has two undergraduate Diplomas in Nutrition, a Bachelor’s in Nutrition, a Master’s in Nutrition, a Graduate Diploma in Herbal Medicine, and a Master’s in Herbal Medicine. As a 32 year veteran of the Dietary Supplement industry, Gene has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines, and peer-reviewed publications. Gene's latest book, A Guide to Complimentary Treatments for Diabetes, is available on Amazon.com, and other fine retailers.