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
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 ROOT
Valerian 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.
HOPS
Hops 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 FLOWER
Passion 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
SCULLCAP
Scullcap 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.
GABA
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
References
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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.
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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. 159–60.