Natural sleep aids

by Karen Schroeder, MS, RD

Maybe youve just crossed a few time zones, or you work the night shift, or youre just stressed out and its interfering with your sleep. A natural remedy may help you get some restful sleep.

In some cases, insomnia may be a sign of an underlying illness. Talk with your doctor about this possibility. However, if there does not appear to be such a condition interfering with your ability to snooze, some of these natural options may help you get quality sleep.

Acupuncture is the insertion of tiny needles into specific points on the body. According to Traditional Chinese Medicine, the balanced flow of a “vital force” called qi (pronounced "chee") maintains the health of body and mind. Acupuncture is felt to restore the normal flow of qi when it becomes blocked. To the extent that insomnia results from an imbalance of qi, a series of acupuncture treatments may improve sleep. In fact, sedation is one of the most common symptoms patients report following an acupuncture session for any reason.

One randomized, controlled study of 40 people with sleeping difficulties found that those given acupuncture for 3-5 sessions at weekly intervals showed significant improvements in an objective measure of sleep. People in the control group had needles inserted, but in non-acupuncture points, and therefore did not know which intervention they were receiving. The therapists, however, could not be blinded. The researchers note that the direct effects of the therapist could not be measured and may have affected the results.

It is unclear exactly how this therapy could help induce sleep. One theory is that acupuncture causes the release of chemicals in the central nervous system that promote calmness and sleep.

Acupressure stimulates the same healing points used in acupuncture, but does so with manual pressure, rather than needles. Proponents of acupressure feel that it can help relieve tension and many common stress-related ailments, including insomnia.

A single-blind, placebo-controlled study, done on 84 nursing home residents, found that those who received 5 minutes of acupressure, 5 times weekly for 3 weeks fell asleep faster and slept more soundly than those who did not receive this therapy. This study has limitations, though. Again, the therapists could not be blinded to the therapy they were providing. Those in the control group could not be blinded either—they received only conversation.

There is good evidence that mental and/or physiologic arousal causes insomnia. Therapies that aim to relax the body and the mind have shown some success in helping people get to sleep. These therapies include:

• Progressive relaxation – the tensing and relaxing of various voluntary muscle groups throughout your body in an orderly sequence. The theory is that when you are emotionally tense, you automatically clench or tighten your muscles. With progressive relaxation, you relax your muscles and release both the physical and mental tension.
• Meditation – the focusing of your mind continuously on one thought, word (mantra), object, or mental image for a period of time. It can also involve focusing on your breathing or on sensations in your body. The goal of meditation is to quiet your mind.
• Hypnosis – often described as a "trance," hypnosis is actually a state of inner absorption, concentration, and focused attention. The unconscious mind is allowed to take over, and positive imagery and suggestions are used to help improve mental and physical health.
• Yoga – a practice that includes physical exercises, postures, balancing, breathing techniques, and meditation.

For centuries, people have turned to the herb valerian to help them sleep. The particular species that is used to counter insomnia is Valeriana officinalis. Valerian is often recommended as an aid for occasional insomnia, but recent studies indicate that it may be helpful on a long-term basis as well. It is unclear exactly how valerian works. Some research suggests that, like sleeping pills, valerian affects the neurotransmitter GABA. This is still under debate.

The FDA categorizes valerian as GRAS—generally recognized as safe. However, there have been some reports of dangerous side effects from products containing valerian in combination with other herbs. In addition, very high levels of valerian (20-40 times the recommended dose) can cause stomach cramps, fatigue, chest tightness, tremors, and light-headedness.

How to use it

One well-designed study used 600 mg of an alcohol-based valerian extract 1 hour before bedtime. If you are interested in valerian, ask your doctor what dose you should take.

Our bodies use the hormone melatonin to help regulate our sleep-wake cycles. When exposure to light decreases, the pineal gland (located in the brain) makes serotonin and then converts it to melatonin. Taking supplemental melatonin seems to stimulate sleep when the natural cycle is disturbed. Although several studies have supported the use of supplemental melatonin to treat insomnia, there are also many studies that have found this supplement to have no effect.

How to use it

Melatonin is usually taken 30-60 minutes before bedtime. The optimal dose has not yet been defined, but studies have found positive results with doses ranging from 2 mg to 10 mg. Ask your doctor what a safe dosage is for you.

Several herbs have been suggested to help promote sleep and reduce insomnia, such as kava, chamomile, and passionflower. However, there is very little scientific evidence for their efficacy. Again, talk these over with your doctor before trying them. For a complete listing and more discussion of these herbs, click here.

There are a few things you can change in your lifestyle to promote good sleep. For example, exercise regularly, cut down on caffeine and alcohol, establish a regular sleep routine, and do not smoke. For more details on each of these and more tips for getting a good night of sleep, click here.

Sources:

National Center for Complementary and Alternative Medicine

National Sleep Foundation