Diet & Fitness

The amino acid, L-tryptophan, a serotonin precursor, taken in amounts of 1 to 4 grams at bedtime, has been used successfully for people with insomnia in many studies,^1,2, including double-blind trials.^3,4,5,6 Some research indicates that people with more severe forms of insomnia may need to take L-tryptophan for several nights before improvement in sleep is noticed.^7,2, One controlled trial found that newborns receiving a bottle feeding in which 420 mg of L-tryptophan per 2.2 lbs of body weight had been added entered quiet sleep sooner and slept for a longer time.⁹ Some preliminary and controlled trials have not found L-tryptophan effective,¹⁰ or have found L-tryptophan effective only for people who awaken more frequently at night compared with those who awaken less frequently.¹¹ Several studies combined L-tryptophan with a carbohydrate-containing meal to improve L-tryptophan uptake into the brain.^4,13 A related compound that occurs naturally in the body, 5-HTP is also converted into serotonin and might, therefore, be helpful for insomnia. In a double-blind study of people without insomnia, supplementation with 5-HTP (200 mg at 9:15 p.m. and 400 mg at 11:15 p.m.) increased rapid-eye-movement (REM) sleep, presumably indicating improved sleep quality.¹⁴ In a preliminary study of people with fibromyalgia, supplementing with 100 mg of 5-HTP three times a day improved sleep quality.¹⁵ However, additional research is needed to determine whether 5-HTP is safe and effective for people with insomnia.In a preliminary study, 5-HTP was also found to be an effective treatment for "sleep terrors,"¹⁶ a common problem in children that causes sudden awakening with persistent fear or terror, screaming, sweating, confusion, and increased heart rate.

Herbal remedies have been used safely for centuries for insomnia. In modern herbal medicine, the leading herb for insomnia is valerian.¹⁵ Valerian root makes getting to sleep easier and increases deep sleep and dreaming. Valerian does not cause a morning “hangover,” a side effect common to prescription sleep drugs in some people.^16,17,18 A double-blind trial found that valerian extract (600 mg 30 minutes before bedtime for 28 days) is comparable in efficacy to oxazepam (Serax), a commonly prescribed drug for insomnia.¹⁹ In a separate double-blind trial, the same amount of valerian extract was found to improve subjective assessments of sleep quality and certain aspects of brain function during sleep as well.²⁰ A concentrated (4–5:1) valerian root supplement in the amount of 300–600 mg can be taken 30 minutes before bedtime. Alternately, 2 to 3 grams of the dried root in a capsule or 5 ml tincture can be taken 30 minutes before bedtime.

A combination of valerian and lemon balm has been tested for improving sleep. A small preliminary trial compared the effect of valerian root extract (320 mg at bedtime) and an extract of lemon balm (Melissa officinalis) with that of the sleeping drug triazolam (Halcion).²¹ The effectiveness of the herbal combination was similar to that of Halcion, but only the Halcion group felt hung over and had trouble concentrating the next day. A double-blind trial found that a combination of valerian and lemon balm, taken over a two-week period, was effective in improving quality of sleep.²²

Another double-blind trial found a combination of 360 mg valerian and 240 mg lemon balm taken before bed improved reported sleep quality in one-third of the participants.²³

Combining valerian root with other mildly sedating herbs is common both in Europe and the United States. Chamomile, hops, passion flower, lemon balm, American scullcap, and catnip are commonly recommended by doctors.²⁴ These herbs can also be used alone as mild sedatives for those suffering from insomnia or nervous exhaustion. Chamomile is a particularly good choice for younger children whose insomnia may be related to gastrointestinal upset. Hops and lemon balm are approved by the German government for relieving sleep disturbances.²⁵ In a double-blind trial, the combination of valerian root and hops was significantly more effective than valerian root alone for treating insomnia.²⁶

The amino acid L-tryptophan has been used successfully for people with insomnia,²⁷ presumably because it is converted to the chemical messenger, serotonin. According to one preliminary trial, L-tryptophan supplementation was 100% effective at promoting sleep in people who awaken between three to six times per night, but not effective at all for people who only awaken once or twice, nor in people who doze on and off throughout the night in a state blurred between sleep and wakefulness.²⁸

A related compound that occurs naturally in the body, 5-HTP (5-hydroxytryptophan), is also converted into serotonin and might, therefore, be helpful for insomnia. In a double-blind trial of people without insomnia, supplementation with 5-HTP (200 mg at 9:15 p.m. and 400 mg at 11:15 p.m.) increased rapid-eye-movement (REM) sleep, presumably indicating improved sleep quality.²⁹ In a preliminary trial of people with fibromyalgia, supplementing with 100 mg of 5-HTP three times a day improved sleep quality.³⁰ However, additional research is needed to determine whether 5-HTP is safe and effective for people with insomnia.

In a preliminary study, 5-HTP was also found to be an effective treatment for "sleep terrors,"³¹ a common problem in children that causes sudden awakening with persistent fear or terror, screaming, sweating, confusion, and increased heart rate.

 

Corydalis contains several ingredients, one of which has been shown to influence the nervous system, providing pain relief and promoting relaxation. People with insomnia were able to fall sleep more easily after taking 100 to 200 mg per day of a corydalis extract (called dl-tetrahydropalmatine, or DHP), according to a preliminary report.³²People taking the extract reported no drug hangover symptoms, such as dizziness or vertigo.

 

Combining valerian root with other mildly sedating herbs is common both in Europe and the United States. Chamomile, hops, passion flower, lemon balm, American scullcap, and catnip are commonly recommended by doctors.³³ These herbs can also be used alone as mild sedatives for those suffering from insomnia or nervous exhaustion. Chamomile is a particularly good choice for younger children whose insomnia may be related to gastrointestinal upset. Hops and lemon balm are approved by the German government for relieving sleep disturbances.³⁴ In a double-blind trial, the combination of valerian root and hops was significantly more effective than valerian root alone for treating insomnia.³⁵

 

The volatile oil of lavender contains many medicinal components, including perillyl alcohol, linalool, and geraniol. The oil's aroma is known to be calming and thus may be helpful in some cases of insomnia.³⁶ One study of elderly people with sleeping troubles found that inhaling lavender oil was as effective as some commonly prescribed sleep medications.³⁷ Similar results were seen in another trial that included young and middle aged people with insomnia.³⁸ Teas made from lavender flowers or from the oil (1 to 4 drops) are approved for internal use by the German Commission E for people with insomnia.³⁹ Internal use of essential oils can be dangerous and should be done only with the supervision of a trained herbalist or healthcare professional.

Caution: Melatonin is a potent hormone and its long-term safety is not established. Melatonin should only be taken with medical supervision.

Melatonin is a natural hormone that regulates the human biological clock. The body produces less melatonin with advancing age, which may explain why elderly people often have difficulty sleeping⁴⁰ and why melatonin supplements improve sleep in the elderly.⁴¹

Middle-aged adults (average age, 54 years) with insomnia also have lower melatonin levels, compared with people of the same age without insomnia.⁴² However, there is not much research on the use of melatonin for sleep problems in middle-aged people.

Double-blind trials have shown that melatonin facilitates sleep in young adults without insomnia,⁴³ but not in young people who suffer from insomnia.⁴⁴However, one trial found that children with sleep disturbances stemming from school phobia had improved sleep after taking 1 mg of melatonin per night for one week, then 5 mg per night for one week, then 10 mg per night for a third week.⁴⁵

The results of one double-blind trial also indicate that a controlled release melatonin supplement providing 2 mg per day improves sleep quality in people with schizophrenia.⁴⁶

Normally, the body makes melatonin for several hours per night—an effect best duplicated with controlled-release supplements. Trials using timed-release melatonin for insomnia have reported good results.⁴⁷ Many doctors suggest taking 0.5 to 3 mg of melatonin one and a half to two hours before bedtime. However, because melatonin is a potent hormone, the long-term effects of which are unknown, it should be taken only with the supervision of a doctor.

Tart cherries contain a small amount of the sleep-regulating hormone melatonin.⁴⁸ In a double-blind trial, healthy young people took one ounce daily of a tart cherry juice concentrate, estimated to contain the equivalent of 90-100 tart cherries, for seven days, which resulted in increased urine levels of melatonin and improvement in several measures of sleep quality.⁴⁹ In a double-blind study of older people with insomnia, drinking eight ounces twice daily of a cherry-apple juice blend [note: ratio not given], estimated to be equivalent to 100 cherries per day, for seven days resulted in small improvements in some measures of sleep quality.⁵⁰

 

Combining valerian root with other mildly sedating herbs is common both in Europe and the United States. Chamomile, hops, passion flower, lemon balm, American scullcap, and catnip are commonly recommended by doctors.⁵¹ These herbs can also be used alone as mild sedatives for those suffering from insomnia or nervous exhaustion. Chamomile is a particularly good choice for younger children whose insomnia may be related to gastrointestinal upset. Hops and lemon balm are approved by the German government for relieving sleep disturbances.⁵²

Bitter orange has a history of use as a calming agent and to counteract insomnia. There is no clinical trial data to support its efficacy in this regard. The usual amount of tincture used is 2 to 3 ml at bedtime.^53,54

 

Combining valerian root with other mildly sedating herbs is common both in Europe and the United States. Chamomile, hops, passion flower, lemon balm, American scullcap, and catnip are commonly recommended by doctors.⁵⁵ These herbs can also be used alone as mild sedatives for those suffering from insomnia or nervous exhaustion. Chamomile is a particularly good choice for younger children whose insomnia may be related to gastrointestinal upset. Hops and lemon balm are approved by the German government for relieving sleep disturbances.⁵⁶

 

Combining valerian root with other mildly sedating herbs is common both in Europe and the United States. Chamomile, hops, passion flower, lemon balm, American scullcap, and catnip are commonly recommended by doctors.⁵⁷ These herbs can also be used alone as mild sedatives for those suffering from insomnia or nervous exhaustion. Chamomile is a particularly good choice for younger children whose insomnia may be related to gastrointestinal upset. Hops and lemon balm are approved by the German government for relieving sleep disturbances.⁵⁸

 

A combination of valerian and lemon balm has been tested for improving sleep. A small preliminary trial compared the effect of valerian root extract (320 mg at bedtime) and an extract of lemon balm (Melissa officinalis) with that of the sleeping drug triazolam (Halcion).⁵⁹ The effectiveness of the herbal combination was similar to that of Halcion, but only the Halcion group felt hung over and had trouble concentrating the next day. A double-blind trial found that a combination of valerian and lemon balm, taken over a two-week period, was effective in improving quality of sleep.⁶⁰

Another double-blind trial found a combination of 360 mg valerian and 240 mg lemon balm taken before bed improved reported sleep quality in one-third of the participants.⁶¹

 

Some people have difficulty sleeping because of a problem known as period limb movements during sleep (PLMS) or another condition called restless legs syndrome (RLS). In a preliminary trial, people with PLMS or RLS who suffered from insomnia had a significant improvement in sleep efficiency after supplementing with magnesium (about 300 mg each evening for four to six weeks).⁶²

 

Combining valerian root with other mildly sedating herbs is common both in Europe and the United States. Chamomile, hops, passion flower, lemon balm, American scullcap, and catnip are commonly recommended by doctors.⁶³ These herbs can also be used alone as mild sedatives for those suffering from insomnia or nervous exhaustion. Chamomile is a particularly good choice for younger children whose insomnia may be related to gastrointestinal upset. Hops and lemon balm are approved by the German government for relieving sleep disturbances.⁶⁴ In a double-blind trial, the combination of valerian root and hops was significantly more effective than valerian root alone for treating insomnia.⁶⁵

 

In two small preliminary trials, people with insomnia resulting from disorders of the sleep-wake rhythm improved after supplementing with vitamin B12 (1,500 to 3,000 mcg per day).^66,67