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    Insomnia (Holistic)

    Insomnia (Holistic)

    About This Condition

    Tired of insomnia? Fortunately, there are alternatives to counting sheep to help you get a healthy night?s sleep. According to research or other evidence, the following self-care steps may be helpful.
    • Create a restful place to sleep

      Remove or block noise, light, and other distractions, and make sure your mattress is comfortable for you

    • Cut coffee and other stimulants

      Eliminate or cut down on drinks and foods that have caffeine, ephedra, or pseudoephedrine; work with your doctor to find alternatives if you take medication with any of these ingredients

    • Learn to relax

      Relaxation tapes and other self-help tools or a counselor experienced in treating insomnia can help you let go of tension

    • Check out valerian

      To fall asleep quicker and enjoy deeper sleep quality, take 300 to 600 mg of a concentrated root extract 30 minutes before bedtime, with or without other relaxing herbs such as lemon balm and passion flower

    About

    About This Condition

    Insomnia refers to a prolonged inability to get adequate sleep. Not getting a good night?s sleep can result from waking up in the middle of the night and having trouble getting back to sleep. It also occurs when people have a hard time falling asleep in the first place. Insomnia can be a temporary, occasional, or chronic problem.

    Symptoms

    Sleep-onset insomnia refers to the inability to fall asleep initially. Sleep-maintenance insomnia refers to the inability to stay asleep, with one or more awakenings during the night.

    Healthy Lifestyle Tips

    A steady sleeping and eating schedule combined with caffeine avoidance and counseling sessions using behavioral therapy has reduced insomnia for some people, as has listening to relaxation tapes.1

    The effect of exercise on sleep has not been well studied. However, some healthcare practitioners recommend daily exercise as a way to reduce stress, which in turn can help with insomnia.

    A naturopathic therapy for insomnia is take a 15- to 20-minute hot Epsom-salts bath before bedtime. One or two cups of Epsom salts (magnesium sulfate) in a hot bath are thought to act as a muscle relaxant.

    Smokers are more likely to have insomnia than nonsmokers.2 As with many other health conditions, it is important for people with insomnia to quit smoking.

    Holistic Options

    Insomnia can be triggered by psychological stress. Dealing with stress, through counseling or other techniques, may be the key to a better night?s rest. Many trials have shown that psychological intervention can be helpful for insomnia.3 A combined program of counseling, sleep restriction methods (i.e., the only time spent in bed is when sleeping), and control of stimuli that might interfere with sleep, significantly increased sleep time in a group of people with insomnia.4

    Acupuncture may be helpful for insomnia, possibly by increasing production of calming neurotransmitters such as serotonin and other substances.5 A preliminary trial found one acupuncture treatment daily for seven to ten days resulted in complete recovery of normal sleep in 59% of patients and partial recovery in 21%.6 A controlled trial treated patients with either acupuncture or fake acupuncture (insertion of needles at non-acupuncture points). The patients receiving true acupuncture had significant improvements in a laboratory measure of sleep quality compared to the placebo group.7 The treatment of insomnia with auricular (ear) acupuncture may provide similar benefits to people with insomnia, according to a preliminary trial.8 However, double-blind trials are necessary to conclusively determine the value of acupuncture in treating insomnia.

    Eating Right

    The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

    Recommendation Why
    Try some carbs before bed
    Doctors will sometimes recommend eating a slice of bread or some crackers before bedtime, which may reduce anxiety and promote sleep.

    Doctors will sometimes recommend eating a high-carbohydrate food before bedtime, such as a slice of bread or some crackers. Eating carbohydrates can significantly increase levels of a neurotransmitter (chemical messenger) called serotonin,9 which is known to reduce anxiety and promote sleep.

    Cut the caffeine
    Stop drinking coffee and tea, and avoid other caffeinated products to avoid night-time restlessness.

    Caffeine is a stimulant.10 The effects of caffeine can last up to 20 hours,11 so some people will have disturbed sleep patterns even when their last cup of coffee was in the morning. Besides regular coffee, black tea, green tea , cocoa, chocolate, some soft drinks, and many over-the-counter pharmaceuticals also contain caffeine.

    Uncover allergies
    Food allergy may also contribute to insomnia. Work with a knowledgeable practitioner to discover potential sensitivities.

    Food allergy may also contribute to insomnia. In a trial involving eight infants, chronic insomnia was traced to an allergy to cow?s milk. Avoidance of milk resulted in a normalization of sleep patterns.12

    Supplements

    What Are Star Ratings?

    Our proprietary ?Star-Rating? system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

    For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

    3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

    2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

    1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

    Supplement Why
    3 Stars
    L-Tryptophan
    1 to 2 grams at bedtime
    L-tryptophan has been used successfully for people with insomnia in many studies,including double-blind trials.
    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,13 , 14including double-blind trials.15 , 16 , 17 , 18 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.19 , 20One 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.21 Some preliminary and controlled trials have not found L-tryptophan effective,22 or have found L-tryptophan effective only for people who awaken more frequently at night compared with those who awaken less frequently.23 Several studies combined L-tryptophan with a carbohydrate-containing meal to improve L-tryptophan uptake into the brain.24 , 25 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.26 In a preliminary study of people with fibromyalgia , supplementing with 100 mg of 5-HTP three times a day improved sleep quality.27 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,"28 a common problem in children that causes sudden awakening with persistent fear or terror, screaming, sweating, confusion, and increased heart rate.
    3 Stars
    Valerian
    300 to 600 mg of a concentrated root extract 30 minutes before bedtime
    Valerian may help you fall asleep faster and enjoy deeper sleep quality.

    Herbal remedies have been used safely for centuries for insomnia. In modern herbal medicine, the leading herb for insomnia is valerian .29 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.30 , 31 , 32 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.33 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.34 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).35 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.36

    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.37

    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.38 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.39 In a double-blind trial, the combination of valerian root and hops was significantly more effective than valerian root alone for treating insomnia.40

    2 Stars
    5-HTP
    Adults: 200 mg two hours before bedtime and 400 mg at bedtime; children: 3 mg per 2.2 lbs (1 kg) body weight
    5-HTP is converted into serotonin and might, therefore, be helpful for insomnia. In one study, supplementing with 5-HTP appeared to improve sleep quality.
    The amino acid L-tryptophan has been used successfully for people with insomnia,41 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.42

    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.43 In a preliminary trial of people with fibromyalgia , supplementing with 100 mg of 5-HTP three times a day improved sleep quality.44 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,"45 a common problem in children that causes sudden awakening with persistent fear or terror, screaming, sweating, confusion, and increased heart rate.

    2 Stars
    Corydalis
    Refer to label instructions
    Corydalis contains several ingredients, one of which has been shown to influence the nervous system, providing pain relief and promoting relaxation.

    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.46People taking the extract reported no drug hangover symptoms, such as dizziness or vertigo .

    2 Stars
    Hops
    Refer to label instructions
    Hops is commonly recommended by doctors as a mild sedative for those suffering from insomnia or nervous exhaustion.

    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.47 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.48 In a double-blind trial, the combination of valerian root and hops was significantly more effective than valerian root alone for treating insomnia.49

    2 Stars
    Lavender
    Refer to label instructions
    Lavender oil's aroma is known to be calming and may be helpful in some cases of insomnia.

    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.50 One study of elderly people with sleeping troubles found that inhaling lavender oil was as effective as some commonly prescribed sleep medications.51 Similar results were seen in another trial that included young and middle aged people with insomnia.52 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.53 Internal use of essential oils can be dangerous and should be done only with the supervision of a trained herbalist or healthcare professional.

    2 Stars
    Melatonin (Tinnitus)
    Take under medical supervision: 3 mg dailly at bedtime
    Supplementing with melatonin may improve sleep quality and relieve other symptoms of severe tinnitus.

    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 sleeping54 and why melatonin supplements improve sleep in the elderly.55

    Middle-aged adults (average age, 54 years) with insomnia also have lower melatonin levels, compared with people of the same age without insomnia.56 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,57 but not in young people who suffer from insomnia.58However, 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.59

    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.60

    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.61 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.

    2 Stars
    Melatonin
    Take under medical supervision: 0.5 to 3.0 mg daily one to two hours before bedtime
    Taking melatonin before bedtime may help reset your body?s internal clock.

    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 sleeping62 and why melatonin supplements improve sleep in the elderly.63

    Middle-aged adults (average age, 54 years) with insomnia also have lower melatonin levels, compared with people of the same age without insomnia.64 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,65 but not in young people who suffer from insomnia.66However, 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.67

    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.68

    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.69 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.

    2 Stars
    Tart Cherry
    1?8 ounces up to twice daily for seven days
    Tart cherries contain a small amount of the sleep-regulating hormone melatonin and may improve some measures of sleep quality.
    Tart cherries contain a small amount of the sleep-regulating hormone melatonin.70 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.71 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.72
    1 Star
    American Scullcap
    Refer to label instructions
    American scullcap is commonly recommended by doctors as a mild sedative for those suffering from insomnia or nervous exhaustion.

    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.73 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.74

    1 Star
    Bitter Orange
    Refer to label instructions
    Bitter orange has a history of use as a calming agent and to counteract insomnia.

    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.

    1 Star
    Catnip
    Refer to label instructions
    Catnip is commonly recommended by doctors as a mild sedative for those suffering from insomnia or nervous exhaustion.

    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.75 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.76

    1 Star
    Chamomile
    Refer to label instructions
    Chamomile is commonly recommended by doctors as a mild sedative for those suffering from insomnia or nervous exhaustion. It is a particularly good choice for children whose insomnia may be related to gastrointestinal upset.

    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.77 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.78

    1 Star
    Lemon Balm
    Refer to label instructions
    Studies have found a combination of valerian and lemon balm to be effective at improving sleep.

    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).79 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.80

    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.81

    1 Star
    Magnesium
    Refer to label instructions
    People with period limb movements during sleep or restless legs syndrome often have sleep problems. In one trial, insomniacs with these conditions slept better after supplementing with magnesium.

    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).82

    1 Star
    Passion Flower
    Refer to label instructions
    Passion flower is commonly recommended by doctors as a mild sedative for those suffering from insomnia or nervous exhaustion.

    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.83 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.84 In a double-blind trial, the combination of valerian root and hops was significantly more effective than valerian root alone for treating insomnia.85

    1 Star
    Vitamin B12
    Refer to label instructions
    In two small preliminary trials, people with insomnia resulting from disorders of the sleep-wake rhythm improved after supplementing with vitamin B12.

    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).86 , 87

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