Paging Dr. Frischer: Herbal sleep remedies

Many of us have trouble getting a good night’s sleep. Instead of focusing on the reasons, including physical and emotional stressors, let’s explore some herbal remedies.

Despite significant medical and technological advancements in pharmaceuticals, the global demand for herbal remedies is on the rise. They are often less costly, and sometimes safer. Keep in mind that these supplements are not approved by the Food and Drug Administration (FDA), and that it's a very good idea to speak with your healthcare provider before starting any new supplements. Do not take them in combination with other sedatives, and be on the lookout for drug interactions. Given those cautions, for those who want to avoid prescription medications, what are some herbal choices for the occasional restless night, or even for long-term insomnia?

  • Melatonin is a naturally occurring hormone. It is produced at night, when the light is low, and helps to regulate the sleep-wake cycle. Research does suggest that melatonin supplements may help sleep issues related to circadian rhythm-related disorders, jet lag, shift work, aging, and insomnia in some children. The most common (but rare) side effects include daytime drowsiness, headache, dizziness, nausea and nightmares.

  • Chamomile is a key ingredient in many relaxing teas. The flowers are most often used, but the leaves may also be dried and used for tea, extracts, or topical compresses. A handful of studies have supported its use for diarrhea, anxiety, abdominal cramping, pain and inflammation, and insomnia. It is safe for most people, but can cause nausea, dizziness, or an allergic reaction in those who react to ragweed, daisies, or marigolds.

  • St. John’s Wort uses the plant’s small yellow flowers to make teas, capsules, or extracts. It was used in ancient Greece, and some studies do support its short-term use for sleep. Historically it was also used in wound healing and to treat depression. It has few and rare side effects, including allergic reactions, dizziness, confusion, and dry mouth.

  • Turmeric has been shown to have an indirect effect on sleep. Its main active ingredient is curcumin, and is known to treat anxiety, which is one of the more common reasons for insomnia. It has also been used to treat inflammation and pain.

  • Valerian is a flowering plant whose roots are thought to affect our levels of gamma-aminobutyric acid (GABA), a calming chemical. Valerian root can be found in capsules, or steeped to make tea. Its use traces back to ancient Greece and Rome, where it was used to relieve restlessness, tremors, headaches, and heart palpitations. Although studies are spotty to date, today it is mostly used for insomnia and anxiety. It is relatively safe, though minor side effects may include headache, dizziness, itchy skin, and stomach pains.

  • Similar to valerian root, passionflower is also thought to help with anxiety and sleep by affecting GABA levels. Limited studies have been performed, and side effects may include drowsiness, confusion, and ataxia.

  • Kava is sometimes recommended for anxiety-related insomnia. Most of the research on kava and insomnia is limited to animal studies. Side effects may include indigestion, mouth numbness, rash, headache, drowsiness, and visual disturbances. NOTE that the FDA has advised consumers about potential risk of severe liver injury from using supplements containing kava.

  • Tryptophan is a naturally occurring amino acid found in milk, fish, turkey, chicken, cheese, peanuts, and various seeds. It is a building block for serotonin, which is converted to melatonin. Research shows mixed results for sleep, but who hasn’t heard that it’s the turkey in our Thanksgiving feasts that causes drowsiness afterwards? Tryptophan supplements are not recommended, due to extensive side effects and potential serious complications.

  • Magnesium is a mineral found in pumpkin and chia seeds, almonds, cashews and peanuts, spinach, soymilk, black beans, and edamame. Research does support its behavior as a natural sedative, both when consumed in foods or in supplements. The most common side effects from supplements include stomach cramping, nausea, vomiting, and diarrhea. Note that magnesium is the main ingredient in Milk of Magnesia, used to treat constipation.

  • We’ve all heard about the effect of cannabidiol (CBD) on sleep. CBD is an active ingredient in cannabis. While THC causes the “high,” CBD does not. Research suggests that CBD may indeed be helpful for treating insomnia, and studies are ongoing. Side effects may include dry mouth, diarrhea, drowsiness, fatigue, and reduced appetite.

I urge you to remember that while herbal products come from natural sources, they are not automatically safe. Consider the source of the product, the dose, potential side effects, and note that they may interact with other medications. Please consult with your physician or pharmacist before starting any new medication, herbal or otherwise. I wish you a peaceful and restful sleep.

Health, NewsDr. Alan Frischer