An Ayurvedic Herb for Better Sleep

Might Ayurvedic medicine—traditional medicine practiced in India for 3,000 years—offer an effective treatment for insomnia?

If you’re looking for an alternative treatment vetted by scientists in controlled clinical trials, the answer is no. But an Indian herb called ashwagandha is receiving attention as a substance that might help people with several health conditions, including chronic stress, anxiety, and memory loss. It’s also being studied as a possible sleep aid. Here’s more about it.

Insomnia may respond to treatment with ashwagandhaMight Ayurvedic medicine—traditional medicine practiced in India for 3,000 years—offer an effective treatment for insomnia?

If you’re looking for an alternative treatment vetted by scientists in controlled clinical trials, the answer is no. But an Indian herb called ashwagandha is receiving attention as a substance that might help people with several health conditions, including chronic stress, anxiety, and memory loss. It’s also being studied as a possible sleep aid. Here’s more about it.

Ashwagandha (Withania somnifera)

Ayurvedic medicine is a holistic healing system. Patients are generally prescribed a combination of herbs, special diets, and daily practices aimed at promoting overall health rather than eliminating a specific problem like insomnia.

But the Latin somnifera means sleep-inducing, and ashwagandha powder, prepared from the root, leaves, or whole plant and taken orally, has been prescribed to improve sleep for centuries. A handful of laboratory studies on rodents have provided evidence for ashwagandha’s sleep-inducing effects. Results of some studies suggest that ashwagandha leaf extract may also protect rats from the consequences of sleep deprivation.

Authors of a recently published paper in PLOS ONE have identified a specific component of the ashwagandha leaf that puts mice to sleep. Following is a summary of their findings.

An Active Component That Promotes Sleep

Biologically active components in ashwagandha include withanolides—naturally occurring steroids—and triethylene glycol, or TEG. TEG is currently used in various manufacturing processes, but how it impacts biological systems is largely unknown. In this study, investigators wanted to find out if one or the other of these substances had sleep-inducing effects.

Via a complicated extraction process, the researchers isolated each of these compounds, mixing them with alcohol and water so they could be administered orally to mice. Here are the results:

  • Compared with the alcoholic medium alone, the alcoholic extract containing a high amount of active withanolides had no effect on the sleep–wake system of the mice.
  • Compared with water alone, the extract containing lots of TEG induced a significantly greater amount of non-REM, or quiet, sleep—without affecting the amount or nature of REM sleep.
  • Commercially available TEG was also administered to the mice in 10, 20, and 30-mg doses. The larger the dose, the more non-REM sleep the mice got over a 12-hour period and the more quickly they fell asleep.

The authors conclude that while low to moderate levels of TEG clearly induce sleep in laboratory animals, possible “toxicological properties of TEG need to be studied in detail before its used is advised in humans.”

Meanwhile, Is Ashwagandha Safe for Humans?

It depends on where you ask the question. Indian practitioners of Ayurvedic medicine have been prescribing it for centuries. A handful of scientific studies also attest to the safety of this herb when used short term in therapeutic doses. (Long-term effects are unknown.)

But an article in Medline Plus lists a number of safety concerns. People who are pregnant and breast feeding, who have diabetes, or who have an auto-immune disorder should steer clear of ashwagandha. The herb can interact with various medications and supplements, too.

For a definitive reading on whether ashwagandha could work as a treatment for insomnia we’ll have to wait and see. But it’s widely available as a dietary supplement in powder, capsule, and tablet forms. Of course, dietary supplements are less well regulated by the FDA than prescription medications. Quality is not assured.

But if you’re looking for better sleep and tempted to try ashwagandha, consult a practitioner of Ayurvedic medicine or a naturopath about whether the herb might have something to offer you.

Timed-Release Melatonin for Insomnia

A friend recently called to talk about insomnia. Her problem, she said, was that she couldn’t sleep past 3 a.m. Her doctor recommended taking melatonin and she wanted to know what I thought of this advice.

If you’ve got the type of insomnia where you wake up too early or too frequently (sleep maintenance insomnia), you may be interested in this update.

Timed-release melatonin may help people who awaken too early or too frequentlyA friend recently called to talk about insomnia. Her problem, she said, was that she couldn’t sleep past 3 a.m. Her doctor recommended taking melatonin and she wanted to know what I thought of this advice. Coincidentally, last week ConsumerLab, a company that tests and reviews dietary supplements, published a review of melatonin supplements.

If you’ve got the type of insomnia where you wake up too early or too frequently (sleep maintenance insomnia), you may be interested in this update.

Hormone and Supplement

The melatonin found in supplements is chemically identical to the sleep-friendly hormone produced at night in the brain’s pineal gland. Secretion of melatonin begins about 2 hours before bedtime and continues through the night, falling off at wake-up time.

Melatonin supplements are thought to be quite safe. They can help night owls fall asleep at an earlier hour. Timed right, supplements can also ease jet lag. But as a treatment for people with sleep maintenance insomnia, melatonin supplements often come up short.

Melatonin and Aging

Melatonin production often falls off as people age. This may occur because of degeneration of neurons in the circadian system or partial calcification of the pineal gland. The resulting low levels of melatonin make it harder to get sound, restorative sleep.

In theory, supplementary melatonin should take care of the problem. The reality is that often it doesn’t. One reason is that the melatonin in most over-the-counter supplements is fast acting. It reaches its maximum strength and is metabolized by the body quickly. The half-life of most melatonin supplements is quite short: 20 to 45 minutes. (Half-life refers to the time it takes for a dose of a drug in the blood plasma to decrease by half.) Compare this to the 5-7-hour half-life of Lunesta, the top-selling prescription sleeping pill in 2013.

Taken before bedtime, most melatonin supplements lose potency too quickly to help users sleep through the night.

Timed-Release Melatonin Supplements

The answer to this problem may lie in some type of timed-release formulation of melatonin. Circadin is one such drug. It’s available by prescription for adults 55 and older in several countries outside the United States. The drug has a half-life of 3.5–4 hours, so it’s longer lasting than most melatonin supplements sold over-the-counter. Clinical trials suggest that compared with placebo, Circadin improves the sleep quality and morning alertness of older adults with insomnia. (Apparently, the trial results are not convincing enough for the drug to gain approval in the US.)

ConsumerLab’s review of melatonin supplements acquainted me with timed-release formulations now sold over-the-counter in the US. Here are some examples:

  • Natrol Melatonin Time Release (1, 3, 5, and 10 mg, advertised as released over 8 hours)
  • Source Naturals Timed-Release Melatonin (2 and 3 mg, advertised as released over 6 hours)
  • Life Extension 6 Hour Timed Release Melatonin (300 and 750 mcg and 3 mg, advertised as released over 6 hours)

No spokesperson I reached at these companies was able to explain exactly what sort of testing was done to establish the 6- and 8-hour release times. Unlike pharmaceutical companies, manufacturers of dietary supplements do not have to conduct clinical trials or obtain approval for their products from the US Food and Drug Administration. Supplement makers are essentially allowed to police themselves, required only to gather enough evidence to show that their products are safe and that claims they make about them are not untrue or misleading. (ConsumerLab did not test the timed-release feature of these drugs.) How long the melatonin in these products will remain active in your body, and how likely the supplements are to improve your sleep quality or reduce your nighttime wake-ups, is impossible to know.

Still, people with sleep maintenance insomnia who decide to try a melatonin supplement are probably better off with a timed-release product than the immediate-release type.

Dosing

Even low-dose melatonin supplements (0.1–0.5 mg) contain a lot more melatonin than humans produce naturally. So taking higher doses (2–10 mg) may leave you feeling groggy in the morning. This is especially true for older adults, who process drugs more slowly.

Starting with a low dose seems like a smart idea.

Have you tried a timed-release melatonin supplement? If so, did it help you sleep, and did you notice any negative effects?

Can Insomnia Be Caused by Dietary Supplements?

I’ve written about common medications that can cause insomnia. But less is known about the side effects of supplements. They’re unregulated in the United States and not required to undergo rigorous testing.

But investigators at ConsumerLab, after reviewing the results of tests that have been conducted, say there’s evidence that 6 supplements may interfere with sleep. Here’s a summary of the findings:

Six dietary supplements that may interfere with your sleepI subscribe to a newsletter from ConsumerLab, a watchdog company that tests and reviews dietary supplements. Last week a question in the newsletter caught my eye:

“Could my CoQ10 supplement be causing my insomnia?”

I’ve written about common medications that can cause insomnia. But less is known about the side effects of supplements. They’re unregulated in the United States and not required to undergo rigorous testing. But investigators at ConsumerLab, after reviewing the results of tests that have been conducted, say there’s evidence that 6 supplements may interfere with sleep. Here’s a summary of the findings:

CoQ10

Coenzyme Q10, or ubiquinone, is an antioxidant compound that cells use to produce energy. The body usually manufactures enough CoQ10 on its own, and small amounts can be gotten from beef and chicken. But CoQ10 production may fall off with age or because of heart disease. CoQ10 supplements are used for congestive heart failure and to reduce the risk of heart problems after a heart attack. They may also lessen the muscle pain associated with taking statin drugs and help to prevent migraines.

The typical daily dose is 100 to 300 mg. Yet taken in the evening, doses of 100 mg and higher reportedly cause mild insomnia in some people. Doses of 300 mg taken in the daytime may also interfere with sleep.

St. John’s Wort

The leaves, flowers, and stem of this herbaceous plant are used to treat major depression of mild to moderate severity. Two chemicals found in St. John’s wort–hypericin and hyperforin—are believed to be responsible for the herb’s antidepressant effects. They act on chemical messengers in the nervous system that regulate mood.

The typical dose varies depending on whether the product is made from an extract or the whole herb and how much hypericin or hyperforin it contains. Stomach upset is the most common side effect. Rarer side effects include anxiety, fatigue, and insomnia.

Chromium

This essential trace mineral is important for insulin function and helps move glucose from the bloodstream into cells for use as energy. The body needs just a little bit, and because chromium is found in so many foods—from meat and potatoes to whole-grain bread and fresh fruit—most people get enough in their daily diet. Adequate intake for adults is low: 20 to 45 micrograms (mcg) daily.

Chromium helps decrease fasting blood glucose levels and regulate insulin. Chromium deficiency is associated with type 2 diabetes, and people with diabetes may be prescribed two 500-mcg tablets daily. However, doses of 200 to 400 mcg daily have caused insomnia and sleep disturbance in some users.

DHEA

Dehydroepiandrosterone (try to pronounce that one!) is a hormone produced by the adrenal glands that the body converts into other steroidal hormones such as estrogen and testosterone. DHEA production peaks when we’re in our 20s and declines with age. Dietary supplements—which are manufactured from chemicals in soybeans and wild yams (DHEA cannot be gotten directly by eating these foods)—are believed to have anti-aging effects. For example, DHEA may improve bone density, skin elasticity, and mood.

The prescribed dose varies widely. Rare cases of insomnia have been reported with daily use.

Garlic

Garlic in its various forms—whole, powdered, and liquid—has been shown in studies to lower serum total cholesterol by 4 to 5 percent. So it’s used to lower cholesterol and may slow the progress of atherosclerosis.

Garlic is believed to be safe even at high doses. But some people taking high doses have experienced insomnia as a side effect.

Policosanol

Policosanol is a cholesterol-lowering supplement made from sugarcane, beeswax wheat germ, or rice bran wax. Some studies show it helps prevent heart disease.

Clinical doses range from 10 to 40 mg daily. But subjects have reported a wide range of side effects, including insomnia and daytime sleepiness.

Have you used any of these supplements? If so, did they interfere with your sleep?