Herbals for Insomnia? Now You Can Test Them at Home

Herbal remedies for insomnia are abundant online—valerian, hops, and chamomile, among the most common. Tested against placebo, none has been found to be definitively effective for insomnia. Yet some medicinal herbs have a long history as traditional calming, sleep-promoting agents. Might one work for you?

Researchers at Massachusetts General Hospital and Harvard Medical School have proposed a method you can use yourself to test herbal remedies via personalized therapeutic trials. Here’s more about herbals and how the trials work:

Insomnia may respond to treatment with herbal supplements and tincturesHerbal remedies for insomnia are abundant online—valerian, hops, and chamomile, among the most common. Tested against placebo, none has been found to be definitively effective for insomnia. Yet some medicinal herbs have a long history as traditional calming, sleep-promoting agents. Might one work for you?

Researchers at Massachusetts General Hospital and Harvard Medical School have proposed a method you can use yourself to test herbal remedies via personalized therapeutic trials. Here’s more about herbals and how the trials work:

Why Herbals for Sleep?

Interest in herbal and other alternative treatments for insomnia seems to be on the rise. About 5% of the participants in a national survey reported use of complementary and alternative medicine (CAM) for insomnia in 2002. A recent analysis of the same national survey conducted in 2007 found that almost 50% of participants with insomnia symptoms used some form of CAM therapy.

Some insomniacs see alternative medicines as less risky than prescription sleeping pills, with fewer potentially harmful side effects. Because they are “natural,” they’re viewed as more appropriate for long-term use than many sleeping pills, which, if used nightly, tend eventually to degrade sleep quality.

Scant Testing, Mixed Results

Most herbal remedies for sleep have not undergone as much testing as prescription sleeping pills (one reason may be that there’s relatively little money to be made on them). But as with sleeping pills, tests that have been conducted on herbals often show subjective sleep improvements that exceed objective measures.

The perception that herbal supplements improve sleep could be due to a placebo effect. Or, say the Massachusetts researchers, it could be attributable to basic differences among trial participants, including different insomnia symptoms. It could be that, just as a particular sleeping pill works for some insomniacs and not others, a particular herb may relieve insomnia in some people and not others.

Herbals That May Relieve Insomnia

Since the overall efficacy of herbal preparations for insomnia is still unknown and may differ from person to person, the researchers opted to consult six authoritative resources in their search for herbal and supplement remedies of potential relevance for insomnia, including reference books such as the Physician’s Desk Reference for Herbal Medicines (PDR) and online sources such as Medline Plus. In all, they came up with a list of over 70 herbal agents of possible benefit to sleep.

These 15 medicinal herbs were listed by 4 or more resources as a remedy for insomnia or another condition indirectly related to sleep, such as anxiety or nervousness:

  1. Ashwagandha
  2. Bitter Orange (Neroli)
  3. Catnip (Nepeta)
  4. Chamomile (German)
  5. Hops
  6. Kava
  7. Lavender (English)
  8. Lemon Balm
  9. Linden
  10. Nutmeg (and Mace)
  11. Oats (Avena sativa)
  12. Passion Flower
  13. Schisandra (Wu-Wei-Zi)
  14. St. John’s Wort
  15. Valerian

Safety of Herbal Supplements

Natural substances are not necessarily safe for unrestricted use. The PDR for Herbal Medicines cautions against using several during pregnancy. Some herbs may be harmful to the liver. And, as herbal supplements are unregulated in the United States, the contents of a supplement do not necessarily reflect what appears on the label. In fact, a majority of herbal remedies evaluated in a recent study had contamination, substitution, or use of fillers not listed on the label.

For safety concerns associated with herbs used for insomnia, see these sources:

Find Out If a Sedating Herb Works for You

Let’s say you’re a sleep maintenance insomniac, awakening at least twice a night to feelings of anxiety. You’ve heard that passion flower is good for sleep and anxiety, and you’d like to try it to see if it cuts down on your nighttime wake-ups. But how long should you try it? Two nights, three nights or more?

Many insomniacs experience quite a bit of night-to-night variability in their sleep. When you’re stressed out you might sleep poorly for 4 or 5 nights in a row before you get a decent night’s sleep. If you tried taking a passion flower supplement for just 2 or 3 nights during a time of stress, the results you obtained wouldn’t be reliable. You might obtain a different result if you tested the passion flower during a 3-day period when your life was moving along on an even keel.

I’ll skip the authors’ discussion of statistical power and cut to the chase: you need to test a substance for 10 nights in a row to have reasonable certainty that the result you obtain is repeatable and you’ve got enough data to answer the question of whether passion flower improves your sleep.

Self-Testing Flow Chart

Follow these 5 steps to determine whether an herbal insomnia remedy works for you:

  1. Simplify sleep. For you, does “good sleep” mean falling asleep sooner, sleeping longer, waking up feeling more rested, or waking up less at night? Choose the one thing that for you would most improve your sleep.
  2. Set a goal. Choose your target “good night” value and a percentage of nights for which this target value must occur. Let’s say you decide that a good night is a night when you awaken just 1 time or less (and on a bad night you awaken 2 times or more). Let’s say you set your goal at awakening 1 time or less on at least 70% (7 out of 10) of the nights.
  3. Choose a therapy. Try one intervention at a time. Starting a passion flower supplement and a yoga class at the same time will muddle the results.
  4. Do the 10-day test. Every day, record good nights and bad nights in a diary.
  5. Calculate the outcome. Did you achieve your goal? If so, you can conclude that passion flower improves your sleep. If you didn’t achieve your goal, clearly the passion flower did not work. Choose another therapy, starting the process at #3. If your results are borderline, continue testing for another 10 days. Then recalculate to ascertain whether you’ve met your goal of awakening 1 time or less on 70% of all 20 nights.

Insomniacs are big experimenters, I learned as I was conducting research for my book, The Savvy Insomniac. Several expressed interest in herbal and other alternative treatments. If you’re going to experiment, you need a systematic way to assess whether the remedy you’re trying improves your sleep or not. These Massachusetts researchers have given us a goal-oriented algorithm for doing exactly that.

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?