Not Sleeping Well Lately? Herbal Remedies for Insomnia

You hear it all--the whine of the refrigerator, the yowl of the neighbor's dog and the shrill siren of a police car off in the distance. You hear it all because you're awake, it's three o'clock in the morning and you have a briefing to give at work in five hours. You can't sleep and the insomnia is getting on your nerves.

Fortunately, traditional herbal remedies are currently available to help you with this common, modern-day problem. Over half of all Americans have some type of difficulty in getting or maintaining a restful night's sleep. Over-the-counter non-herbal medications for insomnia are limited to antihistamines which are normally used for allergies but which help you sleep because they are so sedating. The choices among herbal insomnia remedies, on the other hand, are numerous and mankind has had centuries of practice using them for sleeping difficulties. Several of them even have the backing of scientific research indicating their safety and effectiveness in helping improve sleep patterns.

Valerian root is one of the two more popular herbal therapies for insomnia. The plant from which the root is taken grows in temperate climates worldwide. It has been used for over a thousand years as a sleep remedy, most notably by the great Hippocrates himself. No one knows exactly how it works to induce sleep, however, modern scientific studies have been undertaken which show that it does, in fact, work clinically in human subjects. A German study published in 1998 showed that a combination of valerian root and hops (another sleep-inducing herb) worked as well as a prescription-strength benzodiazepine (similar to Valium) in the treatment of sleep disorders. And valerian root, unlike benzodiazepines, is not addictive.

On the other side of the world, natives of the South Pacific had their own remedy for insomnia. Kava kava, a shrub indigenous to the islands, has long been used by the natives to induce relaxation and provide a feeling of well-being when drunk at important religious rites. Scientific research supports the effectiveness of kava kava as a remedy for anxiety and sleep disorders. An article published in Pharmacopsychiatry in 1997, for example, showed significant improvement in anxiety in those subjects who took kava kava as compared with those who took a placebo. Like valerian, kava kava is not addictive.

Modern science has not been as generous to other herbal remedies commonly used for insomnia. Research on humans using herbs such as hops, passionflower and chamomile is scant and no scientific proof exists to indicate one way or another whether they have an effect on sleep. Still, they are found frequently in herbal sleep-aids. Fortunately, no one has proven them to be unsafe for consumption either. Given centuries of herbal tradition which supports their effectiveness for insomnia, we might expect them to be at least somewhat helpful for those with sleeping problems. Some herbal sleep-aids actually are a blend of a primary herb such as kava kava or valerian along with smaller amounts of hops, passionflower or chamomile. It is believed that the latter three herbs augment the sleep-promoting properties of the primary herbal ingredient.

How much should you take?

Determining the appropriate dose of kava kava or valerian root on the packages at the pharmacy or healthfood store can be complicated enough to keep you awake at night. There are no standards for labeling herbal preparations; many of the labels can be quite confusing (and dare I say, misleading?).

When looking for a kava product, make sure that the capsule contains a "standardized kava extract". Most standardized extracts of kava kava contain approximately 30% kavalactones, the active ingredients in kava. The recommended dose of kavalactones is 60-200 milligrams daily, usually taken twice a day. So, if the package states that a capsule contains 300 milligrams of kava kava standardized to 30% kavalactones, it actually only contains 100 milligrams of the active ingredient. (Hint: multiply 300 milligrams by 30% or 0.3 to get 100 milligrams of kavalactones.) Fortunately, a capsule that contains 100 milligrams of kavalactones is just about right.

When choosing valerian root, look for a capsule that contains at least 500 milligrams of valerian. Two of these capsules should be taken simultaneously for insomnia relief. Valerian root is perhaps more commonly combined with other herbs for sleep than is kava kava. Usually, if you look for a capsule that contains the right amount of valerian root, the rest of the ingredients are in much smaller amounts. While the other herbal ingredients may or may not be effective for sleep, they likely can't hurt either.

I encourage you to experiment with various products to see which one works best for you. None of the herbal remedies is intended to be used every night indefinitely but rather for the occasional night when sleep escapes you. If you have a severe problem with insomnia, I suggest you see your healthcare provider for additional advice. Happy sleeping!

Christine Traxler MD christraxler@msn.com