Posted by Bill Collignon on January 29, 2000 at 06:50:56:

Common Sleep Remedies
Below are the most common remedies for insomnia, listed in order of increasing potency.

* Chamomile (Matricaria camomilla): Chamomile tea, comprised of the dried flowers and leaves of this common plant, can be sipped half an hour before going to bed as a convenient, effective sleep aid. It is especially helpful for mild or transient insomnia.7 Its ability to relieve anxiety is attributed to chrysin, a flavonoid component.8 Passionflower (Passiflora incarnatus), which also contains chrysin, has been observed to have a similar effect.9

Note: Hay fever sufferers who sneeze from ragweed and its cousins the chrysanthemum and aster may also react similarly to chamomile.

* Lavender (L. angustifolia and others): The essential oil of this popular flowering herb has been demonstrated to depress the central nervous system in a way comparable to hypnotics or tranquilizers.10 Most commonly used in cosmeceuticals and aromatherapeutic preparations, lavender oil can be applied topically to relax the muscles or its aroma may be inhaled for a calming effect.11 Lavender tea before bedtime is also useful.

Note: Allergic contact dermatitis has been noted in some patients using lavender products externally.

* Valerian Root (Valeriana officinalis): The roots and rhizomes of valerian are dried to produce this commonly available herb. Studies suggest that valerian is by far the best natural solution for insomnia for most people. Research by P.D. Leatherwood, Ph.D., and F. Chauffard, Ph.D., at Nestlé Research Laboratories in Switzerland, established that 450 mg of valerian in an aqueous extract is the optimum dose as an insomnia treatment; a higher dose results in grogginess without increasing effectiveness.12 Leatherwood and colleagues, in a double-blind crossover study of 128 subjects, also found valerian root to be effective for improving quality of sleep in general.13

Valerian has an effect on the body similar to that of benzodiazepine (an active ingredient in Valium(TM)), but without dulling effects or next-day lethargy. Approved by the German Federal Ministry of Health as a calming sleep aid and widely recommended for treating anxiety-related sleep problems,14 it is entirely nontoxic. Past concerns about toxicity centered on reports that the valepotriates contained in the root were cytotoxic.15 However, P.R. Bradley, writing in the British Herbal Compendium, explains that they are unable to cross the blood/brain barrier. They also disintegrate rapidly into nontoxic metabolites,16 so there is little risk to the consumer, providing persons currently taking sedative drugs or antidepressants take valerian only under the supervision of a health care professional. Unlike prescription sedatives, valerian does not impair the ability to drive or operate heavy machinery; nor does it exaggerate the effects of alcohol.17

Curiously, valerian can act as a delayed stimulant for some individuals, initially calming them down only to energize them by the wee hours--a problem for those people seeking a nighttime sleep remedy. Some professional herbalists suggest that taking fresh valerian root extract is less likely to cause such a reaction than extract from dried valerian.

* California poppy (Eschscholtzia californica): This flowering plant has a long history of use as an insomnia treatment. Unlike its cousin, the Opium poppy, this flower does not contain the narcotic morphine, though its structure is similar. Unfortunately, there have been very few clinical studies on California poppy's effects in humans, and an optimum dose has yet to be determined.18

* Kava (Piper methysticum): A common beverage ingredient in the South Seas, kava roots and rhizomes contain dihydropyrones that promote muscle relaxation and ease the way to sleep without sedation.19

In a 1996 double-blind controlled study of 58 patients, E. Lehmann, M.D., found that 100 mg three times a day of kava extract standardized to 70 percent kava lactones resulted in a significant decrease in anxiety as measured with the Hamilton Anxiety and Clinical Global Inventory scales.20 Someone who is having problems sleeping due to anxiety or muscle tension (such as back spasm) may find kava useful.

Note: Alcohol intensifies kava's effects and therefore may cause sedation.

Kava is available commercially in the United States as a tea and in capsule form. Minor skin irritation is an occasional side effect, and some users experience muscle weakness and visual disturbances until they discontinue use.21

* Melatonin: This hormone, which occurs naturally in the body, has proven effective as a supplement for short-term uses such as resetting the body clocks of shift workers and travelers or treating occasional insomnia.22 Melatonin is released nightly by the pineal gland to signal the body to sleep. As we age, this gland produces less than the normal 0.3 mg/day, according to Richard Wurtman, M.D., professor of neuroscience at Massachusetts Institute of Technology (MIT) in Cambridge, Mass.

Synthetic melatonin supplements routinely list dosage at 3 mg or more--at least 10 times the amount that occurs naturally in the body. Customers would be wise to use well below that amount: 0.5 to 1.5 mg maximum (this will require cutting the tablet into pieces). Larger doses and long-term use may exacerbate depression.23

Note: Melatonin is not appropriate for children younger than age 12, whose bodies naturally produce enough of this hormone; a cup of chamomile tea, however, is an ideal sleep aid for youngsters.

To combat jet lag, experts suggest using melatonin to reset the body clock en route. After takeoff, travelers should set their watches to their destination time. When the watch indicates it's two hours before normal bedtime, they should take 1.5 mg of melatonin, then, if possible, sleep on the plane. Taking melatonin for the first day or two after arrival can help adjust the body clock further.

Homeopathic Alternatives
Homeopathy, based on the premise that "like cures like," traditionally takes a constitutional approach, factoring the patient's health history, family background and emotional state into the healing equation. The essential difference between homeopathic and other treatments is dilution: These remedies contain very small amounts of the active ingredient--e.g., the atropine in belladonna (Atropa belladonna). The smaller the amount, the more potent practitioners believe a remedy to be.24

The nature and possible causes of a patient's sleeplessness is an integral part of homeopathic treatment.

* Pulsatilla (Anemone patens): When repetitive thoughts produce anxiety-related insomnia, then pulsatilla--derived from the poisonous pasqueflower, also known as windflower--is the traditional homeopathic remedy. Homeopathic physicians also use pulsatilla to treat patients who tend to be overemotional or prone to temper tantrums.

* Coffea: Though the caffeine in coffee
from the coffee bush (Coffea arabica) is generally thought of as a stimulant, in homeopathy, its properties are used in minute amounts to ease the way to sleep when excitement arises after hearing good or bad news.

* Nux vomica: As its name suggests, Nux vomica, or "poison nut," is appropriate for indigestion-related sleeplessness. Derived from the strychnine-containing seeds of the Strychnos nux-vomica tree, this popular hangover remedy is often used to counteract other substances when sleeplessness is caused by caffeine (as from coffee, tea or cola drinks), alcohol or drugs.25

A good night's sleep is essential to total health. Without it, our bodies' functioning is impaired and work and home life suffer.

Avoiding OTC tranquilizers gives your customers a chance to awaken refreshed and alert, without the grogginess and risk of addiction or accidental overdose associated with OTC sleep aids and prescription tranquilizers. Encouraging them to consider all aspects of their life and health will promote long-term well being.

Remind customers that physical activity during the day can help make for better sleep since the endorphins released during exercise lift the spirit and relieve anxiety.

As with any natural remedy, your customers may need to try a few options before discovering one that works. Your informed advice can point the way.

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Mary Cole Marquis, R.Ph., is a practicing pharmacist and herbalist at Medical Arts West Pharmacy. Amy Lemley is a freelance health and psychology writer. Both authors live in Charlottesville, Va.

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