Sweet Dreams

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Section: Herbs
herbs for sleep and relaxation

Forget warm milk and counting sheep. When you really need to catch a few Z's, try these botanical aids to lull you to a restful night.

Nobody enjoys a poor night's sleep. Tossing and turning, active and wandering thoughts alternating with trying to clear the mind, breathe deep, and relax are enough to make anyone seek help for a few hours of rest.

In fact, for some, a good night's sleep is almost never had, which is a serious disorder, called insomnia, the most common sleep disorder. It makes most people feel bad, and, if chronic, can lead to job loss, accidents, and is considered a national crisis. In fact, experts estimate that here in the United States, the annual cost of insomnia, including visits to healthcare practitioners, medication, loss-of-sleep related accidents, and diminished productivity, exceeds $100 billion.

When patients come to me complaining of insomnia, I generally take a thorough medical history from them and do a physical exam. I want to know if I am working with a person with "primary" or "secondary" insomnia. Although this sounds like medicalese, primary insomnia means sleeplessness that is not caused by an obvious (separate) medical, environmental or psychiatric reason. Secondary insomnia is a sleep problem that is caused by things like severe pain, hormone fluctuation, travel through many time zones, surgery and medication, and life-disruptive events (like divorce, loss and financial problems)--any of these can bring on secondary insomnia.

In cases of secondary insomnia, I try to dope out the underlying problem, and then try to get the patient back to more normal sleep patterns. Physicians treating insomnia also want to know whether the condition is acute, something that's been present for a short period of time, or chronic, having existed for months or years. Whether using prescription drugs or natural medicines, most healthcare practitioners agree that acute insomnia.

Tackling insomnia
When it comes to treatment, an array of options await the nighttime insomniac. Conventional medicine typically offers three types of medications: benzodiazepines, which are sedatives like Valium, Ativan and Xanax, first popular in the early 1960s; tricyclic antidepressants, like Amitriptyline and Imipramine; and antihistamines, like Sominex and Nytol. These pharmaceutical sleep aids can be effective, but they are not without their costs.

Patients often complain of a "hangover" sensation from sleep medications. Daytime drowsiness, even nausea and headache are not uncommon complaints.

Additionally, most pharmaceutical sleep medications are only recommended for short-term use--a month is about average. Longer than that, and addiction/withdrawal-type problems can crop up. For some, the difficulty with sleep medication is simply philosophical; they just don't want to have to take a chemical in order to sleep.

Botanical sleep aids
Naturally-derived sleep aids are extremely popular. Rough estimates indicate that in any given year at least 10 percent of the U.S. adult population uses some form of non-prescription sleep medication to treat insomnia. Among the most popular choices: amino acids, melatonin supplementation and herbs. Herbs commonly used for sleep are the same plants known for their effectiveness in promoting relaxation: valerian, hops, passion flower, chamomile and several members of the mint family: peppermint, spearmint and lemon balm.

Valerian. Known also as Valeriana officinalis, valerian ranks among the most popular of medicinal plants. With an over 1,000-year history of use as an anti-anxiety/sleep medicine, valerian is both a wild and a cultivated plant. It is a perennial, and it prefers the moist soil of riverbanks and grassy meadows. Valerian will typically grow up to 5 feet in height, with small pink-white flowers. Perhaps the most striking thing about valerian is the stinky, "old-moldy-socks" sort of odor, especially from the root.

It is this smelly root which is used medicinally. No single compound seems to be responsible for valerian's relaxing properties. Scientists speculate that it may be the combination of valerian's many ingredients--volatile oil and alkaloids, etc.--which make valerian a powerful medicine.

Clinical trials indicate that using 300 to 900 mg of valerian before bedtime results in falling to sleep more quickly, an overall improved quality of sleep and a decrease in waking during the night.

Rudolf Weiss, MD, author of Herbal Medicine, recommends valerian tincture, 1-2 teaspoonsful at bedtime.

In my practice, I find that patients with severe insomnia do best if they use valerian to help with nervousness and sleep. By this, I mean that the herb is taken several times throughout the day, to calm the nervous system, and then again at bedtime to help with sleep. After a week or two of doing this, the body is calmer, and normal sleep patterns are easier to achieve. At this point the daytime doses can be slowly eliminated, and eventually valerian may not be needed at all.

Hops. Humulus lupulus is a marvelous botanical name, one which consistently conjures up a smile. Hops, well known for their value in the production of beer, have been used for centuries for disorders related to nervousness. These include insomnia, anxiety, muscle spasms and indigestion.

It is the strobile, or conelike structure, which is the fruit of the hop plant that is harvested for medicine. Hops strobiles can be taken in tea, tincture, or capsules. A traditional use of hops, still popular today, is to fill a tiny pillowcase with fresh strobiles, and place it on the pillow at night to induce sleep.

A couple of cautions are important with hops: because of its estrogenic-like activity, this herb should not be used by pregnant women.

Additionally, hops has a sedating effect and should be not be used in conjunction with prescription sedatives or sleep medications unless directed by a physician.

Passion flower. Named for the fact that the crimson and black flowers are said to resemble Christ's Crown of Thorns, passion flower, or Passiflora incarnata, has mild sedating and pain-reducing properties. Active constituents are both flavonoids and alkaloids.

Passion flower is often used along with other sedating herbs, and can be taken as a tea, tincture or in capsules. Although side effects for this herb have not been reported, some of the plant's constituents are mild uterine stimulants, so the plant is not recommended for pregnant women. Some people find that strong passion flower tea creates nausea.

Chamomile. A gentle, nicely-scented anti-nervousness (nervine) herb is chamomile, Matricaria recutita. Chamomile is best for those with active, restless nervous systems, especially for infants, teenagers and people afflicted with nightmares. The plant compound, apigenin, appears to be the active player in chamomile's sedating properties. Apigenin produces mild sedation without depressing the central nervous system. This makes cham-omile gentle enough for infants and the elderly, and allows chamomile to be readily combined (for adults) with stronger sedating herbs like valerian and hops.

Chamomile is also a good antispasmodic and pain-relieving herb. As such, it is useful in situations where there is pain and restlessness, such as menstrual cramps, colic and spastic colon.

Mint family. The plant group commonly referred to as the mint family includes three plant medicines which are useful for relaxation and to induce sleep. They are, in descending order of potency, lemon balm, peppermint and spearmint.

All three of these herbs contain volatile oil, tannins and bitters. They each have lovely scents, and medicinally offer sedative, pain relieving, and gas-reducing benefits.

For relaxation and sleep purposes, lemon balm is the most effective. To ensure a restful sleep, practitioners recommend taking lemon balm both early in the evening and just before bed. For general relaxation, lemon balm can be taken throughout the day as needed.

Lemon balm. It makes a nice tasting tea, or it can be taken as a tincture or in capsules. In traditional herbology, sleep is typically brought on by a hot beverage. If you want to follow this traditional practice, brew lemon balm tea just before bed, or add tincture to hot water, or take capsules with a hot beverage.

Peppermint and spearmint are helpful when anxiety or insomnia are accompanied by indigestion or nausea. Peppermint helps bile flow, promoting digestion; this herb also relieves nausea and vomiting by gently and temporarily anaesthetizing the mucous membranes of the stomach.

Spearmint is useful in children's formulas, or for anyone who needs a gentle form of mint.

Combining sedating herbs
Consumers who go in search of botanical sleep aids will find lots of preparations from which to choose. Manufacturers have their preferences; some will combine several herbs in one formula, while others prefer the single herb approach.

Since herbal sleep aids are, for most people, quite safe, the best approach to selecting a formula may be to let experience be your guide. It is not uncommon to find that an herb which works wonders for one person will not work for another. If you have the luxury of tasting, sniffing, and sampling a variety of herbs, make the most of it, and find the herb which works best for you.

A note of caution is necessary with botanical sleep products. Use common sense. Don't overuse herbal sleep aids, and don't combine them with other sleep medications, tranquilizers or anti-anxiety products. While herbal medicines can often be substituted for prescription sleep medications, or used in conjunction with prescriptions to lower the daily sleep-medication dose, this kind of prescribing should only be done under the supervision of a licensed healthcare practitioner who is knowledgeable about herbs.

REFERENCE
Attele, A, et al. "Treatment of Insomnia: An Alternative Approach," Alternative Medicine Review 5(3):249-259, 2000.

Foster S, Tyler V. Tyler's Honest Herbal. New York: Haworth Herbal Press, 1999.

Leathwood, P, et al "Aqueous extract of valerian root reduces latency to fall asleep in man." Planta Medica 51:144-148, 1985.

Schultz, H, et al. "The effect of valerian extract on sleep polygraphy in poor sleepers: a pilot study." Pharmopsychiatry 27(4): 147-51, 1994.

Weiss, R F. Herbal Medicine. Beaconsfield, England: Beaconsfield Press, 1988.

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By Jamison Starbuck, JD, ND

J. Jamison Starbuck, J.D., N.D., is a licensed naturopathic and homeopathic physician. Her family practice treats the whole person via constitutional homeopathy, botanical medicine, nutrition, counseling and other natural modalities.

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