Natural Remedies for Insomnia: Do They Work?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Many folks turn to herbal remedies for the treatment of insomnia. Those who want to stay away from prescription medications like zolpidem (Ambien), eszopiclone (Lunesta) and zaleplon (Sonata) look around for natural over the counter remedies. Insomnia can be a sign of an underlying medical disorder, mood disorder (depression and anxiety), or a medication side effect, and sleep deprivation can lead to high blood pressure, impaired quality of life, and family dysfunction, among other things. So, do the herbal remedies work?

Several plants have been used to treat a range of sleep disorders. Ashwaganda (Withania somnifera), hops (Humulus lupulus), lemon balm (Melissa officinalis), German chamomile and valerian root are some common ones. Few trials have been done to see if these actually work for insomnia though—and also remember that these products are not regulated by the FDA.

Let’s take a look. A recent review looked at the evidence for valerian, chamomile, kava and wuling for the treatment of insomnia. Valerian has been the best studied, yet results show little benefit for the treatment of insomnia compared to placebo (an ineffective sugar pill). A few smaller trials have looked at chamomile, kava, and wuling and also found no difference from placebo.

Are there downsides? Valerian was the only one of the four that was associated with a greater number of adverse events per person compared with placebo. Valerian may also lead to liver damage (hepatotoxic) effects.

What about melatonin? It’s not an herbal remedy, rather, melatonin is a hormone secreted by the pineal gland. It does not appear to be beneficial as a treatment for insomnia in most patients with two exceptions: patients who have delayed sleep phase syndrome (problems falling asleep) and in patients with low melatonin levels.

Dr O.

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