Insomnia natural treatment supplements vitamins and herbs that are of benefit, natural remedy, cause and cure
December 21 2016
by Ray Sahelian, M.D.
Natural insomnia treatment, home remedy

The occasional use of 5-HTP at a dose of 50 mg an hour before bed on an empty stomach or half an hour before dinner can be of help.
Graviola herb, of high quality, works well for sleep. You can take two or three capsules two to three hours before bed on an empty stomach (half hour before a meal or at least three hours after a meal).
Melatonin at a dose of 0.3 to 2 mg an hour to three hours before bed can help induce sleep. Limit use to once a week. Sometimes a lower dose such as 0.3 mg taken earlier in the evening, about 6 or 7 PM works better than a higher dose taken later.
The herb hops in tea or pill can also help with sleep. Hops is taken about an hour or two before bed. A Valerian/Hops combination 500mg/100mg may also work well.
Tryptophan is available over the counter.
Passion flower can help relax if taken several hours before sleep.

There is not one cause of Insomnia, but many. Any of the following factors can be a factor:
   Medical conditions that cause insomnia: alcohol withdrawal, asthma or lung disease, chronic pain, 
enlarged prostate, gastroesophageal reflux, heart failure,  hyperthyroidism, lack of exercise, menopause and hot flashes, paroxysmal nocturnal dyspnea, sleep apnea, pruritus or chronic itching, restless legs syndrome, and pheochromocytoma. Those with chronic insomnia are more likely to suffer from depression or an anxiety disorder. People with insomnia or poor sleep quality may be less tolerant of pain.
   Medications and drugs that cause insomnia include amphetamines, beta blockers, caffeine, cocaine, ephedra, pseudoephedrine, and theophylline. High doses of hormones --  such as DHEA, testosterone, progesterone, pregnenolone are also responsible for many cases. Even certain herbs can cause insomnia. I have listed a few of the possible culprits below.
   Psychiatric disorders or mental conditions that cause insomnia can include anxiety disorder, stress, mania, and
depression, stress.
   Poor sleep hygiene is a common cause.

Symptoms of inadequate sleep, shallow or short
These symptoms include fatigue, daytime sleepiness, low mood, poor motivation and productivity are common symptoms of insomnia. Chronic lack of deep rest is one of the major causes of low libido. See this article on libido to find out how to improve sex drive and enjoyment naturally. Chronic sleep loss is rampant in America, and work commitment is a big reason why.

Insomnia treatment, are there natural remedies?
There are a number of steps you can take in order to reduce your risk. A good night's sleep enhances energy, mood, vitality, sex drive, and reduces the risk for chronic medical conditions.
   Here are some practical steps you can take. Perhaps some of these suggestions may offer you an insomnia cure, and help you avoid overly relying on pharmaceutical insomnia medications. If not a cure, at least they will provide some help. However, certain insomnia medications can have serious side effects such as car accidents the next day. This has occurred with Ambien, the popular prescription sleeping pill.

Daily exposure to high-intensity light early in the morning improves sexual satisfaction and boosts testosterone levels in men with reduced libido or erection difficulty and also improves sleep that very night.

Avoid electronics an hour or so before bed
Many people might be losing valuable shut-eye because they spend the hour before bedtime in front of the electronic glow of a television, cell phone or computer. Many experts experts recommend an "electronic curfew" an hour before bedtime, when people should dim lamps and avoid checking their e-mail or watching late-night TV.


Stick to a schedule, and don't sleep too late on weekends
If you sleep late on Saturday and Sunday mornings, you'll get Sunday night insomnia. Instead, go to bed and get up at about the same time every day. You may not need to rely on an alarm clock to wake up when you get enough sleep.

Don't eat or drink a lot before bedtime sleep
Eat a light snack about 2 to 4 hours before sleep. If you drink too much liquid before sleep, you'll suffer insomnia by waking up repeatedly in the night for trips to the bathroom.

Avoid caffeine, nicotine, and stimulants, including sodas such as diet Coke, diet Pepsi, and others
Caffeine may keep you perky in the morning, but it can lead to insomnia, even if you drink coffee in the early afternoon. Some people are so sensitive that even a cup of coffee at lunch can lead to insomnia. Diet Coke and Pepsi can be a problem to those who are sensitive. Also, avoid energy drinks. Frequent drinking of herbal teas can make it difficult for you during the night to get a deep rest.
   Caffeine is found in tea (including green tea), certain soft drinks, chocolate, cocoa, and of course coffee. Caffeine is also found in certain herbs such as guarana and kola nut. Many people do not realize that drinking green tea, at least more than two cups a day, may be a cause for their lack of rest at night.
   Smokers experience withdrawal symptoms at night, and they have a harder time both falling asleep and waking up.

Natural dietary supplements as cause
Diet pills that contain ephedrine type chemicals can lead to insomnia. So can the nutrients phenylalanine, tyrosine, alpha lipoic acid, certain hormones such as DHEA and pregnenolone, ginseng and other adaptogenic herbs, tongkat ali, and the anti-depressants St. John's wort and SAM-e. High doses of B vitamins and certain nutrients, such as CoQ10 and alpha lipoic acid, act as stimulants. High doses of fish oils or krill oil could also be a cause in some individuals. Take most of your supplements early in the day, before or with breakfast.

Emails from readers
Q. Thank you for your website!! I am so glad that I found it this morning. I suffer from insomnia almost every other night and I wonder why. As it turns out, I have been overstimulated by Acetyl L-carnitine (a whopping 750mg) + L-Carnosine 500mg + R Lipoic Acid 200mg. I think I will stop taking any supplement for a week, maybe two.

Q. I read your article about St. John's wort. Three years ago I was hit out of the blue with anxiety, panic, adrenaline rushes!  Nothing helped. It was bad, and uncontrollable. I went through a series of SSRI trials but only had BAD side-effects. As the severe insomnia continued along with the anxiety, I believe I ended up with Adrenal Fatigue. I got minimal help from 5-HTP, Tyrosine, etc... But, I still had really bad anxiety /stimulation / insomnia, etc...I decided to try SJW. It seemed that it helped with my nerves, but took a very long time, over 6 months or so. I started taking 900 mg, (300mg 3x per day). I'm still on 900MG and still not feeling 100%. I changed from 5-HTP to Tryptophan and that made a huge difference, felt much calmer, mood improved some at times. Still take tyrosine and/or phenylalanine as well to help balance dopamine, etc. I did find out that I was very low in magnesium, manganese, B12 and zinc. So, I've been supplementing those, which has really helped. My anxiety / panic is gone. My mood is better but still a bit flat at times, goes up/down a bit. But my insomnia is still really bad at times.

I'm 58 years old and have seen a Dr. for 2 years, just in order to have a better life quality. I didn't have any problem at that time and the insomnia progressed gradually a year ago. Now it is quite difficult to get to sleep, sometimes I spend the whole night awake. During all this time I have taken ginseng, rhodeloa rosea 5-OH-TRIPTOFANO 50mg. All those daily in the morning. I'm a lot thankful for your opinion if those medicines could have insomnia as a secondary effect.
   A. Yes, the ginseng and rhodiola can cause sleep problems. The 5HPT should not but if someone has sleep issues it is best for a couple of weeks to stop all pills and teas.

Drugs, medications, that cause insomnia problems
There are countless, I will mention a few.
Stimulants - Any type of stimulant medication, for instance used for ADD.
The stimulant medications used to treat attention-deficit/hyperactivity disorder can keep some kids awake at night. The medications -- which include drugs like Ritalin, Concerta and Adderall -- already list sleep problems as a potential side effect.
Beta blockers
Alpha blockers
SSRI antidepressants such as Prozac
Corticosteroids such as cortisone
ACE inhibitors
H1 antagonists that are not sedating
Cholinesterase inhibitors
Statins for cholesterol reduction

Exercise
If you're trying to sleep better, the best time to exercise is in the afternoon. Physical activity enhances the deep, refreshing stage of sleep. My best sleeps have been after a full day of walking, hiking, or biking. Also, take a 20 minute walk in the morning to expose yourself to morning light which will help reduce your insomnia.
   Acute moderate-intensity aerobic exercise appears to reduce pre-sleep anxiety and improve sleep in patients. J Clin Sleep Med. 2010 June.Effect of acute physical exercise on patients with chronic primary insomnia. Universidade Federal de São Paulo, São Paulo, Brasil.

Researchers in 2015 looked at data from a survey of more than 429,000 American adults. They found that activities such as walking, bicycling, running, weight lifting, aerobics/calisthenics, gardening, yoga/Pilates and golfing were all linked to better odds of a good night's slumber. But, people who got physical activity from household chores and child care had a greater risk of poor sleep, University of Pennsylvania, news release, June 4, 2015.

A slightly cool room is ideal for reducing insomnia. This mimics your internal temperature drop during sleep, so turn off the heat and save on fuel bills. 

Sleep only at night
Daytime naps can certainly make it more likely to have insomnia. Limit daytime sleep to 20-minute, power naps. Don't take a nap after 2 PM.

Keep it quiet. Silence is more conducive to prevent insomnia. Turn off the radio and TV. Use earplugs, a fan or some other source of constant, soothing, background noise to mask sound that you cannot control, such as a busy street, trains, airplanes or even a snoring partner. Double-pane windows and heavy curtains also muffle outside noise.

Make your bed comfortable.

Don't overly rely on sleeping pills
Check with your doctor before using sleeping pills. Make sure the pills won't interact with other medications or with an existing medical condition.

Use the lowest dosage and never mix alcohol and sleeping pills. The occasional use of prescription sleep pills should not be harmful but regular use can lead to rebound insomnia.

If you feel sleepy or dizzy during the day, talk to your doctor about changing the dosage or discontinuing the pills.
 

Q. I just read Dr. Christiane Northtrup's book, "The Wisdom of Menopause: Creating Physical and Emotional Health and Healing During the Change". She recommends 5-HTP and kava for insomnia. She also recommends two Chinese herbs, tian wang bu xin wang, and chai hu long gu mu li wang. I was not able to find either on your website. If you have them available I would be interested in trying those two as well.
    A. I am not familiar with tian wang bu xin wang and chai hu long gu mu li wang formulas. According to one website, the former has this composition: sheng di huang 120g, wu wei zi , dang gui, tian dong, mai dong, bai zi ren, suan zao ren, 30 g each, ren shen, xuan shen , dan shen, bai fu ling, yuan zhi, jie geng 15 g each. The latter formula Chai Hu Jia Long Gu Mu Li Tang was used in one study to treat 32 cases of neurosis. It significantly improved restlessness, insomnia, anxiety, tendency towards fatigue, and insecure feelings, etc. I am very familiar with a formula I created called Good Night Rx which works quite well when taken 2 to 4 hours before bed.

Use ear plugs and eye shades to block noise and light. You may be amazed on how much better you'll sleep and feel in the morning when you use ear plugs since you will be able to get a deeper sleep without frequent overnight interruptions from traffic noise, airplanes, dogs barking, roommates snoring, etc. Being woken up and exposed to bright light at night can throw off a person's biological clock for the next few days, a new study shows. What's more, the researchers found that being woken up at night at all--even in a dark room--also disrupts the body's timing, although to a lesser degree.

Light from computer screens interferes with our internal body clock and our sleep cycle.

Use sleep relaxation techniques
Once you are in bed, take a deep breath and gradually let it out. Do this a few times. Then, lightly shake one of your feet, and go back to taking a couple of deep breaths. Lightly shake the other foot and then take a couple of deep breaths. Move up to your legs, hips, arms, neck, muscle around the mouth, eye muscles, etc., while going back to the breath after shaking each body part. Soon you'll be in la la land. 


Aromatherapy
The smell of jasmine in the bedroom has been found to help reduce insomnia. Lavender may also help slightly.

Soft Music
In a paper published in the February issue of the Journal of Advanced Nursing, a team from Taiwan’s Tzu Chi University said they studied the sleep patterns of 60 people aged between 60 and 83 who had insomnia. Half were given relaxing music to listen to for 45 minutes at bedtime and half were given no help to sleep. The team found that those who listened to a selection of soft, slow music experienced physical changes that aided restful sleep, such as lower heart and respiratory rates, and their insomnia improved.

Prescription medication
Most insomnia medications require a doctor's prescription because they may be habit-forming or addictive, and overdose is possible. Many insomnia medications can lose their effectiveness once a person has become accustomed to them. Both over the counter and prescription Insomnia medications are available. I prefer to use prescription insomnia medications only on rare occasions.  There are several categories of insomnia drugs : Benzodiazepines. These are the most common hypnotics. They include lorazepam (Ativan), alprazolam (Xanax), triazolam (Halcion), and temazepam (Restoril), among others. Non-benzodiazephines. These insomnia medications may pose less of a risk of dependence. They include zolpidem (Ambien), zopiclone, and zaleplon. Rebound insomnia could also occur after stopping insomnia medications.

Rebound insomnia, a worsening of sleep compared with pretreatment levels, has been reported after discontinuation of sleeping pills, mostly the benzodiazepine hypnotics. Some of these benzodiazepines include triazolam, temazepam, and flurazepam. The risk of rebound insomnia is greater with the short half-life as compared with the long half-life benzodiazepines.
     To reduce the risk of rebound insomnia, you could consider a gradual withdrawal. This could mean taking, let's say, 9/10 of dose one night, then 8/10 of a dose the next night, and gradually taking less each night. Also, make sure you have full days of physical activity and lots of exposure to sunshine in order to minimize the rebound insomnia. Also, eliminate all supplements and herbs, and all caffeine and stimulants.

Insomnia in elderly and seniors
In the elderly, chronic insomnia is complex and often difficult to relieve because the physiologic parameters of sleep normally change with age.
There is a controversy regarding the origin of insomnia in elderly. Are they only due to a senile process of sleep functioning or due to other associated comorbidities? Considering the objective assessment of sleep in elderly (by polysomnography), it has been shown an increasing sleep latency, decreasing total sleep time and sleep efficiency, a lower percentage of slow wave sleep. The circadian clock is also modified by age with phase advance and a decreased amplitude of the circadian rhythms.

Older drivers who use the sleeping pill zolpidem, sold widely as Ambien, may have a higher risk of motor vehicle crashes.

Insomnia natural therapy emails
The purpose of this email is to ask a question about Valerian and Hops for sleep. Right now I am taking 1000 mg of Valerian and 150 mg of Hops for insomnia. I had been taking a sleeping pill called Ambien and did not like the hung over feeling I had in the morning so I weaned myself off of Ambien - slowly; and then I slowly started to introduce Valerian and Hops. So far so good - but here are some nights that I simply do not sleep well. Can "tolerance" develop with these herbs? And, Dr Sahelian, thank you so much for your hard work, dedication, and pioneering spirit in nutritional medicine! I am indeed a fan.
   I appreciate the positive feedback. There are several herbs and nutrients that can help with insomnia, such as hops, valerian, kava, melatonin, 5-HTP, etc., unfortunately, tolerance can develop with most of them, and they are not as consistent as pharmaceutical medicines. I recommend to my patients to alternate various nutrients and herbs, and sometimes I will prescribe the occasional use of a prescription sleeping pill. It's also a good idea to take breaks and not use any pills for sleep for at least a couple of nights.

I have tried treatments prescribed by doctors that are not suitable for daily living. It became a rather harsh experiment trying different sleeping pills and relaxing pills that just made things harder to focus during awake time and to remain a successful professional and mother. So I have decided to give Melatonin Sustain a try. I plan on starting out with 0.3 mg two or three times a week. I have ordered the 1 mg, 60 tab bottle. I know that for each person the product varies on how it reacts. Has your research shown that the product at 0.3 mg dosage to work better, for insomnia, taken 1 hr before bedtime or 3-4 hrs before bedtime? Is there a better time to take melatonin that increases absorption such as with a meal or with empty stomach? Aside from the questions asked above, do you have any suggestions on a pill cutter to give me the measurement of 0.3 mg? I'm looking forward to hopefully see some positive results in a battle I have thought to be never-ending with both the migraines and insomnia.
   It is impossible to predict which dosage of melatonin will work for insomnia and how many hours before. It is trial and error and it does not have to be exactly 0.3, there can be a wide range of dosages from 0.2 to 0.7, more or less. Melatonin is better absorbed on an empty stomach.

I am living in Bali and I am far from any efficient doctor, or specialist for natural product such as yours. I can not consult for my problem and needs. The only solution I have is through internet and emails. My problem is about insomnia. I have no problems to fall in sleep but I wake up all nights around 2 or 3 am and can not sleep again until 6 am. I wake up tired and all along the morning. I recover some energy after lunch and afternoon. I never take sleeping drugs and don't want. I prefer to manage with natural supplements or products. I recently tried Melatonine, and a few months later, 5HTP with same results. They did not work have strong agitation and sleep even less!! I tried just 2 nights for each and then stop regarding the results. Please note, that I have a healthy life style, I do sport (surfing, boxing)
almost every days, and don't drink really (maybe a few beers a week, and even not, every weeks). do you have an explanation for the reverse effect I face? Do you think I should try more than 2 nights to help the body to use to theses products? Do you think Good Night Rx can have a different result? Can you delivery your products to Indonesia?
    Early morning light exposure is very important, such as taking a walk for 20 minutes as soon as you wake up. Being active certainly helps. One should stop all supplements or medications that are not needed and stop all caffeine, herbal teas or sodas. A good option is to take Good Night Rx 3 to 4 hours before bed and then half an hour or an hour later to eat a meal with pasta, spaghetti, with some tomato sauce and small amount of cheese. Another option is to make a fruit smootie with several fruits including banana, and add a little bit of milk or soy milk, and a good amount of maple syrup or agave syrup. The carbohydrate load in the evening will help with sleep. This can be done 2 or 3 nights a week. Also, avoiding afternoon naps is a good idea. The products can be shipped to Indonesia.

I think it is great that you recognize that many supplements can be activating and cause insomnia. I was reading on the OCD page and noticed that no one seemed to mention coffee. I have anxiety and the potential for OCD. However, I find that my use of coffee is what makes all the difference. I have full-fledged OCD if I drink coffee, yet I simply have GAD without obsessive thoughts if I avoid those drinks. I can have a little black tea without a problem, but I would be suffering terribly if I drank coffee daily (as I once did). Coffee also makes all the difference in my skin (clear versus acne).

Phenibut can be of help when used occasionally in those who have, at times, a severe case of insomnia.