Sleep potions are almost as old as insomnia—ancient herbalists and poets alluded to the soporific qualities of poppies and mandrake root, for instance. Many people who don’t want to take prescription sleeping pills turn to such herbs and other dietary supplements promoted for sleep. Some of these ingredients are also found in “relaxation beverages” such as iChill, Bcalm and Drank.
Overall, the evidence for these alternative sleep aids is iffy, at best. Their effects, if any, tend to be weak and unpredictable, and their long-term safety unknown. There’s also likely to be a strong placebo effect. That is, simply taking a pill (even if it’s a sugar pill) may help some people with occasional sleep problems, in part because they expect it to work and it gives them a sense of control.
Some sleep formulas combine various herbs and other ingredients, making their effects (good or bad) even less predictable.
In general, sleep supplements should not be combined with sleep medication or tranquilizers; check with your pharmacist about other drug interactions. To be on the safe side, don’t take them during pregnancy or give them to children.
The best-known sleep supplement, melatonin is actually a hormone produced by the brain’s pineal gland, though the supplements are usually made synthetically. It has been called the “darkness hormone” because it is secreted at night and exposure to light suppresses it. Since melatonin affects circadian rhythms (sleep/wake cycle) and promotes drowsiness, it has long been used as a sleep aid. In fact, one prescription sleeping pill, ramelteon (Rozerem), works by mimicking the effects of melatonin in the body.
The strongest evidence for melatonin supplements concerns their short-term use for preventing or reducing jet lag, though not all studies have had positive results. A 2009 review by the Cochrane Collaboration concluded that melatonin can help adult travelers flying across five or more time zones, particularly in an easterly direction.
The Natural Standard, which reviews complementary and alternative treatments, gives melatonin an “A” (strong evidence) for jet lag, and a “B” (good evidence) for treating insomnia in the elderly and enhancing sleep in healthy people. In contrast, a 2010 Evidence Report from the federal Agency for Healthcare Research and Quality concluded that melatonin is of questionable usefulness for most sleep disorders.
The dried root of the plant Valeriana officinalis, also known as heliotrope, was used medicinally in ancient times. Nowadays it is available as tablets, capsules, and tinctures.
Valerian may be the most studied herb for insomnia, but the results have been inconsistent, according to an Australian paper published in the journal Sleep Medicine Reviews in 2011. Some older studies suggested benefits, but most placebo-controlled trials have found that it works no better than a placebo. The Natural Standard gives it a “C” (unclear evidence) for insomnia.
One problem is that, like all herbs, valerian contains many compounds and it’s not known exactly which one might produce the sedative effect. Thus, there are no “standardized” doses. Testing by ConsumerLab.com has found that many valerian supplements contain no detectable levels of certain key components or much less than the labels claim. Valerian appears to be safe, though headache, nausea and diarrhea can occur.
GABA (gamma-aminobutyric acid) is a neurotransmitter that can dampen nerve activity. Healthy people with insomnia often have reduced levels of GABA. Sleeping pills such as zolpidem and eszopiclone work by improving the ability of GABA to bind to receptors in the brain; the drugs don’t contain GABA itself. However, there’s no credible evidence that taking GABA orally increases GABA levels in the brain—apparently the compound can’t pass from the blood to the brain (through the blood-brain barrier). Nevertheless, GABA is a widely marketed sleep supplement—by itself and combined with other ingredients. The Natural Standard gives it a “C” (unclear evidence) for sleep.
Some supplements claim to have ingredients that “support GABA” and other brain chemicals and thus improve sleep. We’ve found no credible evidence for such claims.
Marketed as a relaxant and anti-anxiety supplement, kava is made from the roots of the shrub Piper methysticum. It can cause severe liver damage and other adverse effects. It is banned in several countries. Don’t take it.
Herbs such as chamomile, passionflower, skullcap, lemon balm and hops may have calming, relaxing effects, but there’s little or no evidence to support their use as sleep aids. At least 100 Chinese herbal formulas are also used to treat insomnia. A 2012 paper in Sleep Medicine Reviews looked at more than 200 studies and could draw no conclusions about effectiveness or safety because almost all of the studies were poorly designed.
Published October 01, 2013