Could Complementary Medicine Help Your Sleep Problems?

Do you occasionally suffer from bouts of insomnia — not being able to get to sleep for hours, no matter what you try, or waking frequently and starting the struggle to fall asleep again each time? Do you perhaps have difficulty going to sleep on a daily basis? 

It’s a very common problem.

Most people have suffered from sleep problems at one time or another. It is estimated that every year 85 percent of the adult population experience difficulty with sleeping, and 10 percent are affected by long-term sleep problems. Typically the problem is either a delay in getting to sleep, or difficulty staying asleep — in other words, waking up and not being able to get back to sleep.

Apparently, sleep problems are more common in women than in men, and are generally first encountered between the ages of 20 and 40. The problem becomes much more common as people get a little older. Perhaps this is related to the life stresses and medical problems people face as they enter middle age.

Finding relief from insomnia

While there are many effective drugs to treat insomnia, some of these, such as benzodiazepines (e.g. temazepam) have acquired a bad reputation for causing "hangover" effects the next day. Many also quickly lead to dependence. 

As a result, some people instead seek help from the realms of complementary and alternative medicine, known as CAM.  

In a US National Health Interview Survey 4.5 percent of people admitted to having tried CAM remedies for their insomnia, and it is estimated that the national figure is 1.6 million people using CAM for sleep problems.

In another survey, of the people who used CAM in a bid to find relief from sleep problems, one third to one half reported it as helping a ‘great deal.’ The biggest draw of CAM may be that people believe that even if it does not help, it will not harm.

Which CAM therapies are used for sleep problems?

Of the vast range of CAM therapies, the most popular treatments for insomnia include preparations derived from plants such as valerian and kava; melatonin, L-tryptophan and homeopathy. There are also physical relaxing therapies, such as yoga, tai chi, massage and aromatherapy, while others seek acupuncture or variations of it like acupressure.

Do CAM therapies work for sleep problems?

A review of a large database of scientific studies on CAM insomnia remedies found that the quality of the studies was generally poor and many were too small for reliable conclusions to be drawn.  

The weakest evidence was for the herb valerian.

But lack of evidence for other promising therapies such as massage, aromatherapy and homeopathy cannot be taken as meaning they do not work, it just indicates that good quality trial data are lacking.

The most reliable study evidence of effectiveness in treating insomnia is thought to come from polysomnography, the name for sleep studies. While the study participants sleep, multiple measurements such as breathing, heart rate, and electrical brain activity are taken.

More about CAM therapies

Melatonin

This is a hormone secreted by a small gland in the brain in response to diminishing amounts of light and most of it is secreted at night and it is barely detectable in the blood during the day. Increased levels of melatonin bring about changes in the body that tend to help us fall asleep more easily. For this reason, people have thought that taking extra melatonin would help with sleep problems, and melatonin supplements are available to buy over the counter. 

There are some risks, however. A long-term study published in JAMA found that more adults than ever are using melatonin to get to sleep. Reported side effects include dizziness and nausea, as well as stomach upset.

It is also important to keep in mind that the processes regulating sleep involve more than just melatonin. Also, because melatonin is contained in some foods it is classified as a food supplement and so subject to less rigorous controls than medicines.  So what you buy may contain very little - or far too much – melatonin.

L-Tryptophan

This is an essential amino acid, meaning it must be obtained from the diet as the body cannot manufacture it. It is involved in the same pathway as melatonin and has shown some success in treatment of sleep disorders.  It is also classified as a food supplement so the same issues apply as with melatonin and care needs to be taken when buying it.

Kava

Derived from the root of a plant, kava is used to reduce anxiety as well as for sleep disorders.  There is conflicting evidence as to its efficacy.

Acupressure

This involves the application of pressure to acupuncture points along the hypothetical meridian switch cover the body. 

Tai Chi

This non-impact traditional Chinese form of exercise has been studied in older people as a remedy for sleep problems. It was found that it reduced the time to sleep (‘sleep latency’) by 18 minutes and increased the time spent asleep by 48 minutes.

Many people find Tai Chi easy and relaxing, and that it brings a sense of well-being. Because of its gentle nature, it is suitable for all different ages and unlikely to cause harm.

So which CAM sleep remedy is best?

As mentioned, good quality studies of CAM therapies are generally lacking, which makes this questions difficult to answer from an evidence-based perspective.  

A lot may also depend on the cause of your sleep problems – the evidence for melatonin and L-tryptophan seems to be strongest in those with jet lag and shift workers.  

Care should be taken when buying CAM remedies classified as food supplements and it might be wise to seek professional advice as to where to source the products and the best dosage to use.