Sleep Supplements: Melatonin, Valerian, and More

From the WebMD Archives

Are you sleeping poorly? Doctors say it's important to look at your lifestyle -- too much caffeine, too little exercise, or too much late-night work or TV. If lifestyle changes aren't enough, medications can help. But supplements may also help provide a peaceful night's sleep.

What's been proven to work? What's safe?

Here's advice on sleep supplements from two experts: Sharon Plank, MD, with the University of Pittsburgh Medical School Center for Integrative Medicine, and Alon Avidan, MD, a sleep researcher at the UCLA School of Medicine.

4 Supplements for Natural Good Sleep

Plank recommends these four supplements, especially valerian and melatonin. They "have good scientific evidence backing them up," Plank tells WebMD.

Start with low doses, and tell your doctor what you are taking. (Some people should not take specific supplements.) Also, don't take any sleep supplement long-term.

"Any sleep aid should not be taken for long periods," Plank says. "You must address lifestyle, too. Make sure something else is not interfering with sleep."

Chamomile Tea for Sleep

People have used chamomile tea for sleep for thousands of years. Studies seem to back up its calming effect. One Japanese study of rats found that chamomile extract helped the rats fall to sleep just as quickly as rats that got a dose of benzodiazepine (a tranquilizing medication). Better research of chamomile is needed, experts agree. The FDA considers chamomile tea to be safe with usually no side effects.

Plank says: "The trick is to make sure you are brewing it properly. Use two or three tea bags. Then put a lid on the pot to keep oils in the water -- so you get the medicinal effects of the tea."

Use chamomile cautiously if you are allergic to ragweed (the plants are related). Also, don't take chamomile tea if you are pregnant or nursing.

Melatonin for Sleep

Melatonin is a natural hormone that helps regulate the sleep-wake cycle (circadian cycles). Studies show that melatonin not only helps some people fall asleep, but also enhances the quality of sleep. "Melatonin comes in two forms -- extended release and immediate release," says Plank. "If you tend to wake up in the middle of the night, you may want to take extended release before you go to bed. If you have trouble falling asleep, try immediate release."

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Also, "melatonin supplements can be effective in treating certain sleep disorders, including jet lag," says Avidan. But studies suggest you must time the melatonin you take carefully to help with jet lag. On the day you depart, take melatonin when it is bedtime at your destination. Continue taking it for several days. It works best when traveling eastward -- and when crossing four or more time zones.

A few cautions: Melatonin is considered generally safe for short-term use. However, there have been concerns about risks of bleeding (especially in people taking blood-thinners like warfarin). There also is increased risk of seizure, particularly in children with brain disorders.

Valerian for Sleep

Valerian root has been used as a sedative and anti-anxiety treatment for more than 2,000 years.

A review of 16 small studies suggests that valerian may help people fall to sleep faster. It also may improve the quality of sleep. Valerian becomes more effective over time, so it's best to take it every night for a short period of time.

Some people have stomach upset, headache, or morning grogginess with valerian. Taking valerian with sleeping medications or with alcohol can compound its effect, so don't use it with other sleep aids. Start with the lowest dose, then increase over several days' time. Valerian is considered safe to take for four to six weeks.

Kava for Sleep

The Kava plant is a member of the pepper family, and has been shown to help relieve anxiety. One review of six studies showed reduced anxiety among patients who took kava, compared with those who got a placebo. Another small study showed that both kava and valerian improved sleep in people with stress-related insomnia.

The American Academy of Family Physicians says that short-term use of kava is okay for patients with mild to moderate anxiety -- but not if you use alcohol or take medicines metabolized in the liver, including many cholesterol medicines. In fact, the FDA has issued a warning that using kava supplements has been linked to a risk for severe liver damage. Before taking kava, ask your doctor if kava is safe for you.

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Lifestyle Tips for Better Sleep

Before you try sleep supplements, doctors suggest you try these steps to sleep better.

  • Keep noise and light to a minimum. Use earplugs, window blinds, heavy curtains, or an eye mask. Small night-lights in your bedroom and bathroom are a good idea.
  • Avoid large meals two hours before bedtime. A light snack is fine.
  • Don't drink caffeine (including tea and soft drinks) four to six hours before bedtime.
  • Regular exercise like walking will reduce stress hormones and help you sleep better. But don't exercise within two hours of bedtime. You may have more difficulty falling asleep.
  • Don't nap late in the afternoon.
  • Stop working on any task an hour before bedtime to calm your brain.
  • Don't discuss emotional issues right before bedtime.
  • Keep pets outside your sleeping area if you can.
  • Make sure your bedroom is well ventilated and at a comfortable temperature.
  • Learn a relaxation technique like meditation or progressive relaxation.

WebMD Feature Reviewed by David Kiefer, MD on April 24, 2012

Sources

SOURCES:

Sharon Plank, MD, integrative medicine physician, University of Pittsburgh Medical School Center for Integrative Medicine.

Alon Avidan, MD, sleep researcher and professor of neurology,  UCLA School of Medicine.

Natural Standard: The Authority on Integative Medicine.

Biological and Pharmaceutical Bulletin, May 2005; vol 28: p. 808-810.

WebMD Medical Reference in collaboration with The Cleveland Clinic: "Alternative Treatments for Sleep Disorders."

The American Journal of Medicine, December 2006; vol 119: pp 1005-1012.

Vitamins & Health Supplements Guide.

NIH Office of Complementary Medicine.

Cochrane Database of Systematic Reviews, 2002.

American Family Physician, Aug. 15, 2007; vol 76: pp 549-556.

Journal of Psychopharmacology, July 2005; vol 19: pp 414-421.

WebMD Medical Reference in collaboration with The Cleveland Clinic: "Tips for a Good Night's Sleep."

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