Supplements That Promise Sleep
Melatonin and valerian are two popular dietary supplements promoted as sleeping aids. Melatonin is actually a human hormone that seems to play a role in synchronizing circadian rhythms, and it is widely marketed in health-food stores as a jet lag cure. There is evidence that melatonin helps people fall asleep faster, but it may not help them stay asleep. Like many prescription sleeping pills, it can also produce drowsiness the next day.
Similarly, a dose of valerian before retiring seems to reduce the time it takes to fall asleep. But it has yet to be shown in a well-designed trial that valerian improves the quality of sleep. And there is no method for standardizing doses of either of these substances.
If you decide to try valerian or melatonin, treat it like any sleeping medication—don't combine it with alcohol, tranquilizers, or barbiturates.
Medications for Insomnia
Prescription sleeping pills—known as hypnotics—and other sleeping aids are among the most frequently taken medications in the United States. But how effective and safe are they—and what, if anything, should you take?
- Over-the-counter sleeping pills. Most such drugs are antihistamines (just like many hay fever remedies, which may also induce drowsiness) and at the suggested dosage are probably harmless. It won't hurt to try them for occasional sleeplessness—they may work for a night or two—but studies show that they quickly lose their effectiveness.
- Benzodiazepines (tranquilizers). Marketed under such names as Valium, Xanax, Dalmane, Restoril, and Halcion, these prescription-only antianxiety drugs act as sedatives and are widely prescribed for people suffering from insomnia. They are less likely than barbiturates (which are no longer used as sleeping pills) to be lethal in overdose or to create physical dependency. But long-term users of benzodiazepines do experience some dependency and will usually have withdrawal symptoms when they stop taking the drugs. Many side effects have been reported for all benzodiazepines—disorientation, confusion, "hangover" the next day, blurred vision, nightmares, and daytime depression.
- Nonbenzodiazepines. Two newer medications, zolpidem (Ambien) and zaleplon (Sonata), belong to a class of medicines that have a shorter "half-life" than benzodiazepines—meaning the new drugs quickly dissipate in the body and the natural sleep cycle takes over. They are also are far less likely to produce next-day grogginess and other side effects associated with benzodiazepines.
- If, for some reason, you and your doctor decide you need one of these drugs, try a low dose first, and don't take it for more than three or four nights in a row. Also, never combine it with alcohol. Your goal should be to reestablish normal sleeping habits without any drugs.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media