Insomnia:The Natural Medicine Perspective

Treating Insomnia by Identifying the Cause

Sleep problems that are not due to disease or metabolic disorders can be relatively easy to treat by identifying and addressing the underlying cause. There are several factors to consider when trying to determine the cause of insomnia. First, it is helpful to know whether the insomnia is due to difficulty falling to sleep (sleep-onset insomnia) or difficulty staying asleep (sleep-maintenance insomnia).

Sleep laboratory research has shown that 50 percent of all insomnia is due to psychological distress, especially anxiety depression.

Other causes of sleep-onset insomnia are: caffeine, alcohol, food reactions, disruptive environment or change in environment, pain or inability to get comfortable, fear of falling asleep and, paradoxically, fear of insomnia.

Sleep-maintenance problems are often caused by alcohol, drugs, food reactions, sleep apnea, restless-leg syndrome (also called periodic limb movement/PLMD, or nocturnal myoclonus), hypoglycemia (low blood sugar), pain or discomfort.

Traditional Chinese Medicine (TCM) Model of Sleep

The 3000-year-old Chinese medical model has divided the 24-hour cycle of a day into 2-hour increments when the qi ("chi" or vital energy of the body) concentrates in various organ systems throughout the body. Observing the time when sleep is disrupted can be an important clue to understanding the cause. For example, waking every night regularly at 2 a.m. coincides with the time when the liver meridian is most active. This may indicate a problem with liver "heat" and detoxification stress. Asthma may wake you between 3 a.m. and 5 a.m. when the lung meridian is most active. A Chinese medical evaluation is also extremely useful for treating insomnia. Chinese medicine and acupuncture provide very effective tools for the treatment of insomnia by treating the underlying disturbances in qi circulation. Usually, restful sleep can return after the first few treatments.

How What You Eat Affects How You Sleep

There are several components in foods that can interfere with sleep. Chemical additives and naturally-occurring compounds are equally responsible. Different people may react differently to different foods. Sulfites, even small amounts found in olives for example, may cause one person to be up all night but have no effect on somebody else. By reviewing what has been eaten throughout the day, especially for the evening meal, a food culprit can usually be identified.

On the nights when you are having trouble sleeping, recall the foods of the day. Begin to pay attention to how you feel after eating. A problematic food will often create an unusual sensation in the body. Sometimes this manifests as a mild humming or buzzing feeling in the abdomen or limbs. Headache or irritability can also indicate food reactivity, as can feeling "wound up" in the evenings after dinner. See the section on food allergies: adaptation and withdraw in the natural medicine glossary for more guidance in these topics.

Hypoglycemia & Sleep Disorders

Low blood sugar is a common cause of sleep-maintenance insomnia. A diet high in refined carbohydrates (breads, pasta and sugar) can lead to problems in blood sugar metabolism.

Lack of Exercise & Sleep Disorders

A lack of exercise can contribute to restlessness at night. Twenty to 40 minutes of aerobic exercise on a daily basis in the morning or late afternoon can substantially improve the quality of sleep at night as well as the sense of vitality while awake.

Restless Legs Syndrome (RLS; also known as Periodic Limb Movement Disorder or PLMD)

Refer to Restless Legs Syndrome & Periodic Limb Movement for a description of this disorder. When there is no family history of this disorder, additional testing is useful to rule out a low-grade iron deficiency or folic acid deficiency. Often there can be a sub-clinical deficiency in these nutrients and supplementing them can resolve the imbalance and help support a good night's sleep. Magnesium and vitamin E are also very helpful.

Other Obstacles to Restful Sleep

Despite the popular lore about a nightcap before be for a restful night, alcohol is a major contributor to sleep deprivation. Drinking even one drink 2 or 3 hours before bed can create problems. Some people are more reactive to alcohol than others, and often the only way to determine if this is a factor is to abstain for several nights and note your sleep patterns.

Herbal Therapies that Improve Sleep

When insomnia is due to nervousness, anxiety or depression, temporary measures can encourage sleep during a crisis so that the immune system does not get too run down. The following botanical treatments, homeopathic combinations and nutrient supplements can be supportive for short periods of time.

Botanical Treatments & Sleep Disorders

  • Valarian (Valeriana officinalis): take 150 to 300 mg standardized extract of 0.8 percent valerenic acid 1 hour before retiring
  • Passionflower (Passiflora incarnata): take 300 to 450 mg standardized extract of 2.6% flavinoids 1 hour before bed
  • Skullcap (Scutellaria laterifolia): use 1 tsp dried herb to 1 cup hot water; drink in the evening to calm the nervous system
  • Kava (Piper methysticum): take 50mg standardized extract to reduce anxiety that may be inhibiting ability to fall asleep

Homeopathic Combinations & Sleep Disorders

There are several over-the-counter formulas that can be very helpful toward getting a restful night's sleep, including:

  • Calms Forte by Hyland Homeopathics: use as directed
  • Calm Formula by Boericke
  • Insomnia Formula by Hylands Homeopathics: take as directed

Nutrient Supplements & Sleep Disorders

These should be taken 1 hour before bed for the best results:

  • 5-Hydroxytryptophan (5-HTP): take 100–300 mg with fruit juice or other carbohydrate (e.g., crackers or soy milk); this amino acid precursor to serotonin can be supplemented to support serotonin production in the brain and improve sleep.
  • Magnesium citrate: 250 mg
  • Flax seed oil: 1 Tbs daily; this essential fatty acid tonifies (strengthens) the nervous system
  • Melatonin: take 3 mg; a low serum melatonin level is often the cause of insomnia in elderly patients. This hormonal preparation should only be taken after blood melatonin levels have been determined, as there may be associated alterations in hormonal balance when melatonin is supplemented needlessly. It is only useful when levels are low. Jet lag is another time when melatonin supplementation may be appropriate to quickly re-calibrate the pineal gland's own production of melatonin and get body's the internal clock back on track.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 01 Jan 2000

Last Modified: 06 Oct 2015