It's four in the morning and you’re wide awake, your mind churning. You toss and turn,rehashing the past or worrying about the future, only to fall into a sound sleep twenty minutes before the alarm goes off. How can you be expected to deal with the busy day ahead on twenty minutes of sleep?
An occasional episode of insomnia can make it difficult to handle the day, but regular episodes of insomnia can make it difficult to handle life. If insomnia bedevils your nights, you can at least take comfort in knowing that you’re not alone. It is estimated that one in four people suffers from insomnia regularly, and about six million people in the United States have such a serious problem that they rely on the regular use of prescription drugs to treat it.
The causes of insomnia are varied, but psychological factors are present in more than 50 percent of the cases. Environmental and dietary factors also play a prominent role, and statistics show that, for unknown reasons, insomnia is more common in females than males. Fortunately, lifestyle changes and herbal medicines can help treat the problem.
Insomnia is classified into two broad categories: sleep-onset insomnia, or difficulty falling asleep, and maintenance insomnia, which causes frequent or early waking. Treating either type of insomnia should begin with an awareness of your needs as well as other influential factors. All people don’t require the same amount of sleep, for example, and some may think they have a problem only because they don’t fit into the norm. Sleep cycles can vary among people and throughout a person’s life, and while one person may only require four hours of sleep, others need ten hours to feel refreshed.
In addition, insomnia can be caused by anxiety, pain, tension, emotional arousal, caffeine, alcohol, drugs, or even worrying about falling asleep. Pinpointing whether one or more of these factors is wreaking havoc on your nights can often bring relief because, through your awareness, you can try to improve the situation. One way to avoid mind-churning insomnia is to abide by the twenty-minute rule: if you lie in bed for more than twenty minutes and can’t fall asleep, get up and do something. Get your mind out of the circular problem of being kept awake by the inability to fall asleep. Read, iron that pile of clothes, or write in your journal.
If such a simple method doesn’t help and you still lie awake nights, consider the following suggestions.
1. Health: Sleep disturbances may have underlying physiological causes, so treating the cause can solve the sleep problem. People suffering from hypoglycemia, or low blood sugar, for example, may experience unsettling fluctuations in blood-sugar levels during the night. The brain needs a constant supply of glucose to function, and a drop in blood sugar signals the body to produce hormones and neurotransmitters that stimulate sugar release. The resulting rise in blood sugar may wake a person up. (A small amount of fruit or juice upon waking will relieve the symptoms.) It is important to have a correct diagnosis, however. If an exam and blood test reveal that you are hypoglycemic, you may wish to ask your health-care provider whether nutritional measures are appropriate for your condition.
Candida yeast infections can influence blood-sugar levels as well: if this is your problem, a nutritional program may be in order to clear it up.
Additionally, serotonin is a natural chemical whose production by the body has been associated with inducing sleep. Sometimes, deficiencies in tryptophan, vitamin B6, niacin, magnesium, or other nutrients can inhibit the formation of this hormone.
2. Daytime stress: Many of my patients apparently need to get wound up to achieve their goals during waking hours, but trouble occurs when stress built up during the day is released while they sleep and awakens them. That’s when they lie in bed with their brains racing, unable to shut off the mental background noise. In Chinese medicine, this type of insomnia is called disturbed shen qi, or a disturbed mental spirit. Some stimulants, such as caffeine, can also encourage this type of insomnia. To combat it, I’ve found that managing one’s day to minimize stress or release it before bedtime by taking a brisk walk or a warm bath is more effective than taking a sedative. And be aware of the amount of caffeine or other stimulants you’re ingesting during the day; try cutting back on them and see whether that relieves the problem.
3. Sleep surroundings: The sleeping environment can have an important bearing on both types of insomniacs. Noise, an uncomfortable bed, a snoring partner, and light are obvious distractions, but there are others. One often overlooked factor is temperature. Most people sleep more soundly in a cool room.
However, wind, changes in barometric pressure, and sudden weather shifts can wake a person up even if the room temperature is ideal.
Sleep surroundings play an especially important role for those who do shift work. An irregular bedtime schedule can upset the body’s natural rhythms. Finding or creating a dark, cool, quiet location to sleep will help establish conditions that promote falling asleep despite an irregular schedule.
As an herbalist, I find most of my solutions for insomnia in the plant world. I most often recommend reishi mushrooms, hops, valerian, skullcap, passionflower, lemon balm, or kava-kava. The type of herb and the dose depend on a person’s specific condition; the dosages listed here are those recommended by the official Commission E of the German government when noted.
4. Reishi mushroom (Ganoderma lucidum) is the plant material I use most often to relieve insomnia. While it’s not traditional in Western herbalism, reishi seems to resolve disturbed shen qi, calm a person during the day, reduce anxiety, help overcome environmental distractions, and regulate sugar metabolism. A tall order for a single herb, but reishi has also been shown to reduce cholesterol and blood pressure, strengthen the heart, and stimulate the immune system.
Reishi’s active ingredients include polysaccharides, which stimulate the immune system, and triterpene acids, which reduce high blood pressure, among other things. The health benefits of this herb have been demonstrated in many studies, both in the lab and clinic, which gives me great confidence in it.
• Dose: Three 1-g tablets of the mushroom taken three times a day. So far, experimental studies indicate that reishi is generally safe to use, although there are few reports on its long-term use.
5. Hops (Humulus lupulus) have been used as a sleeping aid for centuries. The volatile oils of the dried fruits have a significant sedative action. Hop tea can be taken to relieve stress during the day or just before bedtime, or the strobiles can be stuffed into a little sleep pillow, where their fragrance will be released whenever you turn your head.
• Dose: Use about 1 heaping teaspoon of whole hops for every cup of boiling water to make a tea. Hops have been shown to be generally safe, although some people have experienced allergic reactions. The German Commission E recommends a daily dose of 1/2 g, which actually is a goodly amount of this herb, as it is very light in weight.
6. Valerian (Valeriana officinalis) is another herb familiar to insomniacs throughout history. Although beneficial in inducing sleep, it can be mildly habit-forming, with stronger doses needed over time. I therefore recommend taking it only for short periods (up to one month) or occasionally when sleep disturbance is serious. A group of chemicals called valepotriates and valerenic acid have been shown to depress the central nervous system. Valerian is also antibacterial and antidiuretic and lowers blood pressure.
• Dose: To help you sleep, take a dose of 300 to 400 mg of valerian product standardized to 0.5 percent essential oil about one hour before bedtime. While valerian is generally considered to be safe, to err on the side of caution, pregnant women should avoid using it.
7. Nineteenth-century medical practitioners used skullcap (Scutellaria lateriflora) to treat chronic fatigue syndrome and fibromyalgia (pain in the muscles, ligaments, and tendons). Its calming action is mainly due to the component scutellarin, which is an antispasmodic.
• Dose: I generally use this herb in combination with reishi, hops, and valerian or alone as a tincture of 15 to 40 drops two to three times daily. Skullcap leaves can also be used in an herbal sleeping pillow. In Chinese tradition, 1 to 3 teaspoons of the root for every cup of water are used to make a tea (start with boiling water and let simmer before drinking). No health hazards have been linked to skullcap.
8. It is believed that the alkaloids and flavonoids of passionflower (Passiflora incarnata) significantly tranquilize the central nervous system. I find that it gives one a feeling of well-being while reducing spasms and anxiety and aiding sleep.
• Dose: Passionflower tinctures and extracts are generally available in health-food stores. For occasional insomnia, I recommend drinking a cup of tea made by pouring a cup of boiling water over 1/2 teaspoon of the dried herb (your local natural food store may carry dried herbs in bulk); steep, then sip before going to bed. Passionflower contains alkaloids that can reduce the effects of a class of antidepressants known as monoamine oxidase inhibitors; the German government allows passionflower preparations to contain no more than 0.01 percent of these alkaloids.
9. The leaves of lemon balm (Melissa officinalis) are often used as a tea, especially with chamomile, to relax the body and induce sleep. Lemon balm also has antiviral, antibacterial, antispasmodic, and antihistaminic properties. Besides taking it as a tea, I use this herb as an ingredient in a sedative formula (see the last paragraph).
• Dose: Steep 1 to 2 teaspoons of the herb in a cup of hot water. There are no noted side effects.
10. Kava-kava, or kava (Piper methysticum), will probably become one of the most popular healing herbs in the next few years. Compounds called kavalactones give kava its strong relaxing action without affecting mental clarity. This makes kava very useful for highly active people who need to stay calm and mentally awake during periods of stress.
• Dose: The daily dosage used in clinical studies is 100 mg of kava extract standardized to 70 percent kavalactones divided into three portions. People who are pregnant, nursing infants, or going through bouts of depression should avoid it, and it shouldn’t be taken when driving or operating machinery. (For more about kava-kava, see the article on page 42.)
Here’s a typical herbal regime that I use for insomnia when other methods fail. Dosages depend on the individual.
I start with a capsulized reishi extract. Then, for particularly rough times, I might add a combination formula that includes valerian, kava, hops, skullcap, passionflower, and/or lemon balm. If a person is experiencing tight, contracted muscles or is suffering from chronic fatigue syndrome, I would prescribe the reishi and kava root extracts.
While sleeping straight through for seven or eight hours may be the ideal, it’s not necessarily the best sleep pattern for everyone. Some of my patients have had great success on only four hours of straight sleep, supplemented with a fifteen-minute break after every subsequent four-hour period of wakefulness. The break can consist of a catnap, meditation, light exercise, or sipping a cup of tea—it’s their choice. After the sixth of these work/break cycles, instead of the fifteen-minute break, they go to sleep again for four hours.
However, the six cycles take 25.5 hours, which doesn’t fit neatly into the twenty-four-hour day. Still, some people feel that this extended day works best, and they make the odd readjustment here and there to fit in with society. They say that using the fifteen-minute breaks to catnap is key; they go quickly into a sound sleep and awaken feeling refreshed. Leonardo da Vinci, Winston Churchill, and Florence Nightingale, all very productive people, were known to have slept in four-hour cycles.
• Foster, Steven. Herbs for Your Health. Loveland, Colorado: Interweave Press, 1996.
• Willard, Terry. Herbs and their Clinical Uses. Calgary, Alberta, Canada: Wild Rose College of Natural Healing Ltd., 1996.
Terry Willard is president of the Canadian Association of Herbal Practitioners and a member of the Canadian Federal Government Expert Advisory Council on Herbs and Botanical Preparations. He is director of the Wild Rose College of Natural Healing in Calgary, Alberta, and president of Coastal Mountain College of Healing Arts in Vancouver, British Columbia. He lives on an organic herb farm on the eastern slope of the Rocky Mountains.