By Dr. Carolyn DeMarco

In this age of massive noise pollution and increased levels of stress, sleep disorders have become rampant. Insomnia, especially early morning awakening, can also be a symptom of serious depression. Severe sleep disorders deserve a full workup in a specialized sleep lab; however, mild to moderate cases of insomnia can be safely helped with a variety of natural remedies with few side effects.

One of the most important remedies is an herb known as valerian. Valerian officinalis is a perennial plant native to Europe that has been naturalized to North America.Valerian has been known since the time of Galen. Back then it was known as the “phu plant”, an expression of the aversion to the strong odor of its dried roots. More recently that smell has been compared to the odor of smelly socks. The strong-smelling root is very attractive to animals, especially cats and rats.

Fast forwarding to modern times, valerian has been studied in several well designed clinical trials. A placebo-controlled study of 128 patients showed that giving 400 to 900mg of valerian root at bedtime resulted in a decrease in sleep latency (time required to fall asleep at night), a reduction in night time awakenings as well as an increase in dream recall. All this was accomplished with no hangover effect. Lower dosages of valerian were shown to be as effective as higher dosages in this study.

A German study found that the combined effect of valerian root and lemon balm on the sleep patterns of 20 volunteers compared favorably with a tranquilizer in the Valium family known as triazolam.

Based on this and other research, Seattle naturopathic physician Dr. Donald Brown uses valerian root in combination with lemon balm and passion flower for the treatment of insomnia. He also finds valerian root to be “a safe and efficacious tool in the early treatment of anxiety, as well as the long-term management of those unable to use or attempting to withdraw from the benzodiazepines (Valium and its cousins).”

In fact, Valerian has been called the herbal Valium—it normalizes the nervous system, it acts as a sedative in cases of agitation and as a stimulant in cases of extreme fatigue and it also has a minor action of lowering blood pressure, enhancing the flow of bile and relaxing the intestinal muscles. However, its prime pharmacological effect is that of a sedative. Although considered to be safe during pregnancy and lactation, to be on the safe side its use is not recommended.

Other herbs traditionally combined with valerian root include hops and skullcap. Hops or Humulus lupulus is a native British plant well known for its use in making beer. In the herbal world, hops is also used as a sedative and for its sleep inducing effects.

Skullcap, or Scutellaria lateriflora, grows in Europe and North America, and is well known for its beneficial sedative effect on the nervous system. It has been used in the past to treat epilepsy.

In addition, there are many important nutritional supplements that can aid in getting a good night’s sleep. They can be added to any of the herbs mentioned above. These supplements include niacinamide, inositol and combined calcium-magnesium supplements.

Tryptophan, a natural amino acid supplement only available by prescription, is also an excellent sleep aid. L-tryptophan is one of the eight essential amino acids, one of the building blocks of protein. It is precursor to serotonin which is a brain chemical that elevates mood. It is a little known but useful prescription for insomnia including the sleep disorders of fibromyalgia, chronic fatigue syndrome, grief reactions, PMS and menopause. Tryptophan can be used in treating depression, either by itself or in combination with antidepressant drugs like Prozac where it counters the insomnia side effect and prevents the need for increasing the dosage.

Some doctors are still nervous about prescribing tryptophan. In November 1989, the FDA recalled all tryptophan from health food stores due to a serious illness and fatalities induced by one contaminated batch of tryptophan. The tryptophan in question was manufactured by one Japanese company that was using genetically engineered bacteria to produce the tryptophan. Tryptophan is no longer sold in health food stores; it is only available by prescription.

The usual dosage of tryptophan for insomnia ranges from 500 mg to 4,000 mg taken one hour before bedtime. It is best not to take tryptophan with protein as it competes with tryptophan for absorption, but it can be taken with a carbohydrate snack. Vitamin B6 and magnesium enhance the effect of tryptophan. Tryptophan can also be combined with the B vitamin niacinamide for chronic pain or depression.

An alternative to tryptophan that is readily available in health food stores is 5-HTP or five hydroxytryptophan. This compound is a precursor to tryptophan. The dosage, however, is very different—100 to 200 mg at night.

Another very useful sleep aid is melatonin. Although it was recently removed from the Canadian market, is freely available in the United States. Melatonin is a cheap and effective sleep aid in doses of 0.1mg to 6 mg per night. Melatonin also works well for jet lag (taken at bedtime local time) and shift work (taken at the new desired bedtime).