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National Institutes of Health • National Center for Complementary and Alternative Medicine

NCCAM Clinical Digest

Sleep Disorders and CAM :
What the Science Says

December 2010
Sleepy woman in bed stares at alarm clock

Herbs

  • Aromatherapy using essential oils from herbs such as lavender or chamomile is a popular sleep aid; preliminary research suggests some sleep-inducing effects, but more studies are needed.
  • The herb chamomile is commonly used as a bedtime tea, but scientific evidence of its effectiveness for insomnia is lacking.
  • The herb kava has been used for insomnia, but there is no evidence of its efficacy. The U.S. Food and Drug Administration has issued a warning that kava supplements have been linked to a risk of severe liver damage.
  • The herbal supplement valerian is one of the most popular CAM therapies for insomnia. Several studies suggest that valerian (for up to 4-to-6 weeks) can improve the quality of sleep and slightly reduce the time it takes to fall asleep. However, not all of the evidence is positive. One systematic review of the research concluded that although valerian is commonly used as a sleep aid, the scientific evidence does not support its efficacy for insomnia. Researchers have concluded that valerian appears to be safe at recommended doses for short-term use. Some "sleep formula" products combine valerian with other herbs such as hops, lavender, lemon balm, and skullcap. Although many of these other herbs have sedative properties, there is no reliable evidence that they improve insomnia or that combination products are more effective than valerian alone.

Melatonin and Related Supplements

  • Like valerian, melatonin supplements (melatonin is a naturally occurring hormone associated with sleep) are widely used and researched for insomnia. Although more research is still needed, studies suggest that melatonin can help elderly people with insomnia fall asleep faster, and may also be beneficial for other people with insomnia; however, effects are generally small, with larger effects observed in patients whose sleep problems are caused by a circadian rhythm abnormality (disruption of the body's internal "clock"). Studies indicate that melatonin also appears to be safe at recommended doses for short-term use.
  • Dietary supplements containing melatonin "precursors"—L‑tryptophan and 5‑HTP—are also used as sleep aids. (The amino acid L‑tryptophan is converted to 5‑HTP, which is converted to serotonin and then melatonin.) However, these supplements have not been proven effective in treating insomnia, and there are concerns that they may be linked to eosinophilia-myalgia syndrome (EMS), a complex and debilitating systemic condition with multiple symptoms including severe muscle pain.

Other CAM Approaches

  • Traditional Chinese medicine commonly uses acupuncture to treat insomnia. A review of available studies found some evidence of benefits, but many studies had design flaws that make it difficult to draw firm conclusions.
  • There is scientific evidence that music therapy can have sleep benefits for older adults and children.
  • Studies suggest that relaxation techniques may help people with insomnia, although the effects appear to be short-lived. Cognitive forms of relaxation (such as meditation) have had slightly better results than somatic forms (such as progressive muscle relaxation). Preliminary studies suggest that yoga may also improve sleep quality. In addition, when these forms of relaxation are combined with other components of cognitive-behavioral therapy (e.g., sleep restriction and stimulus control), lasting improvements in sleep have been observed. Again, additional research is needed in these areas.

NCCAM Clinical Digest is a service of the National Center for Complementary and Alternative Medicine, NIH, DHHS. NCCAM Clinical Digest, a monthly e-newsletter, offers evidence-based information on CAM, including scientific literature searches, summaries of NCCAM-funded research, fact sheets for patients, and more.

The National Center for Complementary and Alternative Medicine is dedicated to exploring complementary and alternative healing practices in the context of rigorous science, training CAM researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCAM's Clearinghouse toll-free at 1-888-644-6226, or visit the NCCAM Web site at nccam.nih.gov. NCCAM is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

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