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Q. Is there a natural alternative to sleep medications?

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Updated October 04, 2007

A.

Sleep medication is appropriate in certain situations, and many of the newer medications have fewer side effects. If you're currently taking sleep medications, I'd suggest talking with your doctor about whether natural sleep aids might be a good option for you.

There are plenty of natural alternatives that may help people fall asleep and stay asleep. The ones that don't involve taking a herb or supplement can often be combined with medication.

  • Cognitive behavioral therapy (CBT) is a form of short-term psychotherapy that involves modifying sleep habits and behavoirs, such as:
    • using your bed and bedroom only for sleep
    • going to bed and waking up at the same time every day
    • avoiding napping during the day
    • getting out of bed if you're having trouble falling asleep for longer than 15 minutes
    • avoiding caffeine during the day
    • minimizing light and noise in the bedroom

    CBT is one of the better-researched natural sleep aids. For example, a study published in the Journal of the American Medical Association randomized 75 subjects to CBT, progressive muscle relaxation, or placebo. After 6 weeks, the number of nightly awakenings and time to get back to sleep had been reduced by almost 50 percent in the CBT group, compared to 16 percent in the progressive muscle relaxation group and 12 percent in the placebo group.
    National Association of Cognitive Behavioral Therapists

  • Visualization is another drug-free option. It involves imagining a relaxing scene using all the senses. It is generally done about 20-25 minutes before the desired bedtime. For example, if you're imagining yourself on a tropical island, think of the way the warm breeze feels against your skin. Imagine the sweet scent of the flowers, look at the water and listen the waves…you get the picture. Involving more senses is generally thought to be more effective.

  • Progressive Muscle Relaxation has also been explored as a natural remedy for sleep. Starting at one end of the body, it involves tensing then relaxing one muscle group at a time, working your way to the other end of the body. Progressive Muscle Relaxation
Although the herb kava kava is a herb often marketed as a natural sleep aid, it should be avoided. The United States Food and Drug Administration (FDA) has issued a consumer advisory about the potential risk of severe liver injury resulting from the use of dietary supplements containing kava. To date, there have been more than 25 reports of serious adverse effects from kava use in other countries, including four patients who required liver transplants.

Melatonin is a hormone produced naturally in the body. The pineal gland in the brain makes serotonin which is then converted into melatonin at night when it gets dark. It's also available as nutritional supplements.

A number of studies have found that melatonin supplements lessens the time it takes to fall asleep, promotes sleepiness, and lengthens sleep time. Most studies have been small and very short in duration, so more research is needed.

Some experts caution that melatonin should not be used by people with depression, schizophrenia, autoimmune diseases, and other serious illness. Pregnant and nursing women should not use melatonin. And although melatonin is produced in the body in very small amounts, the amounts found in supplements and used in studies have contained much larger amounts. Short-term side effects can include headache and sleeplessness, and it is not known what the long-term side effects are.

And finally, with any sleep difficulty, the first step should be consulting a doctor. Chronic insomnia can be a symptom of an underlying condition, such as depression, heart disease, sleep apnea, lung disease, hot flashes, or diabetes, so it's important to see a doctor if you are having trouble sleeping.

More: Natural Remedies for Insomnia

Sources
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Buscemi N, Vandermeer B, Hooton N, Pandya R, Tjosvold L, Hartling L, Vohra S, Klassen TP, Baker G. Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis. BMJ. (2006) 332.7538:385-93.

Edinger JD, Wohlgemuth WK, Radtke RA, Marsh GR, Quillian RE. Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. JAMA. (2001) 285.14:1856-64.

NCCAM. Kava Linked to Liver Damage. July 23, 2002. http://nccam.nih.gov/health/alerts/kava/

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