Do natural sleep aids work?

DEAR DOCTOR K:

I’m 71 years old and have trouble sleeping. I don’t want to take sleep drugs, but I’m interested in supplements and natural treatments. Do they work?

DEAR READER:

I understand your concern about conventional sleep medicines. Several widely used medicines have been discovered to have important side effects years after they were first approved for use.

However, many supplements and “natural” treatments also can cause side effects. And there has not been a lot of research done to test how effective they are in the many different kinds of sleep disorders that people can have.

The most commonly used herbal sleep aid is valerian root. Some studies suggest that it is mildly sedating and can help people fall asleep and improve their sleep quality. But the evidence is mixed.

An analysis of multiple studies of valerian’s effect on sleep published in 2010 concluded that people fell asleep only about a minute sooner than with a sugar pill. There also is some risk of liver damage from valerian, and some women report headaches after using the herb. I’m not aware of good studies of the long-term use of valerian.

Finally, while the U.S. Food and Drug Administration monitors how conventional medicines are manufactured, it has no authority from Congress to do that for supplements. In fact, impurities have been found in some herbal preparations that are available over-the-counter. For all these reasons, I don’t recommend valerian.

Another popular natural sleep aid is melatonin, which is a hormone made in the brain. It influences body temperature, sleep and daily body rhythms (circadian rhythms). The question is whether melatonin taken as a pill can help with sleep.

For most types of sleep problems, I don’t think melatonin has been shown in scientific studies to help sleep.

But one condition where melatonin may help sleep is in older adults, like you. People over 60 with insomnia often have lower levels of nighttime melatonin (as measured in the urine) than those without insomnia. Some studies have found that such people may sleep better if they take melatonin supplements.

Acupressure appears promising. In acupressure, pressure is placed on acupuncture points without needles.

Tai chi and yoga may help you fall asleep faster and improve your quality of sleep. Both have the added benefits of promoting mental relaxation as well as muscle relaxation. Meditation may help as a calming and relaxing technique as well.

You can also try drinking a cup of chamomile tea before bed. This age-old home remedy appears to help people relax and become drowsy. Chamomile is both mild and safe. (But avoid it if you’re allergic to plants in the daisy family.)

An excellent, short and inexpensive e-book about treatments for women battling insomnia is “Successful Sleep Strategies for Women” by Harvard Medical School’s Dr. Julia Schlam Edelman. You can learn more about this book, below.

(This column is an update of one that ran originally in January 2013.)