Go On, Knock Yourself Out: My Favorite Herbs for a Good Night's Sleep

Let’s face it: Sleep doesn’t come first for most of us. But maybe it should.

Did you know that poor sleep increases your risk for heart disease, diabetes, and obesity? That it decreases your ability to concentrate and focus, increases hunger, and negatively impacts metabolism? That it is associated with anxiety and depression? And that the National Sleep Foundation reports that approximately 100,000 car accidents per year are the result of drowsiness and estimates the direct and indirect annual costs of sleep disorders to the US economy at $100 billion?

Yikes! This is why I counsel my patients over and over again about the need to (ahem) wake up and prioritize sleep.

Conventional medical sleep treatment focuses on prescription medications that are often habit-forming, have problematic side effects, and don’t provide the deep restful sleep we so desperately need. While some cases of insomnia may require these medications, many do not, and most of us can greatly improve our sleep by focusing instead on sleep hygiene, stress management, and blood sugar balance. I have found that herbal medicine can be profoundly effective to manage occasional sleep issues, and even regular bouts with insomnia.

So go on! Knock yourself out with these safe reliable herbs**:

1. Cannabidiol or CBD from Hemp You can get CBD from medical or recreational cannabis, too, but I choose hemp because I know that a hemp-derived CBD product can’t contain more than 0.3% THC. THC, the cannabinoid most known for its psychoactive effects, can help some people fall asleep faster, but it can also worsen sleep quality long-term. On the other hand, CBD, which has no psychoactive effect, shows promise for supporting sleep quality including REM sleep. In an open label trial, hemp-derived CBD improved sleep by 67% after 4 weeks. CBD helps to balance our endocannabinoid system which is the system that keeps us balanced by regulating the fight or flight response, modulating the endocrine system, and supporting immune function, including a healthy inflammatory response. That means that while CBD may help you sleep, it could also be quieting your anxiety and decreasing pain and inflammation!
2. 5HTP is a form of the amino acid tryptophan derived from Griffonia simplicifolia, a woody climbing shrub. 5HTP has been reported in numerous double-blind studies to decrease the time required to get to sleep and to decrease the number of night awakenings. Taking 5-HTP will raise serotonin levels, an important initiator of sleep. If estrogen levels are fluctuating, serotonin production will be affected – an explanation for the prevalence of sleep issues at times of hormonal change. Also, adequate serotonin is needed to make melatonin, another important hormone for sleep.
3. Nervine (Calming) Herbs This class of mildly sedating herbs, called nervines (also includes skullcap, catnip, chamomile, and California poppy), has been used traditionally for centuries by herbalists for sleep disturbance, anxiety, and nervous restlessness. Valerian has been used for centuries as a sedative, including as an aid for insomnia. The German Commission E and the World Health Organization (WHO) endorse the use of valerian for sleep. In fact, the WHO lists valerian as a milder alternative to or possible substitute for stronger sedatives like benzodiazepine drugs. Studies have shown valerian to improve sleep onset, reduce night waking, and improve sleep quality, especially in women. Passionflower, Hops, and Lemon Balm have each been shown to have individual sedative effects, but most studies have focused on the use of these herbs in combination, often together and/or with valerian. While lacking rigorous clinical trials, these herbs are considered quite safe for the general population, including children.
4. Cinnamon, Holy Basil, and a protein snack at bedtime can support blood sugar balance while you sleep. If your blood sugar drops during the night (from too much alcohol, sweets, or carbs before bed), your cortisol will spike and may wake you up.  To avoid nocturnal awakening, I recommend that my patients cut the sugar and carbs at bedtime, and instead have a protein snack like hummus and carrots, rice cake and nut butter, or small portion of protein smoothie (with cinnamon!) to help keep blood sugar stable during the night. You can also sip cinnamon or tulsi (holy basil) teas, as both herbs have been shown to help with glycemic control.
5. Kava Kava has been shown to be a potent effective herb for anxiety. It impacts GABA receptors in the brain that promote calm and focus. Long-term use of kava for anxiety and sleep should be under the care of a doctor. Short-term use for 4-6 weeks, however, is considered safe and can be a great tool for poor sleep due to anxiety.

Try Kava Sangria instead of wine around dinnertime. You'll need:

• Wine glass
• Soda water
• Tart juice, i.e.: tart cherry juice or pomegranate juice (no sugar added)
• Fresh limes and/or oranges
• HerbPharm or Gaia Herbs Kava Kava liquid tincture

Fill wine glass half full with soda water, add an additional quarter-glass    of juice, and fresh squeezed limes and/or oranges to taste. I like to throw the fruit in as well after squeezing. Add 1-2 dropperfulls of Kava. Kava is  very bitter, but you’ll get used to it. You can add more fruit or soda water if needed. Relax and enjoy!

Insomnia can be a symptom of an underlying problem. Medical conditions and issues that can cause insomnia include hormonal changes (menopause, PMS, pregnancy, post-partum), anxiety, psychiatric and mood disorders, esophageal reflux (GERD), nocturnal hypoglycemia, restless leg syndrome, respiratory problems like sleep apnea, arthritis, fibromyalgia, chronic or intermittent pain, headaches, congestive heart failure, cancer, Alzheimer’s disease, Parkinson’s disease, and peripheral vascular diseases. Other causes can include caffeine, alcohol, nicotine, recreational drugs, medications, and stress.

A qualified integrative practitioner can assist in determining the cause of your sleep disturbance by doing a thorough history and physical, ordering selected tests, and by giving instructions on the use of a sleep diary. She can then explore the various modalities appropriate for you including sleep hygiene, diet, herbs, supplements, homeopathy, hormones, and prescription medicines. 

** Don’t REALLY knock yourself out. It is not my intention that you use all these herbs together! Please work with your naturopathic doctor to choose the right herb(s) for you and to assist with dosing.