’Tis the season of daylight savings time and holiday travel and stress, which means many of us will spend a lot more time staring up at our bedroom ceilings in the middle of the night. Lately it feels like there’s an insomnia epidemic, particularly among women. So many of my friends and colleagues — including me, lately — don’t sleep well.
Estée Lauder sponsored a study published back in the summer that demonstrated that a lack of sleep increases the signs of aging and decreases your skin’s ability to recover from “stressors” like UV damage. Not sleeping can also negatively affect your immune system, not to mention make you want to lash out at your significant other for no good reason and send inappropriately bitchy e-mails.
Dr. Michael Breus (a.k.a. “The Sleep Doctor”), a clinical psychologist who specializes in sleep disorders, blames a lot of insomnia on, duh, stress. “If you look at the times, since 2008, we’re seeing a higher amount of stress and that of course leads to insomnia and sleeplessness,” he said. People then start hunting for sleep aids, which has helped make Ambien a $13 billion drug, according to Dr. Breus.
But Ambien has received some bad press lately, thanks to weird side effects like sleep-eating and even sleep-driving. (Or sleep-e-mailing Anna Wintour, like Isaac Mizrahi once did.) As a result, the FDA recently changed the dosage recommendations from 10 mg to 5 mg for women.
Besides Ambien, there aren’t a lot of prescription sleep medications out there. Dr. Breus thinks we need more.
“There are many different flavors of insomnia," he says. "There’s the I-can’t-fall-asleep kind; there’s the I-can’t-stay-asleep; there’s the I-wake-up-too-early; there’s insomnia associated with anxiety. We don’t have enough specific meds out there to target insomnia appropriately. That’s really what medicine is looking for.”
In the meantime, people are turning to so-called “natural” sleep aids to tackle insomnia. But it’s not like trying out a new shampoo — these substances act like drugs. Don’t be fooled by the word “natural” on packaging — it’s essentially meaningless. There are absolutely no regulations or guidelines — anyone can call anything "natural." Deadly nightshade is natural, but that doesn’t mean it’s good for you (um, as the name boldly proclaims). Also, everything that comes from plants is not necessarily safe. Some of the most toxic chemotherapy medications are plant-derived. When you hit up the supplement aisle at Whole Foods, just remember that herbal supplements can have pretty potent active ingredients, are not regulated by the FDA in the same way drugs are, and a lot of them haven’t been properly tested.
Knowing all this, I decided to systematically and as safely as possible try some common nonprescription sleep aids. My primary issues were jet lag (after a two-week trip to Hawaii) and your run-of-the-mill “Holy crap, I have too much going on and am completely overwhelmed” stress. My ultimate goal was to try to get to sleep earlier.
Scroll down for the various sleep aids I tried, including how they work, Dr. Breus’s comments, potential side effects, studies that have been done, and how the supplements worked for me. A few things I excluded: I didn’t test kava, which actually had some promise for insomnia and/or anxiety treatment, because there’s evidence that it causes liver toxicity (I’m sure, thanks to the nineties, my liver is already toxic enough). I also didn’t test lavender, which has a reputation for promoting relaxation, because it’s not commonly found in oral form. The one preparation I found in my local Whole Foods was advertised as a ‘non-drowsy’ formula — not helpful. And finally, there are countless preparations that mix various supplements. The doses are all different in each formula, and I wanted to test each supplement individually to see how they act on their own.
But please, do not try any of these until you speak to your own health-care provider. Many of them could interact with whatever medications you may be taking, or exacerbate a medical condition. If you want to get a sense of safety, side effects, and dosage, you can also check Medline Plus.
How it works: It’s a hormone that tricks your body into thinking it’s nighttime. “It’s not a sleep initiator, like Ambien,” Dr. Breus said. Meaning, don’t expect it to knock you out.
Science says: Evidence is mixed, but it does seem to have the ability to regulate rhythms. In Europe, melatonin is only available as a prescription. (Melatonin is the only hormone in the U.S. available as a supplement.) Dr. Breus recommends, “You should take it 90 minutes before lights out. Most of the melatonin out there is in an overdosage format. The appropriate dose is between 0.5 and 1 mg.” Oh, and forget about melatonin brownies. The FDA shut down that concept back in 2011 because hormones are not appropriate food additives.
Potential side effects: Fatigue, hypertension, vivid nightmares. Side effects from long-term use aren’t known. Very large doses have been tested as a contraceptive (!).
My experience: According to Dr. Breus, the 5 mg dose (which was how the pills came) I took was probably too much. I started taking it on the red-eye flight back from Hawaii, which is six hours behind New York. I slept for several hours on the plane, and then continued the melatonin for the next five days. The first three days I was up and wide awake at 2:30 a.m. By day six, I was on a normal sleep schedule. I didn’t shake the jet lag any quicker than when I travel and don’t take anything. I continued the melatonin for two days after that then quit.
How it works: It’s an herb with a mild sedative effect. The exact mechanism of action is unknown.
Science says: Per Dr. Breus, it’s one of the best-studied supplements. There are studies that show it can help decrease the time it takes to fall asleep. Adding hops (yep, the stuff in beer) seems to increase the effects of the valerian.
Potential side effects: Headaches, dizziness, itchiness, gastrointestinal disturbances.
My experience: Valerian smells disgusting, like rotten food. I choked down one 250mg capsule an hour before bed for three days. According to my Jawbone — I knew this thing would come in handy for something practical someday! — I fell asleep in eleven minutes on those nights, where previously my falling-asleep times had been in the twenties. Each morning after I took a dose, I woke up feeling nauseous and not quite right. Dr. Breus suspects the 250 mg dose was a bit high for me. But I would consider it again if I can track down a smaller-dose form.
How it works: It’s an amino acid that’s a building block for the neurotransmitter serotonin, which helps regulate mood, sleep, appetite, and stress. L-tryptophan is best known for being the reason you feel exhausted after eating Thanksgiving turkey, although studies have shown that the amount of l-tryptophan in food portions is probably not enough to make you sleepy.
Science says: Several studies suggest that it’s helpful for people who suffer from mild insomnia. The FDA recalled it in 1990 after it was linked to several deaths and 1,500 cases of a disease called eosinophilia-myalgia syndrome. The cases were ultimately traced to one Japanese factory and it was put back on the market a few years later.
Potential side effects: Heartburn, gas, nausea, headache, light-headedness, visual blurring, sexual problems (because you’re too tired?).
My experience: I had high hopes, since I’d definitely call my insomnia mild and episodic. But on two of the four nights I took it (1.5 gm per the bottle), I was wide awake until 1:30 a.m. watching Golden Girls reruns. Based on its history and side-effect profile, I can’t say I was sorry to stop it.
5-HTP (5-HYDROXYTRYPTOPHAN), $16.99
How it works: 5-HTP is also a building block of serotonin. Unlike L-tryptophan, you can’t get 5-HTP from your diet.
Science says: There are more studies of 5-HTP for depression than insomnia, but at least one showed that it helped people fall asleep more quickly, at doses of 200–400 mg. The problem is you need to stay on it for six to twelve weeks to see effects.
Potential side effects: Gas, nausea, heartburn, “serotonin syndrome” at high doses. In the late eighties, there were reports of the same eosinophilia-myalgia syndrome as L-tryptophan, but not as many.
My experience: I took 50 mg (much lower than study doses — there are warnings about higher doses) before bed, per the instructions on the bottle’s label for about five days. It didn’t help me fall asleep, but I didn’t have any side effects either. I would consider looking into this supplement on a more long-term basis, though, because there have been studies showing that it helps migraines — which I get a few times a month — and can also suppress your appetite. (My afternoon cookie habit is getting out of control.)
How it works: It’s an amino acid commonly found in green and black tea. It helps promote relaxation, so it works indirectly on sleep.
Science says: Some small studies have shown that it’s useful for decreasing anxiety. Dr. Breus has also had patients who have responded well to it.
Potential side effects: None reported, but it interacts with some chemotherapy medications.
My experience: I had the most peculiar and pleasant experience with this one. I was sitting on the couch at night with my computer on my lap and the TV on, stressed out about a deadline. About a half hour after I took it (200 mg), a sudden sense of calm came over me and I just went to bed. Same thing the second night. It’s either the best placebo ever or it really works. Either way: Zen. Also, as I was cleaning out my kitchen cabinets a few days later, I found an old tube of L-theanine I’d forgotten I had. My vet had given it to me to calm my cat down when she had a virus. So, um, yeah.
How it works: Passionflower is a flowering herb which supposedly increases levels of the neurotransmistter gamma-aminobutyric acid (GABA). More GABA equals better relaxation.
Science says: There are a few small, questionable studies that suggest passionflower can help you relax.
Potential side effects: Minimal, but rapid heart rate, nausea, and vomiting have been reported.
My experience: It’s hard to find passionflower alone — it’s often used in combination with other herbal supplements. I found a small bottle containing liquid with a dropper. I added 30 drops to some water, per the instructions, and drank. It tasted as if someone had dissolved a few tablespoons of dirt in my water. I tried it three nights in a row, and didn’t feel particularly relaxed. I’d actually go so far as to say it stressed me out more, because I went on a hunt for mints to wash out the dirt taste, and couldn’t find any. Then I noticed the bottle contained “65% to 75% grain alcohol,” and not even that did anything to help me sleep. I’d stick with a shot of tequila.
CHAMOMILE TEA, $6.25
How it works: The mechanism isn’t clear, but it promotes relaxation.
Science says: There aren’t many studies, and the results are generally inconclusive. But people swear by chamomile tea, if the chat rooms and blog posts about chamomile are any indication.
Potential side effects: Don’t drink it if you’re allergic to ragweed — chamomile and ragweed are relatives.
My experience: I like the nighttime tea ritual, and in general it helps relax me anyway, no matter what kind of herbal tea I’m drinking. But I think my expectations were so high for this particular tea, that there was no way it was going to work for me. I had two cups and it just made me need to go to the bathroom.