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By Jennifer Davis

Is the sandman eluding you? Don't turn to drugs to cure your insomnia when there are natural, nonaddictive ways to help you snooze.

By now it's 3:26 a.m. and you're awake. Wide awake. You close your eyes and try to ignore the glaring red numbers on the digital clock, but somehow they burn right through your eyelids. You turn over and will yourself into a deep slumber, but your mind races with inconsequential thoughts.

    At 4:11 a.m. you're still awake. You think you're too hot, so you throw the covers off. Then you're too cold, so you pull the blanket up to your chin and flop onto your back. You lie there long enough to see the first rays of daylight peek through the blinds, and finally, at 6:23 a.m., you fall asleep. At 6:30 a.m. your alarm shrieks.

    Though it may feel as if you're the only person tossing and turning, you're not alone. Up to 40 percent of the population suffers from insomnia every year, says Teresa Lucchesi-Cook, N.D., L.Ac., of San Diego, Calif. As many as one out of two Americans has experienced insomnia, according to a 1995 Gallup poll conducted for the National Sleep Foundation in Washington D.C. Insomnia comes in three forms. It can cause physical and emotional health problems and results from a variety of factors.

    As frustrating as nighttime sleeplessness can feel, the real problems associated with lack of sleep assert themselves in the daytime. Cook reports that people suffering from long-term insomnia have two-and-a-half times more car accidents than those who enjoy good sleep. They also demonstrate reduced productivity, have decreased cognitive abilities, suffer impaired memory and concentration, experience excessive daytime sleepiness, are more irritable, and get sick more often. Insomnia can interfere with work, relationships and simple enjoyment of life.

Shedding Light on Insomnia

So, how do you beat insomnia? The first step is identifying the type you suffer from—whether you have difficulty falling asleep (sleep onset insomnia), periodic waking throughout the night or early-morning waking (both sleep maintenance insomnia). You also need to recognize if your insomnia is transient (lasting a few nights), short-term (two to three weeks) or chronic (three or more weeks). Next, before you can beat your particular kind of insomnia, you must figure out what's causing it. Causes vary widely from person to person. 

    Sleep onset insomnia may result from anxiety, environmental change, emotional arousal, fear of insomnia, phobia of sleep, disruptive environment, pain or discomfort, caffeine or alcohol. Causes of sleep maintenance insomnia may include depression, environmental change, sleep apnea (a night-time breathing disturbance), nocturnal myoclonus (a nerve and muscular disorder characterized by involuntary muscle contraction), restless legs syndrome (an irresistible urge to move the legs about upon waking), pain or discomfort, drugs or alcohol, according to the Encyclopedia of Natural Medicine (Prima Publishing) by Michael Murray, N.D., and Joseph Pizzorno, N.D. "Insomnia may result from anything that causes discomfort, whether physical or psychological," Cook says.

    Insomnia resulting from a change in your environment (such as a new job or a move), temporary stressors (a project or assignment that will pass), or temporary pain or discomfort (such as periodic headaches, injury or postoperative pain) may disappear on its own. During such times, take extra care of your body—especially the immune system, says Cook. She recommends herbal remedies such as echinacea (Echinacea angustifolia, purpurea and pallida), goldenseal (Hydrastis canadensis) and astragalus (Astragalus membranaceous) to boost the immune system through their infection-fighting properties. According to the Encyclopedia of Natural Medicine, people who experience stress or have weakened immune systems should supplement their diet with nutrients such as zinc, vitamins C and E, beta-carotene and selenium.

    While transient and short-term insomnia often correct themselves, temporary causative factors such as stress may lead to other problems. If sleeplessness persists for longer than three weeks, seek professional help such as that of a naturopathic physician.

    "The beauty of treating insomnia with complementary therapies is that the treatment can be specific," Cook says. "You have a more individual diagnosis," she continues. Generally, naturopathic diagnosis of insomnia follows a lengthy interview process, exploring all facets of a person's life, and a complete physical exam to get to the source of the problem, says Cook. She examines issues such as relationships; work, school or home pressures; substance abuse and medications; physical discomfort, illness or hormonal disorders; psychological disorders; diet; past and present traumas; and the patterns of sleeplessness. Based on the individual's needs, Cook recommends a tailor-made botanical formula, exercise, diet, body work, psychotherapy and even bright light therapy to regulate circadian body rhythms—the body's mechanism to regulate sleeping and waking tendencies with respect to daylight and nighttime.

    "In comparison, conventional medicine has very little to offer besides sedative and hypnotic medications," Cook says. In fact, as many as 10 million people in the United States receive prescription drugs to aid sleep every year, reports the American Journal of Natural Medicine (May 1995). While these medications may promote sleep, they're often of inferior quality and followed by "morning hangover." In addition, many drugs can be physically and emotionally addictive. 

    For example, benzodiazepine drugs such as Halcion and Valium aid sleep by blocking arousal of brain centers. They disrupt normal sleep by suppressing REM (rapid eye movement) sleep. Yet, REM is the period when the body undergoes repair and rejuvenation. Without enough REM sleep, an individual awakes unrefreshed. Benzodiazepines are addictive and associated with serious side effects such as impaired memory and coordination.

Natural Remedies

In her practice Cook uses homeopathic and Chinese remedies to treat the causes of insomnia. "The remedies vary just as people do," says Cook. She feels that the most significant cause of insomnia is lack of time to rest, and her remedies reflect that. "People are constantly rushing, trying to accomplish as much as they can in as short a time as possible. They forget that their bodies need time to recuperate," she says.

    When people overwork their bodies, they experience excess tension, which disrupts sleep and overloads and depletes their nervous systems. In turn, this tension leads to a state of deficiency in which the body's systems are depleted and unable to function properly. In response to this, Cook concurrently treats the sleeplessness while she tries to heal the whole body. "When a person's health is restored constitutionally, good sleep will come naturally. But, that takes time. Meanwhile it's important to aid sleep," she explains.

    To treat excess tension and to promote sleep, Cook advises her patients use herbs such as valerian (Valeriana officinalis) ,which acts as a sedative. Studies report that valerian's valepotriates and valeric acid bind to the same brain receptors as Valium does, but without inducing the same side effects such as morning hangover, addiction and decreased mental abilities (American Journal of Natural Medicine, May 1995). Although their names sound similar, valerian and Valium are unrelated.

    Passionflower (Passiflora incarnata) also demonstrates sedative properties and has been used to treat insomnia, tension and hyperactivity, according to Rodale's Illustrated Encyclopedia of Herbs (Rodale Press). Chamomile (Chamaemelum nobile) treats tension and restlessness. 

    When systems have become depleted from tension overload, Cook chooses trophorestorative herbs (herbs to restore nourishment) such as scullcap, oats, St. John's wort, verbena and hops. These herbs restore strength to the body's systems in efforts to improve their ability to handle stress naturally. Scullcap (Scutellaria laterifolia) acts as a central nervous relaxant and restorative to ease nervous tension. Oats (Avena saliva) also restores the entire nervous system. St. John's wort (Hypericum perforatum) is often used in restorative tonics to treat anxiety that has lasted long enough to contribute to depression or fatigue. Verbena (Verbina officinalis) is used to calm states of debility such as nervous exhaustion. Hops (Humulus lupulus) acts as a sedative and relaxes smooth (involuntary) muscle but should be avoided in cases of depression, according to The Dictionary of Modern Herbalism (Healing Arts Press).

    Although botanical remedies are often safer than prescription medications such as benzodiazepines, Cook doesn't recommend them for long-term use. "The goal should be to achieve truly unmedicated restful sleep," she says. To do that, the cause of your insomnia must be discovered and treated. "I may give patients valerian or scullcap to help them sleep, but at the same time, I will try to uncover and treat the deeper problem," Cook says. She explains that any medical assistance given to an individual suffering from insomnia will eventually generate dependence. "People worry about not being able to sleep without their tincture, drug or tea," she says.

    Cook stresses the importance of remembering that insomnia may signify a more serious problem than irritating sleeplessness. "Insomnia is a symptom," she says. Persistent anxiety and chronic headaches in conjunction with insomnia may signify a serious, underlying mental health problem such as depression. "In 60 percent of patients with chronic insomnia, symptoms are secondary to psychiatric illness. Depression is the most common diagnosis. In addition, depression eventually develops in a majority of patients with chronic insomnia," reports Cook, citing American Family Physician (May 1993).

    In addition to professional health care, you can take steps yourself to promote healthier, quality sleep. According to the Encyclopedia of Natural Medicine, supplements such as niacin, vitamin B₆ and magnesium taken 45-minutes before bed may encourage sleep.

    Some health practitioners also recommend supplemental melatonin to promote sleep. Naturally produced in the brain's pineal gland, melatonin regulates the internal clock. While sunlight inhibits the production of melatonin, dusk stimulates it promoting rest. As we age the body apparently becomes less able to produce melatonin resulting in the need for supplementation. However, The National Nutritional Food Association, a supplements industry advocacy group, recommends that adults younger that 40 not take melatonin on a regular basis and that children never use it. They suggest seeking a health practitioner's advice before using melatonin if you're pregnant, lactating, have an autoimmune disorder, suffer from depression or have diabetes or other endocrine disorder. Some natural products companies offer products they claim contain a natural melatonin precursor that helps your body produce more melatonin only when needed. Your doctor may be able to recommend one.

    In addition to supplementation, Cook recommends going to bed and getting up at the same time each day and discourages stimulating activity such as watching TV before bed. "If you've been awake in bed for longer than half an hour, get up," Cook advises. "But don't do anything that will stimulate you." She also recommends keeping the bedroom dark and the temperature comfortably cool and constant. A light snack? Not a heavy meal or anything containing caffeine, may also promote sleep. Foods such as bananas, which contain the amino acid tryptophan, may be helpful.Sweet dreams.

Homeopathy for Sleepless Nights

Teresa Lucchesi-Cook, N.D., L.Ac., recommends the following homeopathic remedies to treat sleeplessness lasting just a few nights. This information should not be taken as medical advice.

Arsenicum album

Eases restlessness resulting from fear, worry or anxiety, especially when sleeplessness is worse before midnight. The arsenicum patient prefers to have the head raised with pillows and may suffer from asthma during the night.

Coffea Cruda

Homeopathic coffee promotes sleep in the individual who has an active mind and has too many excited thoughts and dreams. This person typically wakes at 3 a.m. and can't sleep further or only dozes periodically. Coffea is useful in cases of menopausal insomnia.

Nux Vomica

Soothes mental strain that leads to insomnia and aids the person who has unrefreshing sleep after menses, wakes between midnight and 3 a.m., can't sleep after consuming caffeine, suffers from constipation or sour stomach, or awakes with "morning hangover." 

Pulsatilla

Eases sleeplessness accompanied by internal heat or twitching of the limbs. Pulsatilla is for the individual whose mind races with the same thoughts over and over, feels sleepy in the afternoon, sleeps with the hands over the head, is suffering PMS, or is moody, weepy and irritable.

Reprinted with permission from the March 1997 issue of Delicious! Magazine, a publication of New Hope Communications, Boulder, CO.