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Steven Y Park, MD  
Male, 54
New York, NY

Specialties: Sleep-breathing disorders

Interests: Running, Baking, origami
Private Practice
New York, NY
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The Truth About Sleeping Pills, Herbs, and Natural Remedies

Jun 10, 2010 - 0 comments

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You’ve been tossing and turning for the past two hours, and you need to get a good night’s sleep in preparation for that important presentation in the morning. Insomnia is a common condition that almost everyone has suffered from at one time or another, but for some people, it can be not only a major quality of life issue, but a source of potentially serious medical problem as well. Recent studies have shown that people who sleep less than 5 hours or longer than 9 hours have a much higher chance of suffering from depression, diabetes and heart disease. Lack of sleep also has been shown to promote weight gain.

It’s estimated that up to 50% of people suffer from insomnia occasionally, and about 10% have chronic insomnia. There are a lot of reasons that can cause insomnia, from stress to medical conditions to external factors such as excessive noise. Yet, the most conditioned response from people whenever they can’t fall asleep is to take a sleeping pill. Unfortunately, this is not the best solution for most people.

In Search of the Best Sleep Remedy

Prescriptions for sleeping pills are at record volumes (56 million in 2008). In times of either emotional or financial stress, symptoms of insomnia rise, and so do prescriptions for sleeping pills. But how effective are they? A recent study funded by the National Institutes of Health (NIH) in 2005 showed that sleeping pills decreased the time it took to fall asleep by 18 minutes, and increased total sleep time by 28 minutes per night, on average. Pharmaceutical company funded studies show much more optimistic results, but there’s definitely a wide range of opinions within the sleep community regarding effectiveness of prescription sleep aids. Not to mention the various known side effects such as daytime drowsiness, sleep walking and sleep eating. Also, as with many studies, many people in the placebo arm also had significantly improved results.

In my experience with patients, sleeping pills are a hit or miss. The results vary depending on the individual. It’s safe to say that some people are much more susceptible than others without very many side effects. The same goes for the various natural supplements, herbs and remedies that are recommended, such as warm milk, L-theanine, valerian and melatonin. Regardless of whether or not there’s scientific evidence over which one works or doesn’t work, if it works for you, you can keep taking it, as long as there are no major side effects. Preferably, you should take a non-prescription medication, as they tend to have less side effects. The one exception is the over the counter sleep aid ingredient, diphenhydramine, which is the main ingredient in Benadryl. It’s also included alone or in combination with many other brand names. This ingredient is a strong antihistamine (used for allergies) that also can make you drowsy. Some elderly who use it have experienced  mental status changes as well as other various side effects.

There have been many studies using melatonin. Melatonin is a natural hormone that your body produces more of as you fall asleep. Darkness causes melatonin to increase and sunlight stimulates receptors in your eyes that cause it to drop. Results for the use of melatonin as a sleep aid have generally been positive, but somewhat conflicting. Ramelteon is a recently introduced melatonin-like chemical that stimulates melatonin receptors in the brain. Results show that, in general, although it does help, it’s not as effective the standard sleep aids.

Another recent study showed that valerian was not better than placebo in treating insomnia. This contradicts a number of my patients that swear by valerian. Again, studies report statistical averages, which lumps together people who respond with people that don’t.

Simple Steps to Resolve Insomnia

For most people, practicing routine beneficial sleep habits is all you’ll need to avoid taking pills or medications. Setting aside at least 30 minutes to wind down and do something relaxing is one way. Avoiding anything stimulating (such as playing video games, surfing the internet, checking email, or even exercising) can help you fall asleep faster.

Everyone has different sleep needs, so don’t stress if you can’t get 8 hours of sleep. People need anywhere from 6-8 hours of sleep to function normally. It’s also important to get out of bed within 30 minutes every morning, even on the weekends. Try to get outdoors and get exposed to sunlight. This helps to strengthen your sleep clock.

If you’re not drowsy within 30 minutes of getting into bed, get out and do something that’s quiet and relaxing, until you feel drowsy. Try to reduce the total time in bed to match the total time you actually sleep. If you’re tired during the day, try taking a short nap in the mid to late afternoon.

Try practicing relaxation techniques and breathing exercises such as meditation or yoga, especially before going to bed. Use the bed for sleep and sex only—don’t read, watch TV, or work on your computer while in bed.

Lastly, don’t exercise too close to bedtime. Leave about 2-3 hours after exercising before going to bed. Elevation of core body temperature will keep you from falling asleep. As body temperature drops, you’ll feel more drowsy.

Various practitioners will tout one natural herb or supplement as being helpful for insomnia, but as I’ve pointed out previously, not everyone will benefit significantly. However, even if it works, as long as you’re not treating what’s causing your insomnia, it’s definitely going to come back. In some cases, there may be an underlying medical condition that could be presenting as insomnia. Many people with insomnia, for instance, actually have obstructive sleep apnea.  That’s why taking a pill, although it seems like the path of least resistance, will only worsen the situation in the long run.

If you currently rely on sleeping pills every night to help you fall asleep, or you feel tired and lethargic no matter what steps you take, then it’s time to see a doctor about your insomnia problem.

Steven Y. Park, MD  is a surgeon and author of the book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. Endorsed by New York Times best-selling authors Christiane Northrup, M.D., Dean Ornish, M.D., Mark Liponis, M.D., Mary Shomon, and many others. http://doctorstevenpark.com

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