Various herbal and alternative therapies are also used in the treatment of insomnia.1 These include:
The available clinical data suggest minimal to no efficacy for the majority of these agents in the treatment of insomnia, and there is little data supporting safety.2 The herbal and alternative agents outlined previously can be purchased from health food shops and from the Internet. However, since these products are not regulated and there is no obligation for the manufacturers to monitor the safety of their products, the content and purity of each may vary. Whilst there are no reported specific safety issues associated with long-term use of some of these products, their unregulated long-term use does pose safety concerns for others. For example, valerian-based remedies have been associated with hepatotoxicity.1
Amongst ‘alternative’ therapies, alcohol is well known for its sedative properties, and is a common resort for those who self-medicate.3 However, in addition to the risks of dependence and tolerance, alcohol is also associated with increased numbers of night-time awakenings, disrupted sleep stages, and higher levels of daytime sleepiness. 3,4 These unfavourable outcomes may be due to the short half-life of alcohol, which results in an effect that quickly dissipates.
References:
1. Wheatley D. Medicinal plants for insomnia: a review of their pharmacology, efficacy and tolerability. J Psychopharmacol 2005; 19 (4): 414–421.
2. National Institute of Health. NIH State of the Science Conference statement on manifestations and management of chronic insomnia in adults statement. J Clin Sleep Med 2005; 1 (4): 412–421.
3.Roth T, Stubbs C, Walsh JK. Ramelteon (TAK-375), a selective MT1/MT2- receptor agonist, reduces latency to persistent sleep in a model of transient insomnia related to a novel sleep environment. Sleep 2005; 28 (3): 303–307.
4. Roth T, Roehrs T, Zorick F, Conway W. Pharmacological effects of sedative-hypnotics, narcotic analgesics, and alcohol during sleep. Med Clin North Am 1985; 69 (6): 1281–1288.