Sleep aids

Over-the-counter products are short-term solutions, but there are other ways to improve sleep.
 
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  • Updated:9 Jan 2005
 

03.Complementary medicines

We shopped around and found 15 different products consisting of preparations that contained:

  • solely valerian (five)
  • valerian and magnesium (one)
  • valerian and other herbs (six).

Only three preparations didn’t contain valerian.

Of all of the popular herbal sedatives, valerian has undergone the most clinical trials to try to establish its effectiveness and safety as a treatment for insomnia. It also has a very long tradition of use as a medicinal herb.

Although some of the clinical trials showed possible benefits of valerian as a treatment for insomnia, results were contradictory and therefore inconclusive.

Preliminary findings suggest valerian may improve sleep for children with intellectual disabilities, who commonly suffer from sleeping difficulties, but again more research is needed.

Valerian

According to the labels of our valerian preparations they contained between 86 and 2500 milligrams of valerian per tablet or capsule. Those that contained less than 1800 mg in each tablet recommended taking two or more at a time, usually 30 to 60 minutes before bed. In clinical trials, doses of valerian root extract to treat insomnia ranged from 300 to 900 mg, administered half-an-hour to an hour before bed. But in the products we purchased, the recommended dose of valerian ranged from 258 to 4000 mg — a huge variation between brands.

Valerian is also described as “standardised” on many of the labels, but according to Australia’s medicine regulatory body, the Therapeutic Goods Administration (TGA), there’s no definition of the term “standardised” in the legislation.

Although valerian seems to be generally benign, there have been rare reports of liver damage. Stomach upset, headache and vivid dreams are some other rarely reported side effects. Valerian shouldn’t be used during pregnancy or breastfeeding as its safety for such users hasn’t been established — one of the active ingredients in valerian has been shown to be able to cause DNA changes in cells. While risk of cell damage is probably low, it may not be something you’d want to use regularly.

There’s also evidence valerian might take a couple of weeks to become effective, by which time the insomnia might have disappeared anyway.

In conclusion, while it does seem that valerian has potential as a sleep aid, most experts agree that further trials need to be carried out to find out more about this herb and its effects.

Other herbal aids

The remaining complementary preparations we bought contained a variety of herbs including passionflower, hops and chamomile. These herbs, while traditionally used to treat anxiety and sleeplessness, have limited or no clinical trials to support their safety and efficacy as sleep aids.

Some of the products also contained vitamins and minerals such as calcium, magnesium, vitamin B6 and vitamin K. We couldn’t find any evidence to say the small amounts in these preparations would induce relaxation or sleep.

Most of the products claimed to relieve or help relieve insomnia and sleeplessness, although a product distributed by NUTRA-LIFE claimed to “help calm and reduce nervousness and aid relaxation, particularly in cases of sleep disorders”.

We contacted the manufacturers to ask for supporting evidence. Out of 10 companies, we heard back from five: NUTRA-LIFE, BRAUER, BLACKMORES, CARLSON HEALTH and IPA (distributor of SOUL PATTINSON goods), but none added anything significant to the limited evidence we could find for the ingredients. However, all the complementary products are listed with the Therapeutic Goods Administration (TGA), which means they contain well-established ingredients used for a long time and are considered by the TGA to be low-risk.

It’s worth noting that even with low-risk medicines, there can be rare cases of adverse effects. For instance, an Australian woman was hospitalised after a severe reaction to passionflower. There have also been reports of liver damage from use of preparations containing American skullcap, which we found in one preparation. While rare, these cases are a reminder to be careful when using herbal preparations.

Always let your doctor know if you’re taking any kind of over-the-counter complementary medicine. Herbal preparations, like other drugs, can modify chemical processes in the body and interact with other medications. As CHOICE has often noted, the problem with herbal remedies is that ‘herbal’ sounds safe, but they’re not tested in the same way as other medications.

 

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