The Big Sleep

Vegetarian Times, Dec, 1998 by Martha Schindler

Twelve herbs that can gently ease you into dreamland.

Insomnia is an affliction that, like motion sickness, mystifies those who've never had it. "I don't know what you're talking about," said a friend recently when I tried to explain the dark circles under my eyes with a tale of my on-again, off-again insomnia, which (sadly) was on again. "I fall asleep the minute my head touches the pillow." Lucky her. "Insonmia. Isn't that the sign of a guilty conscience?" another friend joked.

To anyone who's ever spent precious dreamtime channel surfing through late-night infomercials while dreading the next day's exhuastion, insomnia is no laughing matter. Chronic insomnia, characterized by difficulty falling asleep, frequent waking in the night, the inability to fall back asleep, or waking too early in the morning, plagues 67 percent of Americans. According to a 1998 poll conducted by the National Sleep Foundation in Washington, D.C., 37 percent of those surveyed admitted that they're so sleepy during the day, they have trouble functioning.

The news gets worse: Chronic insomnia can result in mood swings, lack of coordination, frazzled nerves, impaired mental functioning and a decreased ability to fend off infections. It can even be life-threatening. According to a report published in the journal Sleep (July 1996), chronic insomniacs are 2.5 times more likely to be involved in car crashes than people who routinely get enough sleep. In fact, the National Highway Traffic Safety Administration estimates that at least 100,000 auto accidents each year are caused by driver fatigue. "Sleep deprivation," says Nancy Russell, M.D., a holistic practitioner of internal medicine in Kansas City, Mo., "is one of the most critical issues facing our society."

Everyone differs in the amount of sleep they require--some folks need nine hours, others get by just fine on four--so scientists don't have any hard-and-fast criteria about what makes an insomniac. But according to Peter Hauri, Ph.D., director of the Mayo Clinic's Sleep Disorder Center in Rochester, Minn., it's not how long you sleep, but how well. If you wake up feeling refreshed after just a few hours of shut-eye and can function during the day, don't worry. If you're regularly fuzzy-headed, even after a solid eight hours, you may have insomnia.

Insomnia can last a few days, a few months or several years. It can come and go. And while anyone can have an off night, persistent insomnia is more common in women. Although sleep researchers don't completely understand insomnia's mechanisms, they believe fluctuating levels of the hormones estrogen and progesterone play a part. "It is absolutely certain that one of the underlying causes of insomnia is the changes in hormonal activity that take place during the premenstrual period or around menopause," says Gary Zammit, Ph.D., director of the Sleep Disorders Institute in New York City. "Sometimes treating the hormonal problem can result in dramatic improvement in sleep."

Experts also believe that close to half of all cases of sleeplessness stem from emotional or physical stress--anxiety about work or family issues, pain, depression, sleep apnea (in which one stops breathing while asleep), mild irritations like jet lag, an uncomfortable bed and a snoring bed mate. "Stress is the most commonly reported underlying cause of insomnia," says Zammit.

Over-the-counter (OTC) and prescription medications also keep the Sandman at bay. These drugs often contain stimulants, such as caffeine, and have side effects, including morning-after "hangovers."

An occasional night of restless tossing and turning is no cause for concern. But if the problem persists for more than a month and strikes more nights than not, Russell advises consulting a health-care professional. An alternative medical doctor will look for physical (and stress-related) causes; a therapist can help identify emotional blocks to sound slumber. You can also check out one of the country's certified sleep disorder centers (see Resources, p. 17). "It's very important to figure out what's causing the problem instead of just trying to get rid of the symptoms," says Russell.

HERBAL HELPERS

For once-in-a-blue-moon insomnia, Russell recommends herbal preparations. "As a holistic physician, I'm always concerned that herbs not be a substitute for pharmaceutical drugs," she says. "There's usually some trigger for insomnia, and unless you identify it, you can take all the herbs you like, and they won't really help."

But when combined with dietary changes, regular exercise, stress management and relaxation techniques, Russell says herbs are just as effective as many OTC and prescription sleep aids, without the side effects. Tinctures and extracts, with their alcohol base, are the speediest and most potent form of delivery. Take them straight or mix them in water or juice. Herbal teas are weaker but still soothing--perfect when you need to relax, not conk out. The herbs listed here are safe, but pay attention to our caveats. Although we provide dosage guidelines, read label instructions also because the products vary in quality and strength.