A health treatment that is not classified as standard western medical practice is referred to as "alternative." Alternative therapy encompasses a variety of disciplines that include everything from diet and exercise to mental conditioning and lifestyle changes. Examples of alternative therapies include acupuncture, guided imagery, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage and many others.

Complementary medicine is essentially alternative medicine that is taken along with conventional treatments.

Some complementary and alternative therapies used to treat insomnia include supplements, acupuncture, relaxation and meditation, and exercise.

Supplements

Herbs

The effects of the root of valerian (Valeriana officinalis) on sleep have been examined in people with sleep problems. Some studies have suggested that valerian helps with the onset of sleep and with sleep maintenance. In one study, valerian extract was found to be as effective as the antianxiety drug Serax in patients with insomnia. However, more research is needed before a final conclusion can be made about the safety and effectiveness of valerian for insomnia.

Chamomile is another commonly used herb for the treatment of insomnia. The FDA considers chamomile to be safe and the herb has no known adverse effects.

Other herbs promoted as effective sleep remedies include passionflower, hops, ginseng, lemon balm and skullcap. The German government has approved certain herbs (valerian, hops and lemon balm) for the relief of sleep problems. However, clinical studies to evaluate the effectiveness and safety of herbs are scarce. More information is required before these herbs can be recommended as a first line of treatment against insomnia.

Since herbal supplements can interact with certain medications, always inform your health care provider if you are using any herbal supplements.

Melatonin

Melatonin is a hormone that is synthesized by the pineal gland in humans and produced in animals as well as plants. Although the effects of melatonin are complex and poorly understood, it plays a critical role in the regulation of sleep-wake cycle and other circadian rhythms. Melatonin has been studied as a possible treatment of circadian rhythm disorders and may be helpful in decreasing sleep disturbances caused by jet lag.

Adverse effects of melatonin are minimal, but long-term studies examining efficacy and toxicity of melatonin supplements are needed.

Acupuncture

Acupuncture is often used in Traditional Chinese Medicine for the treatment of insomnia. This procedure involves the insertion of very fine needles (sometimes in combination with electrical stimulus or with heat produced by burning specific herbs) into the skin at specific acupuncture points in order to influence the functioning of the body. The results of recent preliminary clinical trials of acupuncture have indicated improvements in sleep quality in people with insomnia. However, additional research is required before the effectiveness of acupuncture is proved conclusively for the relief of insomnia.

Relaxation and Meditation

Increased muscle tension and intrusive thoughts interfere with sleep. Therefore, it is not surprising that techniques aimed at relaxing muscles (progressive muscle relaxation and biofeedback) and quieting the mind (meditation) have been found to be effective treatments for insomnia. Most people can learn these techniques, but it usually takes several weeks before they can sufficiently master the techniques well enough to help ease insomnia. There is a growing body of evidence that supports the value of meditation in treating insomnia. Several studies show that regular meditation practice, either alone or as a part of Yoga practice, results in higher blood levels of melatonin, an important regulator of sleep.

Exercise

Regular exercise deepens sleep in young adults with or without sleep disorders. In addition, several studies show that exercise can improve sleep in older adults. Recent studies show that even the low-to-moderate Tai Chi and Tibetan Yoga practices enhance sleep quality in older persons and cancer patients with sleep problems, respectively.

Points to Consider

Alternative therapies are not always benign. As mentioned, some herbal therapies can interact with other medications you may be taking. Consider the following points before starting alternative therapy.

Always talk to your doctor before trying an alternative approach and be sure to tell all your doctors what alternative treatments you are using.
If you experience side effects such as nausea, vomiting, rapid heartbeat, anxiety, diarrhea or skin rashes, stop taking the herbal product and notify your doctor immediately.
Avoid preparations made with more than one herb.
Beware of commercial claims of what herbal products can do. Look for scientific-based sources of information.
Select brands carefully. Only purchase brands that list the herb's common and scientific name, the name and address of the manufacturer, a batch and lot number, expiration date, dosage guidelines and potential side effects.

Reviewed by The Sleep Medicine Center at The Cleveland Clinic.

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