By Dr. Terry Vanderheyden, ND, RH
Adequate and restorative sleep is fundamental to health. Note that slow-wave sleep (deep sleep) is especially essential for mental and emotional well-being and for proper immune function.
The Canadian Sleep Society reports that about 10% of the adult population in Canada experiences persistent insomnia, while an additional 20%-25% experience occasional sleeplessness. The symptoms suffered by poor sleepers are broad and debilitating and include fatigue, inability to maintain focus and concentration, poor memory, mood disturbance, daytime sleepiness, low motivation or energy, and proneness to errors and accidents. Also, research suggests that there is a correlation between insomnia and other more serious health risks, including anxiety disorders and other psychological problems, as well as hypertension, obesity, and decreased immune function.
Roll Over, Big Pharma
It’s A Wasteland Of Pharmaceutical Hypnotics
Benzodiazepines may still have a limited use in medicine; let’s face it, though – routine prescribing of these for insomnia is no longer a good idea. We now know, for example, that they carry a risk for dementia. Pooled hazard ratios for dementia risk suggest the association to be about 1.5, while a 2015 systematic review and meta-analysis of studies noted that users of hypnotics or anxiolytics had a 43% higher chance of dying than non-users. These medications may also raise the risk for cancer. Although the same analysis also revealed a 73% increased risk of mortality from Z-drugs, the findings did not reach statistical significance. Note that the use of hypnotics does not increase deep sleep (slow-wave sleep), but rather lowers it, while increasing the quantity of light sleep.
Valerian: A Better Solution
Because adequate slow-wave sleep is essential to health and, as shown above, pharmaceutical hypnotics decrease it, what is to be done?
Several studies present compelling evidence of the effectiveness of valerian in the treatment of insomnia. These include a 6 week clinical trial with 202 patients suffering from insomnia for an average of 3.5 months. This trial found valerian and the benzodiazepine, oxazepam, to be equally efficacious at enhancing sleep quality. Both treatments increased duration of sleep, dream recall, degree of refreshment after sleep, and evenness of temper and calmness in the evening, as well as mitigating mental exhaustion before sleep. Valerian was also shown to significantly increase the amount of slow-wave sleep in another pilot study with 16 subjects, administered 600mg each evening, for a 2-week period. Finally, a clinical trial in 27 poor sleepers was conducted that demonstrated the superiority of a combination of valerian, hops and lemon balm, but only when valerian was present at 400mg versus 4mg, while the content of hops and lemon balm stayed constant between products. The authors noted that 89% reported improved sleep, while 44% said they experienced “perfect sleep” after use of the combination containing 400mg.
It is thought that valerian’s mechanism of action is through GABA neurotransmitters, which regulate motor function, vision, and other cortical activities, as well as controlling anxiety.
Sleep And The HPA Connection
Optimal hypothalamus, pituitary, and adrenal (“HPA axis”) health also underlies adequate and restorative sleep. HPA axis dysregulation often manifests with cortisol abnormalities. With its diurnal pattern out of sync, the normal pattern of highest cortisol after waking and lowest levels at or about midnight can be lost; this in turn disrupts normal sleep patterns. Cortisol dysregulation creates a vicious cycle that contributes to poor sleep, thus reinforcing the HPA dysfunction.
When it comes to reversing HPA imbalance, the next best thing to moving to Bora Bora is adaptogen use. Rhodiola is one such herb that has been shown to lower elevated circulating levels, as has ashwagandha. Ashwagandha has dual adrenal restorative and mental sedative properties, making it ideal for those with insomnia, and appropriate even for use at bedtime. Ashwagandha is also restorative to sex hormones and is thus excellent for the aged. Stress-relieving properties, including a normalization of serum cortisol level, were noted in two human clinical trials, one of which also demonstrated significant relief of anxiety.
Meanwhile, rhodiola is an excellent mood stabilizer and energizer, best for those with fatigue and depression. It should be taken mornings and, at latest, midafternoon so as not to disrupt sleep.
All in all, botanical medicines like valerian, rhodiola, and ashwagandha are important allies in the fight to restore healthy sleep and improve adrenal and HPA balance.
Fully referenced footnotes available on request.
Who is it for
Over 10% of Canadians claim to suffer from some form of insomnia or sleep disturbances.
How it helps
St. Francis Herb Farm has used the valerian herb in both our Valericalm herbal tincture and new capsule to help Canadians sleep better naturally.
. J Psychopharmacol 2005 19: 414.
. Canadian Sleep Society
. Behavioural Sleep Medicine2003; 1(4): 227-47.
. BMJ 2012; 345:e6231.
. Australian and New Zealand Journal of Psychiatry2016 June; 50(6): 520-33.
. Cf. note 7
. Cf. note 1
. Alternative Medicine Review2004; 9(4): 438-441.
. European Journal of Medical Research 2002;7(11):480-6.
. Pharmacopsychiatry2000; 33: 47-53.
. Pharmacol Biochem Behav 1989; 32(4): 1065-1066.
. Frontiers in Pharmacology2017 February; 8(96): 1-7.
. Curr Clin Pharmacol. 2009;4(3):198-219.
. Cf. note 15.
. Indian J Psychol Med 2012; 255-262.
. J Am Nutraceutical Assoc2008; 11: 50
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