Sleep and Alternative Medicine: I



Nervousness, trembling, headaches, heart palpitations, gastrointestinal spasms and distress, epileptic seizures, and attention-deficit hyperactive disorder, during menopause


Nervous tension

Skull cap, valerian


St. John’s wort

Sleep apnea



Passion flower, lime blossom, linden, arsenicum

Nervous exhaustion


Overactive mind


Muscle cramps

Passion flower

During menopause

Valerian, lemon balm

HTN on beta–blockers


Jet lag



Dragon bones, magnetite

Alcohol or substance-related sleeplessness

Nux Vomica

Emotional upset


Mental stress, aches, and pains


Talking and laughing during sleep



Acupuncture, acupressure, reflexology, chiropractic, biofeedback

Mental stress

Yoga, tai chi, exercise, biofeedback

Muscle tension

Massage, biofeedback, yoga

Circadian rhythm disorders

Melatonin, light/dark therapy

Other herbal remedies that are helpful in relieving insomnia include [23]:

  • catnip (Nepeta cataria): poor sleep

  • chrysanthemum (Chrysanthemum morifolium): insomnia

  • hops (Humulus lupulus): overactive mind

  • lime blossom (Tilia cordata): anxiety

  • linden (Tilia species): anxiety

  • oats (Avena sativa): poor sleep and nervous exhaustion

  • passionflower (Passiflora incarnata): anxiety and muscle cramps

  • skullcap (Scutellaria lateriflora): nervous tension

  • squawvine (Mitchella repens): insomnia

  • St. John’s wort (Hypericum perforatum): depression

  • vervain (Verbena officinalis): nervous tension, sleep apnea

Dietary supplements such as Vitamins B6, B12, and D, and Calcium and magnesium may also be helpful.

Melatonin is a naturally occurring hormone associated with sleep. According to a recent randomized controlled study, melatonin supplements may help improve sleep in people with high blood pressure (hypertension) who take beta-blockers [10]. Beta-blockers are prescribed to treat a number of health problems and are the most commonly prescribed class of drugs for hypertension. However, frequent side effects of these drugs are difficulty sleeping and daytime fatigue, which may result from their suppression of melatonin; a hormone that promotes sleep. Since beta-blockers are taken typically for life in these patients, melatonin supplements would be highly beneficial [11, 12]. However, larger effects of melatonin are observed in patients whose sleep problems are caused by a circadian rhythm abnormality (disruption of the body’s internal “clock”) and may be helpful in decreasing sleep disturbance caused by jet lag. Dietary supplements containing melatonin “precursors”—ltryptophan and 5-hydroxytryptophan (5HTP)—are also used as sleep aids. (The amino acid l-tryptophan is converted to 5-HTP, which is converted to serotonin and then melatonin.) However, these supplements have not been proven effective in treating insomnia, and there are concerns that they may be linked to eosinophilia–myalgia syndrome (EMS), a complex and debilitating systemic condition with multiple symptoms including severe muscle pain.

Practitioners of traditional Chinese medicine usually treat insomnia as a symptom of excess yang (positive) energy. Either magnetite or “dragon bones” are recommended for insomnia associated with hysteria or fear.

Dietary factors: It has been proved that intake of some nutrients is associated with sleep problems [13]. Those nutrients include alpha-carotene, selenium, dodecanoic acid, calcium and hexadecanoic acid, salt (OR = 1.19), butanoic acid, carbohydrate, vitamin D, lycopene, hexanoic acid, vitamin C (OR = 0.92), cholesterol, moisture, theobromine, and potassium. Avoiding taking these nutrients in excess may be beneficial. Some naturopaths recommend Vitamins B6, B12, and D for the relief of insomnia. Calcium and magnesium are natural sedatives, which help to explain the traditional folk recommendation of drinking a glass of warm milk at bedtime. Tryptophan may relieve insomnia; as turkey is high in tryptophan, a turkey sandwich as a bedtime snack may be helpful. Melatonin is widely used to induce sleep although adequate studies of its effectiveness are lacking [14].

  1. 2.

    Manipulative and Body-Based Methods based on manipulation and/or movement of one or more parts of the body.


Acupuncture is a traditional Chinese medicine which is shown to have improved the sleep quality. 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 [15, 16].

Acupressure: Acupressure involves stimulating the same points as in acupuncture, but by using finger pressure rather than inserting needles. Acupressure is used in various disorders and painful conditions. The pressure points on both heels, the base of the head, forehead part in between the eyebrows, and on the inner side of the wrists can be used to relieve sleeplessness. It can be performed by lay people and so it is easily and economically accessible. Acupressure therapy can also be used to improve fatigue, stress, and sexual dysfunction and to enhance the immune system.

Reflexology: Reflexology is a form of touch therapy in which pain is relieved by stimulating certain pressure points on the feet and hands. Reflexologists work from maps of certain pressure points that are located on the hands and feet. These pressure points are believed to connect directly through the nervous system, affecting the body’s organs and glands. The reflexologist manipulates the pressure points according to specific techniques of reflexology therapy. By means of this touch therapy, any part of the body that is the source of pain, illness, or potential debility can be strengthened through the application of pressure at the respective foot or hand location. The use of the reflexology points for the diaphragm, pancreas, ovary/testicle, pituitary, parathyroid, thyroid, and adrenal gland helps to relieve insomnia. However there is no clear evidence of its role in insomnia [17].

Chiropractic is also a kind of holistic medicine. Chiropractic is derived from Greek words meaning done by hand. It is grounded in the principle that the body can heal itself when the skeletal system is correctly aligned and the nervous system is functioning properly. To achieve this, the practitioner uses his or her hands or an adjusting tool to perform specific manipulations of the vertebrae. Chiropractic care includes adjustments, massage, and physical therapy that can all be beneficial to aid with sleep problems. Spinal manipulation can reduce stress upon the nervous system, thus allowing relaxation. Further studies are needed to prove its efficacy as minimal evidence is available [18].

Exercise: Physical activity [19] has been shown to have beneficial effects on sleep in the general population. Results of the study by Andrews et al. [19] in patients with chronic pain suggest engagement in high intensity activity and high fluctuations in activity is associated with poorer sleep at night; hence, activity modulation may be a key treatment strategy to address sleep complaints in individuals with chronic pain. Regular exercise [20, 21] deepens sleep in young adults with or without sleep disorders.

Massage. Therapeutic massage can relieve the muscular tension associated with chronic insomnia.

  1. 3.

    Alternative medical system: This mode of treatment is used in place of conventional medicine which includes ayurvedic medicine, homeopathy, naturopathy, and traditional Chinese Medicine (TCM). Ayurvedic medicine [22] is a practice of holistic medicine from India that is based on bringing humans into harmony with nature. It provides guidance regarding diet and lifestyle, to enhance health and improve disease. Therapies include diet, herbal, visual, and audio therapies, aroma therapy, and meditation. Ayurvedic treatments for insomnia or nightmares include scalp and soles massage with essential oils such as sesame, brahmi, a warm bath, or a nutmeg paste applied to the forehead. Tranquility tea (jatamansi, brahmi, ginkgo, and licorice root), and yoga are also found to be helpful. Sleep apnea is treated by avoiding sleeping on the back, using a humidifier for ambient air, and using nose drops with warm brahmi ghee (clarified butter) [23].


Homeopathy is a system for treating disease based on the administration of minute doses of a drug that in massive amounts produces symptoms in healthy persons similar to those of the disease. Homeopathic remedies are chosen according to the specific causes of insomnia [2426]). They may include: Nux vomica (alcohol or substance-related sleeplessness), Ignatia (emotional upset), Arsenicum (anxiety), Passiflora (mental stress, aches, and pains), and Lycopodium (talking and laughing during sleep).

  1. 4.

    Mind–body interventions:


Progressive muscle relaxation is a therapy in which the therapist instructs patients to contract and release different muscle groups. Studies suggest that relaxation techniques may help people with insomnia, although, the effects appear to be short lived. Cognitive forms [27] of relaxation such as Meditation have slightly better results than somatic forms such as progressive muscle relaxation. Regular meditation practice can counteract emotional stress. Several studies have shown that regular meditation practice either alone or part of yoga practice results in higher blood levels of melatonin. Yoga is a mind–body approach that has components of meditation, breathing, and postures. Preliminary studies [28, 29] suggest Yoga can promote relaxation by releasing muscular tension and improve quality of sleep. When these forms of relaxation are combined with other components of cognitive-behavioral therapy (e.g., sleep restriction and stimulus control), lasting improvements in sleep have been observed.

Music therapy uses music prescribed in a skilled manner by a music therapist. Wang et al. [30] found that Music has significant impact in improving sleep quality of patients with acute and chronic sleep disorders. For chronic sleep disorders, music showed a cumulative dose effect and a treatment duration of more than three weeks is required to assess its effectiveness. There is scientific evidence that music therapy can have sleep benefits for older adults and children [31, 32].

Biofeedback, or applied psycho-physiological feedback, is a patient-guided treatment that teaches an individual to control muscle tension, pain, body temperature, brain waves, and other bodily functions, and processes through relaxation, visualization, and other cognitive control techniques. The name biofeedback refers to the active physiological monitoring of biological signals (such as electromyography activity) that are fed back, or returned, to the patient in real time in order for the patient to develop techniques of manipulating them. This technique can help in improvising quality of sleep by promoting relaxation.

Tai chi is a Chinese exercise system that uses slow, smooth body movements to achieve a state of relaxation of both body and mind, thus strengthening cardiovascular and immune systems [33, 34]. Recent studies have shown that it improves sleep quality in older adults and in patients with heart failure who experience insomnia and impaired breathing during sleep. It is not yet proven as to which component of tai chi meditation, relaxation or physical activity, is responsible for its beneficial effects on sleep.

Visualization may also help to promote relaxation.

  1. 5.

    Energy Therapies


Light/dark therapy involves making the bedroom very dark at night and exposing the patient to early morning sunlight (or a light box). It also helps to treat depression. Bright Light Therapy is used to manage circadian rhythm disorders such as delayed sleep phase syndrome (DSPS), a condition which shifts the normal sleeping pattern outside what is considered the social norm. Treatment with true green light can balance the nervous system and may relieve insomnia. Low-energy emission therapy (LEET) is a clinically proven treatment for chronic insomnia [3537]. LEET treatment involves delivering electromagnetic fields through a mouthpiece.

Neural therapy is a modified form of acupuncture with local anesthetic injections.

Naturopathic medicine is a multimodal therapy including diet, herbs, nutritional supplements, homeopathy, physical medicine, and counseling. It emphasizes prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process. It has been used for treatment of insomnia in adults as well as children [38].

CAM and Insomnia: Insomnia is a disorder of sleep initiation or maintenance difficulties or unrefreshing sleep. Research on CAM and insomnia has produced promising results for some CAM therapies. However, evidence of effectiveness is still limited for most therapies, and additional research is needed. This section summarizes what is known about some of the CAM approaches that people use for insomnia.


  • Aromatherapy using essential oils from herbs such as lavender or chamomile is a popular sleep aid; preliminary research suggests some sleep-inducing effects, but more studies are needed. The herb chamomile is commonly used as a bedtime tea, but scientific evidence of its effectiveness for insomnia is lacking.

  • The herb kava has been used for insomnia, but there is no evidence of its efficacy. The US FDA has issued a warning that kava supplements have been linked to a risk of severe liver damage.

  • The Herbal supplement valerian is one of the most popular CAM therapies for insomnia. Several studies suggest that valerian (for up to 4-to-6 weeks) can improve the quality of sleep and slightly reduce the time it takes to fall asleep. However, not all of the evidence is positive. One systematic review of the research concluded that although valerian is commonly used as a sleep aid, the scientific evidence does not support its efficacy for insomnia [39]. Researchers have concluded that valerian appears to be safe at recommended doses for short-term use. Some “sleep formula” products combine valerian with other herbs such as hops, lavender, lemon balm, and skullcap. Although many of these other herbs have sedative properties, there is no reliable evidence that they improve insomnia or that combination products are more effective than valerian alone [39, 40].

  • The findings of a Chinese study in mice suggest that treatment with Wen-Dan Decoction, a formula of traditional Chinese medicine, may improve sleep deprivation-induced negative emotions by regulating orexin-A and leptin expression [41].

  • Recently, a study in Bangladesh, evaluating sedative and hypnotic effect of the ethanolic extract of whole plants of Scoparia dulcis (EESD) in mice, showed significantly decreased induction time to sleep and prolonged the duration of sleeping, induced by thiopental sodium [42].

  • The seeds of Ziziphus mauritiana Lam are popularly used as a sedative and hypnotic drug in China, and Southeast Asia. A study from Thailand correlated the hypnotic effect of these seeds with the contents of total phenolics and total flavonoids in the extract and assessed weight-based doses effective in mice [43].

  • Si Ni San freeze-dried powder is a traditional Chinese medicine, consisting of four herbs that are bupleurum, white peony, immature bitter orange, and licorice. A Chinese study in rats showed that it extended the total sleep time and prolonged slow wave sleep (SWS) and REM sleep for both insomniac and normal rats [44].

  • Melatonin and Related Supplements

  • Like valerian, melatonin supplements are widely used and researched for insomnia. A 2013 evaluation of the results of 19 studies concluded that melatonin may help people with insomnia fall asleep faster, sleep longer, and sleep better, but the effect of melatonin is small compared to that of other treatments for insomnia. Greater effects are observed in patients with circadian rhythm sleep disorders. Studies of melatonin in children with sleep problems suggest that it may be helpful, both in healthy children and in those with conditions such as autism or attention-deficit hyperactivity disorder. However, both the number of studies and the number of children who participated in the studies are small, and all of the studies tested melatonin only for short periods of time [46].

  • Melatonin supplements appear to be relatively safe for short-term use, although the use of melatonin was linked to bad moods in elderly people (most of whom had dementia) in one study. The long-term safety of melatonin supplements has not been established.

  • Dietary supplements containing substances that can be changed into melatonin in the body—l-tryptophan and 5-HTP—have been researched as sleep aids.

  • Dietary supplements containing melatonin “precursors”—ltryptophan and 5-HTP—are also used as sleep aids. The amino acid l-tryptophan is converted to 5-HTP, which is converted to serotonin and then to melatonin. Studies of l-tryptophan supplements as an insomnia treatment have had inconsistent results, and the effects of 5-HTP supplements on insomnia have not been established. Also, there are concerns that they may be linked to eosinophilia–myalgia syndrome (EMS), a complex and debilitating systemic condition with multiple symptoms including severe muscle pain.

Other CAM Approaches

Oct 7, 2017 | Posted by in NEUROLOGY | Comments Off on Sleep and Alternative Medicine: I

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