Chromium This is an effective solution for blood-sugar imbalances, which often cause middle-of-the-night wakefulness, notes Sateia. There's no danger of toxicity with doses less than 300 micrograms; a daily dose of 200 mcg in capsule form with a vitamin C chaser to increase absorption is recommended.
Chamomile To calm the digestive system, reduce muscle tension, and trigger other sleep-inducing activity in the brain, sip a cup of chamomile tea. (Or take 1 teaspoon of tincture with water up to three times a night.) If chamomile doesn't help, lavender or passionflower tea may have a stronger sedative effect.
Kava Containing active compounds called lactones, kava produces anesthetic and muscle-relaxing effects. A nightly dose of 100 mg about 30 minutes before bedtime may help promote deeper, more restful sleep. NOTE: The U.S. Food and Drug Administration has issued an advisory about the potential risk of liver injury from the use of supplements containing kava, and people should consult a physician before using it. Wong says she takes kava's risks seriously and doesn't prescribe it to her patients.
Valerian This herb works by stimulating the brain to release a neurotransmitter called gamma-aminobutyric acid, which inhibits nerve impulses and helps the brain and body relax. Valerian can take up to a month to be effective, but it rarely produces side effects, doesn't lead to dependency (as prescription and OTC drugs can), and won't cause morning drowsiness, says Wong. She recommends taking 400 mg in capsule form within an hour of bedtime. Herbal sleeping formulas often contain valerian combined with passionflower and other ingredients.
Coffea Cruda This homeopathic remedy for sleeplessness is actually made from a dilution of coffee. It works well to beat insomnia caused by overexcitement or by drinking too much caffeine, says Dana Ullman, M.P.H., co-author of Everybody's Guide to Homeopathic Medicines. Take one dose of 30C-strength remedy a half-hour before bedtime, or follow label instructions.
Arsenicum Album If you feel too exhausted to sleep, Ullman recommends this homeopathic option. It's also good for people who have difficulty staying asleep, especially those who wake up between midnight and 2 a.m., worrying about work, health, or family matters. Take one dose of 30C-strength remedy as soon as you wake up, and repeat every 30 minutes until you fall back asleep, or follow label instructions.
Whatever remedies you choose, you need to create a well-organized sleep-wake schedule, says Kavey. And taking sleep medications or supplements before you normally feel tired will provide the best results.
"Our brains have naturally occurring circadian rhythms, and it's important to learn what your particular rhythm is and respect it," he explains. "Maybe you're naturally a night owl. You want to set the stage for [natural or pharmaceutical] treatments to be their most effective, and you don't want to take something for sleep when your brain is cycling into its awake phase."
Live to sleep
Lifestyle changes are often the most powerful natural sleep therapies. Here are some areas to focus on:
Limit your intake of alcohol, caffeine, and nicotine. Alcohol consumption can cause night wakefulness, while caffeine and nicotine are stimulants that keep you awake. Caffeine is found in chocolate, coffee, black teas, soft drinks, and many OTC cough and cold medicines.
Skip daytime naps. Some people find that an afternoon siesta improves alertness and reduces the symptoms of fatigue. But if you have insomnia, naps may leave you less sleepy at night.
Exercise several hours before bedtime. "A brisk walk or a bike ride in the early evening can release muscle tension and stress and promote deeper sleep that night," Kavey says. However, exercising too close to bedtime will boost adrenaline levels and keep you awake.
Get out of bed. "Insomniacs who stay in bed waiting to fall asleep are training their brains to associate wakefulness with being in bed," Sateia says. "You want to replace that message with one about bed as a place of relaxation and sleep. So restrict the amount of time you spend there. Don't watch television, read, pay bills, or do anything other than sleep in your bed until you've conquered your insomnia."
Get some acupuncture. "This can help balance the nervous system and clear the obstructions in muscle and nerve channels that might be causing stress and sleeplessness," explains Wong. A small-scale German study, published in Forschende Komplementarmedizin, found that acupuncture improved sleep quality (measured by polysomnography in a sleep laboratory as well as through patient interviews) when compared with a placebo group.
Some people worry so much about sleeplessness that it keeps them from sleeping. "The longer they're awake, the more they worry about the impact that not sleeping will have on them the next day, and the worse the problem becomes," says Sateia. He suggests cognitive behavioral therapy as a way to recognize the distorted thought patterns that are part of insomnia and replace them with more calming, sleep-conducive alternatives.
Most likely, some combination of lifestyle changes, natural supplements, and alternative therapies will finally bring you relief from all your tossing and turning in the wee hours. "Whichever route you go, make sure you do it with a doctor's supervision," Sateia cautions. "And remember that the first step toward getting a good night's sleep is to relax. So close your eyes, take a deep breath, and stop stressing about insomnia."