Sleep Disorders: In Depth

What Are Sleep Disorders and How Important Are They?

There are more than 80 different sleep disorders. This fact sheet focuses on insomnia—difficulty falling asleep or difficulty staying asleep. Insomnia is one of the most common sleep disorders.

Is It a Sleep Disorder or Not Enough Sleep?

Some people who feel tired during the day have a true sleep disorder, but for others, the real problem is not allowing enough time for sleep. Adults need at least 7 to 8 hours of sleep each night to be well rested, but the average adult sleeps for less than 7 hours a night.

What the Science Says About Complementary Health Approaches and Insomnia

Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be:

• Nutritional (e.g., special diets, dietary supplements, herbs, probiotics, and microbial-based therapies).
• Psychological (e.g., meditation, hypnosis, music therapies, relaxation therapies).
• Physical (e.g., acupuncture, massage, spinal manipulation).
• Combinations such as psychological and physical (e.g., yoga, tai chi, dance therapies, some forms of art therapy) or psychological and nutritional (e.g., mindful eating).

Nutritional approaches include what the National Center for Complementary and Integrative Health (NCCIH) previously categorized as natural products, whereas psychological and/or physical approaches include what was referred to as mind and body practices.

Research has produced promising results for some complementary health approaches for insomnia, such as relaxation techniques. However, evidence of effectiveness is still limited for most products and practices, and safety concerns have been raised about a few.

Psychological and Physical Approaches

• There is evidence that relaxation techniques can be effective in treating chronic insomnia.

• In a preliminary study, mindfulness-based stress reduction, a type of meditation, was as effective as a prescription drug in a small group of people with insomnia.

• Preliminary studies in postmenopausal women and women with osteoarthritis suggest that yoga may be helpful for insomnia.

• Some practitioners who treat insomnia have reported that hypnotherapy enhanced the effectiveness of cognitive-behavioral therapy and relaxation techniques in their patients, but very little rigorous research has been conducted on the use of hypnotherapy for insomnia.

• A small 2012 study on massage therapy showed promising results for insomnia in postmenopausal women. However, conclusions cannot be reached on the basis of a single study.

• Most of the studies that have evaluated acupuncture for insomnia have been of poor scientific quality. The current evidence is not rigorous enough to show whether acupuncture is helpful for insomnia.

Nutritional Approaches

Melatonin and Related Dietary Supplements

• Melatonin may help with jet lag and sleep problems related to shift work.
• 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.

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

Herbs

• Although chamomile has traditionally been used for insomnia, often in the form of a tea, there is no conclusive evidence from clinical trials showing whether it is helpful. Some people, especially those who are allergic to ragweed or related plants, may have allergic reactions to chamomile.
• Although kava is said to have sedative properties, very little research has been conducted on whether this herb is helpful for insomnia. More importantly, kava supplements have been linked to a risk of severe liver damage.
• Clinical trials of valerian (another herb said to have sedative properties) have had inconsistent results, and its value for insomnia has not been demonstrated. Although few people have reported negative side effects from valerian, it is uncertain whether this herb is safe for long-term use.
• Some “sleep formula” dietary supplements combine valerian with other herbs such as hops, lemon balm, passionflower, and kava or other ingredients such as melatonin and 5-HTP. There is little evidence on these preparations from studies in people.

For more information on dietary supplements.

Other Complementary Health Approaches

• Aromatherapy is the therapeutic use of essential oils from plants. It is uncertain whether aromatherapy is helpful for treating insomnia because little rigorous research has been done on this topic.
• A 2010 systematic review concluded that current evidence does not demonstrate significant effects of homeopathic medicines for insomnia.

NCCIH Research on Sleep Disorders

NCCIH funds research on complementary health approaches for sleep disorders.

If You're Considering Complementary Health Approaches for Sleep Problems

• Talk to your health care providers. Tell them about the complementary health approach you are considering and ask any questions you may have. Because trouble sleeping can be an indication of a more serious condition, and because some prescription and over-the-counter drugs can contribute to sleep problems, it is important to discuss your sleep-related symptoms with your health care providers before trying any complementary health product or practice.

• Be cautious about using any sleep product—prescription medications, over-the-counter medications, dietary supplements, or homeopathic remedies. Find out about potential side effects and any risks from long-term use or combining products.

• Keep in mind that “natural” does not always mean safe. For example, kava products can cause serious harm to the liver. Also, a manufacturer’s use of the term “standardized” (or “verified” or “certified”) does not necessarily guarantee product quality or consistency. Dietary supplements can cause health problems if not used correctly. The health care providers you see about your sleep problems can advise you.

• If you are pregnant, nursing a child, or considering giving a child a dietary supplement, it is especially important to consult your (or your child’s) health care provider.

• If you are considering a practitioner-provided complementary health practice, check with your insurer to see if the services will be covered, and ask a trusted source (such as your health care provider or a nearby hospital or medical school) to recommend a practitioner.

• Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

For More Information

Key References

All Other References