Poor evidence for natural treatments for insomnia

New study shows over the counter or herbal remedies may not help insomnia or other sleeping issues.

What do we know already?

Insomnia, or poor sleep, is a common problem that can make it difficult to live life normally. It's estimated that, at any time, around 1 person in 4 in the UK has problems getting to sleep.

For most people, their sleeping problems go away in time. But if you have sleep problems on at least three nights a week for one month or more, and these problems aren't caused by an illness, then you may have chronic primary insomnia. Insomnia has been linked to other problems such as heart disease, and can increase your risk of accidents.

There are treatments your doctor can prescribe you to help insomnia. But some of these treatments can only be prescribed for a few weeks because of the risk that people may become dependent on them. Some of them may also cause bothersome side effects such as headaches. Some people find the treatments can make them feel less clear-headed, and they struggle to think and remember things.

So there's an interest in over-the-counter, herbal remedies. But it's unclear whether these work and if they are safe. To see what the evidence says, researchers reviewed published studies of different herbal remedies for managing insomnia, and looked closely at 18 studies.

What does the new study say?

The researchers found very little evidence that the herbal medicines most often included in studies are helpful for treating insomnia.

• Valerian. A large review of good-quality studies found that although valerian is safe to take, it doesn't help you sleep longer. However, there is some evidence that it can improve the quality of sleep. Studies that have compared people who were randomly assigned to take either valerian or a dummy pill found that people who took valerian didn't sleep more than people who took a dummy pill. There have also been some reports that people who took valerian had liver problems, but these have been extremely rare.
• Valerian with hops. Studies showed that these herbal medicines in combination worked better than valerian on its own. But the trials have been small and short term.
• Chamomile. There have only been a few studies of chamomile as a treatment for insomnia. There does seem to be some improvement in sleep for people who take chamomile, but the difference is slight.
• St John's wort. Most of the studies have looked at using St. John's wort as a treatment for sleeping problems in people who have other illnesses, such asdepression. We don't know if the results of these studies apply to people with primary insomnia.

The researchers also looked for evidence for other popular herbal medicines, such as lavender, but didn't find any studies where these have been used as a treatment for insomnia.

How reliable is the research?

This was a review of good-quality studies. However, many of the studies were small and lasted only a few weeks. This can make them less reliable.

What does this mean for me?

This review of the literature highlights the need for more research into whether herbal remedies are useful for insomnia. But of all the herbal remedies looked at, the combination of valerian and hops showed the most promise as a treatment forinsomnia symptoms.

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