The Use of Supplements, Herbs, and Alternative Therapies in the Treatment of Insomnia
Insomnia, one of the most common complaints seen in the primary care office, affects at least 30% of the U.S. adult population at an estimated cost to the healthcare system of $241 billion annually.
A number of medications—both over-the-counter (OTC) and prescription—are used to treat insomnia, yet all have varying degrees of unwanted side effects. Antihistamines are the most widely used OTC medications and can have side effects ranging from dizziness to urinary retention. Benzodiazepines, one of the most-used classes of prescription medications for insomnia, can also have deleterious side effects, including daytime sedation and memory impairment.
Due to both the real and perceived side effect profiles of these OTC and prescription medications, more patients are turning to alternative and non-pharmacological therapies to treat their insomnia. Some popular herb and dietary supplements used to treat insomnia include melatonin, tryptophan, valerian, chamomile, lemon balm, and kava. Non-herbal treatments for insomnia include osteopathic cranial manipulation and acupuncture.
With the continuing widespread use and acceptance of complementary and alternative therapies for a wide range of medical conditions, family medicine physicians need to be aware of what alternative therapies their patients may be using for sleep disturbances. While many patients believe that alternative or ”natural” products are completely safe, herbs and other supplements can have unwanted side effects and interactions with prescription medications of which both physicians and patients need to be aware.
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