The Use of Supplements, Herbs, and Alternative Therapies in the Treatment of Insomnia

  • Edward R. Rosick, DO Michigan State University College of Osteopathic Medicine


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.


Neubauer DN. The Evolution and Development of Insomnia Pharmacotherapies. Jour Clin Sleep Med 2007; 3(5): S11-15.

Bramoweth AD, Taylor DJ. Chronic Insomnia and Health Care Utilization in young adults. Behav Sleep Med 2012; 10(2): 106-21.

Richardson GS, Roehrs TA, Rosenthal L et al. Tolerance to daytime sedative effects of H1 antihistamines. J Clin Psychopharm 2002; 22: 511-5.

AARP, NCAM. What people 50 and over are using and discussing with their physicians. Washington, D.C., AARP; 2007.

Morin, CM, LeBlanc M, Daley M et al. Epidemiology of Insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med 2006; 7(2): 123-30.

Chaitow L. Cranial manipulation re-examined. Int J Alt Comp Med 1997; 15: 28-32.

Cutler MJ, Holland BS, Stupski BA et al. Cranial manipulation can alter sleep latency and sympathetic nerve activity in humans: a pilot study. Jour Alt Comp Med 2005; 11(1): 103-8.

Kalavapalli R, Signareddy R. Role of acupuncture in the treatment of insomnia: a comprehensive study. Comp Ther Clin Prac 2007; 13: 184-93.

Cao H, Pan X, Li H, Liu J. Acupuncture for the treatment of insomnia: a systematic review of randomized controlled trials. Jour Alt Comp Med 2009; 15(11): 1171-86.

Chen XH. Clinical observation of therapeutic effects of acupuncture according to syndrome differentiation combined with medicine on treatment of asthenia insomnia. Jour Chin Med 2003; 26: 36-37.

Li XJ, Bi LP. Differentiation of syndromes and use acupuncture combined auricular therapy on treatment of insomnia: 133 case clinical observations Lish Med Mat Med 2007; 18: 66-78.

Zhdanova IV, Wurtman RJ, Regan MM et al. Melatonin treatment for age-related insomnia. J Clin Endo Metab 2001; 86(10): 4727-30.

Luthringer R, Muzet M, Zisapel N, Staner L. The effect of prolonged release melatonin on sleep measures psychomotor performance in elderly patients with insomnia. Int Clin Psychopharm 2009; 24(5): 239-49.

Wade GA, Ford I, Crawford G et al. Nightly treatment of primary insomnia with prolonged release melatonin for 6 months: a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety. BMC Med 2010;8(51): 1-18.

Lyseng-Williamston KA. Melatonin prolonged release in the treatment of insomnia in patients aged >55 years. Drugs Aging 2012; 29(11): 911-23.

Hartman E, Spinweber CL. Sleep induced by L-tryptophan. Effect of dosages within the normal dietary intake. J Nerv Ment Dis 1979; 167(8): 497-9.

Schneider-Helmert D. Interval therapy with L-tryptophan in severe chronic insomniacs. A predictive laboratory study. Int Pharm 1981; 16(3): 162-73.

Korner E, Bertha G, Flooh E et al. Sleep-inducing effect of L-tryptophane. Eur Neuro 1896; 2: 75-81.

Hudson C, Hudson SP, Hecht T, MacKenzie J. Protein source tryptophan versus pharmaceutical grade tryptophan as an efficacious treatment for chronic insomnia. Nutr Neurosci 2005; 8(2): 121-7.

Houghton PJ. The scientific basis for the reputed activity of valerian. J Pharm Pharm 1999; 51: 501-12.

Richman A, Witkowski JP. 4th annual herbal products sales survey. Whole Foods 1998; 21: 19-26.

Richman A, Witkowski JP. 5th annual herbal products sales survey. Whole Foods 1999; 22: 49-56.

Donath F, Quispe S, Diefenbach K et al. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsyc 2000; 33(2): 47-53.

Hadley S, Petry JJ. Valerian. Amer Fam Phys 2003; 67(8): 1755-58.

Bent S, Padula A, Moore D et al. Valerian for sleep: a systematic review and meta-analysis. Amer Jour Med 2006; 119: 1005-12.

San-Martin MIF, Masa-Font R, Palacios-Soler L et al. Effectiveness of valerian on insomnia: A meta-analysis of randomized placebo-controlled trials. Sleep Med 2010; 11: 505-11.

Taavoni S, Ekbatani N, Kashaniyan M, Haghani H. Effect of valerian on sleep quality in postmenopausal women: a randomized placebo-controlled clinical trial. Menopause 2011; 18(9): 951-5.

Ziegler G, Ploch M, Miettinen-Bauman A, Collet W. Efficacy and tolerability of valerian extract compared with oxazepam in the treatment of non-organic insomnia-a randomized double-blind comparative study. Eur J Med Res 2002; 7(11): 480-486.

Srivastava J, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with a bright future. Mol Med Report 2010; 3(6): 895-901.

Viola H, Wasowski C, Stein L et al. Apigenin, a component of Matricaria recutitia flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med 1995; 61(3): 213-6.

Zick SM, Wright BD, Sen A, Arned JT. Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: a randomized placebo-controlled pilot study. Comp Alt Med 2011; 11(78): 1-6.

Cenry A, Schmidt K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers: a double-blind, placebo-controlled, multicentre study. Fitoterapia 1999; 70: 221-8.

Dressing H, Riemann D, Low H et al. Insomnia: are valerian/balm combination of equal value to benzodiazepine? Therapie 1992; 42: 726-36.

Cases J, Ibarra A, Feuillere N et al. Pilot trial of Melissa officinalis leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances. Med J Naturo Metab 2011; 4: 211-18.

Keledjian J, Diffield PH, Jammieson DD et al. Uptake into mouse brain of four compounds present in the psychoactive beverage kava. J Pharm Sci 1997; 1003-6.

Kinzler E, Kromer J, Lehmann E. Effect of special kava extract in patients with anxiety, tension, and excitation states of non-psychotic genesis. Double blind study with placebos over 4 weeks. Arzniem 1991; 41: 584-588.

Monograph-Piper methysticum (kava kava). Alt Med Rev 1998; 3(6): 458-60.

Lehrl S. Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter randomized placebo-controlled double-blind clinical trial. Jour Affect Disor 2004; 78: 101-10.

How to Cite
Rosick, DOE. R. “The Use of Supplements, Herbs, and Alternative Therapies in the Treatment of Insomnia”. Osteopathic Family Physician, Vol. 6, no. 2, Mar. 2014,
Review Articles