We all know know how important good sleep is to health and quality of life. Unfortunately, sleep issues are due to a combination of stress, nutritional and environmental factors. Since these factors are not always under our control, getting sound sleep can be a challenge.
Thankfully, Nature has provided us with many sleep remedies that can be both safe and effective. But results from picking something from the supplement aisle are likely to be less than stellar. What’s needed is a clear understanding of the strengths of the different remedies, along with why sleep is troubled in the first place. That way an informed choice can be made.
Let's start with a quick rundown of basic sleep hygiene.
Sleep Hygiene
Most of these points are pretty common-sensical--but a good read-through will help ensure there’s not a hidden culprit at play in your sleep woes.
When facing any kind of sleep issue, it’s always a good idea to:
· Avoid caffeine after 2pm, or after 10am if you’re sensitive to it. Caffeine can linger in the body for a surprisingly long time and affect sleep quality even if you’re able to fall asleep okay.
· Avoid screens and bright light after 9pm. Blue-light reducing apps like f.lux can also help make evening screen use easier on the brain.
· Avoid work and stressful situations insofar as possible after dinner. Let the evening be a time to unwind.
· Avoid eating a heavy meal too late. Give yourself at least 2 hours to digest (3 is better) before heading to bed, otherwise active digestion may disrupt sleep.
· Avoid alcohol about dinner – it can interfere with sleep quality.
· Create a simple, relaxing bedtime routine for yourself that involves low light, self massage, relaxing music, stretching, etc.
· Use earplugs and/or an eye mask if unwelcome noise or light is an issue.
Understanding Sleep Disorders
Sleep depends on many bodily systems working well at the same time. These systems include the nervous and endocrine systems, the digestive system, the respiratory system, the circulatory system, and the urinary system. That’s a lot of systems!
Let’s take them one at a time.
The Nervous System and Sleep
When we're overstimulated (e.g. by caffeine or a horror movie), it's difficult if not impossible to fall asleep. Even if we do go under, sleep quality can suffer under these circumstances, leaving us feeling unrested and performing below capacity the next day.
Many of us suffer from chronic stress and nervous tension, which can mean we’re more wound up than we realize. Technically, our sympathetic (fight or flight) nervous system is engaged while our parasympathetic (rest and digest) nervous system is shut down.
To help address this critical balance between the two sides of the nervous system, so-called nervines and nervous system tropho-restorative herbs can be helpful (see below). By addressing the balance of the nervous system, they can support sleep along with addressing one of the major causes of anxiety.
Nervous system-related sleep problems include: frequent waking, inability to fall asleep as well as specific disorders such as restless leg syndrome (RLS).
The Endocrine System and Sleep
Not an organ you can point to, the endocrine system refers to our hormones and the network of glands that secrete these chemical signals. Working hand in hand with the nervous system and other systems, this is the body’s overarching way of keeping the body regulated and in tune.
A key pathway within the endocrine system is the so-called HPA (hypothalamus-pituitary-adrenal) axis. This pathway plays a central role in stress response, through regulating how much stress hormones (cortisol and epinephrine) the adrenals secrete. Under prolonged chronic stress, adrenal fatigue or burn out can develop: there’s simply nothing left to squeeze out of the exhausted adrenal glands. Signs can include exhaustion, dark circles under the eyes, an achy low back, and jitteriness.
Some degree of adrenal fatigue or exhaustion is all too common in the modern world and can definitely play a part in sleep issues. A typical scenario here is the “too tired to sleep” effect. Treatment typically involves addressing the nervous system while also restoring the body’s deep reserves with nutrition and nourishing herbs—and ideally, a good vacation. Deeply restorative herbs and foods are critical here—see for instance Rehmannia root, below.
The Urinary System and Sleep
Waking up frequently to urinate is a common complaint especially in older patients, who may get up to pee four or more times per night. The possible causes of frequent urination are beyond the scope of this article. However, in some cases calming the nervous system alone can be enough to reverse or mitigate the tendency toward frequent urination.
The Digestive System and Sleep
If you’ve ever woken up nauseous or with a stomachache, you know that digestion needs to be settled in order for good sleep to occur. Even when there are no overt digestive symptoms like acid reflux, belching or abdominal pain, sub-optimal digestion can adversely impact sleep.
For this reason, it’s recommended to avoid eating a large meal late in the evening, avoid drinks which dampen the digestive fire, and ideally to make sure dinner is a relatively light and easy-to-digest. Digestive herbs can play a role as well, but are best used with consideration of the type of the Chinese medicine pattern at play (see below).
The bottom line: a happy belly makes for happy sleep.
The Respiratory System and Sleep
The lungs are an under-appreciated organ when it comes to their role in healthy sleep. TCM is helpful here with its “organ clock” model of tidal flow between the bodily organ systems. In this model, the lungs govern roughly 3am to 5am—one of the most common times people report waking, in this clinician’s experience. Important to note, this “lung pattern” of insomnia does not necessarily come with any obvious signs of respiratory distress, i.e. there may not be any coughing. However, weakness in the lungs, or “lung qi deficiency” can result in waking during the early morning lung window. Supporting the yin (moisture) of the lungs may be indicated, as we’ll explore below.
The Heart / Circulatory System and Sleep
Once again, TCM can help us appreciate how the holistic role of the organs in is not limited to their biomedical functionality. From the Western perspective, the heart is a blood pump; from a traditional Chinese perspective, the heart has additional roles such as “storing the shen.” Shen can be translated as spirit or consciousness. In this understanding, then, the heart and the blood are where our consciousness goes to rest at night.
If there is “shen disturbance,” a kind of catch-all phrase for mental unrest, then this settling process will be disrupted and we’ll have trouble sleeping. Likewise, insomnia can result if there is not enough blood (heart blood deficiency in TCM terms).
In such cases, herbs can be chosen to promote sleep by nourishing the heart blood and calm the shen.
The Liver and Sleep
In Chinese medicine's understanding, the liver is responsible for the free flow of emotions and qi (sometimes spelled "chi"). When this flow is blocked, stagnation and frustration can result. Eventually this can lead to symptoms such as irritability, a bitter taste in the mouth, burning eyes, abdominal distention, and more.
"Liver qi stagnation" type insomnia can involve difficulty falling asleep or fretful, fitful sleep. Besides appropriate herbal remedies or acupuncture, finding ways to release pent-up emotion and express oneself is often key to successful resolution of symptoms in these cases.
Pain and Sleep
Acute or chronic pain can greatly influence sleep quality. We’ll see that herbs can be part of a holistic pain reduction strategy, but it’s important to address the root causes of pain insofar as possible and not to rely on herbs or drugs to knock out the symptoms alone.
Treatment of pain is beyond the scope of this article, but topical herbs, liniments and compresses can be useful allies, as can heating pads and old-fashioned hot water bottles. It's important to address root causes insofar as possible.
Herbalism and Sleep
We’ve explored how different organ systems can contribute to sleep trouble. Where do herbs come in?
As you’ve probably guessed, there is no one-size-fits-all sleep remedy. Different herbs work for different people, depending on individual constitution (who you are) and condition (what’s happening now in your body).
Different herbal traditions have various ways of assessing this compatibility and matching the right plants(s) with the right person at the right time. This match-making is both an art and a science, which is why herbalism can’t be learned from reading an article! However, the following overview should help you get a sense of what all an herbalist may take into account.
Sleep and Constitution
Individual constitution (similar to body type) can indicate a predilection toward certain types of sleep disorders, and in turn, an affinity for certain sleep remedies.
Lean, high-strung, airy types (Vata) are prone to nervous tension in general and are probably the most likely constitutional type to have sleep problems overall. Besides nervous and endocrine issues, digestive, respiratory and heart/blood problems may all play a role for these relatively sensitive people. Staying grounded and nourished is key.
Muscular, athletic, fiery types (Pitta) are less prone to insomnia as a rule but may suffer from restless leg syndrome or from burn-out, along with heart/blood issues. Fiery types may also be more sensitive to ambient temperature, with a need to keep things cool both externally and internally.
Solid, steady, water-earth types (Kapha) tend to fall asleep easily and sleep long and late. However sleep quality can be an issue, especially as this type is prone than others to sleep apnea. In this disorder, breathing involuntarily ceases at intervals throughout the night, forcing the person awake. Sleep apnea can be difficult to address herbally, but a healthy discipline around food and exercise can help keep things flowing freely for these folks.
Onto the remedies.
Natural Remedies for Sleep
Passionflower and Skullcap and Milky Oats
Also known as Passiflora, Scutellaria officinalis and Avena, these Western herbs work with the nervous system, each in its own way. They can play an important role in a herbal formula for sleep.
Try them for restless legs (especially the first two) and for any sleep problems associated with anxiety. Especially for air (Vata) and fire (Pitta) types; Milky Oatseed in particular can be too rich and heavy for water/earth (Kapha) types.
Passionflower leaf is the most anti-spasmodic (spasm-relieving) of these three, and can help relax involuntary tension, both physically and mentally.
Skullcap is a great all-purpose nervine herb, combining relaxing tension relief with nourishment for the nervous system. It is also excellent at sedating excess heat: think of it as cooling you from the top down, as the name suggests.
Milky Oatseed, simply immature oats in the milky stage of ripeness, are another wonderful and underrated ally for the nerves. Their strength is in deep nourishment, and they bridge the ‘nervine’ and ‘restorative’ categories.
Passionflower and Skullcap can be given as an infusion (tea) or tincture (alcohol extract), while Milky Oatseed is best as a tincture. Prepared properly, Milky Oatseed tincture should be an opaque, milky green, quite thick and with a distinct sweetness. You may well find its thick sweetness delicious, especially if your system needs this remedy.
Ashwagandha and Nutmeg
Ashwagandha (Withania somnifera) is a well-known “adaptogen” from the Indian system of medicine, Ayurveda. This tough, white root helps strengthen resistance to stress and supports muscle mass and anabolic activity as well as calming the nerves. It is best suited for tense, airy Vata types, who may try it with warm milk (or substitute almond or oat milk) with a bit of freshly grated nutmeg. Heat the milk with ½ - ¾ teaspoon ashwagandha root powder, or add 30-50 drops ashwagandha tincture to the milk.
You may notice some immediate benefit to sleep quality with ashwagandha, but its strength is in working slowly over time to improve resilience to stress. Combines well with milky oatseed in those who are very depleted or exhausted. Note that ashwagandha is not suitable for people with too much heat or fire, as it is quite warming.
Rehmannia Root
Speaking of depletion, Rehmannia root or dihuang is a key herb from Chinese herbal tradition for re-filling the tanks in adrenal fatigue. Not a sleep herb per se, this dense, black, nutritious herb is nonetheless called for in cases of exhaustion as part of a rejuvenating or replenishing strategy.
Being dense and difficult to digest, Rehmannia requires a skilled hand to administer properly and, as with many East Asian herbs, is best used in the context of a traditional formulation such as shen qi wan or zhi gancao tang. Consult an East Asian-trained herbalist if you suspect you mau be a candidate for this kind of approach.
Chamomile
Don’t discount the relaxing potential of a nice cup of chamomile tea.
Chamomile is well-known as a sleep remedy gentle enough for small children but effective enough for mild sleep trouble in adults. Its specialty is calming irritability and soothing the stomach along with the nerves. It’s good for fussy “babies of any age,” as herbalist Matthew Wood likes to say. Tea is the traditional method of administration, and a little milk and honey can be added to help the medicine go down. A tincture is an option, too.
Valerian Root
A popular sedative herb, stinky-smelling valerian root has marked relaxant effects that work much better for some people than for others. In fact, it’s an herb that some people find effects them the opposite way, causing unwelcome stimulation. Others swear by it.
While valerian can be useful in the short-term for tension relief, it’s not an ideal herb to take long-term. Its drug-like action can be dulling to the mind and may cause a slight hangover the next morning. This tea or tincture is best for occasional use only.
Ginger, Fennel, Licorice and Mint
Moving into the digestive realm, these well-known herbs are generally safe bets for calming an upset stomach and thus aiding sleep. The combination is nicely balanced for various constitutions and conditions, without pulling too hard in any one direction.
However, those with anything more serious than mild digestive complaints should consult a licensed herbal practitioner for a more targeted formula.
Suanzaoren
This Chinese herb, also known as spiny ziziphus seed, forms the core of one of the oldest and most famous Asiain sleep remedies, suanzaoren tang. Even used singly, suanzaoren can be effective in cases of stress and exhaustion, with a ‘too tired to sleep’ feeling.
From a TCM perspective, it works by nourishing the heart blood and calming and stabilizing the shen (spirit).
Seldom available in Western herbal commerce, this medicinal may need to be procured via a licensed East Asian style herbalist. It is most effective in combination with other medicinals.
Danshen / Red Sage
Also known by its botanical name Salvia miltiorrhiza, red sage is a one-stop shop in terms of herbs for the blood. The intimate connection between the heart, blood and sleep (as discussed above) makes danshen a useful natural remedy for insomnia.
Although danshen is generally a safe herb, it is known to thin the blood and is contraindicated in bleeding conditions or with blood-thinning medications.
Lily Bulb
Not widely known outside of East Asian medicine circles, mild and delicate lily bulb (baihe) is a beautiful ally for the nervous system and lungs, especially the lung yin. Along with other lung herbs, it can be useful in patterns involving waking around 4am and in cases of nervous restlessness.
Like many of the sleep remedies discussed here, Lily Bulb is best used in the context of a synergistic formula given by an experienced East Asian herbal practitioner.
Banxia (Pinellia)
Pinellia (or banxia) is less-appreciated sleep remedy from the Chinese Medicine tradition. This medicinal, a slippery rhizome, helps descend the qi (energy) of both the heart and the stomach, making it a useful ally for sleep, especially when digestive issues are involved or where phlegm is present.
Note: raw or unprocessed banxia contains irritating crystalline compounds that can cause severe pain in the mouth and throat, so this medicinal needs to be prepared properly with ginger (which helps neutralize the irritating, needle-like crystals) and a long cook time in order to be safe for use.
Again, best used in an appropriate formula from a trained practitioner.
Coptis
Coptis root (huanglian) is a powerful herb for excess fire and can treat signs of heat rising, including some forms of severe insomnia; it is even useful in some cases of mania.
Bright yellow-orange Coptis root is intensely bitter and very strong; it can harm the stomach when used inappropriately, and really needs to be combined with other herbs in a formula to balance it out. Even then, this remedy is reserved for quite severe cases where there are clear signs of excess heat, in Chinese medicine terms. Consult a qualified practitioner if you suspect you could use something like this.
Peach Leaf
Last but not least, Peach leaf tincture (yes, made from peach trees) is Southern US folk remedy that can be remarkably effective for insomnia, especially when the pattern involves heat signs. (Such “heat” can be recognized by agitation, restlessness, a red tongue tip, etc.).
Because it contains cyanogenic compounds, peach leaf is another sleep remedy that needs to be properly prepared, used with care and dosed appropriately. Like Coptis and Pinellia, Peach leaf is best administered by a knowledgeable professional.
Aromatherapy for Sleep
Scent is a direct pathway to the limbic system, a part of the brain that influences the nervous and endocrine systems. This is why fragrance can affect our mood so quickly.
*Natural* incense and essential oils are good ways of harnessing the power of scent.
Scents to consider include:
Lavender, Rose, Nutmeg, Sandalwood, Hina (an attar from India), and sustainably-grown Agarwood (also known as Oud). The latter is expensive and its complex, deep, sometimes funky scent can be something of an acquired taste, but some people swear by its relaxing effects.
Remember, the nose knows, so use what you find you like.
As with all natural products, make sure you are working with a reputable company that does not adulterate their oils with synthetic fragrances (diluted oils in a neutral carrier oil base are fine).
Consultation and Safety
Although most of the natural sleep remedies discussed above are safe and non-toxic (except where otherwise indicated), it’s important to consult with a licensed healthcare provider in order to find a suitable remedy that truly fits the situation. This is doubly true if you are on prescription medications.
Not every herb is for every person; always listen to your body and discontinue any herb that is causing adverse effects. When in doubt, again, consult a licensed provider.
Note that even a safe herb can do harm when improperly administered. (And even water or salt can be toxic in the wrong quantities.) Use common sense, pay attention, and don’t hesitate to seek professional medical care from a naturopath, integrative MD, licensed herbalist or East Asian Medicine practitioner.
In Conclusion
Nature provides us with a bounty of natural remedies for sleep, and it's a rare case of insomnia that can't benefit from a well-chosen herb or herbal formula.
Educating yourself on the basics is a good idea, and some careful trial and error may yield results. However, consulting with an expert practitioner who can apply their knowledge and experience is the surest bet for finding a natural sleep remedy that works like a charm.
Do you have experience with natural sleep remedies? Let us know in the comments.
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Jonathan H Edwards, LAc. is an experienced Traditional East Asian Medicine practitioner and herbalist with a background in both Eastern and Western herbal styles. He sees patients remotely as well as via his office in the North Carolina Triangle.