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Insomnia: Nutritional Considerations
The following steps may be helpful in promoting sleep:
- Avoidance of alcohol: Small amounts of
alcohol (e.g., one drink per day) may not have negative effects on
sleep for most people. In increasing amounts, however, alcohol may
cause insomnia by decreasing deep sleep, decreasing melatonin levels
(see below), or increasing stimulant chemicals in the brain. Alcohol is
metabolized in the liver to aldehydes, which have stimulant properties.
- Limiting caffeine: Caffeine produces differing effects on
different people. Some people can drink many cups of coffee per day
with no effects on sleep, while others are much more sensitive to the
effects of caffeine. This is particularly true for elderly persons.
Caffeine is present in many sources in addition to coffee. These
include cola beverages, tea, chocolate, and over-the-counter
medications.
- Avoidance of milk: Infants with cow's milk allergy have been
found to have frequent awakenings during sleep and shorter sleep
cycles. In one study, after participants eliminated cow's milk for
several weeks, a significant decrease in the number of arousals
occurred, while total sleep time increased significantly. Although
confirmation from other investigations is necessary before cow's milk
elimination can be recommended for children with sleep disorders, it is
a useful, low-cost strategy without side effects.
- Avoidance of over-the-counter weight-loss products: Products
that contain ephedra alkaloids (e.g., Ma huang or ephedrine) in
combination with caffeine have been increasingly used for weight loss,
but they have been found to cause insomnia.
- Iron supplementation: Although more research is needed,
available evidence suggests that low iron levels in the brain are
associated with insomnia. Iron supplementation was found effective for
improving insomnia in teens with low iron stores.
The following two supplements are under investigation for their roles in treating insomnia:
- Melatonin: Melatonin is a brain
chemical that is associated with sleep. Deficiencies of melatonin are
more common among both elderly persons and shift workers, and evidence
suggests that this can be partly treated by melatonin supplements.
Although studies suggest that melatonin is safe and effective, it has
not been tested in many groups of individuals. Melatonin particularly
appears to help elderly individuals. Additionally, patients who suffer
from withdrawal symptoms from benzodiazepines often find melatonin
useful.
- Valerian root: Doses of 400 to 500 milligrams/day have been
found to significantly improve sleep quality. However, not all studies
have found valerian to be effective. In addition, side effects may
include headache, hangover, restlessness, and cardiac disturbances, as
well as potentially dangerous interactions with some medications (e.g.,
barbiturates, benzodiazepines, and opiates) and alcohol.
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