The big sleep

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Twelve herbs that can gently ease you into dreamland.

Insomnia is an affliction that, like motion sickness, mystifies those who've never had it. "I don't know what you're talking about," said a friend recently when I tried to explain the dark circles under my eyes with a tale of my on-again, off-again insomnia, which (sadly) was on again. "I fall asleep the minute my head touches the pillow." Lucky her. "Insomnia. Isn't that the sign of a guilty conscience ?" another friend joked.

To anyone who's ever spent precious dreamtime channel surfing through late-night infomercials while dreading the next day's exhaustion, insomnia is no laughing matter. Chronic insomnia, characterized by difficulty falling asleep, frequent waking in the night, the inability to fall back asleep, or waking too early in the morning, plagues 67 percent of Americans. According to a 1998 poll conducted by the National Sleep Foundation in Washington, D.C., 37 percent of those surveyed admitted that they're so sleepy during the day, they have trouble functioning.

The news gets worse: Chronic insomnia can result in mood swings, lack of coordination, frazzled nerves, impaired mental functioning and a decreased ability to fend off infections. It can even be life-threatening. According to a report published in the journal Sleep (July 1996), chronic insomniacs are 2.5 times more likely to be involved in car crashes than people who routinely get enough sleep. In fact, the National Highway Traffic Safety Administration estimates that at least 100,000 auto accidents each year are caused by driver fatigue. "Sleep deprivation," says Nancy Russell, M.D., a holistic practitioner of internal medicine in Kansas City, Mo., "is one of the most critical issues facing our society."

Everyone differs in the amount of sleep they require--me folks need nine hours, others get by just fine on four--so scientists don't have any hard-and-fast criteria about what makes an insomniac. But according to Peter Hauri, Ph.D., director of the Mayo Clinic's Sleep Disorder Center in Rochester, Minn., it's not how long you sleep, but how well. If you wake up feeling refreshed after just a few hours of shut-eye and can function during the day, don't worry. If you're regularly fuzzy-headed, even after a solid eight hours, you may have insomnia.

Insomnia can last a few days, a few months or several years. It can come and go. And while anyone can have an off night, persistent insomnia is more common in women. Although sleep researchers don't completely understand insomnia's mechanisms, they believe fluctuating levels of the hormones estrogen and progesterone play a part. "It is absolutely certain that one of the underlying causes of insomnia is the changes in hormonal activity that take place during the premenstrual period or around menopause," says Gary Zammit, Ph.D., director of the Sleep Disorders Institute in New York City. "Sometimes treating the hormonal problem can result in dramatic improvement in sleep."

Experts also believe that close to half of all cases of sleeplessness stem from emotional or physical stress--anxiety about work or family issues, pain, depression, sleep apnea (in which one stops breathing while asleep), mild irritations like jet lag, an uncomfortable bed and a snoring bed mate. "Stress is the most commonly reported underlying cause of insomnia," says Zammit.

Over-the-counter (OTC) and prescription medications also keep the Sandman at bay. These drugs often contain stimulants, such as caffeine, and have side effects, including morning-after "hangovers."

An occasional night of restless tossing and turning is no cause for concern. But if the problem persists for more than a month and strikes more nights than not, Russell advises consulting a health-care professional. An alternative medical doctor will look for physical (and stress-related) causes; a therapist can help identify emotional blocks to sound slumber. You can also check out one of the country's certified sleep disorder centers (see Resources, p. 17). "It's very important to figure out what's causing the problem instead of just trying to get rid of the symptoms," says Russell.

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HERBAL HELPERS
For once-in-a-blue-moon insomnia, Russell recommends herbal preparations. "As a holistic physician, I'm always concerned that herbs not be a substitute for pharmaceutical drugs," she says. "There's usually some trigger for insomnia, and unless you identify it, you can take all the herbs you like, and they won't really help."

But when combined with dietary changes, regular exercise, stress management and relaxation techniques, Russell says herbs are just as effective as many OTC and prescription sleep aids, without the side effects. Tinctures and extracts, with their alcohol base, are the speediest and most potent form of delivery. Take them straight or mix them m water or juice. Herbal teas are weaker but still soothing--perfect when you need to relax, not conk out. The herbs listed here are safe, but pay attention to our caveats. Although we provide dosage guidelines, read label instructions also because the products vary in quality and strength.

Lavender (Lavendula officinalis) The essential oil of lavender relieves nervous tension. Use a few drops in a bedtime bath or massage, place a few drops on your pillow or sheets, or scent the air in your bedroom with a diffuser or lavender candle before you hit the hay. . Lavender is gentle, with only one caveat: Do not ingest essential oils.

Chamomile (Matricaria recutita) This delicate flower has been dubbed by German fans Alles zutraut, or "capable of anything." Calming but not sedating, a cup of chamomile tea makes for a relaxing bedtime ritual, even if you don't have trouble sleeping, says Ellen Kamhi, Ph.D., R.N., H.N.C. (board-certified holistic nurse), director of Natural Alternatives Health Education in Oyster Bay, N.Y. Chamomile also comes as an essential oil (use it like lavender oil) and as the homeopathic remedy Chamomilla (see "Homeopathy for Sleep," p. 16). Caveat: Avoid chamomile if you're allergic to ragweed.

Lemon Balm (Melissa) Germany's Commission E (the government's regulatory body on herbal medicine) gives high marks to this member of the mint family for its mild sedative powers and ability to relieve muscle tension. Brew it as a bedtime tea.

Passionflower (Passiflora incarnata) As a sedative, muscle relaxant and an anxiety-reducer, passionflower (a popular sleep aid in Germany and England) is a good choice for anyone whose insomnia stems from nervous tension. It's best taken as a tincture since its flavor isn't as alluring as its name suggests. Kamhi recommends about 150 milligrams (mg.) before bed.

Hops (Humulus lupulus) The ingredient that gives beer its distinctive flavor, hops makes a reliable sedative. But as much as you may like the idea of getting your hops in a pint of lager, think twice. Alcohol helps you nod off initially, but it interferes with sleep quality. Your best bet is to take a tincture (Kamhi recommends 100 mg.) or lay on a pillow stuffed with dried hops flowers, a time-honored European sleep solution.

Kava kava (Piper methysticum) As a muscle relaxant, kava kava is wonderful for anyone whose sleep is plagued by pain. Plus, its anti-anxiety components can quiet your mind if you're lying awake worrying that you're lying awake. Kava kava is an acquired taste, so Americans may prefer tincture to tea. Take what Kamhi calls.a "loading dose"--300 mg. of standardized extract at bedtime. Kava kava affects motor function, so don't drink it before driving.

Valerian (Valeriana officinalis) The Scud missile of anti-insomnia herbs, valerian is often called "herbal Valium" (even though it's unrelated to the prescription drug) because of its proven ability to relax muscles, reduce anxiety and bring on sleep, swiftly and predictably. And although it has a distinctive odor (similar to sweaty gym socks), it actually makes a tasty tea. You can also try the tincture mixed in water or juice. Kamhi recommends 300 to 400 mg. of standardized extract at bedtime. Tim Blakely, a Rutland, Ohio-based herbalist, combines valerian with kava kava (four dropperfuls each) to make a very potent cocktail right before bedtime. Because valerian depresses the central nervous system, it should not be taken before driving and should be avoided during pregnancy. Caveat: In 10 percent of adults, valerian acts as a stimulant rather than a sedative.

Resources
National Sleep Foundation
729 15th St. NW, 4th. fl.
Washington, DC 20005
www.sleepfoundation.org

American Sleep Disorders Association
1610 14th St. NW, Ste. 300
Rochester, MN 55901
www.asda.org
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By Martha Schindler

Martha Schindler is a freelance writer in Cambridge, Mass.

HOMEOPATHY FOR SLEEP
Homeopathy is based on a simple premise: Substances that provoke symptoms of an illness in one who is healthy can help stimulate an ill person's capacity to heal the same symptoms.

One of the most popular homeopathic sleep aids is derived from the plant revered the world over for its ability to keep us awake: coffee. Homeopathic Coffea cruda can be very useful for insomnia brought on by an overactive mind, says Nancy Russell, M.D., a holistic internist in Kansas City, Mo. Other homeopathic remedies for insomnia include Chamomilla (chamomile), Passaflora (passionflower), Nux vomica (helpful when you wake up in the middle of the night or too early in the morning because of anxiety or a racing mind) and Ignatia (for the insomniac who keeps herself up worrying about her sleeplessness). All of these remedies are vegetarian and can be taken in 30 strength potencies; follow label instructions for proper dosages.

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