When considering the use of CAM for insomnia in particular, an analysis of the National Health Interview Survey (NHIS) dataset (74.3% response rate) in 2008, by Pearson et al. revealed that 4.5% adults (over age 18, noninstitutionalized) used some form of CAM for their insomnia or trouble sleeping in the past year.

The most commonly used CAM modalities in adults were biologically based therapies (64.8% of adult CAM users) and mind-body therapies (39.1% of adult CAM users); those with comorbidities tended to prefer biologically based therapies.

Lets look at some of the biologically based therapies for insomnia

Melatonin

Melatonin is one of the most thoroughly studied CAM biologic compounds used for sleep. It is a hormone produced by the pineal gland that is postulated to play a significant role in regulating the sleep-wake cycle. It has low daytime circulating levels and elevated nocturnal levels that coincide with the sleep phase. Melatonin has the ability to influence the timing of the circadian sleep-wake cycle, as has been demonstrated by work in subjects with a free-running circadian rhythm.

It may also have sedative effects possibly via direct inhibition of the suprachiasmatic nucleus via a feedback loop. Melatonin injected into other brain regions, such as the medial preoptic area, can induce sleep as well.

Numerous studies have shown decreased melatonin levels in the elderly relative to subjects under age 30.

The presence of insomnia itself is also independently associated with serum melatonin deficiency in some studies but not in others. Melatonin deficiency is due to three potential factors: medications, age-related changes, and melatonin suppression from co-morbid medical condition.

Valerian

Valerian has been studied in several randomized, placebo-controlled trials, including several studies in older adults. There is evidence of a mild subjective improvement in sleep with valerian, especially when used for two weeks or more. However, the objective testing has had less consistent results with little or no improvement noted. The plant species Valeriana, in particular Valeriana officinalis and to a lesser extent Valeriana edulis, is the source of the ingredients in valerian.

Herbs for Insomnia

Herbal and other natural sleep aids are gaining popularity, as herbs commonly used for their sedative-hypnotic effects do not have the drawbacks of conventional drugs.

While similar effectiveness and risk concerns exist for herbal remedies, many individuals turn to such alternatives to prescriptions for insomnia. Like prescription hypnotics, herbal remedies that have undergone clinical testing often show subjective sleep improvements that exceed objective measures, which may relate to interindividual heterogeneity and/or placebo effects.

Browse the below links for an alphabetical list of herbal remedies –

Natural remedies may be perceived as safer than prescriptions, although risk concerns have been raised for many supplements. A recent report indicated that the majority of herbal remedies sampled had contamination, substitution, or use of fillers not indicated in the labeling.

Studies suggest that St. John’s wort (Pipericum perforatum), Kava kava (Piper methysticum), Valerian (Valerinana officinalis) and Passion flower (Passiflora incameta) and other herbs, which have been used for the treatment of insomnia have become popular as an alternative medicine.However, preclinical and clinical studies are needed to evaluate the precise effects of natural products for the treatment of insomnia.

References

Alternative remedies for insomnia: a proposed method for personalized therapeutic trials @ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364017/