Sleep Disorders and CAM: At a Glance 

People who have trouble sleeping may try dietary supplements, 

relaxation therapies, or other forms of complementary and 

alternative medicine (CAM) in an effort to fall asleep faster, stay 

asleep longer, and improve the overall quality of their sleep. This 

fact sheet provides basic information on sleep disorders and “what 

the science says” about the effectiveness of CAM practices people 

use as sleep aids. If you are considering a CAM therapy for sleep 

problems, this information can help you talk with your health care 

provider about it. 

About Sleep Disorders 

Chronic, long-term sleep disorders affect millions of Americans each 

year. These disorders and the sleep deprivation they cause can 

interfere with work, driving, social activities, and overall quality of 

life, and can have serious health implications. Sleep disorders 

account for an estimated $16 billion in medical costs each year, plus 

indirect costs due to lost productivity and other factors. 

There are more than 80 defined sleep disorders. Insomnia— 

difficulty falling asleep, difficulty staying asleep, and/or poor sleep 

quality—is one of the most common sleep disorders. Insomnia tends 

to increase with age, and is often associated with an underlying 

medical or psychiatric condition. Other sleep disorders include sleep 

apnea (breathing interruptions during sleep), restless leg syndrome 

(a tingly or prickly sensation in the legs), and narcolepsy (daytime 

“sleep attacks”). This fact sheet focuses on insomnia. 

Lifestyle changes—for example, To learn more about healthy establishing a regular sleep sleep, visit the National Heart, schedule, relaxing before bedtime, Lung, and Blood Institute’s Your exercising regularly, and avoiding Guide to Healthy Sleep at: alcohol, caffeine, and nicotine— 

www.nhlbi.nih.gov/health/ can sometimes improve sleep public/sleep/healthy_sleep.pdf. quality. (A common 

misconception is that drinking 

alcohol will aid sleep; although it can bring on a light sleep, alcohol 

actually robs people of the deeper stages of sleep.) Many 

prescription medications and over-the-counter sleep aids are widely 

advertised and used for insomnia; most have side effects and are 

intended for short-term use. Evidence suggests that cognitive­
behavioral (nondrug) therapies for insomnia may have long-term benefits. People with 

insomnia may also try dietary supplements and other CAM therapies. 

CAM Use for Insomnia 

In 2002 and 2007, the National Health Interview Survey (NHIS) asked participants about CAM 

use. In 2002, 2.2 percent of respondents who used some form of CAM in the past 12 months 

said they used it for insomnia or trouble sleeping; in 2007, that figure was 1.4 percent. 

An analysis of data from the 2002 NHIS found that 17.4 percent of all participants said they 

regularly had insomnia or trouble sleeping in the past 12 months; most who reported insomnia 

also reported other medical/psychiatric conditions, such as anxiety or depression, chronic 

heart failure, diabetes, hypertension, and obesity. Among participants with insomnia, 4.5 

percent (which translates to a total of 1.6 million U.S. adults) used some form of CAM to treat 

their condition—primarily biological/herbal therapies (64.8 percent) or mind-body/relaxation 

therapies (39.1 percent). Most found these therapies helpful. 

Among the CAM approaches that people use for insomnia are 

	 Herbs, including aromatherapy, chamomile tea, and herbal supplements such as valerian 

and various “sleep formula” products 

 Melatonin and related dietary supplements 

 Other CAM modalities, such as acupuncture, music therapy, and relaxation techniques. 

What the Science Says About CAM and Insomnia 

Research on CAM and insomnia has produced promising results for some CAM therapies. 

However, evidence of effectiveness is still limited for most therapies, and additional research 

is needed. This section summarizes what is known about some of the CAM approaches that 

people use for insomnia. 

Herbs 

	 Aromatherapy using essential oils from herbs such as lavender or chamomile is a popular sleep 

aid; preliminary research suggests some sleep-inducing effects, but more studies are needed. 

	 The herb chamomile is commonly used as a bedtime tea, but scientific evidence of its 

effectiveness for insomnia is lacking. 

	 The herb kava has been used for insomnia, but there is no evidence of its efficacy. The U.S. 

Food and Drug Administration has issued a warning that kava supplements have been 

linked to a risk of severe liver damage. 

	 The herbal supplement valerian is one of the most popular CAM therapies for insomnia. 

Several studies suggest that valerian (for up to 4-to-6 weeks) can improve the quality of 

sleep and slightly reduce the time it takes to fall asleep. However, not all of the evidence is 

2 
positive. One systematic review of the research concluded that although valerian is 

commonly used as a sleep aid, the scientific evidence does not support its efficacy for 

insomnia. Researchers have concluded that valerian appears to be safe at recommended 

doses for short-term use. Some “sleep formula” products combine valerian with other 

herbs such as hops, lavender, lemon balm, and skullcap. Although many of these other 

herbs have sedative properties, there is no reliable evidence that they improve insomnia or 

that combination products are more effective than valerian alone. 

Melatonin and Related Supplements 

	 Like valerian, melatonin supplements (melatonin is a naturally occurring hormone 

associated with sleep) are widely used and researched for insomnia. Although more 

research is still needed, studies suggest that melatonin can help elderly people with 

insomnia fall asleep faster, and may also be beneficial for other people with insomnia; 

however, effects are generally small, with larger effects observed in patients whose sleep 

problems are caused by a circadian rhythm abnormality (disruption of the body’s internal 

“clock”). Studies indicate that melatonin also appears to be safe at recommended doses for 

short-term use. 

	 Dietary supplements containing melatonin “precursors”—L-tryptophan and 5-HTP—are 

also used as sleep aids. (The amino acid L-tryptophan is converted to 5-HTP, which is 

converted to serotonin and then melatonin.) However, these supplements have not been 

proven effective in treating insomnia, and there are concerns that they may be linked to 

eosinophilia-myalgia syndrome (EMS), a complex and debilitating systemic condition with 

multiple symptoms including severe muscle pain. 

Other CAM Approaches 

	 Traditional Chinese medicine commonly uses acupuncture to treat insomnia. A review of 

available studies found some evidence of benefits, but many studies had design flaws that 

make it difficult to draw firm conclusions. 

	 There is scientific evidence that music therapy can have sleep benefits for older adults 

and children. 

	 Studies suggest that relaxation techniques may help people with insomnia, although the 

effects appear to be short-lived. Cognitive forms of relaxation (such as meditation) have 

had slightly better results than somatic forms (such as progressive muscle relaxation). 

Preliminary studies suggest that yoga may also improve sleep quality. In addition, when 

these forms of relaxation are combined with other components of cognitive-behavioral 

therapy (e.g., sleep restriction and stimulus control), lasting improvements in sleep have 

been observed. Again, additional research is needed in these areas. 

3 
NCCAM Research on Sleep Disorders 

The National Center for Complementary and Alternative Medicine (NCCAM) funds clinical 

trials that look at CAM for sleep disorders. Recent projects include studies of: 

 High-intensity light therapy to help Alzheimer’s disease patients sleep 

 Hypnosis to relieve sleep impairment in people with posttraumatic stress disorder 

 Melatonin supplements as a sleep aid for people with hypertension 

 Mindfulness-based stress reduction to improve sleep quality 

 Valerian for improving sleep in healthy, older adults and in patients with Parkinson’s disease 

 Yoga as a treatment for insomnia. 

In addition to clinical trials, NCCAM also supports basic science research aimed at 

understanding the underlying biological mechanisms of CAM therapies, including those used 

to treat sleep disorders. 

If You Are Considering CAM for Sleep Problems 

	 Talk to your health care providers. Tell them about the therapy you are considering and 

ask any questions you may have. They may know about the therapy and be able to advise 

you on its safety, use, and likely effectiveness in relieving your sleep problems. Because 

trouble sleeping can be an indication of a more serious condition, it is especially important 

to discuss any sleep-related symptoms (such as snoring or daytime fatigue) with your 

health care providers before trying a CAM approach. 

	 Be cautious about using any sleep product—prescription medications, over-the-counter 

drugs, or CAM dietary supplements. Find out about potential side effects and the effects of 

long-term use and use of more than one product at a time. 

	 If you are considering herbal or other dietary supplements, keep in mind that “natural” 

does not always mean safe. For example, the herbs comfrey and kava can cause serious 

harm to the liver. Also, a manufacturer’s use of the term “standardized” (or “verified” or 

“certified”) does not necessarily guarantee product quality or consistency. Herbal or other 

dietary supplements can act in the same way as drugs. They can cause medical problems if 

not used correctly, and some may interact with medications you are already taking. The 

health care providers you see about your sleep problems can advise you. It is especially 

important to consult your health care provider if you are pregnant or nursing a child, or if 

you are considering giving a child a dietary supplement. For more information, see the 

NCCAM fact sheet Using Dietary Supplements Wisely at nccam.nih.gov/health/supplements/ 

wiseuse.htm. 

	 If you are considering a practitioner-provided CAM therapy such as acupuncture, check 

with your insurer to see if the services will be covered, and ask a trusted source (such as 

your doctor or a nearby hospital or medical school) to recommend a practitioner. 

	 Tell all your health care providers about any complementary and alternative practices you 

use. Give them a full picture of what you do to manage your health. This will help ensure 

coordinated and safe care. For tips about talking with your health care providers about 

CAM, see NCCAM’s Time to Talk campaign at nccam.nih.gov/timetotalk/. 

4 
 

Selected References 

Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, 


2007. CDC National Health Statistics Report #12. 2008.
 

Bent S, Padula A, Moore D, et al. Valerian for sleep: a systematic review and meta-analysis. American Journal of Medicine. 


2006;119(12):1005-1012.
 

Bliwise DL, Ansari FP. Insomnia associated with valerian and melatonin usage in the 2002 National Health Interview 


Survey. Sleep. 2007;30(7):881-884. 


Brzezinski A, Vangel MG, Wurtman RJ, et al. Effects of exogenous melatonin on sleep: a meta-analysis. Sleep Medicine 


Reviews. 2005;9(1):41-50.
 

Buscemi N, Vandermeer B, Hooton N, et al. The efficacy and safety of exogenous melatonin for primary sleep 


disorders. A meta-analysis. Journal of General Internal Medicine. 2005;20(12):1151-1158. 


Buscemi N, Vandermeer B, Pandya R, et al. Melatonin for Treatment of Sleep Disorders. Evidence Report/Technology 


Assessment no. 108. Rockville, MD: Agency for Healthcare Research and Quality; 2004. AHRQ Publication No. 05-E002-2. 


Cheuk DK, Yeung WF, Chung KF, et al. Acupuncture for insomnia. Cochrane Database of Systematic Reviews (Online). 


2007;(3):CD005472. 


Information paper on L-tryptophan and 5-hydroxy-L-tryptophan. U.S. Food and Drug Administration, Center for Food 


Safety and Applied Nutrition Web site. Accessed at http://www.cfsan.fda.gov/~dms/ds-tryp1.html on August 25, 2008.
 

Kierlin L. Sleeping without a pill: nonpharmacologic treatments for insomnia. Journal of Psychiatric Practice. 


2008;14(6):403-407. 


Melatonin. Natural Standard Database Web site. Accessed at http://www.naturalstandard.com on August 19, 2008.
 

Morin AK, Jarvis CI, Lynch AM. Therapeutic options for sleep-maintenance and sleep-onset insomnia. Pharmacotherapy. 


2007;27(1):89-110. 


Morin CM, Bootzin RR, Buysse DJ, et al. Psychological and behavioral treatment of insomnia: update of the recent 


evidence (1998-2004). Sleep. 2006;29(11):1398-1414. 


National Institute of Neurological Disorders and Stroke. Brain Basics: Understanding Sleep. Accessed at 


http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm on August 19, 2008. 


National Institutes of Health. State of the Science Conference Statement on Manifestations and Management of Chronic 

Insomnia in Adults. NIH Consensus and State-of- the-Science Statements. 2005;22(2):1-30.
 

Natural Medicines in Clinical Management of Insomnia. Natural Medicines Comprehensive Database: Clinical 


Management Series. Accessed at http://www.naturaldatabase.com on August 12, 2008.
 

Pearson NJ, Johnson LL, Nahin RL. Insomnia, trouble sleeping, and complementary and alternative medicine. Archives 


of Internal Medicine. 2006;166(16):1775-1782.
 

Sleep disorders. Natural Standard Database Web site. Accessed at http://www.naturalstandard.com on August 19, 2008.
 

Taibi DM, Landis CA, Petry H, et al. A systematic review of valerian as a sleep aid: safe but not effective. Sleep Medicine
 

Reviews. 2007;11(3)209-230.
 

Valerian. Natural Standard Database Web site. Accessed at http://www.naturalstandard.com on August 19, 2008.
 

Valerian. Office of Dietary Supplements Web site. Accessed at http://ods.od.nih.gov/factsheets/valerian.asp on
 

November 3, 2008. 


For More Information 

Visit the NCCAM Web site (nccam.nih.gov) for more information about the CAM therapies 

discussed in this fact sheet (including clinical trials), as well as important tips for being an 

informed consumer of CAM services and products. 

5 
NCCAM Clearinghouse 

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications 

and searches of Federal databases of scientific and medical literature. The Clearinghouse does 

not provide medical advice, treatment recommendations, or referrals to practitioners. 

Toll-free in the U.S.: 1-888-644-6226 

TTY (for deaf and hard-of-hearing callers): 1-866-464-3615 

Web site: nccam.nih.gov 

E-mail: info@nccam.nih.gov 

PubMed® 

A service of the National Library of Medicine (NLM), PubMed® contains publication information 

and (in most cases) brief summaries of articles from scientific and medical journals. CAM on 

PubMed®, developed jointly by NCCAM and NLM, is a subset of the PubMed system and focuses 

on the topic of CAM. 

Web site: www.ncbi.nlm.nih.gov/sites/entrez 

CAM on PubMed®: nccam.nih.gov/camonpubmed/ 

National Heart, Lung, and Blood Institute (NHLBI) 

NHLBI provides global leadership for a research, training, and education program to promote 


the prevention and treatment of heart, lung, and blood diseases. 


Web site: http://www.nhlbi.nih.gov/ 


National Center on Sleep Disorders Research: http://www.nhlbi.nih.gov/about/ncsdr/ 


NIH National Library of Medicine’s MedlinePlus 

Sleep disorders listing: www.nlm.nih.gov/medlineplus/sleepdisorders.html 

Acknowledgments 

NCCAM thanks the following people for their technical expertise and review of this 

publication: Nalaka S. Gooneratne, M.D., Geriatric Sleep Research Program, University of 

Pennsylvania Medical School; Daniel S. Lewin, Ph.D., and Michael Twery, Ph.D., National 

Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute; David P. White, 

M.D., Sleep Disorders Program, Brigham and Women’s Hospital, Boston; and Barbara C. Sorkin, 

Ph.D., NCCAM. 

This publication is not copyrighted and is in the public domain.
 

Duplication is encouraged.
 

NCCAM has provided this material for your information. It is not intended to substitute for the medical 

expertise and advice of your primary health care provider. We encourage you to discuss any decisions 

about treatment or care with your health care provider. The mention of any product, service, or therapy 

is not an endorsement by NCCAM. 

National Institutes of Health 



U.S. Department of Health and Human Services 

D437 

Created July 2009 

Updated September 2010