What happens when things go bump in the night and you are awake to hear them?  Well, the answer is insomnia.  For some a slight annoyance Insomnia pt2 shrunkand for others a living hell.  This is the second part in a multi- part series on insomnia for fluoroquinolone sufferers (Part #1 is here).  In this part I will look at herbs for insomnia.

Those of you who know me, know that I am definitely not a fan of pharmaceutical medications, however there is something that should go without saying: all herbs are plant-derived drugs, without exception.  Just because things are “natural” doesn’t mean that they are natural to the body or that the the body will respond any better than synthetic medications.  Having said that here is a  list of the most popular herbs used for insomnia.  When possible I have included a quick summary of any anecdotal floxed information passed to me.  Please consult with your trusted medical professional before beginning any new medication (herb or otherwise).

Valerian (Valeriana officinalis): The herb Valerian is available in capsules, tea, or tincture, however I find the valerian tincture quite repugnant smelling and unpleasant tasting.  Valerian does work on the GABA receptors and some floxed folks report paradoxical symptoms with Valerian just as if they are taking benzodiazepines.  If taking capsules it is best to take them about an hour before bed.   Some people take them during the night if they wake up and cannot get back to sleep.   Regular use of Valerian can cause your body to get use to it and the effects become diminished, so it is best to take a break after a while and switch to something else.

California Poppy (Eschscholzia californica):  This herb is generally used for insomnia due to restlessness and anxiety.  According to some, this herb can help you to fall asleep, it improves the quality of your sleep as well.  Some people have combined this with valerian, if they find they need a stronger sedative (however if you are a sensitive individual I would caution against this until you know how you respond to one or the other). This herb is available in capsules and tincture.  The tincture is the most powerful way to take this herb.

Passion Flower (Passiflora incarnata): The herb Passion flower seems to be useful for those who have a tendency  to wake frequently throughout the night. Passion flower seems to have a good safety record and the body does not seem to build up tolerance as easy as other herbs.  It seems that some individuals have to take quite a bit to get the desired effects.  The herb comes in capsules and tincture, again the tincture  seems to be more powerful.

Hops (Humulus lupulus): Hops seem to be a fast-acting and mild sedative that can reduce anxiety before bed. This herb is also reportedly used in combination with Valerian very frequently. This herb does contain natural steroids which should be avoided by some individuals such as pregnant women and children under two years of age.  Usually available in capsules, tincture or tea.

Chamomile (Matricaria recutita):  Generally used as a tea, but also available in capsule form, this herb seems to have mild anti-anxiety properties which probably helps promotes relaxation and drowsiness at bedtime.  Researchers have not been able to directly correlate a link between sleep and humans,  but it has been used for centuries by humans for its tranquil effects.

Kava Kava (Piper methysticum): Kava kava is often used as an herbal insomnia remedy. This herb is available in tincture and capsule forms. This particular herb is from the South Seas, where it was is used for a variety of health complaints, one of them being insomnia.  When used as natural sleep aid, kava kava can induce a natural calm feeling. This herb has been growing in use for insomnia and chronic fatigue in the U.S.  Kava has many health concerns associated with its use.  The most important is liver toxicity.  Kava is extremely hard on the liver and reports of liver damage have occurred even with short term use.  It has many drug interaction warnings due to its heavy cytochrome P450 substrate usage.  It is always wise to consult a healthcare professional if you use any herbs, and that caution is especially important with this herb.  More info on liver effects here. 

Skullcap (Scutellaria lateriflora): Traditionally used for restless leg syndrome and other causes of insomnia. Skullcap reliefs nervous tension and renews the central nervous system. It is often combined with other herbs to create blends of herbs for insomnia.   Many people who have tried skullcap alone say that it is more effective as a very mild relaxant and some report no sedatative effects whatsoever. Be careful when choosing a source as all skullcap products are not always what the labels claim. The plants germander and teucrium are often unwanted and unlabeled ingredients in skullcap products. Secondly, you may think you are buying Scuttelaria lateriflora, the species of skullcap that has been studied for medicinal use, but the product may contain a different species of skullcap instead. The most often substituted species are Western Skullcap (Scuttelaria canescens), Southern Skullcap (Scutellaria cordifolia), or Marsh Skullcap (Scutellaria galericulatum). These species contain different chemicals, so they are not considered interchangeable. More information on liver effects here.

Magnolia Bark (Magnolia officinalis): Magnolia bark seems to help reduce stress and probably helps promotes relaxation and drowsiness at bedtime. It appears this herb accomplishes this by reducing coristol which, for some, is responsible for nighttime sleeplessness.  Some have claimed that this herb  can promote rapid drowsiness so caution would be needed if mental concentration is needed such as operating a vehicle.  This herb maybe useful for when you wake in the night only more so than other recommended herbs, since, for some, magnolia bark promotes rapid drowsiness. It also appears that pregnant and nursing women should avoid this herb.

Ashwagandha (Withania somnifera): Ashwagandha is a remarkable herb that is an adaptogenic, helping the body adapt to stress. Although it is not a sedative per se, it can help get you back to sleep if you are experiencing cortisol/anxiety spike.  I have heard of several folks who have used this herb to help with the effects of stress.  It seems to reduce stress effects by delaying the release of cortisol, it gets to work healing the effects of stress on the body.  One effective way of taking it, is by a 500mg daily tonic. This herb seems to be safe for most individuals however since it has effects on many systems in the body I recommend the each person research this for themselves.

Lemon Balm (Melissa officinalis):  Lemon balm was traditionally used for digestive disturbances. It is currently used for relieving nervousness, improving sleep, reducing over excitability and has a mild sedative effect. Lemon balm seems to works by enhancing GABA activity thus calming the brain and nervous system.

Although I am sure one can find many more herbs that could be useful to help promote sleep, this list should serve as a basic primer on some of the more popular herbs.  The confounding aspect of insomnia is its myriad of sources regardless if the root cause was initially fluoroquinolone (FQ) exposure. FQ induced sleeplessness can be due to anxiety, spiking cortisol, spiking or dropping blood sugar levels, certain drugs and/or supplements or even food intolerances.  It is generally found that herbs used to treat insomnia generally have fewer or gentler side effects than drugs prescribed for the same purpose.  Some herbs can help you sleep by helping to relieve anxiety, stress, or restlessness, while others work directly on the central nervous system to promote sleepiness. Stay informed.   In the next part in this series on insomnia, I will look specifically at supplements used to for insomnia.