July-Week2
Harrison Graves, M.D., FACEP

Alternative Treatments for Insomnia

Do you have trouble sleeping?
You are not alone.

The world is in the midst of epidemic insomnia. In the USA alone, 60 million prescriptions per year are written for sleeping pills. The global market for these drugs is expected to reach $9 billion in 2015.

Unfortunately, prescription sedatives are not the best treatment for insomnia. Safer and more natural alternatives are available. In this series of blogs, you will learn how to treat insomnia with Ayurveda, the holistic medicine from India.

The Problem with Ambien and the Other Z-Drugs

Ambien (zolpidem), and its competitors, Lunesta (eszopiclone), and Sonata (zaleplon), a group called the Z-drugs, have become the favorites of business travelers, shift workers, and insomniacs around the world. Even though these drugs have largely replaced the more addictive old school tranquilizers like Dalmane (flurazepam), Ativan (lorazepam), and Restoril (temazepam), problems with side effects still remain.

Dr. Nancy Collop, president of the American Academy of Sleep Medicine, had something surprising to say: “If someone comes to me on a sleeping pill, usually my tactic is to try to take them off it.” Leading sleep specialists around the world want to get their patients off sleeping pills, while patients want safer and more natural ways to treat insomnia.

Why I Stopped Prescribing Sleeping Pills

During my 25 years in the ER, I heard many patients complain of sleepless nights. Every time I chose to write a prescription for Ambien or any other sedative, I was not prescribing a cure. I was merely providing a quick fix, treating a symptom of insomnia, without addressing the real problem, the daily stress.

In addition, every patient with a prescription is exposed to a long list of side effects. According to Sanofi, the company that makes Ambien, these side effects may include:

  1. Impaired morning alertness
  2. Worsening of depression and suicidal thinking
  3. Drowsiness and incoordination that may lead to falls and severe injuries, especially in the elderly
  4. Possible drug dependence and withdrawal (Note: The Z-drugs are less addictive than the benzo class of tranquilizers, e.g., Valium, Xanax, Ativan.)

In addition, Ambien is not recommended for pregnant women or for patients under age of 18 – 7% of children given the drug hallucinated.

In 2013, the FDA required the manufacturers of Ambien (zoplidem) to cut the recommended dosage for women in half after laboratory studies showed that the drug, especially Ambien-CR (controlled-release), can leave patients drowsy in the morning and at risk for car accidents.

It is important to know that these sleeping pills are intended for short-term use only, up to 14 days. For many, however, insomnia is a long-term problem. Unfortunately, doctors often prescribe these pills for months on end, increasing the likelihood of drug tolerance and drug dependence. (Note: Many prescription sedatives need to be withdrawn gradually to help prevent withdrawal symptoms.)

As a physician interested in alternative medicine, I felt there must be a better way to treat insomnia. Fortunately, I discovered Ayurveda, “The Science of Life,” the 5,000-year-old system of natural healing from India. Ayurveda does not use the prescription pharmaceuticals so prevalent in the West. Instead, it uses the following natural and holistic ways to soothe the mind and induce effortless and restful sleep:

  1. Healing herbs by mouth
  2. Ayurvedic massage with herb-infused oils
  3. Mantra Meditation (aka Ayurvedic Sound Healing or The Yoga of Sound)
  4. An Ayurvedic diet, in which healing foods become medicines
  5. Yoga (the eight-part yoga system)
  6. Ayurvedic Psychological Counseling (APC)
  7. natural sleep environment
  8. Meditation (Yoga Nidra, a guided meditation for better sleep)

In my experience, most patients with insomnia, as well as those with mild to moderate anxiety and depression, can be successfully treated by Ayurvedic means alone — without the prescription pad. These holistic therapies have helped many patients eliminate their dependency on sleeping pills, antidepressants, tranquilizers (benzos), and even opiates.

This series of blogs will give you the Ayurvedic tools needed for a more restful sleep.

Going Natural: Ayurvedic Herbs for Better Sleep

One of the most powerful herbs in Ayurvedic healing is ashwagandha (Withania somnifera). It has been used since ancient times as a stress-buster, prescribed for insomnia, anxiety, lack of energy, fatigue, and difficulty concentrating. According to Dr. Deepak Chopra, ashwagandha can help alleviate these symptoms and support a new sense of wellbeing.

The root of the ashwagandha plant is the part most commonly used in Western herbal remedies. A relative of the tomato plant, ashwagandha is frequently referred to as “Indian ginseng” because of its rejuvenating properties, even though ginseng and ashwagandha are unrelated botanically.

How to Take Ashwagandha

Ashwagandha is typically ingested in capsule form. The recommended dose is 600 to 1,000 mg, twice daily.

For people who suffer from insomnia, having a cup of hot milk containing a teaspoon of powdered ashwagandha, one hour before bedtime, is most beneficial.

Medical Caution

Ashwagandha is not recommended for women who are pregnant. In addition, some patients may experience stomach irritation, lower blood sugar, and lower blood pressure.

In contrast to prescription sedatives, ashwagandha can improve memory and reaction time. It has been reported to help reduce brain cell degeneration and enhance sexual potency.

In addition to ashwagandha, other natural herbs that promote sleep include chamomile flowers, valerian root, nutmeg, and passionflower.

Many European herbal sleep remedies contain passionflower, or Passiflora incarnata, even though the plant comes from the tropical regions of the Americas, where it was widely used by the Aztecs. The leaves and flowers have a mild flavor and a reputation for reducing anxiety and sleeplessness caused by anxiety.

A Home Remedy

Are you fresh out of ashwagandha and passion flower?

One of the best sleep-inducing remedies is also the most readily available:
one cup of hot milk mixed with one teaspoon honey and one-half teaspoon nutmeg, taken one hour before bedtime. Milk contains tryptophan, an amino acid which helps induce sleep. Hot beverages are relaxing, while cold beverages are stimulating.

Summary

In this blog we covered some of the shortcomings of prescription sleeping pills and featured some of Ayurveda’s holistic alternatives.

Next month’s blog will focus on Ayurvedic massage with herb-infused oils and aromatherapy oils for sleep.

Harrison Graves, MD, FACEP

Q & A with Dr. G

What other Ayurvedic herbs do you recommend?


There is one Ayurvedic herbal formula that is recommended for almost every adult. It is a three-in-one tonic called Triphala, or “the three fruits,” and is used for both rejuvenation and detoxification. It consists of the three herbs amalaki, haritaki, and bibhitaki.

Amalaki is a rejuvenative tonic, packed with Vitamin C, which can help lower cholesterol.

Haritaki has been called the Tibetan “king of medicine.” It maintains regular elimination, helps promote healthy body weight, and supports comfortable and complete digestion. Haritaki is highly revered in India, since it is believed to increase energy, intelligence, and awareness.

Bibhitaki is one of the best herbs for detoxifying and rejuvenating the entire body.

Check out Part 2: Ayurvedic Massage and Aromatherapy & Part 3: Meditation of this blog series for other ways to help treat insomnia.

About Harrison Graves, M.D., FACEP:
Dr. Harrison Graves, M.D., FACEP is our expert in holistic medicine, specializing in the treatment of anxiety, depression, or insomnia. He is heavily influenced by Ayurveda, the holistic medicine of India, and believes that many illnesses, especially those that are anxiety related, can be prevented with Ayurveda, lifestyle changes, and yoga. In his articles for the BoomSpot, the blog of the online store theBoomShop.com, Dr. Graves provides insight on alternative methods of maintaining physical and mental wellbeing. You can learn more by visiting his website, asktheholisticmd.com.
DISCLAIMER: The content of theBoomShop.com and BoomSpot is offered on an informational basis only, and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified health provider before making any adjustment to a medication or treatment you are currently using, and/or starting any new medication or treatment. All recommendations are "generally informational" and not specifically applicable to any individual's medical problems, concerns and/or needs.