<h2><strong>Prevalence</strong></h2><ul><li>In Australia, insomnia has an estimated prevalence of 20-30% in the adult population1</li><li>33-45% of Australians experience at least one symptom of insomnia, such as difficulty falling asleep or staying asleep, at least three nights per week1</li><li>It is more prevalent in women, older adults, and those with medical or mental health conditions1</li></ul><p> </p><h2><strong>There are several types of insomnia:</strong></h2><p><strong>1. Sleep onset insomnia (also known as sleep latency insomnia)</strong></p><ul><li>Characterised by difficulty falling asleep within 30 minutes of going to bed5</li><li>Causes: not fully understood, but popular hypotheses include hyperarousal of the central nervous system (through stress or anxiety), imbalances in neurotransmitters, and disruption of the circadian rhythm2,5</li><li>Other contributing factors: genetics, caffeine and alcohol consumption, irregular sleep schedules, and environmental factors such as noise and light exposure3</li></ul><p><strong>2. Sleep maintenance insomnia</strong></p><ul><li>Characterised by difficulty staying asleep, leading to frequent awakenings during the night5</li><li>Causes: may be related to hyperarousal of the central nervous system (through stress or anxiety), imbalances in neurotransmitters, and disruption of the circadian rhythm2,5</li><li>Other contributing factors: genetics, medical conditions, such as sleep apnoea and restless legs syndrome, as well as lifestyle factors such as alcohol and caffeine consumption3</li></ul><p><strong>3. Early morning awakening insomnia</strong></p><ul><li>Characterised by awakening in the early morning and inability to go back to sleep5</li><li>There is a link between mood disorders such as depression, and this form of insomnia4</li></ul><p><strong>4. A combination of the above</strong></p><h3><strong> </strong>

Herbs for sleep support</h3><h3></h3><img src="https://images.contentstack.io/v3/assets/blt948bd74310fc0ad0/blt30bf3357cdbdff11/69f29b6661d51a1c4bdbf2e2/herbs-for-sleep-support.jpg" alt="herbs-for-sleep-support.jpg" class="embedded-asset" /><h3>
Nutrients for sleep support</h3><h3></h3><img src="https://images.contentstack.io/v3/assets/blt948bd74310fc0ad0/blt55d178f1a81ff791/6a7ea8efc5d6fd11d5959bb4/Nutrients_for_sleep_support.jpg" alt="Nutrients for sleep support.jpg" width="764" height="398" class="embedded-asset" style="max-width:764px;width:764px;max-height:398px;height:398px" /><h2><strong></strong></h2><h2><strong>An Integrative approach</strong></h2><p><strong>Complementary medicines:</strong></p><ul><li>Improve sleep quality and duration by selecting the most appropriate complementary medicine ingredients</li></ul><p><strong>Diet and lifestyle interventions:</strong></p><ul><li>Decrease body-mass index6</li><li>Increase exercise and physical activity6</li><li>Lower caffeine coffee, tea and caffeine containing energy and sports drinks6,7</li><li>Maintain a regular sleep schedule7</li><li>Avoid large meals before bedtime7</li><li>Yoga and tai chi may improve sleep duration or quality8</li><li>Good evidence supports cognitive behavioural therapy and relaxation therapy7</li><li>Improve sleep hygiene and sleep environment6</li><li>Reduce digital screen time before bed6</li></ul><h2><strong></strong></h2><p>For full list of interactions see the <a href="https://www.blackmoresinstitute.org/cmig" target="_self">Complementary Medicine Interactions Guide</a> (CMIG).</p><p></p><h2> References
</h2><ol><li>Sleep Health Foundation. (2019). Asleep on the job: Counting the cost of poor sleep in Australia. Sydney, Australia: Sleep Health Foundation. https://www.sleephealthfoundation.org.au/ (accessed 05.04.2023)</li><li>Riemann D. et al. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev. 2010 Feb;14(1):19-31.</li><li>American Psychological Association. https://www.apa.org/monitor/oct01/insomnia (accessed 03.04.2023)</li><li>Tribl GG. et al. Dreaming under antidepressants: a systematic review on evidence in depressive patients and healthy volunteers. Sleep Med Rev. 2013 Apr;17(2):133-42.</li><li>Sleep Foundation. https://www.sleepfoundation.org/insomnia/types-of-insomnia (accessed 03.04.2023)</li><li>Merrill RM. et al. The effects of an intensive lifestyle modification program on sleep and stress disorders. J Nutr Health Aging. 2007;11(3):242-8.</li><li>Mayo Clinic. Insomnia. https://www.mayoclinic.org/diseases-conditions/insomnia/diagnosis-treatment/drc-20355173 (accessed 14.04.2023)</li><li>Sarris J, Byrne GJ. A systematic review of insomnia and complementary medicine. Sleep Med Rev. 2011;15(2):99-106.</li><li>Yamadera W. et al. Glycine ingestion improves subjective sleep quality in human volunteers, correlating with polysomnographic changes. Sleep and Biological Rhythms. 2007;5(2):126-131.</li><li>Inagawa K. et al. Subjective effects of glycine ingestion before bedtime on sleep quality. Sleep and Biological Rhythms. 2006;4(1):75-77.</li><li>Bannai M. et al. The effects of glycine on subjective daytime performance in partially sleep-restricted healthy volunteers. Front Neurol. 2012;3:61.</li><li>Rao TP. et al. In search of a safe natural sleep aid. J Am Coll Nutr. 2015;34:436-447.</li><li>Lyon MR. The effects of L-theanine (Suntheanine®) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trial. Altern Med Rev. 2011;16:348-354.</li><li>Schmidt HS. L-tryptophan in the treatment of impaired respiration in sleep. Bulletin Europeen de Physiopathologie Respiratoire. 1983 Nov-Dec;19(6):625-629.</li><li>Lieberman HR. et al. Tryptophan Intake in the US Adult Population Is Not Related to Liver or Kidney Function but Is Associated with Depression and Sleep Outcomes. J Nutr. 2016;146(12):2609S-2615S.</li><li>Abbasi B. et al. The effect of magnesium supplementation on primary insomnia in elderly: a double-blind placebo-controlled clinical trial. J Res Med Sci. 2012;17(12):1161-1169.</li><li>Dimpfel W, Suter A. Sleep improving effects of a single dose administration of a valerian/hops fluid extract: a double blind, randomised, placebo-controlled sleep-EEG study in a parallel design using electrohypnograms. Eur J Med Res. 2008;13(5):200-204.</li><li>Salter S, Brownie S. Treating primary insomnia: the efficacy of valerian and hops. Aust Fam Physician. 2010;39(6):433-437.</li><li>Donelli D. et al. Effects of lavender on anxiety: A systematic review and meta-analysis. Phytomedicine. 2019;5:153099.</li><li>Kang HJ. et al. How Strong is the Evidence for the Anxiolytic Efficacy of Lavender?: Systematic Review and Meta-analysis of Randomized Controlled Trials. Asian Nurs Res (Korean Soc Nurs Sci). 2019;13(5):295-305.</li><li>Dressing H. et al. Insomnia: are valerian/balm combinations of equal value to benzodiazepine? Therapiewoche. 1992;726-736.</li><li>Cerny A, Schmid K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers (a double-blind, placebo-controlled, multicentre study). Fitoterapia. 1999;70:221-228.</li><li>Muller SF, Klement S. A combination of valerian and lemon balm is effective in the treatment of restlessness and dyssomnia in children. Phytomedicine. 2006;13(6):383-387.</li><li>Taavoni S. et al. Valerian/lemon balm use for sleep disorders during menopause. Complementary Therapies in Clinical Practice. 2013;19(4):193-196.</li><li>Lee J. et al. Effects of Passiflora incarnata Linnaeus on polysomnographic sleep parameters in subjects with insomnia disorder: a double-blind randomized placebo-controlled study. Int Clin Psychopharmacol. 2020;35(1):29-35.</li><li>Maroo N. et al. Efficacy and safety of a polyherbal sedative-hypnotic formulation NSF-3 in primary insomnia in comparison to zolpidem: a randomized controlled trial. Indian J Pharmacol. 2013;45(1):34-39.</li><li>Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers. Altern Ther Health Med. 2003 Mar-Apr;9(2):74-78.</li><li>Brock C. et al. American Skullcap (Scutellaria lateriflora): a randomised, double-blind placebo-controlled crossover study of its effects on mood in healthy volunteers. Phytother Res. 2014 May;28(5):692-698.</li><li>Deshpande A. et al. A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults. Sleep Med. 2020 Aug;72:28-36.</li><li>Kelgane SB. et al. Efficacy and Tolerability of Ashwagandha Root Extract in the Elderly for Improvement of General Well-being and Sleep: A Prospective, Randomized, Double-blind, Placebo-controlled Study. Cureus. 2020;12(2):e7083.</li><li>Langade D. et al. Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study. J Ethnopharmacol. 2021 Jan 10;264:113276.</li><li>Bent S. et al. Valerian for sleep: a systematic review and meta-analysis. Am J Med. 2006;119(12):1005-1012.</li><li>Fernández-San-Martín MI. et al. Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep Med. 2010;11(6):505-511.</li><li>Leach MJ, Page AT. Herbal medicine for insomnia: A systematic review and meta-analysis. Sleep Med Rev. 2015;24:1-12.</li><li>Mahmoudi R. et al. Investigation the effect of jujube seed capsule on sleep quality of postmenopausal women: A double-blind randomized clinical trial. Biomedicine (Taipei). 2020 Dec 1;10(4):42-48.</li><li>Shergis JL. et al. Medicinal seeds Ziziphus spinosa for insomnia: A randomized, placebo-controlled, cross-over, feasibility clinical trial. Complement Ther Med. 2021 Mar;57:102657.</li></ol><p></p>

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