Sleep tight: natural alternatives to sleeping pills. (Your Health).

It happens to most Americans at some point in their lives--the sweet, blissful sleep of childhood is replaced by glaring at the digital clock at all hours and countless 3 a.m. pillow adjustments. Like the common cold, the origins of insomnia can be mysterious, as sleep can be affected by factors as varied as food and drink, mental state or physical pain.

Twenty-two percent of Americans can't get to sleep or stay asleep on a regular basis, and sleep loss accounts for more than $18 billion in lost productivity on the job. Sleepiness also causes a large number of car accidents as drivers nod at the wheel. Insomnia affects the poor and the elderly disproportionately.

What qualifies as insomnia? The National Institutes of Health (NIH) defines the problem as encompassing not only a difficulty falling asleep, but also waking often in the night (and not returning to sleep easily), waking up too early in the morning, or sleep that isn't refreshing. Primary insomnia occurs when a person has any of the above problems independent of other health issues; secondary insomnia means that it's connected to another health condition, such as asthma, depression or arthritis, according to scientists at the University of Pennsylvania.

Traditionally, doctors have prescribed sleeping aids to patients diagnosed with primary or secondary insomnia. Marcia Stein, the director of public relations for the Sleep Foundation, says, "Prescription drugs are usually prescribed for limited use--just a few weeks--but there are also lifestyle changes that should be made for people who have difficulty sleeping through the night." In addition, many sleep aids can be habit-forming and eventually may interfere with restful sleep or even exacerbate insomnia. Over-the-counter remedies can be effective in the short term (a night or two) but, "The problem with these medications is that they tend to have limited effectiveness over the long term and can have a high incidence of 'hangovers,'" reports Dr. Neil Kavey, director of the Sleep Disorders Clinic at New York's Columbia Presbyterian Medical Center. Getting a good night's rest only to feel sleepy the next day defeats the purpose.

Increasingly, there are natural alternatives available for those looking to avoid synthetic sleeping pills. The variety of potential cures includes homeopathy, herbal remedies, behavior modification and sleep therapies.

Improving Your Sleep Hygiene

What causes your sleeplessness is half the key to finding your way to a good night's rest. For some it's obvious; back pain, arthritis or muscle strain can make it difficult to fall or stay asleep. For these people, dealing with the pain is the most straightforward way to deal with their insomnia. Secondarily, using a mild herbal sedative can also encourage rest.

Stress can also cause insomnia. Kavey says, "Sleep is a neurochemical and neurophysiological process, and stress can upset the balance between sleep and wakefulness." Some other causes for insomnia might be an uncomfortable sleep environment or too much nicotine, alcohol or caffeine.

Even if you aren't quite sure what causes your insomnia, experts agree that the simplest and least-expensive route to better sleep is behavior modification. Some basics of "sleep hygiene" include: using your bed for sleep or sex only, which conditions you into knowing that when you are in bed, you're there to sleep; enacting a basic routine before bed; sticking to the same sleep schedule, even on weekends, and taking a warm shower before bed.

Other suggestions from the NIH include meditating or deep breathing exercises, making sure you get enough exercise (but not within three hours of bedtime), avoiding TV in the bedroom, and lest you think getting to sleep sounds like no fun, sex is usually recommended as a sleep-inducer. Dr. Michael Thorpy, director of the Sleep-Wake Disorders Center of Montefiore Medical Center in the Bronx, also reminds us, "Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children or adults."

Herbal Helpers

If improving your sleep hygiene isn't enough, there are several herbal remedies available. According to CNN.com, "Organic sleep aids are generally safer and gentler than sleeping pills." Valerian is the most commonly recommended sleep aid. Alternative medicine expert Dr. Andrew Weil says, "Valerian has a long history of use in folk medicine as a sleeping aid. It's quite safe, it's not addictive, and it can be given to kids. No one reports a 'hangover' the day after use; in fact most people feel more active and alert the next day." Well suggests a teaspoon-full of Valerian tincture added to warm water at bedtime. "You have to experiment a bit with the dose, to see what works for you," he says. Like any depressant, it shouldn't be used every night.

Melatonin is a hormone produced by the brain's pineal gland, and it is also found in small amounts in certain foods, including meat, grains, fruits and vegetables. Melatonin is best for helping to fall asleep, but may not help maintain the slumber, since it is not a depressant. It is most often used by shift workers, jet-lagged travelers and those with Seasonal Affective Disorder to help re-set biological clocks. However, melatonin may inhibit a woman's ovulation by disturbing hormone levels, and large doses can have undesirable side effects, such as daytime fatigue.

Other herbs, some of which are included in herbal sleep concoctions such as Well-in-Hand's Sleep Rescue, also work for some people. Hops flowers, California poppy, skullcap and catnip can all be used to make relaxing teas, and some herbs used in aromatherapy are especially calming, such as chamomile, rose, lavender, passion flower and lemon balm. These oils can be burned or added to a warm bath. All of these herbs are approved by the Food and Drug Administration as food supplements.

Calcium and magnesium, taken before bed in a 2:1 ratio (for example, 1,000 milligrams [mg] of calcium and 500 mg of magnesium), can induce sleep, as does vitamin B3 (niacinamide) in doses of 500 to 1,000 mg.

Homeopathic remedies are also commonly used to treat insomnia. Homeopathic treatments are based on naturally occurring plant, animal or mineral substances in dilute quantities. They usually come in small pill or concentrated liquid form, with measurements indicating the dilution of the primary ingredient. Larger numbers mean more dilution, but homeopathy practitioners say that small doses of remedies are more effective than larger ones. Some homeopathic remedies are coffee cruda (unroasted coffee) for nervous excitement, ignatia for those unable to sleep deeply, arsenicum album for a person suffering from anxiety and restlessness, and nux vomica to keep nightmares at bay and to promote quiet sleep.

Of course, if you are taking other medications, consult with your doctor before taking any insomnia cures. Also keep in mind that natural remedies can take time to work. CONTACT: DrWeil.com, www.drweil.com; Wellin-Hand, [phone], www.wellinhand.com.

STARRE VARTAN is a freelance writer who loves to sleep almost anywhere.