Dr. Michael Ruscio, DC is a clinician, Naturopathic Practitioner, clinical researcher, author, and adjunct professor at the University of Bridgeport. His work has been published in peer-reviewed medical journals and he speaks at conferences around the globe.
When, Why and How to Use Sleep Vitamins and Supplements
When sleep doesn’t come easily, your health and wellbeing can really suffer. Often, something obvious like aches, pain, or mental stress initially triggers insomnia. Other times, the cause is harder to pinpoint, or can be due to imbalances in your gut. Whatever is underlying your symptoms, sleep vitamins and supplements like melatonin are an option worth exploring, together with changes to diet and lifestyle.
In this article, we’ll look at ways you can sleep better, and which sleep vitamins and over-the-counter natural sleep aids may be helpful as part of an overall good health approach.
Key Sleep Vitamins and Supplements
We’ll look at some of the diet and lifestyle basics that can underpin a good night’s sleep further down this article. But if you’re struggling with sleep issues right now, a sleep supplement might have a more immediate effect.
The efficacy of different sleep vitamins varies, and everybody’s experience may be quite different. But sleep vitamins and supplements are less likely to be addictive than sleeping pills, and also less likely to have side effects or to cause daytime drowsiness.
Below are some of the sleep supplements you can try and the evidence behind them, starting with the two that are potentially most useful: melatonin and probiotics.
A key sleep vitamin that many people with sleep issues can benefit from, melatonin is a serotonin-derived hormone secreted by the pineal gland (a tiny organ close to the center of the brain). It signals to your body that it’s time to prepare for sleep, increasing drowsiness. When everything is working well, melatonin is released in a daily rhythm, with levels going up when it gets dark.
However, sometimes you may not be naturally producing enough melatonin, or may be producing it out of sync.
Jet lag, exposure to bright artificial light in the late evening, poor diet, stress, and gut dysbiosis (not enough good gut bacteria) can all disrupt the normal production of melatonin [1, 2, 3].
This is where a melatonin supplement can come in — of all the sleep vitamins, it’s the most well researched. Several systematic reviews of clinical trials suggest melatonin supplements can [4, 5, 6]:
Help to decrease the time it takes to fall asleep,
Improve sleep duration and quality
Regulate the sleep-wake cycle
That said, melatonin didn’t improve sleep in trials involving menopausal women and older people with dementia [7, 8].
Correct Melatonin Dosage
Melatonin supplements come in a variety of strengths, anywhere between 0.1 mg to 10 mg, given up to two hours before bedtime .
Anecdotally, and from the feedback we’ve received from patients, higher doses don’t necessarily produce a bigger benefit. Research hasn’t explored this yet, but some people seem to find that higher dosages actually start to become counterproductive, interfering with sleep rather than improving it.
That’s why, for most people, I’d recommend starting with a lower dosage. Around 3 mg of melatonin at bedtime seems to be the sweet spot that produces the best results in my clinical experience, but the ideal dosage varies from person to person.
If the current dose of melatonin you are taking doesn’t work for you, you may want to experiment with decreasing (rather than increasing intake) to see how you respond. As with anything else, listen to your body.
Clinical trials have shown that taking probiotics can work as a sleep aid, improving sleep quality and reducing sleep disruptions for healthy individuals and those with depression, insomnia, and work-related stress [10, 11, 12, 13].
This is likely to be because probiotics can help to improve gut dysbiosis and inflammation, which then positively affects sleep quality via the brain-gut-microbiome axis .
Other Sleep Vitamins and Supplements
Beyond melatonin and probiotics, there’s a burgeoning range of other sleep vitamins purported to help you get a more restful night. Some of these may indeed be helpful, while for others the evidence is much more “sketchy.” The table below splits sleep vitamins and supplements into high, mixed and low standards of evidence for easy reference.
Remember that dietary supplements, including sleep supplements, are not controlled or regulated by the FDA (Food and Drug Administration), so it’s always worth doing your homework to choose a reputable brand. Also, check for any side effects or contraindications that may mean a particular product is not suitable for you.
Strongest Evidence of Benefit
What the Research Says
Shown to help treat adult insomnia (the effects of passionflower appear similar to zolpidem, a pharmaceutical sedative)
Supplements containing whole valerian root may improve insomnia. However, valerian herbal extracts, due to inconsistencies in their active ingredients, may not be so effective. Side effects, such as diarrhea, or next day sleepiness, may occur.
Although clinical research of magnesium as a treatment for insomnia is fairly sparse, it shows a clear trend toward magnesium being helpful. Plus, it’s safe and inexpensive, so may be worth trying, especially given that mild magnesium deficiency is common.
Sleep should always be a high priority when working to improve your wellbeing. Sleep prepares your brain for the day ahead and is vital for:
Mental functioning: Optimizing your ability to learn and assimilate information
Emotional wellbeing: Helping with your ability to control anger and mood swings
Physical safety: Ensuring you are alert enough to drive or operate machinery
If you are sleep deficient or have other sleep problems it can cause chronic health issues over the longer term. For example, it can increase the risk of :
Heart disease and stroke
High blood pressure
Immune system dysfunction
The Connection Between Sleep and Your Gut
Restful sleep can often be more elusive because of what is happening in your gut. That’s because imbalances in your gut bacteria have far-reaching effects that can extend to disturbances in your sleep cycle.
Research indicates that the connection between your gut health and sleep works both ways. Gut dysbiosis (microbial imbalance) and inflammation can worsen sleep, while poor sleeping patterns can also worsen gut issues.
For example, in a healthy gut, the microbiota influence normal sleep patterns by helping create chemical messengers, such as serotonin and dopamine in the brain. When mice are given antibiotics that destroy their gut flora, the result is disrupted sleep .
There’s also evidence that when our circadian rhythm — the 24-hour biological cycle that plays a major role in healthy sleep — gets out of whack, levels of the sleep hormone melatonin fall, and this affects the ability of the intestinal wall to act as an effective barrier to bacteria and toxins (i.e. the gut becomes more “leaky”) .
This can all add up to significant sleep issues for people with gut issues. For example, one review found that sleep disorders occurred at the rate of 37.5% of irritable bowel syndrome (IBS) patients, which is higher than in the general population .
Steps for a Better Night’s Sleep
Good habits are key when it comes to getting your zzzs, and even more so if you have gut imbalances that could affect your sleep. Keeping a nightly routine that’s as consistent as possible is helpful, but should be underpinned with a healthy diet and lifestyle, and creating a sleep-friendly environment around you.
Adopt a Healthy Diet and Lifestyle
Eat a nutrient-rich diet. Managing weight through healthy diet and exercise has been shown to help in sleep disorders including obstructive sleep apnea [38, 39]. A healthy diet, such as the Mediterranean diet, or a paleo-style diet, will also help improve imbalances associated with impaired sleep, such as inflammation, poor gut health, and hormonal disruptions.
Ease up on caffeine and alcohol. Both of these can disrupt restful sleep and contribute to insomnia . Aim to avoid caffeinated drinks beyond early afternoon and stick to no more than one small alcoholic drink a day.
Be physically active. A systematic review of three meta-analyses found that regular exercise helps adults to sleep an average of 19% better overall .
Create a Sleep-Friendly Environment
Power down screens before bed. When you’re exposed to blue light from tablets and cellphones at night, that blue light tricks your brain into thinking it’s daytime. As a result, production of the sleep hormone melatonin is suppressed and works to make you stay awake [42, 43]. Sleep masks and/or blackout curtains can help to keep your environment dark at night.
Check the temperature of your bedroom. The best temperature for good sleep is around (19–21 C / 66–70 F) for most people . However, you may need to experiment to find the perfect temperature for you. One clinical trial found that people with obstructive sleep apnea did better in warmer environments .
Dial down the noise. A quiet environment avoids your sleep being disrupted . If nighttime noise is unavoidable where you live, try using earplugs or a white noise generator.
Follow a Consistent Nightly Routine
Set a regular sleep schedule. Try to go to bed and wake up at the same time every day. If you’re a shift worker, this won’t be possible, but you can help by keeping the lights bright while you work, taking naps, and trying to limit shift changes so your body clock can adjust .
Have a calming pre-bed routine. Adopt relaxing rituals, such as reading or taking a warm bath in the half hour to an hour before sleep (and remember, no screens!). Also avoid eating or exercising immediately before bed [1, 47].
Shoot for seven hours sleep. This is the consensus recommendation of the American Academy of Sleep Medicine and Sleep Research Society . A sleep tracker, such as the Oura ring, can be very useful to help you track sleep-wake cycles and sleep stages and ultimately improve your sleep hygiene .
Could You Have Obstructive Sleep Apnea?
Some people have breathing difficulties that cause much diminished sleep quality.
Obstructive sleep apnea occurs when the upper airway becomes blocked repeatedly during sleep and is more common in people who are obese.
If you have sleep apnea, your sleep suffers because you frequently wake up for a few seconds to gasp for air. However, you may not actually be conscious of this . A partner may comment that you’re snoring particularly loudly or notice that you stop breathing briefly before rousing during sleep .
Your healthcare provider may suggest sleep studies to diagnose sleep apnea, but another option to consider is an at-home sleep apnea test with a portable device like the WatchPAT. This technique is easier than clinical sleep studies and can help you to identify sleep issues from the comfort of your home.
A breathing device known as a continuous positive air pressure (CPAP) machine is the usual medical treatment for severe cases of sleep apnea. But there’s another much less invasive therapy called myofunctional therapy, which works for many patients.
Myofunctional Therapy and Sleep Quality
Myofunctional therapy is a set of physical therapy exercises of the mouth that improve bite, breathing, and facial posture and can also improve sleep quality in people with sleep apnea. For example:
A 2020 systematic review of clinical trials concluded myofunctional therapy would likely reduce daytime sleepiness and increased sleep quality over the short term .
Another systematic review and meta-analysis found that myofunctional therapy decreased obstructive apnea episodes by approximately 50% in adults. The therapy also improved low oxygen saturation, snoring, and sleepiness .
When working with patients who have obstructive sleep apnea and breathing disorders that affect sleep, I’ve found that referring them for myofunctional therapy can often be very helpful and allow people to avoid CPAP.
The Bottom Line on Sleep and Sleep Vitamins
Sleep is vitally important to every aspect of health and wellness. Sleep vitamins, in association with a gut-healthy diet, probiotics and good lifestyle habits, can help to get your sleep habits back on track.
Melatonin is among the best studied sleep supplements and can have a good effect on sleep quality. Other sleep vitamins, including herbals like lemon balm and passionflower may also be helpful.
My book, Healthy Gut, Healthy You, explains more about sleep and how it factors into your gut health and overall health. For more individualized guidance and support, including having an at-home sleep test, or being referred to a reputable myofunctional practitioner, request a consultation at my functional medicine center.
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