Sleep Supplements

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Many fibromyalgia patients experience difficulty sleeping and frequently seek out various treatment methods to help improve both the quality of their sleep and relieve symptoms of insomnia (trouble falling asleep and/or trouble maintain sleep). Although a number of prescription medications are available to assist in treatment of sleep disorders, they often cause considerable side effects, some of which can be dangerous, such as sleepwalking, the risk of dependence, and allergic reactions. Additionally, prescription sleep aids are generally not recommended for long-term use, which can pose a problem for fibromyalgia patients who typically suffer from chronic and persistent sleeping difficulties. As a result, many people turn to complementary and alternative methods, including dietary supplements and natural remedies, to help improve their sleep quality and quantity. A number of supplements have been investigated for their use in treating sleep disorders, and several have shown to be possibly effective. The two most commonly studied are supplemental melatonin and valerian.

Melatonin

Melatonin is a hormone that is naturally produced within the body and helps to regulate normal sleep-wake cycles. People frequently use melatonin supplements for a variety of reasons, including treatment of jet lag, and adjusting sleep schedules when working odd shifts. Melatonin has been shown to be effective at treating sleeping problems in children with autism and mental retardation, as well as sleep disorders in blind people. In terms of potential side effects, melatonin is likely safe for most individuals. It can cause headache, fleeting feelings of depression, daytime sleepiness, dizziness, stomach cramping, and irritability. Melatonin should not be used during pregnancy and should be used only when advised in children, as it can potentially interfere with other hormones and have adverse effects on development during adolescence. Melatonin can also affect blood pressure, diabetes, and pre-existing depression, and can increase the risk of seizures in individuals with seizure disorders. Finally, melatonin has the potential to interact negatively with numerous medications and herbal supplements; therefore, it is important to consult with a physician prior to taking melatonin.

Supplemental melatonin has been studied in various settings to investigate its effectiveness in reducing the time required to fall asleep, known as sleep latency. Some studies have shown that melatonin can improve sleep latency, but it has not proven effective at improving sleep quality or efficiency (Buscemi et al., 2005; Ellis et al., 1996; James et al., 1990; Buscemi et al., 2004). Melatonin supplementation has also been studied specifically in fibromyalgia patients, though only in a few studies specifically related to sleep. A 2000 study found that melatonin improved sleep quality and tender point counts, however the study was limited in design and confirmation of the findings are needed (Citera et al., 2000).

Valerian Root

Valerian is a plant originally native to Europe and Asia, though it is also found in North America. Valerian has been used for centuries to treat insomnia, anxiety, headaches, depression, irregular heartbeat, and trembling. It is generally taken in the form of a capsule, tablet, liquid extract, or in a tea. Side effects of the long-term use of valerian are not known, however studies have suggested that it is safe to use for short periods of time. Common side effects include headache, dizziness, stomach discomfort, and fatigue (the morning after it is used).

Although valerian has been widely studied for its used in treating insomnia, there have not been enough well-designed studies to confirm that it is truly effective. Moreover, there is also a lack of research to conclusively determine if it works to treat the other conditions for which it is commonly used.  majority of the available research shows that valerian can improve both sleep latency and sleep quality, primarily when taken at doses between 400 and 900mg up to two hours prior to bedtime (Leathwood et al., 1982; Donath et al., 2000; Bent et al., 2001). No studies have been conducted with a specific focus of using valerian extract to treat sleep disorders among fibromyalgia patients.

Other Sleep Supplements

Apart from melatonin and valerian, many other natural supplements have been studied for the purposes of treating insomnia. These include hops, Indian snakeroot, kava, L-tryptophan, lavender, lemon balm, passion flower, and sour cherry. Although some have shown preliminary encouraging findings, there is currently insufficient evidence to support their use as treatments for the symptoms of insomnia and other sleep-related problems, and more research is needed.

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References

1.        Valerian. The National Center for Complementary and Alternative Medicine at the National Institutes of Health. Updated July 2010; Accessed June 27, 2012.

2.        Melatonin. MedlinePlus. Last reviewed December 24, 2011; Accessed June 27, 2012.

3.        Buscemi N, Vandermeer B, Hooton N, et al. The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis. J Gen Intern Med. 2005;20:1151-1158.

4.        Ellis CM, Lemmens G, Parkes JD. Melatonin and insomnia. J Sleep Res. 1996;5:61-65.

5.        James SP, Sack DA, Rosenthal NE, Mendelson WB. Melatonin administration in insomnia. Neuropsychopharmacology. 1990;3:19-23.

6.        Buscemi N, Vandermeer B, Pandya R, et al. Melatonin for treatment of sleep disorders. Summary, Evidence Report/Technology Assessment #108. (Prepared by the Univ of Alberta Evidence-based Practice Center, under Contract#290-02-0023.) AHRQ Publ #05-E002-2. Rockville, MD: Agency for Healthcare Research & Quality. November 2004.

7.        Leathwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behav. 1982;17:65-71.

8.        Donath F, Quispe S, Diefenbach K, et al. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry. 2000;33:47-53.

9.        Bent S, Patterson M, Garvin D. Valerian for sleep: a systematic review and meta-analysis. Alternative Therapies. 2001;7:S4.

10.     Citera G, Arias MA, Maldonado-Cocco JA, Lazaro MA, Rosemffet MG, Brusco LI, Scheines EJ, Cardinalli DP. The effect of melatonin in patients with fibromyalgia: a pilot study. Clin Rheumatol. 2000;19(1):9-13.

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