Most OTC supplements are a mixture of herbs

A browse along your pharmacy shelf will reveal a plethora of sleep supplements available to buy without a prescription. The labels boast a variety of specific benefits including “beauty sleep” “deep sleep” “fall asleep” “sleep recovery”. However if you read the ingredients labels, most of these preparations contain a mixture of similar herbs.

Common herbal preparations in sleep supplements include: valerian, kava, wuling, hops, chamomile, passionflower and St. John’s wort.

Most claims are not backed up by science

Very few scientific studies have examined the effectiveness of these herbal ingredients. The studies that have been done focus on a specific herb rather than the combination you will find in a supplement. Overall, the evidence that herbal supplements will actually help you sleep is “low” (stronger ratings would be “moderate” or “high”). There is, however, some promising research that three herbs may help reduce anxiety: kava, passionflower and chamomile. Anxiety often contributes to poor sleep so these may be of some benefit.

Magnesium supplements

In the last year, there has been an explosion in the availability of supplements containing magnesium for sleep. Although magnesium is crucial for muscle and nerve function, the studies report only a minimal impact, if any, on sleep. A healthy balanced diet will provide you with the recommended amount of magnesium and adding more is unlikely to be helpful. If your diet is lacking vegetables and wholegrains then perhaps a magnesium supplement would be beneficial. Remember it is always better to obtain vitamins and minerals from food rather than a tablet.

Melatonin

Melatonin is not a herbal preparation. It is a natural hormone produced by the brain that signals it is time to go to sleep. Levels of melatonin increase at night, hence it is often referred to as the hormone of darkness. Melatonin is useful for treating jet lag and specific sleep syndromes.

Depending on your country, melatonin may be able to be purchased over the counter as a supplement rather than as a pharmaceutical drug. These supplements are available without a prescription, but they contain such a small amount of melatonin they are very unlikely to help you sleep. It is important to understand that the over the counter preparations are not considered “drugs” and are therefore not subject to the same rigorous testing for quality and effectiveness that prescription medications undergo.

In some countries, melatonin tablets are available by prescriptions to treat certain sleep disorders and depending on your location, may be available for people aged over 55 without a prescription. You should discuss with your pharmacist and doctor if melatonin is likely to help you as for many individuals it will not be effective. Focusing on lifestyle changes can often have a more significant impact on your sleep.

Can sleep supplements be harmful?

Herbal supplements are not tested for safety. There have been reports of serious liver disease from the use of kava while hops are known to cause skin rashes and changes to the menstrual cycle. High doses of magnesium are likely to cause gut side effects and may be dangerous. You should always be cautious with any over the counter product – we often mistakenly think they are safer because they are natural or herbal. They can also interfere with any other medications you may be taking, so be sure to ask your GP before starting to take a supplement.

Understand the real reason you cannot sleep

The first step to improving your sleep is to complete a sleep diary. These are freely available on the internet. Complete the diary for one week. You will observe connections between things you do during the day and the quality of your sleep. For example, it took you a long time to fall asleep when you spent several hours scrolling on your phone in bed; or you had a good sleep on the night you did yoga after work. Noticing will allow you to make specific changes to your daily routine.