Health: Help, I'd do anything for a good night's sleep

Insomnia can be beaten with sleeping pills. But at what price to users, their partners, friends and colleagues? By Jerome Burne
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The Independent Culture
DRINKING AND driving is, we all know, dangerous and irresponsible. Once over the legal limit, you are four times more likely to be involved in an accident. So what would you say about people who take a drug that makes you 16 times more likely to have an accident? We are talking here about the 85 million prescriptions for sleeping pills dispensed by GPs every year.

"Sleeping pills are dangerous drugs," says Ian Hindmarch, professor of Human Psychopharmacology at Sussex University. "They all have a bad effect on your performance the next day. None of them are free of side-effects." But there is an alternative. Valerian, a herbal preparation used to induce sleep for centuries, is just as efficient as the pharmaceuticals, without the side effects.

An estimated 20 per cent of the population suffers from sleep difficulties from time to time. Other figures show that four out of 10 individuals don't get a regular night's sleep. "The effect of sleep deprivation can be very serious," says Hindmarch. "It's linked with depression, reduced quality of life and poor concentration."

As a leading sleep expert Hindmarch is indignant about the bad deal we are getting from sleeping pills at the moment. "Waking and sleeping are intertwined," he says. "If a pill puts you to sleep, you have to ask what effect it has in the day." Studies at the Dayton Veteran Administration Hospital in the USA found that reducing sleep for just an hour and a half for one night lowers daytime alertness by up to 33 per cent and cuts reaction times.

So what's needed is something that gives you a good night's sleep without putting you, and anyone you meet, at risk the next day. The answer, Hindmarch believes, is the traditional remedy valerian. "At least half a dozen well- conducted trials now show it's much more effective than a placebo, and you don't wake up with any kind of a hangover."

Journalist Shelley Bovey swears by the commercial extract Valerina Night Time. "I've got ME and one of the symptoms is that you get very disturbed sleep. I can fall asleep OK but then I wake after about three hours and can't get back to sleep. I tried sleeping tablets but I hated the feeling of being knocked out and in the morning I felt so groggy. Then my daughter told me about Valerina. It was brilliant. I sleep right through the night and wake up feeling so chirpy."

What's happening with valerian could prove to be a repeat of the St John's Wort saga. This is the herb, long used traditionally to treat mild depression, which, in recent double-blind clinical trials, has equalled the likes of Prozac, with far milder side-effects. In the last year, an extract of it has proved a best-seller. St John's Wort could also turn out to be the answer to a problem that keeps GPs awake at night.

There is a type of patient that makes a GP's heart sink - the one who says they are tired all the time. Doctors call them TATTs. The typical TATT patient doesn't have a problem sleeping, but they never feel they get enough. They talk about feeling as if they are wading through treacle during the day. They are worried they have a serious disease but there is nothing wrong with them.

Jane Crook, a 32-year-old childminder was a typical TATT patient. "Last January I felt very unfit and low. I wasn't depressed, just dreadfully tired. I'd sleep all right but when I woke up I wasn't revitalised. I still felt wacked out. In the evening I'd sit down with one of the children and just want to collapse."

In an attempt to find a solution to the TATTs problem - and they can make up about 10 per cent of a GP's caseload - a small pilot study used St John's Wort. Twenty TATT patients were given an extract call Kira over a six-week period and they all reported a significant improvement.

Jane doesn't need any more evidence. "After three days on St John's Wort I felt completely different. The quality of my sleep had improved and I found it much easier to get up.It was as though someone was behind me, driving me on."

Although there haven't been that many trials involving valerian, there are virtually none on any other traditional herbal remedies for sleep. Other Western remedies include: camomile, catnip, lavender, lime flowers, passion flower, hops and skullcap taken as a tea or capsule. Sleeping on a lavender pillow may also be suggested.

Foods may also help. One approach is to encourage eating those rich in tryptophan, the chemical our brains use to make the feel-good neuro-transmitter serotonin. These include: turkey, bananas, figs, dates, milk and tuna. At the same time, avoid foods high in tyramine, used to make the stimulant noradrenalin, such as: bacon, cheese, chocolate, eggplant, potatoes and wine.

Certain vitamins and minerals may also be useful in helping with sleep. The B vitamins, especially B5, are good for promoting a restful state, while calcium is calming but should be balanced by magnesium.

Valerina Night Time is available in chemists and health food shops. A pack of 80 tablets costs pounds 4.99. Kira is an extract of St John's Wort. A pack of 30 costs pounds 14.95.

For a food and herbal approach to the problems of insomnia, try the Women's Nutritional Advisory Service, PO Box 268, Lewes, East Sussex, BN7 2QN. Tel: 01273 487366

Insomnia is always a symptom of some underlying condition. It may be due to stress or may be a sign of a deeper disturbance. If it persist for more than a week you should always see your doctor