Opinion | Haims: On the efficacy of sleep aids
Nearly one-third of our life is spent asleep. It is a highly active and organized process that is essential for both physical and mental health. Because millions of people struggle with falling asleep or staying asleep, supplement sleep aids have become increasingly popular to improve sleep quality and duration. However, understanding whether these supplements are truly effective first requires an understanding of how sleep itself works. Throughout the night, the brain and body move through several distinct phases of sleep, each playing an important role in memory, recovery, learning and emotional well-being. By examining the four phases of sleep, it becomes easier to evaluate how supplement sleep aids may affect the body’s natural sleep cycle and overall restfulness.
Sleep begins with Stage 1 Non-REM (NREM), the lightest stage of sleep and the transition between being awake and asleep. During this phase, brain activity slows, muscles relax and a person can be awakened easily. Although brief, this stage helps the body begin settling into sleep.
After stage 1, the body enters NREM Stage 2, where sleep becomes deeper and more stable. Heart rate and body temperature decrease, and brain activity slows further. This stage is important for memory, learning and preparing the body for deep sleep.
Next, the body moves into NREM Stage 3, also called deep sleep. During this phase, brain waves slow significantly, allowing the body to repair tissues, strengthen the immune system and restore energy. Because this stage is so deep, waking up during it can cause grogginess. This is also the stage where our brain initiates a clearing of metabolic waste.
Finally, the body enters REM sleep, the stage most associated with vivid dreaming. Brain activity becomes more active while the body remains relaxed and temporarily immobile. REM sleep is important for memory, emotional regulation and learning. Together, these four phases repeat throughout the night to support both physical and mental health.
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If you are unaware, while there is a plethora of sleep supplements available, most are not catch-all solution for sleep. For example, melatonin is most likely the top-of-mind product people think of for sleep relief. However, melatonin does induce quick sleep. Rather, it helps regulate your body’s natural sleep-wake cycle (circadian rhythm). In general, it helps you fall asleep but not stay asleep or prevent awakenings throughout the night. It’s really a product to assist with stage 1 sleep.
There are several supplements that may indirectly support stage 2 and 3 sleep by promoting relaxation and reducing nighttime arousal. L-theanine may increase relaxation, reduce anxiety and make it easier to enter and remain in this stage. Additionally, magnesium, valerian, ashwagandha, passion flower and 5-HTP may lower stress and cortisol levels, calm the nervous system and potentially reduce sleep fragmentation — however, none provides a comprehensive sleep solution.
From a sleep-science perspective, there is currently more evidence that supplements improve sleep initiation and sleep quality than evidence that they selectively enhance REM sleep. Melatonin is the closest exception, but even there, the strongest and most reproducible effect is on circadian timing rather than REM augmentation.
As I have shared before in previous articles, I have sleep challenges and have tried just about every product available. While my personal preferences are various teas, I have found that a product called Insomnitol works well for not only me, but my children. I was introduced to this product by the guys at Vail Pharmacy in Edwards many years ago. The Insomnitol product they offer is of the highest quality and includes everything but the kitchen sink: Vitamin B6, valerian root, passion flower, lemon balm, German chamomile, Gamma Amino Butyric Acid, L-Theanine, 5-HTP and melatonin.
Other than the aforementioned, there are some naturally caffeine-free herbal teas that are believed to help with sleep. Backed by centuries of use and modern research, chamomile, passionflower, valerian root, lemon balm and lavender teas have been shown to prepare our body for rest by relaxing our mind and reducing anxiety.
Should you consider trying any supplement, please be aware that purity and dosage is an important consideration. Because supplements are not regulated, they are not subject to the same scrutiny as medications. For example, because melatonin is one of the most common sleep supplement, you should know that purity and actual dosage of melatonin supplements vary drastically. As per a review of melatonin in the Journal of Clinical Sleep Medicine, “Melatonin content was found to range from −83% to +478% of the labelled content. Additionally, lot-to-lot variable within a particular product varied by as much as 465%”.
Because supplements can interact with medications or cause side effects, it is best to consult with a healthcare professional to determine the right fit for your specific health needs.
