An estimated 64 million Americans suffer from insomnia each year.

by Maureen Williams, ND

Passionflower Herb Extract
Lemon Balm Leaf Extract
Hops Strobile Extract
California Poppy Herb Extract
Valerian officinalis Root Extract
Lavender Essential Oil

Insomnia is a symptom of a sleep disorder and is characterized by difficulty falling or staying asleep, waking too early in the morning, and not feeling refreshed upon waking. An estimated 64 million Americans suffer from insomnia each year. The chronic sleep deprivation experienced by people with insomnia can lead to a cumulative deterioration of cognitive alertness and ability to function in the daytime. Some of the more common conditions associated with insomnia include anxiety, depression, stress reaction, pain, sleep apnea, and hormonal changes including those occurring with premenstrual syndrome and menopause. In addition, caffeine and alcohol can contribute to insomnia, and some medications have sleep-disruptive side effects.

Behavioral therapies and relaxation techniques often help people with insomnia to improve the amount and quality of their sleep. In addition, some herbal and nutritional supplements have been found to promote relaxation of mind and body.


Passionflower (Passiflora incarnata) is a popular herbal remedy for anxiety and insomnia with a long history of use in North America. Two studies have demonstrated its efficacy in treating anxiety, and in one it was found to be as effective as benzodiazepine medications. i In a controlled trial, passionflower extract effectively alleviated anxiety in pre-surgical patients, a circumstance in which benzodiazepine medications are typically used. ii Animal studies have suggested that chrysin, an active constituent from passionflower, might act similarly to benzodiazepines by affecting GABA (gamma-aminobutyric acid) receptors. iii iv Unlike benzodiazepines, however, regular use of passionflower extract does not appear to lead to dependence, and in one animal study it was helpful in treating benzodiazepine dependence. v

Lemon Balm

Lemon balm (Melissa officinalis) is a medicinal plant in the mint family with mild sedative properties. Lemon balm has traditionally been used for its calming effects on both the central nervous system and the gastrointestinal tract. Extracts have been shown to bind to both nicotinic and muscarinic acetylcholine receptor sites in human brain tissue, enhancing parasympathetic activity. vi A combination of lemon balm and three other medicinal herbs (lavender oil, hops, and oat) was found to alter electrical activity in the brains of healthy adults, reflecting its ability to induce a relaxed state. vii In other research, lemon balm improved self-rated mood, increased calmness, and improved cognitive functioning in healthy people under ordinary circumstances viii ix and during performance of tasks designed to induce stress. x


Hop strobile, commonly known as hops, is the flower cone of the hop plant (Humulus lupulus) and is most familiar for its use in flavoring beer. Its most common medicinal use, as a treatment for insomnia and anxiety, as well as hops’ other traditional uses, as a digestive aid, antibacterial, and antifungal agent, have been supported by animal and in vitro studies. xi xii xiii Results from several studies suggest that hops extract quiets the central nervous system by increasing GABA activity xiv xv and by activating melatonin receptors. xvi Hops have also been used to treat symptoms of menopause, including sleep disturbance, and researchers have identified at least one strong phytoestrogenic constituent. xvii xviii Menopausal women in a controlled trial had a reduction in menopausal symptoms when treated with hops extract. xix

California Poppy

California poppy (Eschscholtzia californicum) is a flowering plant in the poppy family. Although milder than the opium poppy, it is known for its sedative effects and has been used historically for insomnia and nervous tension. Its ability to influence the metabolism of several neurotransmitters has been documented. xx xxi An extract of California poppy was found to inhibit monoamine oxidase,xxii an action that could raise acetylcholine levels and contribute to its sedating effect. Other research suggests that a California poppy extract affects serotonin activity. xxiii In a controlled trial, a combination of California poppy and hawthorn plus magnesium was found to reduce symptoms in people with mild to moderate anxiety. xxiv


Valerian (Valeriana officinalis) is a flowering perennial plant that is well known for its ability to ease nervousness and promote sleep. Findings from several studies suggest that a variety of valerian constituents, including terpenoids and flavonoids, might be involved in its anxiolytic and sedative properties and might work by affecting GABA and GABA receptors. xxv xxvi xxvii xxviii xxix Some studies comparing valerian extract to benzodiazepines have found them similarly effective, xxx xxxi and one study found valerian extract to be helpful in people withdrawing from benzodiazepine therapy for insomnia. xxxii The long-used combination of valerian and hops has also been studied and results suggest its effectiveness in relieving insomnia, xxxiii xxxiv xxxv xxxvi and its similarity in effect to a benzodiazepine drug. xxxvii Despite a broad range of studies that appear to support valerian’s mild sedating effect, researchers have reached conflicting conclusions: in three recent reviews of clinical trials using valerian in the treatment of sleep disorders, one meta-analysis concluded that it was effective, xxxviii one concluded that it was not, xxxix and the third found the evidence inconclusive. xl


L-theanine (N-ethyl-L-glutamine) is an amino acid present in green tea. In animal research, L-theanine was found to increase the release of serotonin and the inhibitory neurotransmitters GABA, dopamine, and glycine, and block the binding of the stimulatory neurotransmitter L-glutamate. xli xlii In humans, L-theanine supplementation increased alpha brainwave activity, indicating movement toward a calmer mind. xliii It also reduced physiologic signs of stress in people given stress-inducing tasks in the laboratory. xliv These findings suggest that L-theanine might help promote sleep by reducing symptoms of stress and anxiety.

Lavender Essential Oil

Lavender (Lavendula angustafolia) is a perennial flowering shrub with a distinctive fragrance. The aroma is widely believed to ease tension and enhance relaxation, and the essential oil responsible for its smell is often used as a topical agent and in aromatherapy modalities. Aromatherapy with lavender oil has had relaxing to sedating effects in a number of studies, xlv xlvi xlvii xlviii xlix but in a few it has not. l

li Inhaling lavender oil during sleep increased deep, slow-wave sleep, decreased rapid-eye movement (REM) sleep, and increased reported sense of vigor upon morning waking in one study, lii and a

preliminary study found that aromatherapy with lavender oil improved sleep in people with insomnia. liii Lavender oil has been shown to help relieve anxiety and improve mood when combined with massage, liv lv lvi and it has demonstrated pain-relieving effects when combined with acupressure. lvii One study found that a lozenge containing lavender oil and extracts from hops, lemon balm, and oat altered brain activity in healthy people in a way that indicated they experienced a relaxing effect. lviii The effect of ingesting lavender essential oil needs further research.


Melatonin is a hormone that participates in regulating the sleep/wake biorhythm. It is secreted by the pituitary gland and its release is strongly affected by ambient light, with levels normally dropping during daylight hours and rising at night. Melatonin levels are low in people with insomnia, lix and supplemental melatonin has been found to be an effective treatment for insomnia in controlled trials. lx lxi lxii It has also demonstrated effectiveness in treating insomnia associated with medical illness in general lxiii and specific chronic conditions including schizophrenia, lxiv lxv chronic fatigue syndrome, lxvi mental retardation, lxvii and bipolar disorder. lxviii Melatonin appears to help shift the sleep phase in some circumstances, and studies have suggested that it can improve sleep in shift workers lxix lxx lxxi and people with jet lag. lxxii lxxiii People using benzodiazepine medicines for sleep disorders have found melatonin helpful during medication reduction and discontinuation. lxxiv lxxv

Recommended Dosage Before Bed:

Passionflower Herb Extract 150mg-450mg

Lemon Balm Leaf Extract 100mg-300mg

Hops Strobile Extract 100mg-300mg

California Poppy Herb Extract 75mg-225mg

Valerian officinalis Root Extract 75mg-225mg

L-Theanine 50mg-150mg

Lavender (Flowering Tops) Essential Oil 20mg-60mg

(Lavandula vera)

Melatonin 0.25mg-0.75mg


i Miyasaka LS, Atallah AN, Soares BG. Passiflora for anxiety disorder. Cochrane Database Syst Rev 2007;Jan 24:CD004518. Review.

ii Movafegh A, Alizadeh R, Hajimohamadi F, et al. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesth Analg 2008;106:1728-32.

iii Brown E, Hurd NS, McCall S, Ceremuga TE. Evaluation of the anxiolytic effects of chrysin, a Passiflora incarnata extract, in the laboratory rat. AANA J 2007;75:333-7.

iv Wolfman C, Viola H, Paladini A, et al. Possible anxiolytic effects of chrysin, a central benzodiazepine receptor ligand isolated from Passiflora coerulea. Pharmacol Biochem Behav 1994;47:1-4.

v Dhawan K, Dhawan S, Chhabra S. Attenuation of benzodiazepine dependence in mice by a tri-substituted benzoflavone moiety of Passiflora incarnata Linneaus: a non-habit forming anxiolytic. J Pharm Pharm Sci 2003;6:215-22.

vi Kennedy DO, Scholey AB. The psychopharmacology of European herbs with cognition-enhancing properties. Curr Pharm Des 2006;12:4613-23.

vii Dimpfel W, Pischel I, Lehnfeld R. Effects of lozenge containing lavender oil, extracts from hops, lemon balm and oat on electrical brain activity of volunteers. Eur J Med Res 2004;9:423-31.

viii Kennedy DO, Wake G, Savelev S, et al. Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (Lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties. Neuropsychopharmacology 2003;28:1871-81.

ix Kennedy DO, Scholey AB, Tildesley NT, et al. Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). Pharmacol Biochem Behav 2002;72:953-64. Rev. 9-08

x Kennedy DO, Little W, Scholey AB. Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (Lemon Balm). Psychosom Med 2004;66:607-13.

xi Zanoli P, Rivasi M, Zavatti M, et al. New insight in the neuropharmacological activity of Humulus lupulus L. J Ethnopharmacol 2005;102:102-6.

xii Schiller H, Forster A, Vonhoff C, et al. Sedating effects of Humulus lupulus L. extracts. Phytomedicine 2006;13:535-41.

xiii Zanoli P, Zavatti M. Pharmacognostic and pharmacological profile of Humulus lupulus L. J Ethnopharmacol 2008;116:383-96.

xiv Awad R, Levac D, Cybulska P, et al. Effects of traditionally used anxiolytic botanicals on enzymes of the gamma-aminobutyric acid (GABA) system. Can J Physiol Pharmacol 2007;85:933-42.

xv Aoshima H, Takeda K, Okita Y, et al. Effects of beer and hop on ionotropic gamma-aminobutyric acid receptors. J Agric Food Chem 2006;54:2514-9.

xvi Butterweck V, Brattstroem A, Grundmann O, Koetter U. Hypothermic effects of hops are antagonized with the competitive melatonin receptor antagonist luzindole in mice. J Pharm Pharmacol 2007;59:549-52.

xvii Zanoli P, Zavatti M. Pharmacognostic and pharmacological profile of Humulus lupulus L. J Ethnopharmacol 2008;116:383-96.

xviii Possemiers S, Bolca S, Grootaert C, et al. The prenylflavonoid isoxanthohumol from hops (Humulus lupulus L.) is activated into the potent phytoestrogen 8-prenylnaringenin in vitro and in the human intestine. J Nutr 2006;136:1862-7.

xix Heyerick A, Vervarcke S, Depypere H, et al. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas 2006;54:164-75.

xx Schäfer HL, Schäfer H, Schneider W, Elstner EF. Sedative action of extract combinations of Eschscholtzia californica and Corydalis cava. Arzneimittelforschung 1995;45:124-6.

xxi Reimeier C, Schneider I, Schneider W, et al. Effects of ethanolic extracts from Eschscholtzia californica and Corydalis cava on dimerization and oxidation of enkephalins. Arzneimittelforschung 1995;45:132-6.

xxii Kleber E, Schneider W, Schäfer HL, Elstner EF. Modulation of key reactions of the catecholamine metabolism by extracts from Eschscholtzia californica and Corydalis cava. Arzneimittelforschung 1995;45:127-31.

xxiii Gafner S, Dietz BM, McPhail KL, et al. Alkaloids from Eschscholzia californica and their capacity to inhibit binding of [3H]8-Hydroxy-2-(di-N-propylamino)tetralin to 5-HT1A receptors in Vitro. J Nat Prod 2006;69:432-5.

xxiv Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin 2004;20:63-71.

xxv Khom S, Baburin I, Timin E, et al. Valerenic acid potentiates and inhibits GABA(A) receptors: molecular mechanism and subunit specificity. Neuropharmacology 2007;53:178-87.

xxvi Fernández S, Wasowski C, Paladini AC, Marder M. Sedative and sleep-enhancing properties of linarin, a flavonoid-isolated from Valeriana officinalis. Pharmacol Biochem Behav 2004;77:399-404.

xxvii Ortiz JG, Nieves-Natal J, Chavez P. Effects of Valeriana officinalis extracts on [3H]flunitrazepam binding, synaptosomal [3H]GABA uptake, and hippocampal [3H]GABA release. Neurochem Res 1999;24:1373-8.

xxviii Marder M, Viola H, Wasowski C, et al. 6-methylapigenin and hesperidin: new valeriana flavonoids with activity on the CNS. Pharmacol Biochem Behav 2003;75:537-45.

xxix Houghton PJ. The scientific basis for the reputed activity of Valerian. J Pharm Pharmacol 1999;51:505-12.

xxx Ziegler G, Ploch M, Miettinen-Baumann A, Collet W. Efficacy and tolerability of valerian extract LI 156 compared with oxazepam in the treatment of non-organic insomnia–a randomized, double-blind, comparative clinical study. Eur J Med Res 2002;7:480-6.

xxxi Andreatini R, Sartori VA, Seabra ML, Leite JR. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res 2002;16:650-4.

xxxii Poyares DR, Guilleminault C, Ohayon MM, Tufik S. Can valerian improve the sleep of insomniacs after benzodiazepine withdrawal? Prog Neuropsychopharmacol Biol Psychiatry 2002;26:539-45.

xxxiii Brattström A. Scientific evidence for a fixed extract combination (Ze 91019) from valerian and hops traditionally used as a sleep-inducing aid. Wien Med Wochenschr 2007;157:367-70.

xxxiv Koetter U, Schrader E, Käufeler R, Brattström A. A randomized, double blind, placebo-controlled, prospective clinical study to demonstrate clinical efficacy of a fixed valerian hops extract combination (Ze 91019) in patients suffering from non-organic sleep disorder. Phytother Res 2007;21:847-51.

xxxv Morin CM, Koetter U, Bastien C, et al. Valerian-hops combination and diphenhydramine for treating insomnia: a randomized placebo-controlled clinical trial. Sleep 2005;28:1465-71.

xxxvi Vonderheid-Guth B, Todorova A, Brattström A, Dimpfel W. Pharmacodynamic effects of valerian and hops extract combination (Ze 91019) on the quantitative-topographical EEG in healthy volunteers. Eur J Med Res 2000;5:139-44.

xxxvii Schmitz M, Jäckel M. [Comparative study for assessing quality of life of patients with exogenous sleep disorders (temporary sleep onset and sleep interruption disorders) treated with a hops-valarian preparation and a benzodiazepine drug] Wien Med Wochenschr 1998;148:291-8. [Article in German]

xxxviii Bent S, Padula A, Moore D, et al. Valerian for sleep: a systematic review and meta-analysis. Am J Med 2006;119:1005-12. Review. Rev. 9-08

xxxix Taibi DM, Landis CA, Petry H, Vitiello MV. A systematic review of valerian as a sleep aid: safe but not effective. Sleep Med Rev 2007;11:209-30. Review.

xl Miyasaka LS, Atallah AN, Soares BG. Valerian for anxiety disorders. Cochrane Database Syst Rev 2006;Oct 18:CD004515. Review.

xli Yamada T, Terashima T, Okubo T, et al. Effects of theanine, r-glutamylethylamide, on neurotransmitter release and its relationship with glutamic acid neurotransmission. Nutr Neurosci 2005;8:219-26.

xlii Nathan PJ, Lu K, Gray M, Oliver C. The neuropharmacology of L-theanine(N-ethyl-L-glutamine): a possible neuroprotective and cognitive enhancing agent. J Herb Pharmacother 2006;6:21-30.

xliii Nobre AC, Rao A, Owen GN. L-theanine, a natural constituent in tea, and its effect on mental state. Asia Pac J Clin Nutr 2008;17 Suppl 1:167-8.

xliv Kimura K, Ozeki M, Juneja LR, Ohira H. L-Theanine reduces psychological and physiological stress responses. Biol Psychol 2007;74:39-45.

xlv Lehrner J, Marwinski G, Lehr S, et al. Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiol Behav 2005;86:92-5.

xlvi Moss M, Cook J, Wesnes K, Duckett P. Aromas of rosemary and lavender essential oils differentially affect cognition and mood in healthy adults. Int J Neurosci 2003;113:15-38.

xlvii Morris N. The effects of lavender (Lavendula angustifolium) baths on psychological

well-being: two exploratory randomized controlled trials. Complement Ther Med 2002;10:223-8.

xlviii Holmes C, Hopkins V, Hensford C, et al. Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry 2002;17:305-8.

xlix Saeki Y. The effect of foot-bath with or without the essential oil of lavender on the

autonomic nervous system: a randomized trial. Complement Ther Med 2000;8:2-7.

l Graham PH, Browne L, Cox H, Graham J. Inhalation aromatherapy during radiotherapy: results of a placebo-controlled double-blind randomized trial. J Clin Oncol 2003;21:2372-6.

li Muzzarelli L, Force M, Sebold M. Aromatherapy and reducing preprocedural anxiety: A controlled prospective study. Gastroenterol Nurs 2006;29:466-71.

lii Goel N, Kim H, Lao RP. An olfactory stimulus modifies nighttime sleep in young men and women. Chronobiol Int 2005;22:889-904.

liii Lewith GT, Godfrey AD, Prescott P. A single-blinded, randomized pilot study evaluating the aroma of Lavandula angustifolia as a treatment for mild insomnia. J Altern Complement Med 2005;11:631-7.

liv Imura M, Misao H, Ushijima H. The psychological effects of aromatherapy-massage in healthy postpartum mothers. J Midwifery Womens Health 2006;51:e21-7

lv Lee SY. [The effect of lavender aromatherapy on cognitive function, emotion, and

aggressive behavior of elderly with dementia] Taehan Kanho Hakhoe Chi 2005;35:303-12. [Article in Korean]

lvi Soden K, Vincent K, Craske S, et al. A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med 2004;18:87-92.

lvii Yip YB, Tse SH. An experimental study on the effectiveness of acupressure with aromatic lavender essential oil for sub-acute, non-specific neck pain in Hong Kong. Complement Ther Clin Pract 2006;12:18-26.

lviii Dimpfel W, Pischel I, Lehnfeld R. Effects of lozenge containing lavender oil, extracts from hops, lemon balm and oat on electrical brain activity of volunteers. Eur J Med Res 2004;9:423-31.

lix Attenburrow MEJ, Dowling BA, Sharpley AL, Cowen PJ. Case-control study of evening melatonin concentration in primary insomnia. BMJ 1996;312:1263–4.

lx Kayumov L, Brown G, Jindal R, et al. A randomized, double-blind, placebo-controlled crossover study of the effect of exogenous melatonin on delayed sleep phase syndrome. Psychosom Med 2001;63:40-8.

lxi Smits MG, Nagtegaal EE, van der Heijden J, et al. Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial. J Child Neurol 2001;16:86-92.

lxii Peck JS, LeGoff DB, Ahmed I, Goebert D. Cognitive effects of exogenous melatonin administration in elderly persons: a pilot study. Am J Geriatr Psychiatry 2004;12:432-6.

lxiii Andrade C, Srihari BS, Reddy KP, Chandramma L. Melatonin in medically ill patients with insomnia: a double-blind, placebo-controlled study. J Clin Psychiatry 2001;62:41-5.

lxiv Suresh Kumar PN, Andrade C, Bhakta SG, Singh NM. Melatonin in schizophrenic outpatients with insomnia: a double-blind, placebo-controlled study. J Clin Psychiatry 2007;68:237-41.

lxv Shamir E, Laudon M, Barak Y, et al. Melatonin improves sleep quality of patients with chronic schizophrenia. J Clin Psychiatry 2000;61:373-7.

lxvi van Heukelom RO, Prins JB, Smits MG, Bleijenberg G. Influence of melatonin on fatigue severity in patients with chronic fatigue syndrome and late melatonin secretion. Eur J Neurol 2006;13:55-60.

lxvii Niederhofer H, Staffen W, Mair A, Pittschieler K. Brief report: melatonin facilitates sleep in individuals with mental retardation and insomnia. J Autism Dev Disord 2003;33:469-72.

lxviii Bersani G, Garavini A. Melatonin add-on in manic patients with treatment resistant insomnia. Prog Neuropsychopharmacol Biol Psychiatry 2000;24:185-91. Rev. 9-08

lxix Bjorvatn B, Stangenes K, Oyane N, et al. Randomized placebo-controlled field study of the effects of bright light and melatonin in adaptation to night work. Scand J Work Environ Health 2007;33:204-14.

lxx Smith MR, Lee C, Crowley SJ, et al. Morning melatonin has limited benefit as a soporific for daytime sleep after night work. Chronobiol Int 2005;22:873-88.

lxxi Yoon IY, Song BG. Role of morning melatonin administration and attenuation of sunlight exposure in improving adaptation of night-shift workers. Chronobiol Int 2002;19:903-13.

lxxii Srinivasan V, Spence DW, Pandi-Perumal SR, et al. Jet lag: therapeutic use of melatonin and possible application of melatonin analogs. Travel Med Infect Dis 2008;6:17-28.

lxxiii Suhner A, Schlagenhauf P, Höfer I, et al. Effectiveness and tolerability of melatonin and zolpidem for the alleviation of jet lag. Aviat Space Environ Med 2001;72:638-46.

lxxiv Siegrist C, Benedetti C, Orlando A, et al. Lack of changes in serum prolactin, FSH, TSH, and estradiol after melatonin treatment in doses that improve sleep and reduce benzodiazepine consumption in sleep-disturbed, middle-aged, and elderly patients. J Pineal Res 2001;30:34-42.

lxxv Garfinkel D, Zisapel N, Wainstein J, Laudon M. Facilitation of benzodiazepine discontinuation by melatonin: a new clinical approach. Arch Intern Med 1999;159:2456-60.