Key Points: Treatments that target sleep-wake rhythms could help many people with insomnia or other sleep disorders get better rest. Melatonin is a well-known option, but it's not the only one; NAD, omega-3, and valerian supplements may also be helpful, depending on age, sleep challenges, and other factors.
Contrary to what many people think, melatonin is NOT a sedative. It is a sleep regulator and a sleep facilitator, and a key hormone in maintaining the healthy functioning of circadian sleep-wake rhythms. The body makes its own melatonin in the brain’s pineal gland, and the production of melatonin is stimulated by darkness. Exposure to light suppresses melatonin—that’s why the body’s melatonin levels stay naturally low during the day. That’s also why exposure to artificial light at night is so damaging to healthy sleep and to circadian rhythms.
Melatonin promotes healthy sleep by helping to keep daily sleep-wake rhythms in sync, and may ease symptoms of insomnia for some people. Scientific research shows that melatonin supplementation can strengthen and improve sleep-wake cycles. With stronger, more regular sleep-wake cycles typically come more healthful sleep patterns, including an easier time falling asleep and sleeping on a regular schedule.
Melatonin has been shown to be effective in addressing insomnia symptoms (including trouble falling asleep and staying asleep) in older adults. As we age, our circadian clocks are more likely to fall out of sync, making older adults especially open to benefiting from supplemental melatonin to strengthen their circadian clocks and keep them ticking in sync.
A growing body of scientific research shows melatonin’s array of health benefits beyond sleep. A powerful antioxidant, melatonin has been shown to have protective and therapeutic benefits for cardiovascular health and brain health, and is a potent anti-cancer agent, suppressing the growth of cancer cells, preventing metastasis, and improving the effectiveness of cancer treatment.
Melatonin isn’t the only supplement that can improve sleep rhythm.
NAD, short for nicotinamide adenine dinucleotide, is a coenzyme, which helps enzymes function effectively, and as such it performs a range of helper functions for the body, including several that are directly related to sleep. NAD helps the body’s circadian system communicate with cells. NAD also helps maintain the proper activity of the genes that communicate circadian messages, and works to repair DNA that directs circadian function.
The human body produces its own supply of NAD, and NAD is also available in supplement form. NAD production declines naturally with age. Age-related decline in NAD may be one reason that circadian rhythms are less robust and in sync with age, and sleep can become more restless and less restorative. And NAD’s impact on other health systems—including metabolism, cardiovascular, and brain health—can have powerful indirect effects on sleep cycles.
Research suggests that omega-3 fatty acids can also boost your sleep quality, and may help you fall asleep more quickly. Omega-3 fatty acids also appear to help the body produce melatonin. Studies show low levels of the omega-3 DHA cause melatonin deficiency—and that increasing levels of DHA cause melatonin levels to rise. And omega-3 fatty acids may offer protection for a gene protein that is involved in circadian rhythm function. Research has shown that the omega-3 fatty acid DHA reduces disruptions to the circadian clock gene Bmal1, one of several core clock genes that keep circadian clocks and rhythms functioning in sync.
What’s Right for You?
The answer to that question is highly individual, and dependent on a number of factors, including your individual health profile, family history, age, genetics, lifestyle, and habits. It’s important to consult your physician to determine the right natural therapy for your sleep issues. We can look broadly at sleep issues that indicate interference with sleep drive and sleep rhythm. What follows is not medical advice; it is information that you can use as a conversation-starter with your doctor or a certified sleep-specialist.
There are several types of circadian rhythm sleep disorders, including delayed sleep phase disorder, irregular sleep-wake disorder, and shift work sleep disorder. People with these disorders often struggle to fall asleep and to get sufficient sleep. They often have chronic difficulty sleeping at the times they need to in order to function and meet the demands of their daily lives. Therapies that target sleep rhythm may be most effective for these people. As I’ve said, older adults who have symptoms of insomnia or difficulty getting sufficient sleep may benefit from natural therapies that strengthen sleep-wake rhythms.
Jet lag is a form of circadian sleep-wake disruption, and melatonin can be useful in alleviating symptoms of jet lag.
Adults and children with autism spectrum disorder (ASD) may find help for sleep from melatonin supplementation. That’s because people with ASD have been shown to have lower levels of melatonin than people without ASD. There’s a body of research showing melatonin can help children and adults with ASD sleep longer, get higher quality sleep, and fall asleep more easily, with additional benefits for behavioral issues.
For general insomnia, when taken at the right dose, melatonin may help many of us fall asleep more easily and more quickly. It’s less clear from the current scientific evidence that overall sleep amounts and sleep quality are improved by melatonin.
Using supplements that enhance sleep drive (natural sedatives) can often be effective for generalized insomnia, including difficulty falling asleep. These natural remedies may be particularly effective for people whose insomnia or other sleep issues stem from issues such as stress or anxiety or chronic pain. In these cases, the arousal of stress, anxiety, or physical pain may be overriding and overwhelming the body’s sleep drive, and natural sedatives such as valerian may help you relax and allow your body’s internal drive toward sleep to progress more easily.
What matters most, of course, is that you tend to the sleep issues in your life, with guidance and support from your physician.