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Natural remedies often first choice for anxiety and insomnia

01 Sep 2013

Many insomnia and anxiety sufferers go to the pharmacy for natural health supplements as first-line treatment before seeing a GP, say pharmacy staff, as Pharmacy Today New Zealand reports

Insomnia affects people in various ways, from having trouble going to sleep, to having a disturbed sleep and waking up several times throughout the night.

Anxiety causes feelings of being tense, nervous and worried, and it can trigger sleeping problems. Both health issues can cause disruptions to people’s everyday lives.

A New Zealand pharmacist, Ban Quillinichi, said his Auckland city staff regularly treat people with sleep problems who want to try a complementary health solution so as to avoid taking prescription medications.

“People always have a concern that they will come to rely on it [prescription medication],” she said.

In such instances, Ms Quillinchi most often recommends magnesium supplements, which help relax the muscles, aiding people to get to sleep. Magnesium is also particularly beneficial for those who are have trouble sleeping due to stress.

Products with passionflower can help people sleep as it has a drowsiness effect.

Increasingly, people come into her pharmacy after searching information on the Internet, but often what they have read is incorrect, such as dosage information, she said.

Pharmacists should be aware of this and advise customers on options and correct dosages, Ms Quillinchi said.

A retail manager at another pharmacy, Delwyn Galbraith, also regularly gives complementary healthcare advice to people suffering from insomnia and anxiety.

Ms Galbraith agreed there is a stigma of addiction to prescription medicines, so people often seek a natural alternative.

She also recommends passionflower and magnesium products for insomnia and anxiety, as well as chamomile tea for sleep support.

She frequently recommends vitamin B supplements to aid anxiety as it helps to support the nerves.

As a retail manager, she is clear about where her limitations lie in recommending these products, and will always call a pharmacist into the conversation if the person is taking other prescription medications, or has other health issues, to check for contraindications.

Tart cherry, valerian root are great aids

Medical researcher Shaun Holt said there are a number of natural health products which are effective in treating both insomnia and anxiety issues.

While tart cherry is “quite new” to the market as a sleep aid, Mr Holt says there is some merit to its use.

Tart cherry contains naturally occurring melatonin, which helps to promote sleep. A number of studies also back its use.

However, both Ms Quillinchi and Ms Galbraith are reluctant to recommend tart cherry supplements, as they say they have more experience with other supplements.

Interestingly, melatonin supplements are only available on prescription in New Zealand.

“In America you can buy it [melatonin] from the corner store, but here it’s classed as a hypnotic,” Mr Holt said.

He believes a move to reclassify melatonin as a pharmacy-only medicine would make it more accessible to New Zealanders suffering from sleep deprivation.

Valerian root is a safe and natural sedative, and can be used to help treat insomnia and anxiety, he said.

However, due to its strength, pharmacists should “make the same recommendations they do for alcohol,” Mr Holt said.

Do not operate heavy machinery, be careful with, and avoid where possible, using other sedatives, and monitor alcohol consumption if taking valerian root, he added.

People with insomnia and anxiety issues could also consider kava. Widely used in the Pacific islands, the roots are used to create a drink which has sedative properties.

Other products for helping with anxiety and sleep include tryptophan and 5-hydroxytryptrophan, which are both amino acids.

Researchers have found high levels of tryptophan in turkeys, which is said to be the cause of the drowsy feeling after consuming a turkey dinner, he says.

Aromatherapy can also help relax people, which may work as a sleep aid. While Mr Holt recommends all of these products for treating both sleep and anxiety, he specifically suggests vitamin B supplements, in a tablet form, for anxiety.

There is also “weak evidence” to support the use of chamomile tea as a sleep aid, but he recommends the other options first.

Manage people’s expectations

It is important that pharmacy staff manage people’s expectations when recommending natural health supplements for anxiety and insomnia.

“It is sometimes trial and error and [effectiveness] does depend on the individual,” Ms Galbraith said.

Products can take two to three weeks to be effective and people should be aware of this.

The pharmacy staff should also follow up with people, particularly elderly patients, about a week after they have started taking natural supplements for insomnia, to see if they have been effective or whether they should try something else.

Go beyond selling products

The experts all stress the importance of helping people get to the root cause of their insomnia or anxiety issues, with a particular focus on individual lifestyles.

For example, people should take into account how much caffeine they have throughout the day – specifically coffee and energy drinks.

As both are stimulants, they hype people up and it may take them a while to fall asleep at night, Ms Galbraith said.

One customer came into the pharmacy complaining of trouble going to sleep, but when asked about her coffee drinking habits, she admitted she drank around five cups a day.

Sleep disruption is also often linked to drinking excessive alcohol or a lack of regular exercise, Mr Holt said. –PTNZ

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