Sleep can be tough to come by these days. A 2021 systematic review of 44 studies, which involved more than 54,000 participants in 13 countries (including the United States), found that 36 percent of subjects were experiencing problems falling or staying asleep.
Even before the stressful events of 2020, the Centers for Disease Control and Prevention reported that around one in 25 American adults had used a prescription sleep aid in the past month.
And a survey of older adults published in 2018 found that more than a third of them used medications to aid sleep — most commonly, over-the-counter (OTC) sleep aids.
Prescription and OTC sleep aids often come with side effects, including daytime drowsiness, headaches, memory problems, gut disturbances, and dizziness. A 2017 study published in the journal Sleep reported that such medications increase the risk of falls for older adults.
Other research suggests that long-term use of sedatives and hypnotics, such as Ambien (zolpidem), can double the risk of dementia.
Such pharmaceutical and OTC sleep aids also carry the risk of both physical and psychological dependence. Over time, higher doses are usually needed, and stopping the drug can trigger anxiety, agitation, restlessness, and other psychological symptoms.
Yet there is good news for the sleep-challenged: Conventional sleep aids are not the only option. There are supplemental nutrients that can also help.
“When we think about what we need to have good sleep, they’re things we get from food,” explains functional nutritionist Jesse Haas, CNS, LN. “Nutrients run the body.”
These include the vitamins, minerals, and electrolytes our bodies use to create sleep-promoting neurochemicals, such as melatonin, serotonin, and GABA (gamma-aminobutyric acid).
A nutrient-first approach to sleep tends to circumvent the side effects of sleep drugs. Meet some of the star sleep-supporting nutrients.
Melatonin is a hormone primarily made by the pineal gland in the brain, although some is also produced in the gut. As the sun sets and darkness falls, the hypothalamus signals the gland to ramp up melatonin production. In turn, the hormone sends a clear signal to the brain and body to get ready for sleep.
You can find melatonin in many pharmacies alongside other sleep aids, but it doesn’t operate in the same way as those that offer sedation. “A common misconception people have is that melatonin is a sedative that will put you to sleep,” says Lindsay Christensen, MS, CNS, LDN, a functional nutritionist in Conifer, Colo.
In fact, melatonin serves to regulate the body’s sleep–wake cycle and circadian rhythms, she explains. That means if someone’s sleep problems are related to stress or cortisol levels instead of a disrupted circadian rhythm, melatonin probably won’t help. (For more on circadian health, see “Get in Sync: On Sleep and Health“.)
“A common misconception people have is that melatonin is a sedative that will put you to sleep.”
“Think of sleep as the Olympic 100-meter race,” suggests neuroscientist Matthew Walker, PhD, in his book Why We Sleep. “Melatonin is the voice of the timing official that says, ‘Runners, on your mark,’ and then fires the starting pistol.” Melatonin governs when the race begins, but the runners are “other brain regions and processes that actively generate sleep.”
To make melatonin, the body first converts tryptophan into the mood-regulating neurotransmitter serotonin; serotonin is then converted into melatonin. “Melatonin is the end product of a long-chain chemical reaction,” Haas explains.
While melatonin is best known for its capacity to help with sleep, it also supports other functions. “Melatonin is a potent antioxidant,” says Haas, noting that it’s sometimes used in holistic cancer treatment to reduce side effects from radiation and chemotherapy.
It also, somewhat mysteriously, may help treat acid reflux. And it’s been shown to ease the symptoms of acute COVID-19 (and may benefit those with long COVID as well) — possibly because of its anti-inflammatory, antioxidant, and immune-modulating effects.
[Melatonin is] sometimes used in holistic cancer treatment to reduce side effects from radiation and chemotherapy.
Whole-Food Sources: Nuts, milk, fish, eggs, and goji berries all contain melatonin. Tart cherries are one of the most potent sources, and drinking tart-cherry juice has been found to improve sleep. Kiwifruit, meanwhile, is a great source of food-based serotonin — an important ingredient in the melatonin-production cycle.
Supplements: Melatonin supplements are safe and well-tolerated by most people. Still, relying on them for the long term may disrupt the body’s melatonin-producing pathway. And if melatonin drops off, rebound wakefulness can occur.
Supplements may be best used to adjust the timing of the sleep–wake cycle. They can be particularly helpful for shift workers or international travelers whose circadian rhythms need a nudge, says nutritionist Karman Meyer, RD, LDN, author of Eat to Sleep.
Taking 1 to 3 mg of melatonin about an hour before bedtime can signal to the body that it’s time to wind down. (You can also experiment to find timing that’s right for you — some people do better taking melatonin about 30 minutes before bed.)
“Melatonin is great in the short term — it’s a great way to get over the hump of jet lag,” Meyer says. “If you’re trying to establish a regular sleep pattern, some people might use it for up to two years. But for most, it’s more like a month or two.” She notes that long-term use can sometimes lead to headaches, grogginess, depression, or dizziness.
Although supplementing is a useful tool, most experts suggest that the goal is to support the body’s ability to produce its own melatonin. “As with digestive enzymes or acids, we can take these things supplementally for a period of time to regulate the mechanisms those compounds support, but we ultimately want the body to make them,” Haas says.
Vitamin D is key to the body’s ability to create melatonin, notes Christensen. Many of her clients use sleep trackers, and they’ve found that when their vitamin D levels improve — whether through sun exposure or supplementation — their feedback will often show a significant improvement in their sleep quality.
Recent research corroborates Christensen’s findings. A 2018 meta-analysis found that levels of vitamin D lower than 20 ng/mL (nanograms per milliliter) were associated with a 60 percent greater risk of poor sleep.
And in a randomized controlled trial published in 2017, participants with sleep disorders reported significant improvements in several measures of sleep after taking a megadose of 50,000 IUs of vitamin D3 every other week for eight weeks.
“Lack of vitamin D can lead to an increase in inflammatory substances in the body that can interfere with sleep processes.”
This may all be traced back to inflammation, suggests Meyer. “Lack of vitamin D can lead to an increase in inflammatory substances in the body that can interfere with sleep processes.”
Emerging evidence suggests that vitamin D may enhance immune health by limiting the release of inflammatory substances, such as prostaglandin D2, tumor necrosis factor alpha, and cytokines. Other research has shown a correlation between a well-regulated immune system and quality sleep.
Whole-Food Sources: Daily exposure to sunshine is the best way to get vitamin D. Egg yolks, wild salmon, sardines (with skin and bones), and mushrooms that have been treated with UV light (look for a label stating this) are among the few food sources for this important vitamin. Note that mushrooms supply vitamin D2, whereas sunlight and animal foods supply D3; the latter more effectively raises serum levels of vitamin D. (For more on this nutrient, see “Vitamin D: What You Need to Know“.)
Supplements: Vitamin D3 supplements are extremely helpful for those living at latitudes where there is less sunlight in winter.
Calcium supports sleep in two ways. First, it helps the body convert tryptophan into melatonin. Dairy products, which contain both tryptophan and calcium, are among the most sleep-promoting of all foods. A warm glass of milk at bedtime is a cliché for a reason.
Secondly, calcium — along with zinc, copper, and magnesium — supports the signaling process that governs the sleep–wake cycle. Haas calls these nutrients gatekeepers that “let information in and out of cells and move brain chemicals around.”
Research has found that low calcium intake is associated with insomnia and poor sleep.
As with vitamin D, research has found that low calcium intake is associated with insomnia and poor sleep, particularly disturbances in REM sleep, where dreaming and memory formation take place.
Whole-Food Sources: Good sources of calcium include kale, sardines with bones, tofu, yogurt, edamame, figs, almonds, and cottage cheese.
Supplements: Calcium-citrate supplements offer a potentially more bioavailable option for getting this nutrient; these often combine calcium with another sleep-supportive nutrient — magnesium. (For more on wise ways to supplement calcium, and how to best combine it with other nutrients, see “How to Optimize Your Calcium Intake“.)
In addition to supporting melatonin synthesis, magnesium helps regulate stress hormones, making it a good choice if melatonin doesn’t seem to work for you. “Magnesium can help reduce cortisol, the stress hormone, which can spike at night,” explains Christensen.
In a healthy cortisol cycle, the hormone rises in the morning and declines gently throughout the day. But if you’ve awakened in the middle of the night with a spinning, anxious mind, you may have a disrupted cortisol cycle to thank. “Optimizing magnesium intake in the evening can downregulate cortisol production.” (For more on optimal cortisol timing, see “How to Balance Your Cortisol Levels“.)
This mineral may regulate other hormones as well, Christensen notes. Magnesium and calcium help metabolize estrogen, which may help address the hormone-related sleep disturbances that are a hallmark of perimenopause and menopause.
“[Magnesium] can help prevent migraines, menstrual cramping, muscle contractions — those things that are enough all by themselves to wake you up in the middle of the night.”
Magnesium is also needed for relaxation, Meyer adds. “It can help prevent migraines, menstrual cramping, muscle contractions — those things that are enough all by themselves to wake you up in the middle of the night.” It also stimulates the brain’s receptors for GABA, a calming neurotransmitter.
One small 2012 randomized clinical trial found that daily magnesium supplements helped relieve insomnia in elderly subjects; the participants also showed improvements in their melatonin and cortisol levels. Another study using animal subjects found that a magnesium-deficient diet was correlated with light, restless sleep. (See “Magnesium: Your Body’s Spark Plug” to learn more about this critical nutrient.)
Whole-Food Sources: Because of declining soil health, magnesium is increasingly difficult to get from food, says Haas. “It’s disappearing from our food system as a side effect of conventional agricultural practices.” Still, pumpkinseeds, almonds, cashews, black beans, brown rice, and edamame are all good sources of magnesium if the soil in which they’re grown is nutrient dense.
Supplements: As far as magnesium supplements for sleep are concerned, the Cleveland Clinic advises opting for magnesium glycinate (200 mg) or magnesium citrate (200 mg) about 30 minutes before bedtime. Avoid magnesium oxide, which is primarily a stool softener.
The gut microbiome is involved in nearly every aspect of our health, including melatonin production. “Melatonin is primarily made in the brain but also in the gut,” says Christensen. “If the bacterial ratios in the gut are imbalanced, then gut-derived melatonin could be lower, which could affect sleep.”
Some gut microbes also help make calming neurotransmitters, such as GABA. “If we have low levels of those GABA-producing bacteria, we can be less able to wind down,” she adds.
“Melatonin is primarily made in the brain but also in the gut. If the bacterial ratios in the gut are imbalanced, then gut-derived melatonin could be lower, which could affect sleep.”
Poor digestion, meanwhile, can contribute to irritability, diarrhea, constipation, and moodiness — conditions that by themselves can disrupt good sleep. “And with poor gut health, you’re not absorbing nutrients well,” Meyer says. This can lead to trouble getting the calcium, magnesium, and other nutrients you need.
Whole-Food Sources: To support a healthy microbiome, Christensen recommends, limit processed foods and eat a diet rich in prebiotics — foods that feed good bacteria in the gut. These include Jerusalem artichokes, asparagus, lentils, unripe bananas, leeks, oats, and chickpeas. Probiotic fermented foods, such as yogurt and pickled vegetables, can also be a great source of beneficial bacteria.
Supplements: A daily probiotic can lend extra support. (For tips on how to find a quality probiotic, see “How Do I Find the Right Probiotic Supplement for Me?“.)
CBD for Sleep
Research on CBD (cannabidiol), a cannabinoid found in both hemp and marijuana, as a sleep aid has produced mixed results. Part of the reason, says functional nutritionist Jesse Haas, CNS, LN, is that “CBD is all over the map in terms of sourcing, dose, and potency.”
CBD does show consistently promising results in reducing anxiety, and this may be one reason it helps with sleep. “CBD may provide a calming effect,” says Karman Meyer, RD, LDN, author of Eat to Sleep.
Studies show CBD can enhance the binding power of the body’s receptors for GABA, the relaxing neurotransmitter, and that it may increase available levels of tryptophan, which the body uses to make serotonin and melatonin. (For more on CBD, see “Is CBD Effective?“.)
Herbs for Sleep
Several herbs are renowned for their sleep-supporting properties. Passionflower and valerian root may enhance GABA, the neurotransmitter that calms the central nervous system.
Valerian may also produce a sedative effect, particularly when used in combination with other calming herbs, says Karman Meyer, RD, LDN. “Some research shows a synergistic effect between valerian root and lemon balm, so it’s good to have these together.”
Lavender, chamomile, and hops also have a calming effect on the nervous system and can help induce sleep, says functional nutritionist Jesse Haas, CNS, LN. Many of these can be found in tea blends marketed to help with sleep, which are a great remedy for occasional sleep disruption. For chronic issues, try a concentrated extract; these can provide a standardized dose of specific sleep-promoting herbs.
Adaptogenic herbs, such as maca, tulsi (holy basil), and Panax ginseng (also known as red ginseng), offer other routes to aid sleep, Haas notes. These are not sedating, so they’re not taken at bedtime — instead they offer a slow course-correction for the body. “Adaptogens are useful when we’re thinking about a long-term macro impact on the nervous system.” (For more on adaptogens, see “Ancient Healers: Adaptogens“.)
Sleep Support for Kids
Sleep supplements, including herbal remedies, may be too potent for kids, says functional nutritionist Jesse Haas, CNS, LN. “We want to find gentle interventions for those little bodies.”
She recommends trying sleep teas with calming herbs, such as chamomile or lavender, or using lavender essential oil in a diffuser. A bedtime bath with Epsom salts can be relaxing for kids too, she adds; the magnesium in them may also be absorbed through the skin.