Valerian for sleep: what the NHS says and what helps insomnia

Valerian is a plant whose root is used in herbal remedies marketed for sleep and relaxation. In the UK it is sold in pharmacies and health shops as tablets or liquids, sometimes in combination products alongside other plant ingredients such as lavender.

The NHS describes these as products you can buy from a pharmacy that may help you sleep better. It lists valerian and lavender as examples of natural ingredients, and notes that others contain an antihistamine. The NHS herbal medicines page adds that herbal medicines are not available on the NHS and are not tested in the same way as standard medicines.

The NHS is clear about the limits. These products cannot cure insomnia, they may help you sleep better for 1 to 2 weeks, and they should not be taken for longer than that. Some can cause side effects such as drowsiness, which could make it difficult to do certain things such as drive.

It adds that you should check with your doctor before taking anything for your sleep problems. The wider NHS herbal medicines page asks people to check with a pharmacist before taking a herbal medicine if they are already taking other medicines, and to tell any doctor treating them that they are using one.

The same page lists groups who should not take herbal medicines without advice: people who are pregnant or breastfeeding, those with kidney or liver problems, and those taking medicines such as statins, antidepressants, diabetes medicines, blood pressure medicines, blood thinners or hormonal contraception.

The NHS says insomnia usually gets better by changing sleeping habits. Its advice is to go to bed only when sleepy, get up at the same time every day, wind down for at least an hour before bed, keep the bedroom dark and quiet, exercise regularly during the day and keep the mattress, pillows and covers comfortable.

It also lists things to avoid: smoking, alcohol, tea or coffee for at least 6 hours before bed, big meals late at night, exercise within 4 hours of bed, screens right before bed because blue light makes you more awake, daytime napping and sleeping in after a bad night.

The NHS advises seeing a GP if changing your sleeping habits has not helped, you have had trouble sleeping for months, or insomnia is affecting your daily life so that it is hard to cope. A GP will try to find out what is causing it, since stress, anxiety, depression, alcohol, medicines and conditions such as sleep apnoea, restless legs syndrome or an overactive thyroid can all contribute.

Treatment may include CBT for insomnia, face to face or online, and referral to a sleep clinic if there are signs of another sleep disorder such as sleep apnoea. The NHS says GPs now rarely prescribe sleeping pills because they can have serious side effects and people can become dependent on them, and that they are prescribed for a few days or weeks at most when insomnia is very bad and other treatments have not worked.

Understanding the cause matters more than the choice of product. The NHS lists the most common causes of insomnia as stress, anxiety or depression, noise, a room that is too hot or cold, an uncomfortable bed, alcohol, caffeine or nicotine, illegal drugs such as cocaine or ecstasy, jet lag and shift work.

Other conditions can also be involved, including mental health conditions, Alzheimer disease or Parkinson disease, restless legs syndrome, an overactive thyroid and menopause, and many medicines can cause insomnia. Long-term pain, snoring or interrupted breathing in sleep, narcolepsy and nightmares can also disturb sleep. Treating the underlying problem is often what restores sleep.