The term insomnia comes from the root word “somnia” which we define as “like sleep”, so insomnia is the inverse of sleep. Insomnia can be further described as difficulty in initiating and/or maintaining sleep, and those suffering from insomnia often experience one or the other, if not both, of these symptoms.

It is important to rule out any primary sleep disorders, such as sleep apnea, narcolepsy or periodic limb movements during sleep (a variation of restless leg syndrome). These disorders may need to be evaluated at a sleep disorders center.

There are also secondary sleep disorders in which insomnia may be caused by a particular medical phenomenon, environmental issue or transitional hormonal irregularity (such as a thyroid disorder or menopause). One of the main complaints of menopause are hot flashes that may occur during the daytime, nighttime or both. In addition, some women may have alternating chills or sweating that can cause waking during the night.

Once the cause of the insomnia is identified, treatment can be relatively straightforward. For example, progesterone has a hypnotic or sedative effect on the body and I prescribe it frequently to help with sleep. In addition, very low-dose vaginal estriol can be used to eliminate hot flushes, without significant systemic absorption, thus clearing a symptom that can interfere with sleep. Chinese herbs and homeopathic remedies work very well for unwanted menopausal symptoms when estrogen replacement therapy is not desirable or is medically contraindicated.

I occasionally recommend to patients a combination of L-Tryptophan and melatonin to aid sleep. L-Tryptophan is converted to serotonin then into melatonin, and when used together they work synergistically. Besides having properties that help with sleep onset and maintenance, melatonin has other properties, which boost the immune system and in some cases even lower blood pressure.

If you are experiencing insomnia, consider consulting a licensed naturopathic doctor to determine the root cause of your sleep issues and to help evaluate the best course of treatment for you.


Timothy Schwaiger, ND, is clinical associate professor and core faculty member at Bastyr University California. He also is a clinical supervisor at Bastyr University Clinic. If you are interested in learning more about treatment for sleep disorders, visit or call the clinic at 858-246-9730 to schedule an appointment.