Sleep quality

What is keeping you awake?

Trouble falling asleep, waking repeatedly and waking too early can leave you exhausted during the day. An assessment can look for contributors such as pain, medicines, anxiety or a physical illness. Suspected breathing problems during sleep may need specialist investigation. 1

What helps persistent insomnia?

Cognitive behavioral therapy for insomnia (CBT-I) is usually the first treatment for long-term insomnia. It commonly takes six to eight weeks and can be delivered in person, by phone or online. Regular sleep times and a quiet, dark bedroom are useful parts of sleep care. 2

Where does melatonin fit?

Melatonin is a hormone involved in the timing of sleep and wakefulness. That role does not make a supplement an established treatment for chronic insomnia: the guidelines summarized by NCCIH found insufficient strong evidence to recommend it for that purpose. 3

What should you check before taking melatonin?

The BfR cautions against unsupervised use, particularly in children, pregnancy and certain medical conditions. Melatonin can cause next-day drowsiness and interact with medicines, including some blood pressure medicines and anticoagulants. Discuss suitability and driving safety with a clinician. 4

How much difference did melatonin make?

The following review measured time to fall asleep, sleep duration and reported sleep quality. 5

MelatoninMixed

Across 19 studies involving 1,683 participants with primary sleep disorders, melatonin shortened the time to fall asleep by about seven minutes and increased total sleep by about eight minutes compared with placebo. The average improvement in sleep quality was small. These pooled results included adults and children, not one uniform insomnia population. 5

Is magnesium a reliable sleep aid?

The evidence below concerns older adults with insomnia. 6

MagnesiumToo little evidence

A review of three trials involving 151 older adults found a shorter time to fall asleep, but no statistically clear increase in total sleep time. Evidence quality was low or very low, with substantial concerns about study bias. This does not establish a dependable effect or a preferred magnesium formulation. 6

What about ashwagandha?

Short studies can suggest benefit while leaving longer-term questions unanswered. 7

AshwagandhaMixed

A 2021 review of five randomized trials involving 400 adults found an improvement in combined sleep outcomes. Results differed across studies; stronger effects appeared in some subgroups. The authors emphasized that serious adverse effects and long-term safety needed more study. 7

Does herbal mean low risk?

Ashwagandha can cause drowsiness and stomach upset; rare liver injuries have been reported. NCCIH advises avoiding it during pregnancy and breastfeeding and cautions about thyroid disorders and interactions with sedatives. 8

Which products are outside this review?

This page does not assess valerian, CBD, GABA, glycine, saffron, individual magnesium salts or multi-ingredient sleep products.

Questions people ask