Nothing makes for a grumpier mood than a night of restless, barely-there sleep. Getting a good eight hours of Zzzz’s is far more than just preventing the embarrassment of nodding off during a board meeting. We need sufficient sleep for a healthy, refreshed mind and body, inside and out. Lack of sleep has been implicated as a contributing factor in health problems ranging from depression, immune health problems, skin issues, stroke and more.

Unfortunately, we are in the midst of a sleepless epidemic, with some 32% of all Americans losing sleep at least once per week (1). All in all, this statistic isn’t too surprising given all we have on our minds. “Our society is very stressful, particularly with today’s economic pressures. Fast food and over-scheduled urban and suburban lives have replaced natural foods and the comfortable buffer zones created by rural and small town living. Families are more likely to be separated than ever before, with broken homes and people moving away from their hometowns. We never seem to have enough time,” says Neil E. Levin, CCN, DANLA, nutrition education manager for NOW Foods, Bloomingdale, IL.

At a presentation delivered at Expo West 2008 in Anaheim, CA, Maryellen Molyneaux of market research firm Natural Marketing Institute used the term “Generation Zzzz” to describe the masses of 25–45-year-olds who survive on caffeine-packed drinks during the day and sleeping pills at night. These burnt-out but gung-ho consumers lead crammed lives, which drains them of the energy they need to make it through the day. Plagued by sleep disorders, Molyneaux found this group often gets less than seven hours of shuteye per night—which is not nearly sufficient.

Serving this sleep-deprived community represents a huge opportunity for the natural products industry, as “Generation Zzzz” is knocking on our doors for healthy, sustained energy solutions that will help them de-stress and sleep soundly at night.

Stressed Out?
Trouble sleeping may be caused by any number of factors, but stress is a major contributor. In fact, 65% of Americans lose sleep due to stress and 16% have stress-induced insomnia (1). What’s keeping Americans awake at night, says The Better Sleep Council, is a combination of worrying about family issues (23%), finances (16%), current events (2%) and other issues.

While a little stress may help us keep on our game, chronic stress that goes unchecked can be dangerous. Matt Warnock, president of RidgeCrest Herbals, Inc., Salt Lake City, UT, explains why: “The hormonal stress response is orchestrated by the brain and the adrenal glands, which dump adrenaline and related hormones into the bloodstream, increasing heart rate and blood pressure, and generally keying up the body for a quick and active response that may be needed to save your life in a crisis situation.”

One hormone secreted during stress is cortisol (i.e., adrenaline), which is released by the hypothalamic-pituitary-adrenal (HPA) axis. It can remain active for long periods of time, proving to be “problematic when there is a malfunction because the HPA axis affects many body processes including digestion, restoration, repair, immune function, energy expenditure, energy storage, mood and sexual responses,“ notes Kevin Connolly, Ph.D., director of scientific affairs and product development at Jarrow Formulas Inc., Los Angeles, CA.

Information provided by Mineral Resources International, Inc. (MRI), Ogden, UT, indicates that stress may cause the body to use nutrients (like amino acids, B-vitamins, vitamin C and minerals) and other resources too quickly. “Without a sufficient intake of essential minerals and vitamins to compensate for their body’s increased need, many are vulnerable to the damaging effects of stress,” says MRI.

For example, when the body uses too much cortisol (including its reserve stock), one experiences fatigue. “Cortisol levels are highest in the morning,” says Keri Marshall, M.S., N.D., medical director of Gaia Herbs, Brevard, NC, adding, “If cortisol reserves are depleted due to stress over time, the body has a difficult time waking up and feeling refreshed in the morning.”

Fatigue is only the tip of the iceberg for stress-related health problems, unfortunately. Todd Oretsky, president of Inspired Naturals, sites some statistics from the U.S. Centers for Disease Control and Prevention that “speak for themselves,” as he puts it. Stress is the cause of as many as 90% of doctor visits and is linked to the six leading causes of death.

Digestive and heart problems are notorious stress-related conditions. Says Mitch Skop, director of new product development, Pharmachem Laboratories, Inc., Kearny, NJ, “Depending on the stressor, the heartbeat will accelerate, muscles will tense and blood pressure elevates.” Clearly, this spells trouble.

Stress can even cause risky behavioral changes such as excessive eating, drinking and smoking. “You may not even be aware these behaviors are unhealthy, when in reality they are taking years from your life. Staying stress free is almost impossible, but there are many alternative ways to coping and dealing with stress in our daily lives,” says Polly Olson, vice president of sales and marketing of Davisco Foods (maker of BioZzz), Eden Prairie, MN.

Conquering stress may involve a stress awareness/management program. The first step, says Laureen Grenus, founder and president of Herbescent Organic Tea & Botanicals, Mesa, AZ, is to identify the source of stress and try to make minor lifestyle changes to related aspects. “For example, the stress may only be our attitude toward what is happening in our lives and could simply be adjusted by beginning a process of changing your thoughts and attitudes toward your situation. It could be the demand and expectations that others place upon you.

Whatever the stress may be, the mental and emotional issues need to be addressed along with the physical side effects of stress and fatigue. While changing attitudes, beginning a daily meditation practice or going to bed earlier three times a week can be helpful to reduce stress and fatigue,” says Grenus.

Several natural supplements are available to lend support during stressful times in our lives, she adds. Such calming formulas will be discussed later in this article.

The Sleep–Nutrition Link

Food Choices. If your shoppers are counting sheep until 2:00 in the morning, their diet may be to blame. Some of the most infamous offenders are caffeinated coffees, drinks and sodas, which, ironically, might be the beverages of choice for fatigue fighting. Unfortunately, they work against us at bedtime and create a repeated cycle of tiredness. “Cutting that out is a great step in feeling less jittery and anxious. And, we encourage stressed-out individuals also to drink a lot of water: water is excellent for helping to flush out toxins,” says Eileen Sheets, managing director of Bioforce USA, Ghent, NY.

A nutritionally poor diet also is a factor in sleep. Too few nutrients and too much fat and sugar not only leads to extra inches around the waste, but also keeps the body from “producing important compounds like serotonin and melatonin, both of which are critical to proper sleep and general brain and body health,” says Warnock.

In fact, avoiding sweets may decrease adrenal exhaustion and waking up at night because of low blood sugar, says Tom VonderBrink, president of Bioenergy Life Science, Minneapolis, MN, “Interestingly, a special sugar called ribose, which is made by the body and not present in food, can get depleted in stress. In a recently published study, giving Bioenergy D-ribose five grams three times a day for three weeks (then twice a day), helped increase daytime energy an average of 45% after three weeks and improved sleep by 25%. It also decreased pain, and improved overall well being by an average of 30%. This was done in those with fibromyalgia and chronic fatigue syndrome—the groups with the severest insomnia and fatigue.”

Eating too late is a mistake, too. Says Skop, “Eating the wrong foods and eating too much prior to sleeping will cause sleep disturbances, including nightmares and night terrors.”

Deanne Dolnick, director of sales for Next Pharmaceuticals, Salinas, CA, adds, “Sleep is a time for cellular recovery. If the body has to be digesting food, recovery is slowed and to compound matters, an individual may not sleep as well.”

On the flip side, some foods may be helpful for a good night’s sleep. According to Marshall, protein may help balance blood sugar, “which could be in part what is causing restlessness in the evening,” she says.

Dietary Supplements. Luckily for bleary-eyed consumers, the natural products industry has much to offer in the form of supplements that can help ensure a good night’s sleep.

Tryptophan/Melatonin. There’s a kernel of truth in the wives’ tale that eating turkey makes you sleepy. Turkey is rich in tryptophan, an amino acid that (in the converted l-tryptophan form) plays a major role in the production of serotonin.

Let’s take a step back…The pineal gland manages our “internal clock” and controls when we rise in the morning and turn in at night. To keep us sleeping, this gland secretes melatonin in response to darkness, peaks in the wee hours of the morning and tails off at sunrise (2). Once melatonin production stops, the pineal gland produces the mood-supporting transmitter, serotonin (2). “Our biological clock can be disturbed by stress, crossing time zones and changing work shifts,” says Connolly, who notes that supplemental melatonin “has shown some efficacy in modulating circadian rhythms and thus being useful in promoting a healthy sleep cycle.”

Others ways of ensuring adequate melatonin supplies may be through tryptophan. This amino acid, says Beeta Little, PMP, director of product development and technical services at Bluebonnet Nutrition Corporation, Sugar Land, TX, is the “only natural substance that can be converted into serotonin.” Once it crosses the blood-brain barrier, l-tryptophan turns into 5-hydroxytryptophan (5-HTP), which then converts to serotonin. Tryptophan further metabolizes into vitamin B6, niacin and melatonin (which induces sleep). “Due to the ingredient’s ability to increase brain levels of serotonin and/or melatonin, l-tryptophan supplements are utilized for several purposes, including aiding in sleep, calming disruptive social behaviors, elevating mood, relieving symptoms of premenstrual syndrome and reducing carbohydrate cravings,” says Little.

Select Product Offerings: Pharmaceutical-Grade L-Tryptophan 500 mg Vcaps from Bluebonnet Nutrition Corp. (vegetarian sourced TryptoPure); 5-HTP (Griffonia simplicifolia combined with Tyrosine, B3 and B6) from NOW Foods; Jarrow FORMULAS L-tryptophan; Pain & Stress Center’s 5-HTP (50 mg); and Jarrow FORMULAS Melatonin Sustain.

L-Theanine. Another important amino acid in this category is l-theanine, the amino responsible for green tea’s health benefits that may help create a “relaxed, yet alert, state of mind” (2). Levin notes that l-theanine “encourages relaxing alpha wave production, even protecting the brain somewhat against the stimulant effect of caffeine.”

Studies show l-theanine controls the release and the concentration of several mood-related neurotransmitters such as dopamine. According to Little, “It can increase dopamine, can either increase or decrease serotonin and/or raise gamma-aminobutyric acid (GABA) levels in the brain. Over time, l-theanine allows for increased focus and concentration, improving the ability to remember and learn, in conjunction with promoting a sense of relaxation and well being without interfering with cognitive abilities. Furthermore, by increasing the concentration of several neurotransmitters (such as dopamine and GABA) and influencing the brain concentrations of serotonin.” Select Product Offerings: L-Theanine 200 mg Vcaps from Bluebonnet Nutrition Corporation; Suntheanine brand theanine from NOW Foods.

GABA. GABA is the “brain’s natural calming agent,” which prevents neurons from firing too many messages from the brain to other parts of the body (2). This amino acid may be helpful for those with insomnia, which is often caused by stress and anxiety. “If constant waking up is a problem, open a GABA capsule, put it in water and sip on it. The GABA will lower your anxiety and allow you to relax and go back to sleep. Remember, deep breathing alone can change the chemistry of the brain and allow you to return to sleep,” says Billie J. Sahley, Ph.D., C.N.C., executive director of the Pain & Stress Center in San Antonio, TX.

Amanda Steele, co-founder/CEO of Dreamerz, San Francisco, CA, agrees that GABA combined with ingredients like low-dose melatonin (or low-dose melatonin with lactium) can “help the body to de-stress and wind down in preparation for a good night’s sleep.”

Select Product Offerings: Dreamerz offers pillow chocolates, herbal fruit mixes and dairy beverages (containing a low-dose of melatonin and either GABA or lactium); Jarrow FORMULAS Sleep Optimizer combines GABA, lemon balm and tryptophan to promote relaxation; The Pain & Stress Center offers Melatonin (3 mg) and combination formulas such as Sleep Link (melatonin, GABA, l-theanine, herbs and more), Anxiety Control (Magnesium, B6, GABA, herbs and more), Mood Sync (5-HTP, GABA, B6 and more), Mellow Mind (ashwagandha plus Ester C), Brain Link (GABA, Glutamine, Glycine, vitamins and more); Inspired Naturals is the maker of Relaxity (GABA plus herbs).

Proteins. Developed from the idea that newborns fall asleep quickly after drinking milk, a branded milk-derived protein hydrolosate (Lactium distributed by Pharmachem in the United States) is said to contain a bioactive decapeptide with anti-stress properties. According to Skop, “Lactium has been clinically shown to promote restful sleep in individuals with moderate anxiety or depression, or who show high reactions to stress-related events,” he says. Skop cites several research studies that indicate its efficacy including:

• In a double-blind study, Lactium (150 mg/day) significantly reduced stress systems.
• In 10 biathletes, Lactium prevented cortisol increases caused by demanding exercise.
• Lactium (150 mg/day) improved length/quality of sleep in those with moderate anxiety or depression.

Another interesting supplement uses alpha-lactalbumin (an isolated whey protein), which is rich in tryptophan. According to Olson of Davisco Foods, the supplement “improves sleep quality and morning alertness, cognitive performance under stress and mood under stress.” Studies indicate this supplement decreases plasma cortisol levels and blood pressure (3).
Select Product Offerings: BioZzz from Davisco Foods; Pharmachem offers Lactium.

Herbs. One herbal standby in the sleep aid category is valerian. Recent research indicates that valerian can induce sleep after just one dose. In a study of 44 subjects with poor sleep histories, researchers found that 2 ml of valerian (Valerian Complex from Bioforce USA) gave participants more time in a deeper sleep than a placebo (303 minutes versus 265 minutes). “Researchers observed a shift not only to deeper sleep stages, but also toward the period of 90 minutes,” says Sheets.

A separate study reported in the February 2009 issue of WholeFoods (p. 10) showed that the supplement (valerian/hops combination) works in one dose without side effects.

Another calming herb, kava (or kava kava), is said to induce relaxation. Levin points to some interesting data: “It has been put to the test in studies comparing it with anti-anxiety prescription drugs, with a similar rate of improvement (60–75%), but fewer and milder side effects. “

Kava products should be used with caution, however, because they may cause liver problems when used by alcohol drinkers or those already with liver damage. The U.S. Food and Drug Administration advises those who want to begin taking kava to consult a physician first (4).

Another interesting plant-derived supplement is a proprietary combination of Magnolia officinalis and Phellodendron amurense (Relora from Next Pharmaceuticals). This blend helps calm an over-stimulated HPA, which (as previously mentioned) increases cortisol levels, says Dolnick. According to Levin of NOW Foods, this product also offers “stress-related appetite control while inducing a non-sedative state of relaxation. By attaching itself to specific receptor sites in the nervous system, Relora aids in the normalization of stress-related hormone levels.”

Another plant-based ingredient (Seditol from Next Pharmaceuticals) combines Magnolia officinalis bark and a Ziziphus spinosa seed extract. “A recent receptor binding assay trial showed that the actives in Seditol bind to the GABA (benzodiazepine), serotonin, dopamine and adenosine receptors. These are the receptors that produce a calming effect on the entire body,” says Dolnick.
Other anti-stress herbs include hops, ginseng and skullcap.

Select Product Offerings: Valerian Complex and Stress Management from Bioforce USA; Sound Sleep, Valerian, Serenity Liquid Phyto-Caps and Adrenal Health Liquid Phyto-Caps from Gaia Herbs; Herbescent Organic Tea & Botanicals of supplement teas for sleep, anxiety relief and meditation including Dream Spirit Herbal, Equilibrium Herbal, Calming Spirit Herbal and Immunity Spirit Herbal; NOW Foods sells kava kava; Relora is a raw ingredient from Next Pharmaceuticals found in finished products such as NOW Food’s Relora and NOW Food’s Super Cortisol Support. Next Pharmaceuticals also supplies Seditol; RidgeCrest Herbals offers Anxiety Free, DreamOn and Adrenal Fatigue Fighter.

Vitamins and Minerals. Proper intake of the B-complex vitamins, says Chris D. Meletis, director of science and research for Trace Minerals Research, Ogden, UT, and various antioxidants are key to warding off stress and sleepless nights. “The adrenal glands, in particular the source of adrenaline and cortisol, concentrate vitamin C and vitamin B5. Thus, we know for certain that there are these needs. Yet, we must look at the entire nervous system, which is largely dependent upon virtually all the B complex vitamins to support brain chemistry that help us at the mental level deal with stress. There is a physical and mental battle that occurs when faced with stress, and nourishing the body is essential to meet these demands,” he explains.

Also commenting on the importance of B-vitamins, MRI notes that this complex is “necessary for numerous body processes including but not limited to energy production, metabolism, signal transduction and maintenance of genomic integrity.” The firm cites studies in which those taking thiamin (B1) experience improved moods.

On the mineral side, experts agree that magnesium is a major player in this segment. Unfortunately, most of us (75%) don’t consume sufficient amounts daily. “This leaves us deficient,” says Ken Whitman, president of Peter Gillham’s Natural Vitality, Burbank, CA. “This in itself can cause stress along with other possible symptoms including low energy, muscle tension, muscle spasms and cramps.” Lack of magnesium also leaves us with headaches, constipation, weakness, an abnormal heartbeat, and—you guessed it—anxiety, fatigue and sleeplessness.

Experts say magnesium helps ward off sleeping problems at the cellular level. During rest, magnesium is present in the cell and calcium is on the outside. When a cell goes into an active state, calcium flows in. Magnesium controls the channels that allow calcium to flow in and out of the cell (which, in turn, controls the cell’s movement from active to resting state). “Without sufficient nutritional magnesium, the cells cannot fully close the channels and calcium leaks into the cells. This is much like leaving a light switch half on. The current is still flowing, but the light is never fully off. In the body, with the cells never fully able to rest, this results in stress,” says Whitman.

Therefore, replenishing magnesium stores through supplementation is important—especially for those who take calcium. “Most women take calcium and most of them don’t balance their calcium intake with sufficient magnesium,” Whitman adds.

Other important mineral supplements to consider for your stressed-out clientele include potassium (which is secreted during stress) and boron (for increased mental alertness and memory).

Select Product Offerings: STRESS-X from Trace Minerals Research offers a nutrient selection of B-vitamins, other nutrients and herbs such as ginseng and valerian; The Pain & Stress Center offers Mag Link and MagChlor 85 (liquid); Peter Gillham’s Natural Vitality offers Natural Calm, The Anti-Stress Drink and Osteo Calm; MRI offers Stress Formula.

Dealing with Restless Leg Syndrome
If you’re part of the 10% of the U.S. population that has restless leg syndrome (RLS), you know that a good night’s sleep can be especially difficult to come by (5). RLS is a neurological condition that causes an itching/pulling sensation in the legs and an overwhelming urge to move them. Symptoms get worse while resting, leading to many a sleepless night. As a result, says Sahley, “This has a negative impact on jobs, personal relations and daily life. Many people with RLS report they are unable to concentrate, have impaired memory, anxiety and depression.”

Though the cause of RLS is unknown, some experts feel there may be a nutritional link. According to Meletis, “Indeed, folic acid and magnesium in particular are critical for addressing restless leg syndrome. The importance of dealing with RLS cannot be overstressed, as it is the rest that arises from sleep that allows for REST-oration. Rest is key. Also, it is essential to increase antioxidants to address the free radical damage that is believed to accelerate RLS from damaging the substantia nigra, the part of the brain that produces dopamine.”

Sahley agrees with Meletis about the importance of magnesium and folate for RLS sufferers. She explains that magnesium taken daily helps prevent muscle spasms and jerking. “Muscles cannot relax without enough magnesium,” she says. “We have seen many cases of RLS and Periodic Limb Movement Disorder settle down with just the addition of magnesium.” She also adds that low levels of folate (a nutrient involved in energy production and red blood cells) have been implicated in RLS.

It should be noted, however, that some research only found iron and folate supplements helped RLS sufferers who already were deficient in these nutrients, says Connolly.

And, according to VonderBrink, “Bioenergy D-ribose has also been shown to be clinically helpful for RLS, with case reports submitted for publication.”

Given that RLS is a neurological condition, Sahley also adds that a high-quality DHA supplement may benefit RLS sufferers. “DHA, an omega-3 essential fatty acid has been shown to be in high concentrations in the synapses of the brain. These are the microscopic gaps between neurons where neurotransmitters do their work. DHA appears to help with the smooth transmission of messages between neurons, which can improve symptoms of RLS.”

Herbs, too, may offer some relief such as kava kava and black cohosh (with 500–1,000 mg of magnesium and 1 g of calcium) taken an hour before bed, says Marshall.

The RLS market may be one that our industry can explore further. Says Sheets, “We do believe that there does exist adequate research on products of natural origin that may provide a sense of relief. We urge and encourage the industry to more seriously delve into providing effective support for this condition.”

Selling Facts for Sleep Aids
Desperation for a good night’s sleep may lead shoppers to consider prescription sleeping pills, but buyer beware: they come with a host of associated side effects. Information from the Mayo Clinic indicates taking such medication poses risks for those with certain medical conditions like kidney and liver disease. And, these potentially addictive drugs may leave consumers feeling dizzy, groggy, with headaches, and—in severe cases—with episodes of sleep-driving and sleep-eating (not exactly the best way to spend the midnight hours) (6).

The black shadow over prescription sleep pills may creep over into natural sleep aids in the form of guilt by association. For consumers new to the natural market, industry experts offer some advice for handling basic questions about natural sleep aids.

Can natural sleep aids be addictive? No, say sleep aid experts. “Many natural sleep aids work with your body’s natural systems to support sleep,” says Steele. “While these natural sleep aids are unlikely to cause a physical addiction, sleep issues are often very psychological and some people may come to rely on natural sleep aids as part of their bedtime routines,”she adds.

Nonetheless, if prolonged sleep help is needed, consumers should be advised to check with a physician about any related health conditions. Says Marshall, “It is always important to figure out what is the underlying cause and look at addressing the issue. If it is stress, look at ways of addressing stress. If it is anxiety, address that. If you don’t treat the underlying cause and then you remove the sleep aid, the insomnia will likely return. It does not mean it is addictive; rather, the problem was never really treated.”

Will natural sleep aids work immediately? Yes, generally. “I find that within two to three nights you will know if the product you have chosen is the right one for you,” says Marshall. The actual response time varies from product to product and from person to person, though.

Steele says a good rule of thumb is to “use a natural sleep aid for ten days to help regulate the body’s sleep cycle.”

Are there side effects? Will I feel groggy in the morning? Some natural sleep aids may have side effects like morning grogginess or disturbing dreams. Often, this is more a problem with the dose than the nutrient itself. For example, taking too much melatonin may cause some grogginess or a racing heart. “To minimize side effects, we recommend using natural sleep supplements that work with the body’s natural system such as a low (0.3–0.5 mg) dose of melatonin, GABA or Lactium,” Steele says. And, start with the lowest recommended dose first.

Also, timing may be an issue. Levin advises, “It is always best to take these products upon retiring to bed, rather than after not being able to sleep and taking them at 3 a.m.”

But overall, says Scott Boyson, marketing manager for Trace Minerals Research, most supplements don’t have side effects “because they are meant to restore the body with the nutrients it needs to calm down and relax naturally.“

My teenager says he’s/she’s stressed and can’t sleep. What do you sell for him or her? During adolescence, says Sahley, “The teen brain undergoes a multitude of changes, the neural pathways, the connections between neurons affecting emotional skills; physical ability and mental cognition are not yet developed.”

At the same time, teens often experience delayed sleep onset, “resulting in difficulty falling asleep until late at night and the need to sleep in later in the morning. Interestingly, many high schools have found that moving to a later start time alone has helped them to improve test scores,” says Steele.

To help teens sleep soundly, industry experts recommend reinforcing the importance of exercise and a healthy diet before trying supplements. Says Skop, “We heartily recommend that teens have a loving and strong support system in place, and that they are encouraged to eat a healthy diet and to exercise, and if advised by their physicians, to try a well researched natural product before resorting to prescriptions.”

On the diet front, parents should reduce sugar and carbohydrate intake—as well as caffeine. Says Levin, “I would first look at their Red Bull, coffee and cola intake. A lot of teens drink high-caffeine beverages regularly, and then think they need anti-anxiety medications! The teen years can be tough, and many teens don’t eat well. Try to clean up their diet, make sure they are getting enough calcium because their bones are still forming and it can be subtly calming.”

If help is needed from supplements, advise clients to check with a doctor first. Once they have approval, experts recommend a variety of products for teens including Valerian Complex from Bioforce USA, Stress Management drops from Bioforce USA, Ribose (Corvalen, made by Bioenergy) and Corvalen M (which also includes magnesium and malic acid with the Ribose), low-dose melatonin, 5-HTP, Teen Link from Pain & Stress Center (combines 5-HTP, GABA, glutamine, tyrosine, taurine and B6), calming herbs like chamomile, hops and passionflower, and Serenity from Gaia Herbs. WF

References

1. The Better Sleep Council, “Stress and Sleep in America,” www.bettersleep.org/ OnBetterSleep/stress_sleep.asp, accessed February 25, 2009.
2. M. Zimmerman and J. Kroner, 7-Syndrome Healing (Nutrition Solution Publishing, Chino, CA, 2006).
3. M. Messaoudi, et al., “Effects of a Tryptic Hydrolysate from Bovine Milk Alpha S1-Casein on Hemodynamic Responses."
4. University of Maryland Medical Center, “Kava Kava,” www.umm.edu/altmed/articles/kava-kava-000259.htm, accessed February 26, 2009.
5. Restless Leg Syndrome Foundation, www.rls.org, accessed February 24, 2009.
6. Mayo Clinic, “Prescription Sleeping Pills: What’s Right for You?” www.mayoclinic.com/health/sleeping-pills/SL00010.

Published in WholeFoods Magazine, April 2009