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Although there are no studies of the effects of St John’s Wort for insomnia, it is important to remember that sleep difficulties are a cardinal symptom of depression. These difficulties may take the form of having trouble falling asleep, tossing and turning or sleeping fitfully during the night, or waking up too early in the morning. So distressing are such symptoms that they may overwhelm the clinical picture and the depressed person may misdiagnose the condition as insomnia.

All types of anti-depressants may be helpful in reversing insomnia when it is part of the overall picture of depression. St John’s Wort is no exception in this regard. People with insomnia might benefit from reading over the symptoms of depression to determine whether they are suffering from other symptoms of depression as well. If they are, then the herbal remedy is more likely to help resolve their sleep difficulties.

A 56-year-old woman writes to tell me how her sleep difficulties, which were the most troublesome symptoms of her depression, were helped by St John’s Wort: ‘I can sleep again!‘ she exclaims. ‘Getting rest at night has helped everything else; gloom has lifted and I am in good spirits, energetic and positive. I feel a heavy weight off me. Immediately (the first night) I began to have dreams. I used to dream lots until about five to six years ago when the menopause kicked in. I did not dream as usual, if at all. I really hadn’t thought about it until I took St John’s Wort and began to dream again. Maybe the increased dreams are also related to my increased sense of well-being.’

If there are no other symptoms of depression, however, the insomnia may well be due to some other condition. It is worth paying a visit to your GP to have the problem checked out, as some causes of insomnia are potentially dangerous and eminently treatable. One such cause is sleep apnoea, a condition in which people stop breathing for brief spells frequently during the night, which wakes them up repeatedly. This leaves people drowsy and feeling ‘hung over’ during the day, and puts them at risk when driving or operating machinery. The resulting lack of oxygen to the tissues can also be medically harmful. Sleep apnoea is unlikely to respond to St John’s Wort, but can readily be treated by other means, such as a special machine that pumps air into the lungs when the person stops breathing.

Simple but important factors worth considering in identifying possible causes of insomnia include commonly used drugs, such as caffeine, nicotine and alcohol. Often cutting down the number of cups of coffee, tea or caffeinated sodas, particularly in the latter part of the day, can work wonders in bringing insomnia under control. Some people may not realize that nicotine is a stimulant and that smoking in the latter part of the night may be preventing them from falling asleep. Even though alcohol has immediate sedative properties, its effects wear off after a few hours. So too much alcohol at night may appear to promote sleep but may actually disrupt it when blood alcohol levels begin to fall. Removing these drugs from the latter part of the day or, at times, altogether, can be very helpful in promoting restful sleep. In addition, sleep experts emphasize the importance of what they call sleep hygiene – a quiet peaceful bedroom with dim lights and low noise levels. They recommend keeping arguments and conflicts out of the bedroom and engaging in peaceful rituals to wind oneself down before bedtime. If such simple remedies don’t help overcome sleep difficulties in the absence of depressive symptoms, it is worth seeking out the help of an appropriate doctor. If insomnia is part of a depression, however, it may resolve when treated with St John’s Wort or an anti-depressant.

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