* Try acupuncture or acupressure (shiatsu). One randomised clinical trial of 40 insomniacs showed that acupuncture improved sleep, even by objective measurements (Forsch Komplementärmed, 1999; 1 [suppl]: 29-31). Acupressure can work in the elderly (J Gerontol Med Sci, 1999; 54A: M389-94), and hypnosis also works, according to a trial of 37 women (J Abnormal Psychol, 1973; 82: 153-8).

* Use biofeedback techniques appropriate to your symptoms. According to two randomised clinical trials, EEG (electroencephalography) feedback helped those with insomnia due to anxiety, and sensorimotor-rhythm-type biofeedback worked best on those whose insomnia was caused by other conditions (Arch Gen Psychiatr, 1981; 38: 752-8; Biofeedback Self-Regul, 1982; 7: 223-35).

* Investigate food allergies. My own approach is to look for unidentified food hypersensitivity that causes no obvious symptoms apart from insomnia. There is often a delay of around six hours between consumption of the offending ingredient and the 'wide-awake' effect, which is probably linked to an outpouring of various excitatory neurohormones as well as thyroid hormones (Paediatrics, 1985; 76: 880-4).

* Engage in regular moderate exercise - but not just before you retire. Research shows that raising the heart rate by about 50 per cent for at least 20 minutes each day will noticeably improve sleep quality (Sports Med, 1996; 21: 277-91), even in the elderly (JAMA, 1997; 277: 32-7).

* Try homoeopathy. A personal favourite homoeopathic combination remedy is Passiflora Lehning Drops, which combines Avena sativa, Passiflora incarnata, Atropa belladonna, Secale cornutum and Valeriana officinalis at low homoeopathic potencies. This safe and non-addictive homoeopathic combination was tested against standard drugs in women suffering from anxiety-related insomnia. After 30 days, the Passiflora combination was the frontrunner on a number of parameters, including daily sleep duration (Carion V et al. Etude de l'Action de Passiflora Lehning sur Insomnie: Une Analyse Statistique, Metz: Editions Lehning, 1992: 1-16). The standard dose is 20 drops in some water, taken away from meals four times a day. U * Nicotinamide (vitamin B3 or niacinamide) may also lull you to sleep. I often take a functional blood test to check vitamin B3 status. If it’s low, I suggest supplementing with B3 before bedtime along with magnesium and vitamin B6.

* Try the herb valerian, but not the root. In a study of the herb, free of the valepotriates found in the root, there were no adverse reactions, suggesting that it’s a safe and highly effective alternative treatment (Pharmacol Biochem Behav, 1989; 32: 1065-6). Once a normal sleeping pattern has been reestablished, you can decrease the valerian slowly.

* Cut out hidden stimulants. When investigating the causes of insomnia, remember that some herbal tonics contain botanical stimulants, and that numerous over-the-counter and prescription medicines contain caffeine.

Harald Gaier Harald Gaier is a registered naturopath, osteopath, homoeopath and herbalist. He can be contacted at The Diagnostic Clinic, London, tel: 020 7009 4650

Case study A 48-year-old woman came to see me after having been suffering from insomnia for a year. Although she’d always been a sound sleeper, she was now waking up five or six times a night. Her GP offered her sleeping pills, which she refused to take. I recommended that she have her female hormones tested, and the results indicated that she was in perimenopause. As well as recommending some dietary changes, I also gave her a prescription for homoeopathic Folliculinum. Shortly thereafter, she began to sleep soundly again. Her menopause, when it did arrive, was quick and uneventful.