Ask The Doctor: Elderly Woman Can’t Sleep

Dear Doctor Rona,

Let me start by saying that your articles are my favourite thing in Vitality magazine. It is valuable and rare to have an independent voice like yours speaking out on the holistic approach to disease and illness, and I have shared your advice with many of my friends now that I can send the digital magazine to Florida and beyond. My question is in regards to my mother. She is now 86 years old, and suffers from chronic insomnia. She tried calcium but that didn’t work. She often doesn’t go to bed until 3 am or later, and sleeps in until noon. When she asked her doctor for help, he prescribed something that she calls an ‘anti-psychotic’ medication. Since I don’t agree that my mom should be taking strong drugs at her age, I’m wondering if there’s a more natural approach to help alleviate her insomnia. As a further complicating factor, she is being scheduled for kidney dialysis in the near future.
Mary Peters, Sutton, Ontario

Dear Mary:

First, thank you for the kind words. There are many natural remedies that are successful in treating insomnia. Caffeine, aspartame, and other stimulants should be avoided. I usually recommend that people start by using melatonin (1 – 3 mg before bedtime). The sublingual tablet form is best.

Other effective remedies that could be added if the melatonin doesn’t work up to expectations are valerian, St. John’s wort, niacinamide (not niacin), 5-HTP, L-tryptophan, passion flower, kava kava, L-theanine, GABA and magnesium threonate. With all of these health products one has to experiment with the dose. None are toxic in any way and can be taken by dialysis patients. Many supplement companies have combinations of all these remedies in one capsule but each could be tried separately. BTW, never take calcium supplements on their own. Calcium must be combined with an equal amount of magnesium to prevent deposition of calcium into soft tissues like the kidneys.

One more treatment for insomnia that might be helpful, especially in women, is progesterone, the oral bio-identical form. When swallowed, this hormone is converted into a sleep-inducing compound in the liver allowing for restful sleep. This has to be prescribed by a physician or naturopath familiar with bio-identical hormones and filled by a compounding pharmacy. Let me know how things go for your mother.
Dr. Zoltan P. Rona, M.D., M.Sc.