QWhen the plague of insomnia hits Macondo, the inhabitants stop sleeping. At the beginning they seem almost happy with the time gained, but the weeks pass and without sleep they begin to forget everything: the names, the functions of the objects, their own history. That’s how it is Gabriel García Márquez tells one of the most famous pages of One hundred years of solitudeentrusting the salvation of his characters to the potion of a magical and wise gypsy. How similar we are to the inhabitants of that imaginary village! After Covid, in Italy, in just one year, purchases of supplements and herbal teas to give serenity to the night and calm the mind grew by almost 60 percent. An economy of anxiety, as it has been called. Modern potions are melatonin, old benzodiazepines, and new classes of drugs. It should be the doctor who gives the instructions and the patients who follow them, with one certainty: insomnia must be treated. It is more dangerous to sleep chronically poorly than to take medications, even long-term.
The causes: from anxiety to menopause
Almost 13 and a half million Italians suffer from chronic or transient insomnia (estimates from the Italian Sleep Medicine Association), but around half of them, 46 percent, do nothing to solve the problem. A mistake, because sleeping well is essential for memory, but also for mood and general health. For insomniacs, experts recommend having a specialist visit to understand if there is a problem that needs to be treated at the root of the discomfort. Sleep apnea, for example, or restless legs syndrome. And anxiety, which makes it difficult to fall asleep, and depression, which perhaps makes your eyes widen at three in the morning, must be assessed. Nature then intertwined women’s sleep with hormonal rhythms. During the fertile period, sexual hormones contribute to the balance of the main systems that regulate nocturnal refreshment. It is estrogens that help reduce body temperature in the evening and increase the activity of serotonin and Gaba, two neurotransmitters with a relaxing effect. Progesterone also amplifies the action of Gaba, making it easier to fall asleep and calming anxiety. In menopause, with the collapse of sexual hormones, this protection of the nights can undergo an earthquake and sleep becomes lighter and more fragmented. As if that weren’t enough, hot flashes are added, which interrupt the nights. Gynecologists and gynecologists can prescribe hormone replacement therapy, when there are no contraindications. And research is offering other non-hormonal therapies capable of providing sleep continuity.
The action of plants
In fact, people skip the consultation and start trying herbal teas. In truth, trying to fall asleep with a cup of chamomile has a scientific basis. When insomnia symptoms are mild, you can experiment with plant extracts, such as passionflower, hops, valerian, lavender. They are found in infusions, other herbal products or supplements. The action of chamomile and other herbal remedies against insomnia is on the central nervous system and the interesting thing is that there is a certain similarity with what some hypnotic drugs do. Both act on the neurotransmitter Gaba, helping to calm brain excitement, but plant extracts work differently and for this reason they do not create dependence and habituation.
Melatonin dosage
The second step is melatonin-based supplements. Supplement use has increased 425 percent among Americans over the past twenty years. An impressive leap, documented in a study published in the scientific journal Jama. Supplements are available in pharmacies, available without a prescription and at relatively low costs, with formulations from 1 to 5 grams. Many wonder if it is risky to take the substance, if it is really effective, if it causes side effects. To orient yourself, it is better to have the main information, starting from the mechanism of action. Meanwhile: how does melatonin work? The active ingredient is obtained in the laboratory by reproducing the hormone that our brain naturally synthesizes. When it starts to get dark outside and the light becomes dimmer, the pineal gland, a small gland in the brain, begins to secrete melatonin. Our functions then slow down and our eyelids droop. Melatonin is not a sedative, it says it’s time to sleep, kind of like taking a sunset dose. It is usually indicated to avoid work shift disorders and jet lag, or jet lag syndrome, when traveling, but it can also work when you don’t sleep well.
It is not a placebo, the effectiveness is documented, yet there is no guarantee that it is good for everyone. It may happen that some do not close their eyes at all and that others wake up groggy the next morning. We also need to ask ourselves what the right dosage is. A 2024 review, which appeared in the Journal of Pineal Researchanalyzed 26 randomized controlled trials and showed two conclusions: the effectiveness increases gradually up to 4 milligrams per day, while beyond that there are no further benefits. To maximize the hypno-inducing effect, melatonin should be taken two-three hours before sleep, in order to reduce the time it takes to fall asleep. But are there any serious side effects? A note from a team of researchers, presented at a conference in 2025, that melatonin is associated with heart failure has raised concerns among people. Many experts pointed out, however, that the analysis had not yet been published in any scientific journal or subjected to peer review. In summary, that assessment was disavowed. Furthermore, long-term studies have never found evidence that melatonin damages the heart. Quite the opposite. Thus write the authors of a review, which appeared in August 2025 (on Current Issues in Molecular Biology ): «Melatonin exerts powerful antioxidant, anti-inflammatory and cardiometabolic properties».
Psychotherapies and relaxation
When insomnia is chronic, you need to act with the help of a specialist. Some targeted psychotherapies, such as cognitive-behavioral therapy, and relaxation and meditation techniques often give excellent results in people who develop anxiety linked to the fear of not sleeping. There are also various medicines that can be taken as needed or for short periods. The most prescribed sedative-hypnotic drugs are benzodiazepines, barbiturates and so-called Z compounds, such as zolpidem and zoplicone. And there is a new drug, which is not addictive and is effective in 50-60 percent of people. The molecule, daridorexant, approved in 2022, acts on the orexin system, one of the neurotransmitters involved in the sleep-wake rhythm. It can help people who can’t turn their brains off at night, a condition called hypervigilance. Such is the range of options that insomnia should not be experienced as a sentence. It is a common disorder, especially at some point in life, and it is treatable. Asking for help is part of the solution.
The rules of good rest
When you are unable to sleep or the night is interrupted by awakenings, you can try to follow simple advice, the so-called “sleep hygiene”. Among these, avoid too large dinners and alcohol, do not do sports in the evening hours, Try to always wake up and go to bed at the same time, do not drink coffee from mid-afternoon, Don’t watch TV in the bedroom, move away from computer, smartphone and tablet screens at least half an hour before closing your eyes, turn off the bright lights in the evening.
Eliana Liotta (photo by Carlo Furgeri Gilbert).
Eliana Liotta is a journalist, writer and science communicator. On iodonna.it and on the main platforms (Spreaker, Spotify, Apple Podcast and Google Podcast) you can find his podcast series The good that I want.
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