I suffer from insomnia and have for quite a few years now. Things have improved semi-recently and currently average around 5-6 hours of sleep, but for a long time was between 3-5 hours. I’ve focused on good sleep hygiene, no caffeine 6-8 hours before bed, temperature, etc. I also recently had a PSG and do have mild OSA and am working on getting acclimated to my APAP. I am also reading No More Sleepless Nights by Dr. Peter Hauri - as recommended by the doc who performed my PSG - which focuses on treatment/strategies for insomnia. In this he mentions tryptophan as having a potential benefit, although he does admit the research was not conclusive and the book was published in 1990. Some research I have seen does seem semi-promising in reducing sleep latency and awakenings as compared to placebo in folks with diagnosed insomnia. However, many of the papers are not open access so I am not privy to all the details. I see that the BBM podcast on sleep was over 3 years ago, any updated thoughts in regards to tryptophan or anything else sleep related? Sorry for the long-windedness. As always, appreciate the content and good y’all do for folks.
Austin tagged me to provide a response here and I’m happy to weigh in. The long story short is, I am not aware of there having been a significant change in the recommendation of Tryptophan (Trp) supplementation for sleep aid. Trp is a precursor for melatonin, which may explain why it has potential sleep benefits.
As is with most supplements, the quality of evidence for use is sporadic, often single studies that have not been replicated and show a variety of effects on sleep (some show reduced WASO which may suggested improved quality of sleep, other show slightly reduced time for sleep onset).
Which is why I rely pretty heavily on the AASM and other academies to do the heavy lifting of research on supplements via their clinical guidelines. The Clinical Guideline for Pharmacologic treatment of Insomnia by the AASM was written by a task force in 2017 (can be found here, open source https://aasm.org/resources/pdf/pharmacologictreatmentofinsomnia.pdf). The document is probably due for an update, but talks about Trp a decent amount, summarizing the handful of better studies that made some of the claims above. Despite all of this, the AASM recommended against Trp use due to overall unfavorable risk to benefit profile (e.g. unclear or higher risk associated with relatively poor benefit outcomes). That said, the Task Force acknowledged that most patients would be more likely to use Trp for sleep aid than use nothing.
Unlike Trp, there remains a significant body of literature in favor of recommending a multi-approach cognitive behavioral therapy of insomnia (CBTi) for the treatment of chronic insomnia. Unfortunately, with a shortage of sleep trained behavioral health professionals and low incentive to perform the treatment for both patient and provider (due to the time intensive and visit frequency requirements), there remain barriers to this gold standard of insomnia treatment to this day.