Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence.

Class
Qualifying studies
Minimum requirements
A
Systematic review or meta-analysis of human trials
 
B
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
C
RDBPC human trials
1 study
D
Non-RDBPC human or In-vivo animal trials
 

Introduction

Whole person care is a person-centered approach to medicine. It goes beyond treating symptoms or isolated conditions, focusing on the interconnectedness of bodily systems and addressing a wide range of factors. These include biological makeup, behavioral habits, environmental factors, and a patient’s personal beliefs, values, and goals. By tailoring care to align with these unique aspects, healthcare providers can create highly personalized treatment plans that address not only physical health but also emotional and mental well-being.

This template aims to provide healthcare providers with practical suggestions for supplements and lifestyle strategies, helping them design personalized whole person care plans for patients looking for sleep support. 

Sleep takes up about one-third of our lives and is essential for good health. In recent years, there has been a simultaneous decline in sleep quality and altered sleep timing, with statistics showing that 18.2% of people now experience poor sleep quality. (Yin 2023) Achieving good sleep duration (i.e., 7–9 hours per day) and quality (i.e., a low sleep latency, a low number of awakenings, low wake time after sleep onset, and good sleep efficiency) promotes cardiovascular well-being, cognitive function, memory consolidation, mental health, immunity, hormonal balance, and reproductive health. (Binks 2020) 

Sleep testing is a cornerstone of diagnosing and managing sleep disorders. Traditionally, in-lab polysomnography (PSG) has been the gold standard, offering comprehensive data on brain activity, muscle movements, and other physiological parameters. However, lengthy wait times and the need to sleep in a hospital or clinical setting can deter patients from pursuing testing, which may lead to delays in diagnosis. (Hung 2022)

Advancements in technology have introduced at-home sleep testing devices that may provide a more accessible and comfortable alternative. Since these tests are conducted in a person’s normal sleep environment, they may offer more accurate insights into habitual sleep patterns. In contrast, testing in a lab or hospital can be influenced by the unfamiliar setting and disrupted routine, making it harder to fall asleep or maintain typical sleep behavior. At home, individuals are more likely to sleep as they normally would, which can lead to more reliable results. (Hung 2022)

Evidence-based supplements may play a supportive role in addressing disturbed sleep. Depending on the underlying factors, a variety of ingredients can be used, including sedatives or anxiolytic supplements.

Lifestyle modification encompasses a broad range of factors—sleep hygiene, nutrition, physical activity, stress management, environmental influences, and social engagement—that are critical to sleep health. Due to its central role in improving sleep, the American Academy of Sleep Medicine includes behavioral interventions and light therapy, in addition to melatonin, among the primary recommended treatments for sleep disturbances. (Auger 2015)

Effective management of sleep disorders requires whole person care plans that are mechanistically informed, personalized using data from multiple sources, and capable of addressing the complex interrelationships between neural, physiological, and behavioral factors that contribute to healthy sleep. 

Ingredients

Melatonin

Dosing: 2.5–3 mg, total per day (at bedtime), minimum three weeks (Chen 2014)(Scheer 2012)

Supporting evidence:

  • All patients with delayed sleep-wake phase disorder (DSWPD) received behavioral sleep-wake scheduling and then split into groups for a 0.5 mg dose of fast-release melatonin or placebo. Melatonin decreased patient-reported outcomes measurement information system (PROMIS) sleep disturbance, insomnia severity, functional disability, and sleep onset latency by 34 minutes compared to placebo. Additionally, 52.8% of patients in the treatment group had a more than minimal clinician-rated improvement compared to 24% of placebo, suggesting that while behavioral sleep-wake scheduling combined with melatonin is much more effective. (Sletten 2018)
  • A meta-analysis of 12 studies found melatonin efficacious in delaying sleep phase syndrome and decreasing sleep onset latency in primary insomnia. Additionally, melatonin was able to regulate sleep-wake patterns in blind patients. (Auld 2017) 
  • Pooled data from a meta-analysis and systematic review of seven studies found melatonin to be effective for the management of secondary sleep disorders, as demonstrated by the ability of melatonin to lower sleep onset latency and increase total sleep time. (Li 2018) 
  • Patients with insomnia improved quality of sleep, as well as night before and morning alertness, when given 2 mg of prolonged-release melatonin compared to placebo. (Lemoine 2007)
Melatonin in the Fullscript catalog

Valerian (Valeriana officinalis)

Dosing: 1,060 mg, total per day, minimum four weeks (Taavoni 2011)

Supporting evidence:

  • Postmenopausal women demonstrated improved quality of sleep in 30% of the intervention group compared to 4% in the placebo group. (Taavoni 2011)
  • Primary insomnia patients previously treated with nightly benzodiazepines were given valerian or placebo for 15 days. Treatment decreased wake time after sleep onset (WASO), increased sleep latency and alpha count in slow wave sleep, and improved subjective sleep quality after benzodiazepine withdrawal compared to placebo. (Poyares 2002)
  • In a systematic review and meta-analysis, six studies found valerian to have significant benefits in improving sleep quality without side effects at a range of dosing. (Bent 2006)
  • Patients with psychophysiological insomnia demonstrated decreased slow-wave sleep latency of 21.3 minutes compared to 13.5 minutes in placebo. Additionally, there was a low number of adverse effects compared to placebo. (Donath 2000)
Valerian in the Fullscript catalog

Lavender (Lavandula angustifolia)

Dosing: 80 mg Silexan™ daily for a minimum of ten weeks (Seifritz 2019) or diffused essential oil at bedtime (Lewith 2005)(Lytle 2014)

Supporting evidence:

  • A systematic review of 11 randomized controlled trials found that inhaled lavender essential oil had a positive effect on sleep for people with mild sleep disturbances. (Lillehei 2014)
  • When given Silexan™ once daily for ten weeks, sleep and anxiety improved, as shown by a decrease in total scores for Hamilton Anxiety Scale (HAM-A) and Pittsburgh Sleep Quality Index (PSQI), demonstrating the anxiolytic action of Silexan™ rather than sedative. (Seifritz 2019)
  • Patients with insomnia who diffused lavender before bedtime experienced decreased PSQI by 2.5 points compared to an almond oil control group. Notably, a more pronounced improvement in women and younger volunteers with milder insomnia. (Lewith 2005)
  • Patients hospitalized in the ICU experienced increased overall sleep score (48.25 in treatment group, 40.10 in control) and experienced a significantly lower blood pressure between 12 a.m. and 4 a.m. compared to the control group when 3 mL of pure lavender oil was provided at the bedside from 10 p.m. to 6 a.m. (Lytle 2014)
  • 55 μl of lavender essential oil patch placed on the chest at night was effective for improving sleep quality and increasing feelings of refreshment upon awakening in college students with self-reported sleep problems. (Smith Lillehei 2015)

 

Lavender in the Fullscript catalog

Chamomile (Matricaria chamomilla)

Dosing: 200 mg twice per day for a minimum of 28 days (Adib-Hajbaghery 2017) or as a tea for a minimum of two weeks (Chang 2015)

Supporting evidence:

  • Sleep quality improved when elderly people aged 60 or older in daycare nursing homes were given 200 mg twice per day compared to controls. (Adib-Hajbaghery 2017)
  • Postnatal women with poor sleep quality improved physical symptoms related to sleep inefficiency and symptoms of depression when given chamomile tea for two weeks compared to controls. (Chang 2015)
  • A systematic review and meta-analysis of 12 randomized controlled trials found chamomile to be effective in improving sleep quality and generalized anxiety disorder. (Hong Hieu 2019)
Chamomile in the Fullscript catalog

Magnesium

Dosing: 320 mg, total per day of magnesium citrate, minimum seven weeks

Supporting evidence:

  • Magnesium improved PSQI score, which includes improvements in sleep quality, sleep onset latency, sleep duration, sleep disturbance, daytime dysfunction, and hypnotic drug scores in adults with poor sleep quality. Additionally, participants who had a baseline value more than 3.0 mg/L of C-reactive protein (CRP) experienced a decrease. (Nielsen 2010)
  • In addition to decreasing insomnia severity index (ISI) score, sleep onset latency, and serum cortisol concentration, magnesium reduced early morning awakenings in elderly participants. (Abbasi 2012)
Magnesium in the Fullscript catalog

Lifestyle recommendations

Sleep hygiene

  • Recommend 7–9 hours of sleep each night.
  • Encourage patients to maintain a regular sleep-wake schedule.
  • Advise patients to establish a consistent bedtime routine.
  • Recommend regular physical activity.
  • Suggest incorporating mindful or contemplative practices.
  • Counsel patients to limit intake of caffeine, alcohol, and heavy meals, especially later in the day.
  • Advise minimizing exposure to bright light in the evening. (Baranwal 2023)

Nutrition

  • Recommend a high-glycemic-index carbohydrate meal 2–4 hours before bedtime to enhance serotonin and melatonin synthesis, supporting quicker sleep onset.
  • Suggest including tryptophan-rich protein sources, such as α-lactalbumin-enriched whey protein, 1–2 hours before sleep to promote increased sleep duration and efficiency.
  • Encourage incorporating tart cherry juice or kiwifruit in the evening for their natural melatonin, serotonin, and antioxidant content, which may support improved sleep metrics.
  • Advise prioritizing a balanced diet rich in magnesium, vitamin D, calcium, and dietary fiber, nutrients that are inversely associated with sleep disturbances and short sleep duration. (Binks 2020)(Gratwicke 2021)(Ikonte 2019)

Exercise

  • Recommend regular moderate-intensity aerobic activities, such as walking, cycling, or running, 3–5 times per week, to enhance overall sleep quality and reduce insomnia severity.
  • Encourage patients to incorporate mind-body exercises, including yoga or Tai Chi, to help alleviate stress and anxiety, thereby supporting sleep initiation and maintenance.
  • Advise performing resistance training at least twice weekly to improve sleep efficiency and reduce nighttime awakenings. (Amiri 2021)(Dolezal 2017)(Giannaki 2024)

Mind-body

  • Utilize Cognitive Behavioral Therapy for Insomnia (CBT-I) as a primary approach for managing chronic insomnia and circadian rhythm disturbances, incorporating methods such as stimulus control, sleep restriction, and cognitive restructuring.
  • Recommend mindfulness-based practices such as meditation, progressive muscle relaxation, guided imagery, and breathing exercises to help lower pre-sleep arousal and reduce anxiety.
  • Combine these psychological techniques with other lifestyle modifications, particularly for patients experiencing high stress levels or irregular sleep patterns, to comprehensively support improved sleep quality. (Blake 2018)(Tadros 2025)

Environment

  • Advise patients to optimize the bedroom environment by managing light, noise, temperature, and air quality to promote sleep continuity and reduce disturbances.
  • Recommend physical adjustments such as blackout curtains, white noise machines, or soundproofing to minimize external interruptions.
  • Encourage strategic timing of light exposure—particularly bright light in the morning or early afternoon—to help realign circadian rhythms in patients with sleep-wake disorders. (Billings 2019)(Johnson 2018)

Social interactions and support

  • Encourage patients to foster positive social relationships with family, peers, and community groups, as these are associated with improved sleep quality and duration.
  • Proactively address social isolation and incorporate strategies to promote social interaction within lifestyle counseling for sleep disturbances.
  • Combine social support measures with behavioral interventions, such as CBT-I, to help maximize therapeutic outcomes. (Gordon 2021)

Patient Resources

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

View protocol on Fullscript
References
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