- Why aren’t you sleeping well?
- How does sleeplessness affect your health?
- What do you know about sleep hygiene?
- Which supplements can help you sleep?
Read more and get a good night’s sleep tonight….
Insufficient sleep has reached epidemic proportions in the US.
Approximately 70 million people are affected by sleep problems. Of those, over half suffer from chronic sleep disorders while the others are affected by intermittent sleep-related problems.
Smokin’ Mommas – Smoking and pregnancy don’t mix. It follows that women who choose to breastfeed shouldn’t smoke either, but many women relapse following the baby’s birth. A recent study in Pediatrics reports that nicotine in breastmilk disrupts babies’ sleep patterns. The findings raise new concerns regarding nicotine exposure and infant development.
• Why aren’t you sleeping well?
• How does sleeplessness affect your health?
• What do you know about sleep hygiene?
• Which supplements can help you sleep?
Look inside and get a good night’s sleep tonight….
Sleep, that knits up the ravell’d sleeve of care,
The death of each day’s life, sore labour’s bath,
Balm of hurt minds, great nature’s second course,
Chief nourisher in life’s feast.
Sleep as nourishment? Shakespeare’s descriptive verse paints a picture of just how essential it is to get a good night’s sleep. If we take the Bard’s words literally and consider sleep as a form of nourishment, we find that, as a nation, we are definitely malnourished!
Insufficient sleep has reached epidemic proportions in the US. Approximately 70 million people are affected by sleep problems. Of those, over half suffer from chronic sleep disorders while the others are affected by intermittent sleep-related problems. Before Thomas Edison’s invention of the light bulb, people slept an average of 10 hours a night. Today Americans average less than seven hours of sleep on week nights and only 7.5 hours per night on weekends. Unfortunately, the effects of accumulated sleep deprivation are pervasive and devastating.
Economically-speaking, sleep deprivation and sleep disorders are estimated to cost Americans over $100 billion annually in lost productivity, medical expenses, sick leave, and property and environmental damage. According to the National Sleep Foundation’s 2002 Sleep in America poll, 51 percent of Americans said that in the past year they drove while feeling drowsy and 17 percent said they actually dozed off behind the wheel. Yikes!
Not surprisingly, insomnia and other sleep disorders are related to decreased efficiency in the work place, increased psychological and emotional problems, increased hospitalizations, and in some cases, increased mortality. Studies show that poor sleepers receive fewer promotions, have increased rates of absenteeism, and tend to demonstrate poor productivity. And, it doesn’t stop there.
Emerging scientific evidence has linked inadequate sleep to major illnesses including heart disease, blood pressure, breast and colon cancer, diabetes, and obesity. Sleep influences how the nervous, hormonal, and immune systems function. There is also a link between sleep deprivation, metabolic problems, and impaired insulin use. Even in healthy people, insufficient sleep results in health problems and contributes to premature aging.
Clearly, sleep is important, we are not getting enough of it, and those effects can be devastating. In this issue of Nutrition News, we consider how we can nourish ourselves more deeply by restoring our sleep – improving both our health and our lives.
A good night’s sleep
good night of sleep typically results in an alert and refreshed state in the morning. Sleep affects how we look and feel; how we perform on a daily basis; and how we experience our lives. To get the most out of our sleep, both quantity and quality are important. It is widely believed that 7-8 hours of sleep are essential. (Teenagers need at least 8.5-9 hours of uninterrupted sleep to restore their bodies and minds.1) In fact, adequate sleep each night is associated with lower mortality rates from all causes.
1 It is currently estimated that 85 percent of children are not getting adequate sleep.
When sleep is interrupted, the body can’t complete all of the phases needed for muscle repair, memory consolidation, and the release of essential hormones (some of which regulate growth and appetite). As a result, we wake up less prepared to concentrate, make decisions, or engage fully in work, school, and social activities.
Throughout a typical night, we alternate between NREM and REM sleep. NREM is non-rapid eye movement sleep, and the well-known REM signifies rapid eye movement. The cycle repeats itself about every 90 minutes. As we fall into sleep, we enter NREM, which comprises about 75 percent of the night and is composed of four stages.
Stage 1: Twilight zone – between being awake and drifting off to sleep.
Stage 2: Onset of sleep – disengaging from surroundings; even breathing and heart rate; and drop in body temperature. (Sleeping in a cool room is helpful.)
Stages 3 and 4: Deepest and most restorative sleep – blood pressure drops; breathing slows; muscles relax; blood supply increases; tissue growth and repair occurs; energy is restored; hormones are released.
We are in REM the other 25 percent of the night. The first interval occurs about 90 minutes after falling asleep and recurs about every 90 minutes. In REM, the brain is active; dreams occur; eyes dart back and forth; and the body becomes immobile and relaxed. REM provides energy to brain and body, supporting daytime performance.
Additionally, levels of the hormone cortisol dip at bed time and increase over the night to promote alertness in morning. Sleep helps us thrive by contributing to a healthy immune system. It can also balance our appetites by helping to regulate levels of the hormones ghrelin and leptin.2 These play a role in our sensations of hunger and fullness. When we are sleep deprived, we are also energy deprived. This leads to the need to eat more, further encouraging weight gain.
2 For more information about weight management and leptin, see Nutrition News, “Time to Weigh In”.
What’s the problem?
hat keeps us from getting the sleep we need? Is it time? Are we so busy that we sleep less to accomplish our many daily tasks? Or is it insomnia? Insomnia is a sleep disorder characterized by difficulty falling or staying asleep, waking too early (and not being able to go back to sleep), or getting sleep that isn’t restorative. Insomnia that happens most nights for more than a month is categorized as chronic.
Certainly, it makes sense that chronic stress, including that of an unhealthy lifestyle (poor eating habits, irregular sleeping habits, lack of exercise, excessive caffeine intake, smoking and drinking alcohol), can trigger insomnia. Plus, there are a number of psychiatric disorders that contribute to poor sleep. Depression, anxiety, bi-polar disorder, attention deficit hyperactivity disorder (ADHD), and schizophrenia are all associated with insomnia.
Hormone fluctuations have also been observed in people with chronic insomnia. Some studies have reported high levels of the stress hormone cortisol and low levels of melatonin (the “sleep hormone”) in patients with chronic insomnia. Also, aging is associated with a disruption in hormone production. One of these is growth hormone, associated with deep sleep. Meanwhile, low levels of estrogen can cause hot flashes and interrupt normal sleep, resulting the common complaint of sleep deprivation among both perimenopausal and menopausal women.
Some medications contribute to the inability to sleep well. Antidepressants, drugs used to treat asthma and high blood pressure, corticosteroids, diuretics, histamine blockers, and respiratory stimulants can all effect sleep. Further, a number of studies have reported that night shift work can disrupt the body’s circadian rhythm (our 24 hour cycle of wakeful action, rest, and sleep) and lead to chronic insomnia. Of course, environmental factors such as noise, light, and heat (ever tossed and turned on a muggy August night?) as well as excessive computer use have been associated with sleep disturbances.
Finally, sleep problems can actually be secondary symptoms of other diseases and disorders. For example, heart problems (i.e., congestive heart failure), lung diseases (i.e., asthma, emphysema,) and digestive system issues (ulcers, acid reflux, heartburn) can all interfere with sleep patterns. Other causes of insomnia include medical conditions such as allergies, arthritis, cancer, fibromyalgia, enlarged prostate, Alzheimer’s disease, Parkinson’s disease, hyperthyroidism, and restless leg syndrome. These causes become more prevalent as we get older.
How’s your hygiene?
Just as there are things we do each day to take care of our bodies (brushing and flossing, bathing, eating right, exercising, etc.), there are a number of useful behaviors to improve our “sleep hygiene” – the length and quality of sleep. Here are some suggestions:
• Eat according to circadian rhythms.3
• Go to bed and rise at the same times every day, even on weekends.
• If you nap, nap no longer than an hour, and not after 4PM.
• Make your time before bed as peaceful as possible.
• Leave your worries outside your bedroom. (Use the famous Siri Khalsa “Mind-Clearing Technique”.)
• Use your bedroom for sleeping and sleep-related activities only (i.e., don’t take food or work to bed).
• Use a relaxation technique such as progressive muscle relaxation, meditation, yoga, or a warm bath.
•Be sure your bedroom is conducive to sleep. (Turn off TV, radio, lower the room temperature, etc.)
• Drink a glass of warm milk or herb tea, unless liquids are a problem. Otherwise,
•Avoid liquids before slumber to reduce the probability of bathroom trips.
• Do some light reading.
• If you haven’t fallen to sleep after a half an hour or so, leave your bedroom and do something you would like or need to do.
• Analyze the origins of your insomnia.
• Get a complete physical to discount any underlying illnesses.
Incidentally, anxiety and depression, while associated with sleep problems, are not caused by lack of sleep. Check this out too.
3 Breakfast, lunch, and snacks before evening should be higher in protein foods, which enhance alertness. Focus on carbohydrates for dinner and any evening snack, encouraging seratonin levels. (See Sleep Naturally above.)
Oh, bed! Oh, bed! Delicious bed!
That heaven upon earth to the weary head.
– Thomas Hood, c.1820
Need some help sleeping? Here are some helpful natural supplements.
Valerian (Valeriana officinalis). Along with chamomile, valerian is the best known of the calming, sedative herbs. In fact, it continues to be one of the most popular and widely used of all the medicinal herbs.
Although in the US it is used mainly as a sedative, German doctors prescribe valerian preparations for mild to moderate cases of depression. This use demonstrates its potential as a substitute for stronger synthetics such as Valium and Xanax. Unlike prescription drugs, valerian does not cause dependence. In fact, it has been has used to break the chemical dependency of prescription sleep preparations.
Especially helpful to people who have trouble falling asleep, valerian also reduces nighttime waking. We recommend taking standardized capsules rather than the tincture, which has an unfortunate odor. Take 300 to 600 mg of valerian root 30 minutes to two hours before bedtime. Because overuse can result in headache, excitability, and insomnia (!), long-term valerian therapy is not recommended. Also, people with weakened adrenals may find valerian acts as a stimulant. If this happens, discontinue use.
L-Tryptophan. The widespread use of tryptophan actually began in 1982 when the Boston State Hospital Sleep Laboratory reported that taking the amino acid before retiring decreased the time needed to fall asleep. Tryptophan soon became the most widely used of all natural sleep inducers, bringing sleep without altering its normal stages and cycles. One recent study found that tryptophan depletion significantly disrupts sleep patterns, contributing to insomnia.
This amino acid serves as a precursor for the neurotransmitter serotonin which has been implicated in the regulation of sleep, depression, anxiety, appetite, sexual behavior, and body temperature. (In turn, serotonin is involved with the synthesis of melatonin, more below.)
In 1990, the FDA recalled tryptophan from the market because of an association with a severe muscle disease. Although it was soon established that the problem was caused by a contaminated batch of the amino acid, 10 years passed before the FDA allowed it back on the market. Since 2002, L-tryptophan has been sold in the US in its original form. One can find high-quality sources in most health food stores. Tryptophan remains the subject of numerous studies regarding its use, effects and benefits. A dose of 1000-2000 mg before bedtime is recommended.
5-Hydroxytryptophan. 5-HTP is a carrier of the essential amino acid L-tryptophan (above) in the biosynthesis of serotonin. It came into use during the time that L-tryptophan was restricted from the market. Intestinal absorption of 5-HTP is not affected by the presence of other amino acids; therefore, it may be taken with meals without reducing its effectiveness. It easily crosses the blood-brain barrier and increases central nervous system (CNS) synthesis of serotonin. Therapeutic use of 5-HTP has been shown to be effective in treating insomnia as well as depression, fibromyalgia, binge eating associated with obesity, and chronic headaches. It is much more powerful than tryptophan. Recommendations range from 50-250 mg. Take at night. Start low and build-up to meet sleep needs.
Melatonin. Melatonin, the hormone secreted by the pineal gland, regulates the body’s biological clock. Believe it or not, sleep is not melatonin’s primary purpose, but can be considered a happy by-product. Research has suggested that melatonin is a substance that alters and normalizes biological rhythms. The pineal gland itself responds to a larger clock, the sun, and the release of melatonin follows a circadian rhythm, rising and falling in a 24 hour pattern. The enzymes that convert serotonin into melatonin and inhibit that conversion are synchronized by darkness and light. Darkness causes the release of melatonin.
As people age, their bodies produce less melatonin. This can lead to difficulty sleeping. Thus, taking supplemental melatonin at bedtime can be helpful. Dose 3-10 mg about 30 minutes before bed. Sometimes lower doses (1/2 tablet or 1.5 mg) work better than higher doses.
FYI: Patients with Alzheimer’s disease exhibit a profound decrease in this important hormone. Research has found that when Alzheimer’s patients are given melatonin orally, their sleep improves and the progression of cognitive impairment slows.
Lastly, magnesium improves sleep for some people. This mineral is known to promote relaxation, and may be helpful for individuals with insomnia. Taking 200-500 mg of a magnesium chelate (citrate or orotate) at bedtime relaxes the muscles, leading to better sleep.
“Clear Your Head Before Bed”
Your editor-in-chief, Siri Khalsa, developed this technique and has utilized it very successfully. Useful before meditating, sleeping, or anytime the mind is in overwhelm (or overdrive), this non-linear process brings the right side of the brain (the creative side) into play.
1. Use a clean sheet of paper. (Lined works fine.)
2. About the middle of the sheet, write “What’s on my mind” (or something like).
3. Circle it.
4. Listen to your mind and write whatever falls out of it all over the page. (This is freeform. Do Not Attempt to Organize.)
5. Write until no more comes forth.
Once in bed, your mind may chatter on about the very things you wrote. Just tell it “Thank you. I’ve handled it.” Later, if it’s useful to you, you can organize the information. Or, if the metaphor is appropriate, you can burn the paper/worries.
Not just for data-dumping, I also use this technique for anything I want to organize (like this newsletter). It is a fine brainstorming technique. Spill the beans and then put them in order.
• Khalsa, S. (May 2002). Nutrition News, From Fatigued to Fantastic.
• Khalsa, S. (December 2000). Nutrition News, Lullaby Herbs.
• Khalsa, S. (February 1994). Nutrition News, Sleep Like a Baby With Melatonin.
• 5HTP. Retrieved October 5, 2007 from http://www.lef.org/Lefcms/Template/protocol abstracts.
• Children not getting enough sleep. Retrieved October 11, 2007 from the Ohio Parent Information Network: www.OH-Pin.org.
• Dzugan, S.A. (December 2006). LE Magazine. Natural Strategies for Managing Insomnia. Retrieved October 2, 2007 from www.lef.org.
• Insomnia. Retrieved October 2, 2007 from www.lef.org/LEFCMS/
• Nicotine in breastmilk disrupts infants’ sleep patterns. (September 2007). Retrieved on October 7, 2007 from http://aboutnutritionnews.com.
• Sleep statistics. Retrieved October 4, 2007 from http://www.sleepfoundation.org.
• What happens when you sleep? Retrieved October 5, 2007 from http://www.sleepfoundation.org
• Tryptophan. Retrieved October 7, 2007 from http://en.wikipedia.org/wiki/Tryptophan.
Nutrition News c 2007 VOL XXXI, No. 11