Sleep is something we all need in order to function effectively! Not getting enough sleep can leave us feeling irritable, unable to perform tasks properly and generally unwell. Aiming to get between 7 and 8 hours of sleep a night is usually recommended by health professionals. December saw the publication of two studies (1,2) linking adequate sleep to heart health. The relationship has been previously explored and it really does seem that sleep is vital for our health and wellbeing, not just in order to prevent tiredness. The second study (2) found that either too little sleep, 5 hours or less, or too much sleep, 9 hours or more, was associated with an increased risk of heart disease.
Many individuals find that they suffer from the odd bout of insomnia, others find that their insomnia may go on for many months, especially if they are going through an emotionally difficult period. Pharmaceutical sleeping-pills are an option, however they often leave the user feeling heavy-headed in the morning or as if they are suffering from a ‘hang-over’. Many people don’t want to take prescribed sleep medication and worry becoming dependent on such pills. Since sleep is so important for our health and wellbeing I thought I would take some time to look at the many natural ways that can aid good sleep.
Insomnia is the term used to describe problems with quality, quantity and timing of sleep (3). Sleep problems can include trouble falling asleep, problems staying asleep (frequent night waking) and waking early in the morning with difficulty resuming sleep. A typically described feature of insomnia is feeling tired and fatigued the next day to a degree that can disrupt normal daily activities. There are three main categories of insomnia (3):
1.Transient insomnia – which typically lasts for about a week, usually caused by jet lag, stress, environmental factors, exams etc.
2.Short term or sub-acute insomnia – lasting 1-4 weeks, usually related to emotional problems or serious illness.
3.Chronic insomnia – usually lasts for more than a month and is sometimes related to psychiatric disorders or drug abuse.
Reduced amount of sleep can have considerable impact on the life of the patient, their family, friends and work colleagues. It can reduce physical and mental energy, cause irritability, an inability to concentrate and is linked to a deterioration of general health. For someone feeling very tired and fatigued it becomes dangerous to drive or operate machinery. Insomnia can also lead to feelings of low self-esteem and confidence. Worrying about insomnia can make the situation worse so I hope that the following information provides a little helpful advice on how the problem can be approached naturally.
Caffeine has a stimulant effect in the body, it triggers the release of certain stimulating hormones such as adrenaline. Studies have shown that individuals drinking caffeinated drinks such as tea, coffee and cola are more likely to suffer from sleep disruption (4,5). Caffeine tends to arouse us and in some people the effects can last for many hours. If you are going through a period of sleeplessness, especially associated with anxiety it may well be very helpful to eliminate caffeine for a few weeks, or at least try to only consume one cup early in the day until sleep patterns are normalised. Also check the labels of any painkillers you may be taking as they often contain caffeine. Alcohol and nicotine also act as stimulants so be wary of these.
Blood sugar levels
Some individuals find that they can get to sleep very easily but then tend to wake in the middle of the night, often finding it difficult to get back to sleep again. This problem may be related to a drop in the level of sugar in the blood during the night (6). Normally, the body manages to keep a stable blood sugar level during the night. However, if the level drops, the body attempts to normalise it by producing stimulating hormones such as adrenaline and cortisol (known as stress hormones) which can cause night waking. Adrenaline levels often peak at around 3-4am, a time when many individuals wake. The key to resolving such cases of insomnia is to eat a diet during the day that helps the body to maintain stable blood sugar levels. I have written about eating to normalise blood sugar levels previously (8th and 10th September). Blood sugar problems may also be the reason why some individuals wake up hungry during the night or early morning (6)
Balancing blood sugar levels through eating a healthy diet that provides a slow and steady supply of energy throughout the day may also help to prevent cravings and daytime fatigue. A diet rich in vegetables and fruits, healthy fats; especially omega 3 fatty acids from oily fish, fish oil or flax seed oil supplements, and proteins; from nuts/seeds, eggs, lean unprocessed meats, fish and pulses/beans may help to minimise blood sugar imbalances. Vegetables and fruits are great sources of unrefined carbohydrates as are wholegrains with a low glycaemic index (GI) these will help to ensure a steady supply of energy to the body. Please read my previous posts for more detail on glycaemic index and eating to minimise blood sugar swings.
Food sensitivity or allergy may also be an underlying problem in some cases of insomnia. Foods causing allergic reactions are known to provoke many responses in the body such as an increase heart rate which may cause or aggravate insomnia (6). If you think you may be suffering with a food allergy/intolerance it is important that you seek the advice of a health professional who will carry out proper allergy tests, undergoing your own elimination diet is not recommended.
Calcium and Magnesium
Anecdotal evidence suggests that taking calcium and magnesium in the evening, prior to sleep may help to ease trouble falling asleep. These minerals may work by aiding relaxation and reducing anxiety. Women in particular may find these nutrients useful, in the UK many women do not achieve desirable intakes of these minerals, especially magnesium (which is naturally found in high levels in nuts, seeds, pulses and wholegrains). A supplement containing up to 1000mg calcium and 500mg magnesium taken prior to sleep may be helpful.
There are many herbal sleep aids sold online and in supermarkets, pharmacies and health-food stores. Of the most popular are chamomile tea, lavender oil fo use in the bath and on the pillow, valerian supplements, hops supplements and supplements containing a mixture of herbs. The scientific evidence for the use of these herbs is not well documented, however research is beginning to mount. In practice many individuals do tend to find herbal remedies helpful and they may well be worth a try, especially if you suffer from insomnia linked to anxiety and not being able to fall asleep. Most of the herbal remedies available are thought to be calming.
Sleep is induced by the production of certain feel-good brain chemicals including a substance called ‘serotonin’. In the body, serotonin is manufactured from the amino acid tryptophan and tryptophan depletion can lead to insomnia(7). Although tryptophan cannot be bought as a supplement an intermediary in the production of serotonin, 5 hydroxytryptophan (5HT), can be purchased. Supplementing with this substance may help induce and maintain sleep (8). I have used this supplement in the past and found it to be very helpful. The normal recommended dose is 50 mg, taken an hour before bedtime. Often 5-HTP supplements also contain a variety of B vitamins that are naturally part of the serotonin pathways in brain.
Some additional advice to insomniacs (6)
*Avoid napping during the day
*Go to bed and get up at regular times
*Take regular exercise but avoid this 3 hours before bed
*Try to do something relaxing before going to bed e.g. reading, listening to music, taking a warm bath or shower
*If possible avoid emotional upsets before bed
*Avoid working in bed or in the bedroom
*Ensure that the environment is suitable for sleeping e.g. not too cold/hot, not too noisy, comfortable mattress
If insomnia persists for more than a couple of weeks please go to see your doctor. Insomnia can be linked to medical conditions such as pain, bladder problems, gastrointestinal upsets, coughs, upper airway obstruction and depression.
(1)King RC et al. 2008. Short Sleep Duration and Incident Coronary Artery Calcification
(2)Shankar A et al. 2008. Sleep Duration and Coronary Heart Disease Mortality Among Chinese Adults in Singapore: A Population-based Cohort Study. American Journal of Epidemiology. 168(12):1367-1373
(3) Lader M. 2000. Insomnia. Family Medicine Jan/Feb: 8¬12
(4)Shirlow MJ & Mathers CD. 1985. A study of caffeine consumption and symptoms; indigestion, palpitations, tremor, headache and insomnia. In J Epidemiol. 14:239- 248
(5) Bonnet MH & Arand DL. 1992. Caffeine use as a model of acute and chronic insomnia. Sleep. 15:526-536.
(6) Holbrook AM et al. 2000. The diagnosis and management of insomnia in clinical practice: a practical evidence based approach. JAMA. 162:21620
(7)Riemann D et al. 2002. The tryptophan depletion test: impact on sleep in primary insomnia – a pilot study. Psychiatry Res. 109:129-135
(8)Sourlairac A et al. 1977. Action of 5-hydroxytryptophan, serotonin precursor, on insomniacs. Annals Medico-Psychologiques. 135:792-798.
Written by Ani Kowal