We all know it: high-quality sleep is vital to everything in our life, how we feel and even impacts the weight that we have on our body! While the body appears from the outside to be still and inactive, sleep is a time when the body is quite busy. During the night, we restock our supply of hormones, process significant toxins, repair damaged tissue, generate vital white blood cells for immunity, eliminate the effects of stress, and process heavy emotions. Unfortunately we have an epidemic of sleep disorders – from trouble falling asleep to often-interrupted sleep to actual insomnia. There are, however, several straightforward remedies that could help you catch some amazing zzz's and feel more energetic and happier!
If you are struggling with sleep, please make it a priority to help yourself with this balance.
I think it is important to understand what is going on when we are struggling to sleep. As someone who recovered from Bipolar disorder, I have had many times where sleep was completely impossible and I would be sleepless for days or weeks.
We fall asleep due to the gifts of the pineal gland, a small ant-sized lobe near the middle of our skull in the interbrain. Following our circadian rhythm, the pineal gland secretes a neurotransmitter and hormone called melatonin. Melatonin suppresses the activity of other neurotransmitters and helps to calm the brain (in part by countering the stress hormone cortisol from our adrenal gland). And as we become more drowsy, the brain slowly begins to turn off our voluntary skeletal muscle functions, so we don’t move around too much and try to act out our dreams or disrupt the body’s internal revitalization work. (Note this is also why it’s so hard to move your limbs or shout out in response to a nightmare.)
For ideal sleep, melatonin should be rising steadily and cortisol should be rock-bottom low at bedtime. But there’s a catch: the pineal gland secretes melatonin largely in response to darkness. And our evening cortisol levels are lowest in environments with low noise. With our addictions to TV, video games, and email in the evening, however, our choices can get in the way of these natural pro-sleep chemical shifts. These devices mostly display full-spectrum light which can confuse the brain about whether it’s night-time or not. We also, unfortunately, tend to watch shows or view email that can be loud and/or stressful (e.g. the evening news, a crime show, work email, or ever-longer to-do lists). Digesting a heavy meal eaten later in the evening can also prevent (or interrupt) sleep.
So the first thing you can do is take a good look at your“sleep hygiene”. I am amazed at how often this is all a lot of my cleints need in order to get better sleep. I help them to identify more calming, quieter evening activities (e.g. reading a book, taking a warm bath, going for a light stroll outdoors, playing with a pet, folding laundry). I recommend no email, TV, next-day-planning, or stressful conversations in the full hour prior to bedtime. If noise is an issue, I often recommend soft foam ear plugs or the white noise of a fan. It is also important to the bedroom not be too hot, as this can disrupt sleep during the night. Herbal tea (e.g. lavender, chamomile, valerian, passionflower) can also help one to relax and set the tone for sleep. Meditation and a gratitude practice of releasing all the build up of the day is also extremely helpful! I also recommend no food a full two to three hours before bed and no caffeinated food or drink after 2pm in the afternoon (e.g. tea, coffee, soda, chocolate, mate). Many of my clients are stunned to realize how much a later-evening, heavy meal prevents sound sleep.
There are definitely many cases, however, where pro-sleep behavior is simply not enough, and if you have a funky brain like mine was, there is added support that is often needed. For some people, their brains simply aren’t able to make enough melatonin to ensure solid sleep all night long. Or there is a chemical imbalance preventing sufficient relaxation.
- If you have trouble falling asleep, I recommend 1mg of melatonin taken 30 min. prior to bedtime (start with the lowest dose for several days before increasing, as this or even 0.5mg may be enough; taking too much will result in grogginess the next morning). This is safe and effective for short-term use (avoid using every night long-term to keep your own pineal gland secreting to its best ability). Note that melatonin actually helps also to reduce blood pressure during the night too, a key respite for people with hypertension, but please check with your doctor. Use of beta blocker medications or frequent use of NSAIDs can deplete melatonin and cause these sleep difficulties.
- If you fall asleep fine but you awaken in the middle of the night and cannot easily go back to sleep, the problem is likely an insufficient supply of melatonin throughout the night. Using melatonin before bed probably will not help much Instead, I recommend 100-200mg of 5-HTP (5-hydroxytryptophan) before bed. The body makes melatonin from a neurotransmitter called serotonin (think happy hormone!). And we make serotonin from an amino acid called tryptophan. 5-HTP is a precursor to serotonin that, in a healthy body, can be converted to melatonin a few hours later. A steady flow of melatonin will help you sleep more deeply, soundly, and without interruption. Note: do not recommend 5-HTP to any client taking an SSRI or SNRI (or other serotonin-enhancing) antidepressant or sleep medications without your doctor’s review (e.g. Zoloft, Trazadone, Wellbutrin, Ambien); you do not want to risk them developing serotonin sickness, a toxic surplus of serotonin. Usually taking this three hours away from medication is fine, but please check as serotonin sickness can be serious.
- IF you are already using melatonin and/or 5-HTP and still have trouble with waking in the wee hours of the morning, there is often an issue with low cortisol in the middle of the night (this means supporting your adrenals and that is a whole other blog post!).
- If you have full-fledged insomnia, a combination of melatonin and 5-HTP (yes, you can take both at the same time) is often quite helpful in combination with the sleep hygiene methods mentioned above – at least temporarily while you find support to reduce chronic stress and find ways to make the changes to bring more joy in your life! As I also do lifestyle coaching in my practice, I have worked with so many people who are in jobs or relationships that they are struggling in and it greatly impacts sleep.
- If a you have trouble getting stressful thoughts out of their minds at bedtime or cannot sleep due to pain, it is often because of an imbalance of excitatory and inhibitory neurotransmitters in the brain (specifically glutamate and GABA, respectively). You will likely benefit greatly from taking calming herbs one to two hours prior to bedtime. I have explored many blends with clients and find that 500mg of ashwaghanda and/or holy basil leaf works best (perhaps combined with 1-3 capsules (~300mg each) of valerian in extreme cases). All of these are long-standing herbal remedies. It is also key to ensure you are not getting surplus glutamate from their diet, likely via the artificial sweetener aspartame (e.g. Nutrasweet) or MSG (often hidden in food e.g. autolyzed yeast extract, hydrolyzed vegetable protein). If these options don’t work to calm a “racing mind”, then likely you will need more targeted neurotransmitter support and you will want to be working with a Functional Medicine practitioner. I do testing for neurotransmitters through an Organic Acids test to tell what is off.
- If a you have trouble sleeping when you've have had an alcoholic beverage(s) in the evening, this is usually because alcohol interferes with GABA/Glutatmate balance in the middle of the night. Initially alcohol increases GABA (inhibitory) and blocks Glutamate (stimulatory). Once the alcohol is metabolized and its effects wear off, however, there is a rebound effect that increases glutamate which wakes you up and makes sleep light and/or interrupted the rest of the night. Another calming neurotransmitter (and amino acid) called Taurine can be taken at bedtime to ease and reduce the rebound effect. Taurine increases GABA receptor binding and thus promotes an inhibitory state. You may easily recommend they try 1000mg of taurine prior to bedtime to help reduce this interference.
There are many sleep medications available today. These can be useful for triage when one is going through short-term trauma or stress. Unfortunately, all of them work essentially as mild sedatives and are not addressing the root cause of any long-term sleep disturbance. They also come with a wide range of side effects that render them unacceptable for long-term use – from dry mouth to stomach ache to a hangover-like fatigue the following day. But it’s also important to make sure your clients understand that many of these medications can increase the risk of both cancer and death – even with just occasional usage. If you wish to stop taking these medications, talk to your doctor about how to do so slowly (weaning) to avoid any chemical backlash from neurotransmitter imbalance and get your good "sleep hygiene" down!
Without restful sleep, it can be challenging for any of us to consider lifestyle change. Please feel free to be in touch if you would like some extra help here. I am happy to help.