Please be sure to read part one of The Age of Insomnia, for without that information the following treatments will be useless if you suffer from chronic insomnia. In order to properly address the metabolic imbalance of chronic insomnia a comprehensive systems approach as outlined in this month’s newsletter is required. Be aware that none of these interventions are a stand alone. Nutrients mentioned are readily available at local health food stores: not Costco or Drugstores.
* Create a bedtime ritual. The mind needs to know that bedtime is a time to sleep, not a time to engage in other activities such as rehashing daytime events.
* High stress activity will cause increased metabolic synthesis of cortisol, a hormonal stimulant that inhibits deep sleep. If you engage in high stress daily activities, you need to slow down well before bedtime.
* Avoid late night stimulants such as disturbing TV or divisive reading material.
* Guard against disordered circadian rhythms or sleep patterns which result from erratic lifestyle habits.
* Be aware that environmental factors such as excess light, noise, animal dander and strong odors may undermine a good night’s sleep.
* A sleeping environment may need to be assessed for factors such as neurotoxic mold and mildew presence especially if there is a history of water damage.
* Replace poor quality mattress and pillows.
* Be aware of the effect from overactive or restless bedmate(s).
The Exercise Connection
Historically, people exercised a lot every day, and used their minds minimally in terms of the concentrated obsessive way we use our minds today. This balance of regular exercise and minimal mind stress ensured restful rejuvenating sleep. In the 21st century people exercise minimally and frequently over-use their minds, which is a recipe for poor sleep. If the physical body does not get a good work-out then rest is not especially necessary causing insomnia problems. Of course there are exceptions; however most people require good exercise to enjoy good sleep. It’s all about balance, working with the changing rhythms and needs of the body.
Regular physical activity 20-30 minutes daily, several hours before bedtime enhances sleep. For some individuals, a regular exercise schedule is all that’s needed to overcome insomnia.
The Diet Connection
* Avoid stimulants: caffeinated products including coffee, most sodas, chocolate, black tea, green tea, de-café (still has caffeine), nicotine, alcohol and excess salt.
* For some, a light snack near bed will help stabilize blood sugar, which if fluctuating can cause insomnia. Usually a little carbohydrate is better than a little protein.
* Avoid a large meal within 3-4 hours of bedtime. A large meal close to bedtime not only disrupts sleep, but also will lead to unwanted weight gain and stress on the digestive system.
* Drink no or minimal amounts of liquid after dinner to avoid frequent waking to urinate.
* Address allergies which can show with metabolic imbalance, acidic body pH and sleep disorders.
A Systems Approach
I always take a systems approach when addressing chronic health concerns. I find the nervous system and hormonal system to be the two most important systems when addressing metabolic imbalances associated with insomnia. While I emphasize therapies addressing these two systems a whole body approach is still required.
When awake our nervous system functions at the sympathetic level allowing conscious alert thought and movement. In order to sleep soundly the body’s nervous system must shift into parasympathetic. People sometimes experience this shift with a full body twitch just as they fall off to sleep. An incomplete shift translates to insomnia. This shift into parasympathetic is a multi system metabolic event; here are some specific therapies to consider either individually or in combination which quiet the nervous system.
Supplements (Vitamins, minerals, amino acids)
* Calcium citrate: 400 mg during the day and 600-800 mg near bedtime.
* Magnesium: 200-250 mg during the day, and 200-250 mg with calcium near bedtime.
* 5HTP (5 Hydroxytryptophan): 50 mg at lunch, 50 mg at dinner and 50 mg at bedtime if the daytime and dinner dose is insufficient to ensure sound sleep.
* GABA: 500 mg to 1,000 mg near bedtime
* Theanine: 100mg at dinner and 100mg at bedtime.
* Warm 20 minute bath before bed with 1-3 cups Epsom salts and 10 drops lavender oil to shift into parasympathetic.
* Meditation: Helps to foster healthy breathing and the ability to turn down the volume on thoughts.
* Massage: Is an excellent way to relax and shift into parasympathetic mode.
Relaxing Herbs to Consider (Individually or in combination)
* Chamomile, Oatstraw (Avena), Valerian, Lemon balm (Melissa), Passionflower, Hops, Skullcap, Kava and Catnip.
* Herbs that are particularly beneficial if taken during the day to assist your sleep patterns at night include: Siberian ginseng, Skullcap, Oatstraw, Melissa, and Chamomile.
Stress causes hormonal imbalance in the body which can lead to insomnia. The following hormone overview is the one I consider when preparing a comprehensive hormonal balancing protocol. While I do offer tests to evaluate hormonal levels, it is reasonable to select a treatment protocol based on the following interventions with the understanding that tests will be needed if the condition doesn’t readily resolve.
I think of melatonin as nature’s sleepy time natural opiate. By day we are awake, active, engaged and communicative. Daylight inhibits the secretion of melatonin, a hormone synthesized in the pineal gland deep within the brain. As day turns to night, darkness stimulates the release of melatonin, our circadian regulator, and our body shifts into the relaxed parasympathetic state: we become sleepy. Melatonin is the strongest antioxidant known. Some doctors believe that a build-up of free radicals during our waking hours is what determines our need for sleep. When melatonin has reduced this high level of free radicals during sleep, we awake in the morning refreshed and ready to go again.
* Natural Melatonin (not synthetic which the health food stores sell) is what I like to use: .5-3 mg taken near bedtime.
Support for the adrenal glands is perhaps the most important component when addressing a stressed out hormonal system.
* Adaptogenic herbs help restore and maintain optimal health and energy. They are safe for long term use when taken as directed. They can be taken individually or in combination.
* Rhodiola (see my newsletter on Rhodiola): about 200mg at breakfast and 200mg at lunch on an on-going basis.
* Others adaptogenic herbs to consider include Astragalus (also helps immune system), Siberian Ginseng (helps all body systems as well as hormonal) and Gota Kola (especially helps clarity of mind and healing).
* Stress tends to inactivate thyroid hormones causing sluggish metabolism and insomnia, often in spite of normal thyroid lab test results.
* Iodine: 150mcg up to 12 mg daily is a consideration for thyroid disorders.
Pituitary and Hypothalamus
* Maca plant: This herb comes from Brazil and has the ability to support all other hormonal secreting glands by providing nutrients to the pituitary and hypothalamus. Take as directed.
Pancreas and blood sugar balance is important. Blood sugar irregularities including hypoglycemia (see newsletter on Diabetic Syndrome) can cause significant sleep problems, especially that late onset insomnia (2-4 a.m. waking and restlessness).
* Eat real food (organic not synthetic), whole food (not processed), a variety of food, (all the colors of the rainbow), in naturally packaged (not plastic) containers.
* Chromium 200mcg at dinner and 200mcg at bedtime.
Whole Body Nutrients (to be taken with food)
* Good quality Multiple Vitamin and Mineral: In my practice I use a whole food supplement or Basic III nutrient. From local health food stores you can find Natural Factors by Michael Murray as a good quality multiple vitamin and mineral as directed.
* Vitamin D3: 3,000IU Daily
Inflammatory compounds in the body tend to be acidic and irritating to the nervous system. Here are some suggestions if you suspect that this could be a factor for you.
* Liver foods: eggs, beef, wheat germ, oats, nuts, fish, beans, garlic, lentils, onions, yogurt and seeds, cabbage, broccoli, kale, brussels sprouts, oranges, tangerines (but not grapefruits), raspberries & pomegranates
* NAC (N-acetyl-cystiene): 500 mg daily
* Milkthistle: as directed on the bottle
* Probiotic: to ensure healthy colonic environment: this means less toxins for the liver to deal with. A refrigerated acidophilus with or without bifidus as directed.
Best Stress Buster of All
* Ha Ha Ha! Hearty har har har. Laughter is the best medicine of all because it prevents and dispels toxic build-up and subsequent systems dis-regulation. Children laugh about 400 times a day: adults about 15.
* Even fake laugher provides benefit as the body doesn’t distinguish between fake and real laugher. For more information please visit: laughteryogausa.com
A breathing exercise conducive to sleep requires mental focus on the movement of air in and out of your nostrils. Your mind will drift. Each time you notice that it has strayed, bring your mind back to the breath - in and out. The more you bring your mind back to this awareness, the more you will relax, let go of worries, and allow the door toward sleep to open.
Breathing right by day is also essential to prevent the chronic fight or flight rushing habits we get locked into. I have available a stress reducing breathe right CD for my patients and readers.
Other Sleep Problems to Consider
Insomnia may be caused by underlying health problems requiring the aide of a physician. Physical ailments and metabolic abnormalities such as restless leg syndrome, muscular tension, pain, menopause, thyroid disorders, and sleep apnea may cause insomnia. Sleep apnea affects about 5% of the population, and many do not know that they have this condition. Sleep apnea occurs when the breathing passage in the throat closes off. Snoring is pronounced until breathing stops for a spell, to be resumed with a loud gasp. The spells fragment sleep causing extreme daytime fatigue. Please consult a doctor if you think you have sleep apnea. I often find that allergies are at the root of apnea and once addressed the condition resolves.
Finding a solution for chronic insomnia is a complex whole body challenge. Healing insomnia with well intentioned therapeutic interventions offered by even the most skillful practitioner is often elusive, due to the psycho-social origins that require time and diligence to properly address. This two part newsletter provides individuals the foundation for a whole body approach to insomnia which if followed with patience and fortitude will yield results.
I hope you have enjoyed this month’s newsletter and welcome your comments.
Jon Dunn, ND