Insomnia

            Sleep is an essential part of life, but one that is often pushed aside by the consuming tasks of daily life.  If you feel that you are too busy to get a full night’s sleep, consider that sleep-deprivation, both in the short and long-term can cause serious adverse health effects. 

Chronic insomnia is prevalent in 10% of the adult population.  Insomnia is a symptom of difficulty initiating and maintaining sleep or experiencing unrefreshing sleep.  Causes of insomnia include medication, thyroid disorder, menopause, arthritis pain, chronic renal failure, chronic obstructive lung disease, congestive heart failure, heartburn, psychiatric, circadian, and sleep disorders. Although insomnia is typically secondary to another disorder, it can also be a primary disorder.  Primary insomnia is estimated to occur in 25% of all chronic insomnia cases.    Age, sex, medical and psychiatric disease, and shift work all represent an increased risk of chronic insomnia.  Chronic insomnia is associated with absenteeism, frequent accidents, memory impairment, and greater health care utilization.  The consistent impact of insomnia leads to a high risk of depression.  

How well you sleep can seriously alter the balance of hormones in your body.  This alteration can disrupt your circadian rhythm (sleep/wake cycle).  A disrupted circadian rhythm may influence cancer progression through shifts in hormones like melatonin, which the brain makes during sleep.  According to Brain Behavior Immunology October 2003, having a regular circadian rhythm may be necessary for your body to defend against cancer, and sleep/wake rhythms that are disrupted due to stress or other issues may promote cancer growth.  Melatonin is an antioxidant that helps to suppress harmful free radicals in the body and slows the production of estrogen, which can activate cancer.  When your circadian rhythm is disrupted, your body may produce less melatonin and therefore may have less ability to fight cancer.  Another link between cancer and the disrupted circadian rhythm lies with a hormone called cortisol, which normally peaks at dawn then declines throughout the day.  Cortisol is one of many hormones that help regulate immune system activity, including the activity of a group of immune cells called natural-killer cells that help the body battle cancer. 

Yet another mechanism that may be related to the cancer/sleep association is the hormone insulin.  University of Chicago researchers have repeatedly shown that insufficient sleep will result in an increased rate of diabetes due to increased insulin resistance.  Insulin has been clearly linked to cancer in previous studies.  Furthermore, researchers have found that women who slept five hours or less every night were 34% more likely to develop diabetes symptoms than women who slept for seven or eight hours each night.

            Americans average about 6 hours of sleep per night.  Researchers believe that body chemistry might explain the link between sleep deprivation and obesity.  A lack of sleep increases grehlin, a hormone that sends a hunger signal to the brain.  At the same time, the level of protein called leptin drops.  Leptin helps suppress appetite, so when the level is low, appetite increases.  Combine too much grehlin and too little leptin, and you’ve set the stage for an intake of too many calories.  The following statistics were reported from the National Health and Nutrition Examination Survey: less than four hours of sleep per night increases obesity risk by 73%, compared to subjects who slept 7-9 hours.  An average of five hours of sleep per night increases obesity risk by 50%; an average of six hours of sleep per night increases obesity risk by 23%.

            Sleep is critical to achieving and maintaining optimal health and should be a priority for all individuals, as well as proper nutrition and exercise.    The research is quite clear that insufficient rest will result in increased rates of cancer, diabetes depression, impaired memory, and obesity (to name a few).  Optimizing your sleep can slow down the aging process.

The natural human biorhythm is to sleep between 10 PM and 6 AM.  It is optimal to be in bed with the lights out by 10 PM and be up by 6 AM.  Before the advent of electricity, people naturally went to bed after sundown.  Our systems, particularly the adrenals, do a majority of their recharging or recovering during the hours of 11PM and 1 AM.  In addition, the gallbladder dumps waste during this same period.  If you are awake, the toxins back up into the liver, which then secondarily backs up into your entire system and cause further disruption of your health.  At any rate, the take home message is to go to bed at the same time each night and get up at same time each morning.

If you need a good night’s sleep, the following are some general sleep guidelines:

·       No napping during the day; it interferes with the natural circadian rhythm. If extremely tired, limit nap time to 30 minutes or less.

·       Avoid “sleeping-in” (even on weekends/vacation).

·       Aim for 30-60 minutes of daily exercise at least 6 hours before bedtime to avoid over-stimulation.

·       Get at least 30 minutes of exposure to sunlight per day with no sunglasses.  Get some bright light exposure soon after awakening and get some natural light exposure during the mid-portion of the day.

·       Decrease your mental activity after dinner.

·       Develop a bedtime routine at least one hour before bedtime to allow your mind to relax; this process will train your brain to unwind (having a ritual that involves several steps triggers the brain that it is time for bed).  Try journaling, relaxation breathing, progressive relaxation, guided imagery, listening to soft music, taking a relaxation bath with lavender essential oil and Epsom salts.  Try going to sleep to the sounds of the ocean or similar pleasant sounds.

·       Try to view the sunset and dim the house lights after dark, always being mindful of safety.

·       Avoid caffeine after lunchtime (chocolate, coffee, tea, and soda).  Lower caffeine intake to no more than 2 cups per day.  A recent study showed that some people are unable to metabolize caffeine efficiently and feel the effects long after consuming it.

·       Avoid all alcohol, especially from late afternoon on; alcohol is sedating but causes paradoxical sleep disruption during the night.

·       Only read calming or spiritual literature in bed to promote relaxation.  

·       Never watch television in bed and no TV right before bed—it is too stimulating to the brain, and it will take longer to fall asleep.  It also disrupts pineal gland function (see below).

·       Use your bed only for sleep and intimacy; the bedroom should be an oasis of tranquility.  Do not use it as an office or rec room—avoid reading, working, or watching TV in your bed!

·       Keep temperature in your bedroom comfortable, no higher than 68 degrees F.

·       Wear socks to bed.  The feet have the poorest circulation; the feet often feel cold before the rest of the body.  A study has shown that this reduces night waking.

·       Keep bedroom quiet when sleeping; consider earplugs if necessary.

·       Keep bedroom dark; use dark blinds or wear an eye mask if necessary.  No night-lights or clock radio lights.  Never TURN ON lights should you need to get up to use the rest room, because any small amount of light will instantly shut off your melatonin production.  When light hits the eyes, it disrupts the circadian rhythm of the pineal gland and production of melatonin and serotonin.

·       Turn off all lights.  Lie on your back and focus on the way your body feels and on your breathing.  Relax each muscle group individually; begin with your feet and work toward your head.  Take deep abdominal breaths or utilize another breathing technique.

·       Try reciting a prayer, mantra, or sound continuously for five minutes.  Counting your blessings is a great way to end the day.

·       Imagine a tranquil scene (waterfall, forest, or beach)

·       Deal with your problems or anxieties before bed; set aside a worry time for 30 minutes earlier when you can journal or discuss troubles with a supportive person.  Additionally, prepare for the next day.  For example, determine what you would like to accomplish so you do not have to think about it.

·       Take a hot bath for up to an hour with calming fragrances (lavender, vanilla, sandalwood) or Epsom salts (4 cups) 30 minutes before bedtime.  Use the bath to let go of your daily stress; use low lights or candles and music.  After the bath, massage your body with an oil blend.  A hot bath, shower, or sauna taken in the late evening will raise body temperature, and then it will fall at bedtime facilitating sleep.

·       Something warm, like a hot water bottle, may help alleviate your worries, especially when placed between the navel and bottom of rib cage.

·       Listen to a guided bedtime meditation (I highly recommend the free app Insight Timer) or purchase a white noise machine.  Studies indicate that listening to music while falling asleep can decrease the time it takes to fall asleep.

·       Have a household member give a gentle 5-minute back rub prior to bedtime

·       Being overweight can increase the risk of sleep apnea, which prevents adequate rest.

·       Avoid using loud alarm clocks.  It is very stressful on the body to be awoken suddenly.  Consider using a dawn simulator.  All alarm clocks and electrical devices should be kept at least 3 feet from the bed due to electromagnetic fields.

·       Check your bedroom for electro-magnetic fields (EMFs).  EMFs can disrupt the pineal gland and the production of melatonin and serotonin.  Gauss meters measure EMFs.

·       Remove electronics from the bedside.

·       Use natural products for your mattress, bedding, and pillows.

·       Turn off electronic devices which emit blue light, such as TV, computers, smart phones, and tablets at least 2 hours prior to going to sleep as they inhibit melatonin production.  If you insist upon using these devices, use a blue light filtering app such as F-Lux or Twilight.  Alternatively, you can use amber colored glasses to block the blue light.

·       Avoid bedtime snacks, especially grains, sugars, and alcohol.  These foods and beverages will raise blood sugar and inhibit sleep.  Later, when blood sugar drops too low, you might wake up and not be able to fall back asleep.  Alcohol also prevents deeper stages of sleep, where the body does most of its healing.  Instead, eat a high protein snack with a small piece of fruit several hours before bed, because the protein can provide the L-tryptophan necessary for melatonin and serotonin production and the fruit can aid the tryptophan cross the blood-brain barrier.

·       Avoid fluids for two hours before bed.

·       If you find it difficult to sleep in your bed, pick another area of the house to sleep in.

·       Get into bed only when you are sleepy.  If you are unable to fall asleep, get up and go into another dimly lit room and read a paper (nothing too disturbing), book, or magazine or listen to soft music.  Do NOT use a computer, watch TV, or use your smartphone.

·       If you wake during the night, try repeating some of the above techniques or massage your head or feet.

·       If you need to use the bathroom during the night, use a nightlight or as little light as possible to promote continued melatonin production.

·       Make use of full-spectrum bright light, including outdoor light or a light box.  This type of light resets the circadian rhythm.  Early morning light therapy (6-7 AM) is indicated for young adults who do not get sleepy until midnight.  Bright light in late afternoon is indicated for elderly who have onset of tiredness around 6 PM.  Improving your melatonin levels is key to getting a good night’s sleep, so make sure you have exposure to bright sunlight in the daytime and sleep in absolute darkness at night.  Melatonin is a powerful hormone; ideally, it is best to increase levels naturally with exposure to bright sunlight in the daytime (along with full spectrum fluorescent bulbs in the winter) and absolute darkness at night.  It is best to supplement melatonin only if you are unsuccessful with increasing the level naturally.

      If these measures fail, do not lie awake for more than 30 minutes.    Get out of bed and perform a quiet activity.  Return to bed when sleepy.  Repeat as many times per night as needed.  Do not look at the clock when awakening during the night, this will only add to your stress if you are constantly checking the time.

      The following are some mattress guidelines to assure sweeter dreams: (1) the bed should enable the sleeper to lie on his side with a straight spinal column; (2) when laying down, shoulders and hips should press into the mattress; (3) mattresses should rise up to meet the narrower waist and knees; (4) super-firm and too-soft mattresses are rarely recommended.  Experts suggest that when selecting their mattresses, consumers should try each one for 5-10 minutes at a time.  They also stated the longevity of most mattresses ranges between 5-7 years.

      It is important to know the use of prescription and over-the-counter sleeping pills can become habit-forming if used for more than 10 days.  It can be difficult to withdraw from any sleep inducers.  Adverse effects of sedatives include daytime sleepiness, amnesia, early morning insomnia, daytime anxiety and confusion, ataxia, falls in the elderly, and dependence.

      If insomnia persists despite the recommendations listed above, please schedule a discovery call with me to determine if exploring hormone testing might help determine the underlying cause(s) of your persistent sleep disruption.

Check out my favorite sleep supplements here.

Sweet Dreams,

Rachel Oppitz, ND

P.S. For more information on this topic, read Lights Out:  Sleep, Sugar, and Survival by T.S. Wiley and Bent Formby.  One-third of the book is references to peer-reviewed literature.

Helping women go from chaotic to calm with compassion, creativity, and clarity.

Itasca Naturopathic Clinic

https://www.itascanaturopathicclinic.com