Insomnia and Natural Strategies to Sleeping, Part 1

I teach a variety of classes and the class that is the most well attended is my class on naturalsleeping strategies for sleep and insomnia.  As a Traditional Chinese Medicine (TCM) herbalist, I cover this topic from both a TCM and Western viewpoint, as I will in this blog.  When I first started putting together the research for the class a quick search on the internet reveals enumerable sites devoted to sleep issues.  According to some estimates, 30% of the population experiences trouble sleeping.

Although there have been studies linking lack of sleep to long-term clockhealth issues it is important to not get too stressed out.  My experience in working with clients has been that anxiety about not getting enough sleep is a vicious self perpetuating cycle. If you are anxious about your sleep it may effect your ability to fall asleep or remain asleep. When this happens for many nights (or many months), you might start to feel anxiousness, dread, or panic at just the prospect of not sleeping. This is how anxiety and insomnia can feed each other and become a cycle that  may benefit from cognitive and mind body techniques.

For starters if you suspect that you have insomnia do any of these describe you?

  • Need an alarm clock in order to wake up on time
  • Rely on the snooze button
  • Have a hard time getting out of bed in the morning
  • Feel sluggish in the afternoon
  • Get sleepy in meetings, lectures, or warm rooms
  • Get drowsy after heavy meals or when driving
  • Need to nap to get through the day
  • Fall asleep while watching TV or relaxing in the evening
  • Feel the need to sleep in on weekends

If any of these seem familiar, then I would keep reading.  Lets take a look at some indicators that might help you determine whether or not you have insomnia and what type of insomnia it is is classified as.

  • Do you wake up during the night and find that you cannot fall back asleep?
  • Do you lie in bed, tossing and turning for hours each night?
  • Do you dread going to bed because you feel like you never get a good night’s sleep?
  • Do you wake up feeling unrefreshed after sleeping?
  • Does the problem occur even though you have the opportunity and the time to get a good night’s sleep?

The persistence of insomnia is how it is classified according to sleep specialists.

Types of insomnia
Transient Short term 1 or 2 nights a week
Intermittent On and off, from time to time
Chronic Constant, most nights for a month or more

Understanding the mechanics of sleep can help us to understand some strategies of treatment. Current information on sleep indicates that we past through several cycles of sleep, some indicate 4 stages and others 5I1047stages_thumb stages.   These stages progress cyclically from 1 through REM and then begin all over again. A complete sleep cycle takes an average of 90 to 110 minutes. Over the course of the night, the amount of time we spend in a particular stage of sleep begins to shift.  Typically you tend to experience more REM sleep in the earlier hours of the night (e.g., 11p – 3a) and more REM sleep in the later hours of the night (e.g., 3a – 7 a).

Going to bed and increasing your sleep efficiency can be the first step in developing an individualized sleep strategy.  The goal of getting enough sleep is to wake up naturally before the alarm, or when you want to get up.  Below is a calculation you can use to determine your appropriate bed time.

Determining an ideal bed time
 Sleep cycle  90 minutes
 Average sleep cycles per night  5 cycles
 Multiply 90 x 5 450 minutes (7.5 hours)

Then count backwards from the time you want to wake-up time 7.5 hours and you have a starting point for your bedtime.

Now that you know when you should be going to bed the next step is to determine how efficient your sleep is.  This can be done through a simple calculation or there are several excellent sleep apps on the app imagesmarket that track your sleep based on movement and let you see the percentage of time you spend in various sleep states along with determining our sleep efficiency.  Although these are can not substitute for a formal sleep study, they do give you an idea of your sleep patterns.  To determine your sleep efficiency without a sleep app, take the amount of time you spend in bed asleep (minus all the awakenings you may have and how long it takes you to fall asleep), and divide it by the total time you spend in bed, you will get an estimate of the overall percentage of how efficiently you sleep.   In sleep science they like to see this number above 85%. 85% is considered normal and really good sleep efficiency is above 90%.

There are many issues that might cause insomnia including unhealthysleep and aging sleep habits, anxiety or depression, certain foods and medical conditions. As we age we have we have changes in sleep cycles and needs. Ultimately if you feel as if your judgement and energy levels are diminished by your lack of sleep it is time to do something about it.

We are what we eat, so the first line of defense is to reduce our intake of foods that contribute to insomnia.

  • Refined Carbs can drain the body of vitamin B, which the body needs to release serotonin.
  • Bacon  contains tyramine, which increases the release of norepinephrine, a brain stimulant that keeps you up. Others foods that contain tyramine include chocolate, eggplant, ham, potatoes, sauerkraut, sugar, sausage, tomatoes, and wine.
  • Alcohol  can make you tired in the short run but you’re likely to awaken in the middle of the night. Red wine in particular effects sleep in that it contains more substances that people are sometimes allergic to, such as tannins, prostaglandins, and histamines.  If you do have alcohol, timing and the amount is everything.  One drink at least a couple of hours before sleep can have the least effect.
  • Chocolate can elevate your energy levels with bioactive compounds like tyramine and phenylethylamine. Chocolate also contains sugar which wakes you up as well as the other obvious culprit, caffeine.

Foods to incorporate into your diet that contribute to sleep include:

  • Walnuts-Walnuts are a good source of tryptophan, a sleep-enhancing amino acid that helps make serotonin and melatonin.
  • Almonds are rich in magnesium
  • Dairy products, Calcium (found in cheese, yogurt, milk) helps the brain use the tryptophan found in dairy to manufacture melatonin.
  •  Cherries, particularly tart cherries, naturally boost levels of melatonin.
  • Chickpeas are also a good source of tryptophan.

Supplements (all supplements and herbs need to be researched for possible medication interaction):

  • 5HTP-is a popular compound derived from the amino acid L-tryptophan. It is also produced commercially from the seeds of an African plant (Griffonia simplicifolia). 5-HTP acts as a precursor to serotonin, which is a neurotransmitter that is essential for a good night’s sleep. 5HTP has side effects and has not had long term studies, so it is important to research this supplement before using.
  • Magnesium contributes to a good night’s sleepResearch has shown that even a marginal lack of it can prevent the brain from settling down at night. You can get magnesium from food including green leafy vegetables, wheat germ, pumpkin seeds, and almonds.   Lack of magnesium inhibits nerve cell communication, which leads to cell excitability. Magnesium glycinate is a form of magnesium that avoids the side effects of loose bowel.
  • Calcium is directly related to our cycles of sleep.  In a study published in the European Neurology Journal, researchers found that calcium is directly related to our cycles of sleep.  The study concluded that disturbances in sleep especially the absence of REM sleep are related to calcium deficiency.  Calcium helps the brain use the amino acid tryptophan to manufacture the sleep inducing melatonin.  
  • GABA-An amino acid derivative found in green tea, theanine has long been known to trigger the release in the brain of gamma-aminobutyric acid, or GABA activates the major calming neurotransmitters, promoting relaxation and reducing anxiety, but the body has difficulty absorbing supplements containing synthesized GABA.
  • Melatonin-A hormone that regulates the normal sleep/wake cycle. According to research, the body naturally produces melatonin after the sun goes down, letting us know it’s time to fall asleep.  An effective way to take melatonin is to 1 sublingual and a time-released melatonin tablet. Take the time release tablet first and then place the sublingual tablet under your tongue.
  • Theanine-An amino acid derivative found in green tea, theanine has long been known to trigger the release in the brain of gamma-aminobutyric acid, or GABA. Experts recommend theanine, which the body can easily absorb and, ultimately, use to boost levels of GABA. Does above 600 mg without physician oversight.
  • L-tryptophan-Some people take L-tryptophan to try to help them sleep. But research does not show that L-tryptophan supplements are a good or safe treatment for long-term insomnia.  L-tryptophan has been linked to a dangerous, even deadly condition called eosinophilia-myalgia syndrome (EMS). Furthermore they have myriad interactions with medication, so caution is advised.

Coming soon:

Part 2, an overview of herbal protocols and development of individual sleep strategies.

Part 3, an overview of how perimenopause and menopause effect sleep.

 

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1 Comment (+add yours?)

  1. Lesley Ambika Gibbs
    Dec 03, 2014 @ 20:02:05

    Great Info! Thanks so much. I am very much looking forward to your post about how perimenopause and menopause affect sleep. I never had any trouble sleeping until I hit my mid 40s. My insomnia is cyclical and seems very much to coincide with the menstrual cycle. Thanks to your info I just picked up some melatonin today and will give that a try. Be Well!

    Date: Mon, 1 Dec 2014 22:32:09 +0000 To: ambika1008@hotmail.com

    Reply

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