Photo credit: Vladislav Muslakov
If you have problems sleeping you are not alone.
It is estimated that 50-70 million Americans have chronic sleeping problems.
Getting enough sleep is crucial to good health, and unfortunately there is a wide range of medical barriers to it.
Health problems associated with lack of sleep:
Lack of sleep is associated with weight gain. It can lead to poor food choices that affect weight gain, and it adversely affects hormones related to hunger (ghrelin) and fullness (leptin). Studies have shown that those that sleep less have lower levels of leptin and higher levels of ghrelin, so if you are lacking sleep, you may be hungrier, and therefore eat more. When we are sleep deprived we also tend to crave calorie dense foods that are higher in carbohydrates, and this can contribute to weight gain.
Studies have shown that men who sleep 5-6 hours or less are twice as likely to develop diabetes. Also, short duration sleep times are associated with type 2 diabetes and impaired glucose tolerance in men and women. This means that optimizing sleep quality and quantity can have positive benefits for optimizing blood sugar control.
Sleeping problems are associated with cardiovascular disease including heart attacks and stroke, and hypertension.
Sleep loss is associated with mood and behavior problems.
Adults with chronic sleep loss have more mental distress, depressive symptoms, anxiety, and alcohol use.
Often issues with sleep are a symptom of another medical problem, and by addressing it, we can improve sleep.
There are a variety of reasons for trouble sleeping:
Things we eat or take that can keep us awake include alcohol, nicotine, caffeine, cocaine, decongestants like Sudafed, diet pills, Ritalin or other stimulants, herbs like ginkgo biloba, guarana, Siberian ginseng, ephedra, ma huang, bitter orange, and kola nut, and medications including beta blockers, albuterol, Wellbutrin, SSRIs (antidepressants), prednisone and other steroids.
All sorts of health conditions can interfere with sleep:
Take anxiety for example. Diet, sleep and anxiety affect each other. Anxiety makes getting restful sleep challenging and difficulty sleeping can cause anxiety. Reducing levels of anxiety is important, and meditation, yoga, and breathing exercises are examples of interventions my clients find helpful in reducing their anxiety levels.
Depression is linked to poor sleep. Insomnia can cause depression, and remember that antidepressants (like Prozac or Wellbutrin) can adversely affect sleep.
Pain from any number of conditions can lead to poor sleep. Arthritis, headaches, reflux, and fibromyalgia, anything that causes pain can make it hard to fall asleep, and hard to stay asleep. Pain gets worse with lack of sleep. Addressing the underlying cause of pain can help improve sleep quality.
GERD, or gastroesophageal reflux, is a common problem, and reflux symptoms reduce quantity and quality of sleep. One of the first things we look at is how close to bedtime are you eating? Eating too much and eating too close to bedtime can cause GI symptoms like GERD. Ideally, you should wait 4 hours between eating and going to bed. There is a wide range of other reasons for GERD, so this is also something we explore when reflux is present, and GERD has many other problems associated with it aside from sleeping disturbances, and there are nutritional interventions to address it.
Insomnia is considered a symptom of menopause. There are nutritional and herbal interventions that can help. Talk to a professional to see what’s right for you.
Obstructive sleep apnea is disordered breathing during sleep. People that have sleep apnea have a greater risk for high blood pressure, heart attack, irregular heartbeat, diabetes, stroke, asthma, some cancers, cognitive and behavioral disorders in children and adults, and car accidents. Common symptoms include snoring or gasping during sleep, and feeling fatigued during the day. Many people that suffer from sleep apnea live in larger bodies, so nutrition plays a big role here. Appropriately nourishing your body to reach a healthy weight is a primary intervention for sleep apnea, and often helps resolve the issue. There are numerous other reasons that someone may be experiencing sleep disordered breathing, and The Breathe Institute in Los Angeles, CA specializes in addressing all causes of sleep disordered breathing using a multidisciplinary approach.
Desynchronosis is a disrupted circadian rhythm. It’s common in jet lag, and it shift workers, so those who work at night. It’s when your body’s internal clock is out of balance. Our circadian rhythms tend to change based on our stage in life too. Teenagers generally like to stay up late and wake up late, and as we get older we tend to go to bed earlier and wake up earlier. Often those with this condition have abnormal hormone levels, in particular cortisol and melatonin.
Cortisol is your stress hormone and it should be higher in the morning and lower at night. Stress is an unavoidable factor in our lives, and more stress leads to higher levels of cortisol. There are many other causes of high cortisol levels, and cortisol stimulates insulin release, and over time, this can lead to diabetes, and weight gain, especially around your middle. So managing cortisol levels by working on reducing stress is important for sleep and for overall health.
Melatonin, is also important to help promote sleep. Low levels of melatonin lead to problems sleeping.
To learn more about your unique circadian rhythm and sleep cycles, fill out this questionnaire (it's free and provides helpful information): http://www.cet-surveys.com/index.php?sid=61524. It estimates the time of your melatonin onset, and what your natural bedtime should be. Going to bed before or after this time could be a recipe for a poor night's sleep.
Melatonin production increases when it's dark and decreases when it's light. This is a reason why blue light/screen time before bed disrupts sleep. Avoid all screens 2-3 hours before bedtime. When we can’t avoid the screens, we can use glasses during those few hours before bed to help block the blue light:
I think you get a sense of the variety of factors that play roles in sleep problems. This is by no means an exhaustive list.
From a nutritional standpoint:
We look for dietary triggers for the problem.
We can look for underlying conditions that are preventing adequate sleep, like sleep apnea, and reflux.
We can look to food as medicine to address any nutrient deficiencies that may be contributing to the issue. For example, food is a source of neurotransmitter precursors, where your neurotransmitter balance regulates your sleep, and mood in general. Deficiency of certain vitamins and minerals can also disrupt sleep, so we can address these deficiencies by choosing foods containing the nutrients and supplement where necessary.
As you can see, sleep disorders cause a lot more than just feeling tired during the day. If you have problems sleeping, it is worthwhile to check out why. Contact me and we can explore diet, food, nutrients and lifestyle interventions to help bring you relief, and a good night’s sleep. For expert sleep hygiene assistance, I recommend working with Jenni June, Certified Child and Family Sleep Consultant, CLC.
In the meantime, here are 10 of my favorite tips to improve sleep!
Avoid caffeine, nicotine, alcohol and other substances that interrupt sleep
Your bedroom
Keep it set up for a good night’s sleep, and sex, only
Don’t eat, or watch TV in bed
Keep your room dark and quiet
Use something to create white noise to block out sounds that might awaken you
Use earplugs
Keep the temperature in your bedroom cool
Create a soothing bedtime routine to help you relax
Meditate
Relaxation exercises
Read a book (hard copy to avoid blue light, or get those glasses mentioned above)
Take a warm bath
Go to sleep when you are tired (work with your body’s natural circadian rhythms)
This is when you feel the first nudge of sleepiness (and when your melatonin is kicking in), don’t wait, you’ll miss the window (it’s short)
Don’t watch the clock, and if you are a clock-watcher, turn it around so you can’t see it
Keep a consistent sleep schedule and go to bed and wake up at the same time as much as possible (yes even on the weekends)
Keep fluid intake at a minimum about 60-90 minutes before bedtime
Make dinner a lighter meal, and earlier (don’t eat 2-3 hours before bedtime)
First thing in the morning, go outside and let the sunlight hit you, which stimulates and regulates your hormones that regulate your body’s circadian rhythms, and get plenty of natural sunlight during the day/let as much natural light into your workspace as possible
Exercise during the day, and at least 3 hours before bedtime
Sometimes we need more assistance. My favorite supplements are:
Cortisol Manager - Integrative Therapeutics
Best-Rest Formula - Pure Encapsulations
Insomnitol - Designs for Health
Sleep Reset - Integrative Therapeutics
Melatonin 3mg - Pure Encapsulations
You can get these supplements through my online dispensary. Try one at a time and give it a few weeks to see if it helps. Click here to register for a free account. Once you do, you can search for the supplement you are looking for.