Do you sleep well?
If you don’t, you are not alone. Sleep problems are common and may have a negative impact on overall health. So if you aren’t getting the recommended 7-9 hours per night, you may be undoing the good results achieved through eating well or exercising. The importance of sleep is always addressed with new clients at Health Space.
Why is sleep so important?
Adequate sleep is necessary to support immunity and prevent illness, to enable optimal performance and productivity, and to protect against chronic health problems. While you are sleeping, the brain forms new pathways to help you learn and remember information and form memories, your body can recover from illness and injury and regain energy, your vascular system can rest and heal, and important hormones are released. Healthy sleep also helps with balancing emotions and stabilising moods.
Sleep deficiency can contribute to heart disease, hypertension and stroke, kidney disease, obesity, and mental health issues such as depression and anxiety. Poor sleep disrupts the balance of hunger hormones leptin and ghrelin (our ‘hunger hormone’ that stimulates appetite) affecting appetite regulation. This can lead to overeating and is implicated in high blood sugar levels and reduced insulin sensitivity, thus increasing the risk for diabetes.
Sleep deprivation can lead to injuries, workplace and motor vehicle accidents, and loss of productivity. It can interfere with work, focus, study and learning, daily tasks such as driving, and normal social activities.
So what is healthy sleep?
Functioning well each day is dependent upon getting enough total sleep, enough of each type of sleep, and sleeping when your body needs to sleep.
The two basic types of sleep are rapid eye movement (REM) and non-REM. Non-REM sleep is quiet and relatively inactive and progresses through 4 stages, from light to very deep sleep. During REM sleep, dreaming can occur, as well as increases in blood pressure, heart rate and breathing. Generally, non-REM and REM sleep occur in regular patterns of 3–5 cycles each night. A normal person will spend about 25 percent of the night in REM sleep, and the rest in Non-REM sleep.
Healthy sleep needs a combination of the following:
- Quantity – at least 7-9 hours of relatively continuous sleep ideally.
- Quality – unbroken sleep, free of disruptions caused by drugs, alcohol, lifestyle choices, stress, anxiety, bladder issues, illness, medical conditions, or sleep disorders such as snoring, apnoea, teeth grinding and sleep walking.
- Regularity – a regular routine where bedtime and wake up time are similar each day. Sleep patterns of shift workers, caregivers and emergency responders are regularly out of sync with their body clocks.
Quality sleep is best achieved lying down with your eyes closed, in response to the release of chemicals that assist in relaxing muscles. Being upright with eyes open causes arousal of brainwaves which can stimulate and keep us awake.
What controls sleep?
The biological master clock in the brain (the suprachiasmatic nucleus) controls when you are awake and when you are ready for sleep via 24 hour repeating rhythms called the circadian rhythms. Your body’s master clock influences sleep-wake cycles, hormone release, eating habits and digestion, body temperature, and other important bodily functions, and is in sync with cues in the environment such as light and darkness. Light signals received through the eyes tell your brain that it is daytime and help align your body clock with day and night. Two hormones involved in sleep and wakefulness and controlled by your body clock are melatonin and cortisol.
In the morning, your body produces hormones including cortisol which wake you up and get you going. As the day gets darker, melatonin is produced and released by the brain, helping the body to feel drowsy and ready for sleep at night. Disruptors such as bright artificial light form TV screens, computers, mobile phone and tablet screens in the late evening, disturb the process thus making it difficult to fall asleep.
What can help to improve sleep?
If getting a good sleep is difficult for you, try some of the following ideas.
- Keep your sleep schedule constant by going to bed and waking up at the same time each day, or as close as possible. This helps the body clock and sleep patterns stay in sync.
- Shut down computers and digital devices well ahead of sleep time and relax for an hour at least either reading, listening to music or meditating. Artificial light from TVs, mobile phones and tablets can signal the brain to be awake.
- Try daily gentle exercise outside in the sunshine e.g. walking, plus parasympathetic activities like yoga and meditation. These assist with relaxation and in lowering stress and anxiety.
- Avoid strenuous exercise just prior to bedtime as this is too stimulating.
- Meditate at bedtime using apps such as Headspace; Calm; insight Timer; Smiling Mind; Relax Melodies etc. on iPhone or iPad). Listen, don’t look at the screen.
- Have a warm bath or shower before bed, it calms the whole body and relaxes tense muscles.
- Go to the bathroom before bed to reduce the need for getting up during the night
- Keep your bedroom quiet, cool, and dark.
- Try breathing exercises if you are having trouble falling asleep or getting back to sleep when awakened e.g. breathe in for 5 seconds, hold for 2-4, and then breathe out for 5. Belly breathing-switches on the parasympathetic nervous system (calming). Try placing hands palm down on the lower belly, breathing in and out through the nose if possible. In slowly, out slowly, feeling tummy rising and falling with the breath.
- Don’t exceed 20 minutes for daytime naps, if you have trouble falling asleep at night.
- Check hormone levels as progesterone, oestrogen, cortisol, DHEA, melatonin, testosterone and thyroid hormones, as all can disrupt sleep when unbalanced.
Diet and nutrients
- Eat balanced nutritious meals, avoiding foods that trigger gastrointestinal tract discomfort, allergies or intolerances. Ensure adequate protein, complex carbohydrates and good fats are part of you daily diet.
- Have your evening meal at least 3 hours before going to bed. Digesting food takes several hours and the digestive system is working when it should be resting. Also avoid alcoholic drinks before bed.
- Avoid stimulants such as caffeine (tea, coffee, caffeinated drinks, chocolate etc.) and nicotine, which can interfere with sleep. Caffeine can have stimulating effects for up to 8 hours, making sleep onset difficult.
- Include foods containing tryptophan (an amino acid) in your diet along with good carbs. Tryptophan helps synthesis of the relaxing neurotransmitter serotonin. Food such as eggs, cheese, turkey, bananas, dates, oats and many more are high in tryptophan.
- Trying warm milk/almond milk with honey and nutmeg as a soothing, relaxing bedtime drink. Warm milk/almond milk with honey and nutmeg gives tryptophan and calcium. Tryptophan converts to the soothing serotonin and calcium relaxes muscles. Honey is soothing and helps tryptophan across the blood brain barrier to be converted to serotonin. Nutmeg is slightly sedative.
- L-Tryptophan is a precursor to the compound 5-HTP (both are part of the serotonin pathway) and taking both in supplement form can help, as can supplemental melatonin.
- Include co-factors for serotonin synthesis such as Vitamin B6, Niacin and Magnesium with tryptophan to ensure conversion to serotonin. Vitamin B6 found in food such as poultry, fish, chickpeas, and bananas helps your body process tryptophan and turn it into sleep-inducing serotonin faster.
- Take Magnesium, a natural relaxant.
- Taking B complex vitamins is good for the nervous system, but don’t take them in the evening as they can be stimulating.
- Try cherries or sour cherry juice which boosts melatonin levels thus assisting sleep
Herbal Medicine offers some wonderful options to help you achieve better sleep, both with sleep onset (getting to sleep) or sleep maintenance (staying asleep). These can be prescribed in combinations as liquid formulas, or as tablets or capsules. They can accompany lifestyle and dietary suggestions and nutrient supplements. They fall into various herbal categories. Those often used for sleep are:
- Adaptogens- to increase the body’s resistance to physical, environmental, biological or emotional stressors and restore normal physiological function to the body.
- Nervines- to strengthen and nourish the nervous system and can have a relaxant effect.
- Sedatives or hypnotics -to induce sleep
- Anxiolytics – to reduce anxiety, restlessness and irritability reducing tension in the body thus allowing sleep to occur.
- Antispasmodics- to reduce smooth muscle spasms that may cause pain and wakefulness
- Analgesics- to relieves pain that may prevent sleep
- Listed below are some useful herbs and their sleep enhancing actions:
- Eschscholzia californica (California Poppy)- anxiolytic, mild sedative , analgesic, hypnotic
- Matricaria chamomilla (Chamomile)- mild sedative, antispasmodic
- Humulus lupulus (Hops)- hypnotic, mild sedative, antispasmodic
- Piscidia erythrina (Jamaica Dogwood)- analgesic, antispasmodic, mild sedative
- Piper methysticum (Kava)- anxiolytic, hypnotic, antispasmodic, muscle relaxant, mild analgesic
- Melissa officinalis (Lemon Balm)- antispasmodic, mild sedative
- Avena sativa (Oats green/seed) – nervine, anxiolytic
- Passiflora incarnata (Passionflower)- anxiolytic, antispasmodic, mild sedative, hypnotic
- Scutellaria lateriflora (Skullcap)- nervine, anxiolytic, mild sedative, antispasmodic
- Hypericum perforatum (St John’s Wort)- nervine
- Valeriana officinalis (Valerian)- anxiolytic, mild sedative, antispasmodic, hypnotic
- Withania somnifera (Withania/ Ashwagandha)- adaptogen, mild sedative
- Zizyphus spinosa (Zizyphus)- anxiolytic, mild sedative, hypnotic
Sleeping, like eating, drinking and breathing, is a basic human need, and vitally important for good health and well-being. A refreshing sleep at night allows us to function optimally every day. If you are experiencing sleep deficiency problems, a naturopath or nutritionist may be able to help.
Pamela Nelson is a Naturopath, Nutritionist and Herbalist at Health Space Clinics Lane Cove. She is available Wednesdays, Fridays and some Saturdays. She has a special interest in gut health, anxiety, stress and adrenal fatigue.