Your Guide to Getting a Good Night Sleep

There are two panaceas in medicine: sleep and exercise.  This means that sleeps and exercise support your vital force—your inherent ability to heal and maintain wellness—no matter what health problems you struggle with. This is in part because both sleep and exercise raise growth hormone production. Growth hormone is responsible for repair of your body’s tissues—when growth hormone levels decline, aging rapidly accelerates.

Adequate sleep is crucial for healthy immune function. Melatonin levels are highest during sleep and darkness, and several studies have shown an increased risk of cancer, including breast and colon cancer, in people exposed to light at night (e.g., people who work the late shift). Melatonin appears to be a very potent antioxidant with the ability to suppress the growth of tumors.

Sleep researchers still don't completely understand all the reasons we sleep and dream. One reason is that memory consolidation occurs during sleep. If you're having problems remembering things you've learned, make sure you're getting enough sleep. Your brain also processes events of your day during sleep. In addition, sleep allows time for your body to repair damage caused by daily metabolism, stress, ultraviolet radiation, and toxic exposure. 

Although most people have trouble sleeping from time to time, chronic sleep deprivation has been linked to health problems such as depression and decreased concentration. Lack of sleep can cause weakened immunity and poor wound healing. Certain medical conditions are more common with inadequate sleep including heart disease, high blood pressure, and diabetes. Lastly, short sleep duration raises a hormone called "ghrelin", which increases appetite and the likelihood of being overweight or obese.[1]

How much sleep are you getting? Do you wake rested and rejuvenated?  If not, you likely didn’t sleep long enough or well enough. Ideally, you should sleep for 7-9 hours a night. If you're not sleeping well or enough, recognize this as a health problem and commit to doing something about it.  If you snore or your bed partner says you stop breathing at times, please tell your doctor to refer you to a sleep medicine specialist. 

If you're struggling with sleep problems, follow these guidelines:

         Be consistent with your bed time and awakening time as much as possible. Allow yourself a chance to unwind before hitting the pillow and plan for at least 15 to 30 minutes to fall asleep. Your body gets used to falling asleep at a certain time if you keep your bedtime consistent.

         Make sure your bed is comfortable. Since you spend approximately one-third of your life sleeping, invest in a bed that suits your body.

         Keep your room cool, especially if you're hot at night or have night sweats. Your body temperature decreases as you fall asleep, therefore, taking a hot bath and sleeping in a cool environment can enhance this. Also, keep your bedroom between 55 and 75 degrees.

         Maintain darkness since light suppresses melatonin, your sleep hormone. Even small amounts of light, such as a clock radio or streetlight shining through the window, can be enough to keep you up. If you use the bathroom in the middle of the night, try doing so in the dark or keep a small penlight next to the bed to light your way.

         Ditch the TV and computer from your bedroom. Both provide excitatory stimuli to the brain at a time when you're trying to induce a calming state. In addition, news or disturbing TV shows can occupy your thoughts, preventing you from sweet dreams.

         If you're in pain, use adequate pain management. Many people are concerned about getting "hooked" on pain medication, even though their pain keeps them up at night. If you are in pain and it keeps you from sleeping, remember inadequate sleep can prevent healing, increase inflammation, and worsen your pain. There are many different ways to treat pain, long and short-term, and you are not "weak", nor is it a sign of failure, to need pain medication in order to sleep. Talk to your doctor if pain keeps you from sleeping. You deserve to sleep as pain-free as possible, and you can always enlist the help of a pain specialist. 

         Avoid alcohol before bed. Although alcohol may help you fall asleep, you may find yourself awake a few hours later. This is because your brain becomes stimulated as the alcohol is metabolized and cleared from your blood stream. 

         Stop all caffeine after noon. The half-life of caffeine increases with aging; therefore, it can remain in your system longer as you age (up to 14 hours) and you may awaken more often during the night. 

         Don't eat a heavy meal before bed and stop fluid intake after 8:00 pm. You may experience reflux or digestive problems if you lie down with a full stomach. Stopping fluid intake in the evening can prevent awakening due to urination.

         Exercise daily! (But not within two hours of bedtime). Exercise has consistently been shown to promote healthy sleep. A word of caution: please do not sacrifice sleep for exercise. If you must choose due to time constraints, exercise for less time and sleep more. And re-evaluate your schedule to prioritize sleep and exercise over activities that consume your time without supporting your health (e.g., TV, surfing the Internet . . .) 

         Begin a "worry" and "gratitude" journal. Write down all your worries or concerns before going to sleep. Consider writing from a chair or room other than your bedroom so you avoid anchoring your bed to your worries. In addition, jot down at least five things for which you are grateful. Tell yourself you will attend to your worries the next day but that the next several hours are devoted to sleep so you can repair your body and brain. Assigning a "worry time" such as keeping a journal may help you compartmentalize concerns so you don't spend sleep time ruminating (and creating stress hormones). Keeping the things you're grateful for in your awareness will help you fall asleep with positive thoughts. Whatever it takes, do not take your worries to bed with you.

         Make sure your hormones are balanced—low estrogen and progesterone in women commonly causes sleep problems. Bioidentical oral progesterone (Prometrium^® or compounded oral or sublingual micronized progesterone ) is better at helping women fall asleep, but you should avoid it or lower your dosage if you wake feeling groggy. 

If you are genuinely adhering to the above recommendations and you still don't sleep soundly, there are many natural options that may be helpful:

         Sleep Easy (Mt. Peak Nutritionals) — 2 capsules before bed. This comprehensive formula contains precursors for serotonin, often deficient in people with sleep disorders. Also contains GABA, the primary inhibitory neurotransmitter that quiets the brain (sleep medications work by binding to the GABA receptor). Phenibut, a derivative of GABA with an added phenyl ring, allows phenibut to cross the blood-brain barrier and bind to GABA receptors. The amino acids, herbs, melatonin, and magnesium in his formula promote mental calmness, enhance muscle relaxation, and calm the central nervous system.

         Calming Tincture (formulated by Dr. Retzler) contains 50% California poppy (Eschscholzia californica) and 50% Kava kava (Piper methysticum) — 4–6 dropperfuls as needed. Contains Kava kava (Piper methysticum), shown to be anticonvulsant, antispasmodic, and to promote muscle relaxation. Several studies have found Kava kava to be useful in the treatment of anxiety and insomnia.[2] Also contains California poppy (Eschscholzia californica), a mild sedative and mood elevator, not as potent as opium or with any addiction potential. Note: tinctures are herbs extracted in alcohol; if you have a problem with alcohol, please do not use tinctures.

         Magnesium citrate or glycinate — 300–400 mg before bed helps calm the brain (by increasing GABA production) and releasing muscle tension.

         Guided visualization Sleep CD — helps your subconscious mind remember how to sleep. "Garden Sunset" is one created by Daniel Soule, Certified Health Coach.

Sleep medications can be effective but should really only be used short-term since they do not treat the underlying cause, and you may become dependent on them. However, if you need sleep medications short-term, please use them. Many doctors have seen far too many people who haven't slept well, often existing on 2-3 hours a night for years or decades  After trying numerous natural options, they often give up due to fear of taking sleep medications. These people are exhausted, depressed, usually overweight, and have significant health problems from years of sleep debt. Consider using medication for a short while if you are sleep deprived while working on the underlying cause. Sometimes, using a sleep medication for 30 days, combined with guided visualization to retrain the subconscious mind, will reset your circadian rhythm and allow you to sleep naturally again.

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[1] Taheri S, Lin L, Austin D, et al.  Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62. 

[2] Attele AS, Xie JT, Yuan CS. Treatment of insomnia: an alternative approach. Altern Med Rev. 2000;5(3):249-259.