Habitual sleeplessness is classified as insomnia. Failure to get an entire night’s sleep on most nights over a one-month period can be considered chronic insomnia. It affects one out of ten Americans (about 40 million) and at least 30 percent of healthy seniors. In a National Institute on Aging study of more than 9,000 people aged sixty-five and over, more than half of the men and women reported frequent trouble sleeping. Insomnia can take the form of being unable to fall asleep when you first go to bed or waking during the night and being unable to go back to sleep.
While insomnia can be very frustrating, it is usually only a temporary annoyance. In some cases, sleep-related problems can last for months or even years.
Chronic insomnia is often a symptom of a serious underlying medical disorder. Fifty percent of insomnia cases can be attributed to depression and psychological disorders, such as anxiety, stress, or grief. Insomnia can also result from a wide variety of physical causes, including arthritis, asthma, breathing problem, hypoglycemia, hyperthyroidism, indigestion, kidney or heart disease, muscle aches, Parkinson’s disease, or physical pain. Caffeine consumption, jet lag, and the use of certain drugs, including many antidepressants, the antiseizure medication phenytoin (Dilantin), most appetite suppressants, beta-blockers (medications used for high blood pressure and heart ailments), the decongestant pseudoephedrine (found in many cold and allergy remedies), and thyroid hormone replacement drugs can also lead to insomnia.
A lack of the nutrients calcium and magnesium can cause you to wake up after a few hours and not be able to return to sleep. Systemic disorders involving the brain, digestive system, endocrine system, heart, kidneys, liver, lungs, and pancreas all may affect sleep, as can poor nutritional habits and eating too close to bedtime. A sedentary lifestyle can be a major contributor to sleep disorders.
While one or two sleepless nights can cause irritability and daytime sleepiness, with decreased ability to perform creative or repetitive tasks, most people can adapt to short-term periods of sleep deprivation. After more than three days, however, sleep deprivation begins to cause a more serious deterioration in overall performance and can even result in mild personality changes. If chronic, inadequate sleep compromises productivity, create problems in relationships, and can contribute to other health problems.
Normal sleep consists of two main states, designated rapid-eye-movement (REM) and non-rapid-eye-movement (non-REM) sleep. It is REM sleep that is most often associated with dreaming. The stages of sleep are further broken down as follows:
- Stage 1: Light sleep. We drift in and out and can be awakened easily. Our eyes move slowly, and muscle activity slows.
- Stage 2: Light sleep. Our eye movement stops, and our brain waves become slower, with occasional bursts of rapid waves called sleep spindles.
- Stage 3: Deep sleep. Extremely slow brain waves called delta waves appear, interspersed with smaller, faster waves.
- Stage 4: Deep sleep. The brain produces mostly delta waves. There are no eye movements and no muscle activity.
- Stage 5: REM sleep. Breathing becomes more rapid, irregular and shallow. The eyes jerk rapidly while limb muscles become temporarily paralyzed. Dreams almost always happen in this stage but may occur in other sleep stages.
It takes about two hours to go through all the five stages of sleep, after which they are normally repeated. REM sleep usually occurs about ninety minutes after we fall asleep. Adult spend half their sleep time in Stage 2 sleep, 20 percent in REM sleep, and 30 percent in other stages. Infants start out spending about half of their sleep time in REM sleep.
There are 4 stages to non-REM sleep, and the deepest two (stages three and four) are referred to as delta sleep. Older people spend less time in delta sleep, and some may not experience it at all.
There are no hard and fast rules about how much sleep is enough, because every individual’s requirements are different. Some people can function on as little as five hours of sleep a night, while others seem to perform better with nine, ten, or more hours of sleep. Most adults need about eight hours of sleep nightly in order to feel refreshed and function at peak efficiency during the day. Children, especially very young children and adolescents generally require more sleep than adults to be at their best. It is not uncommon for people to sleep less as they get older, especially after the age of sixty. The cardinal sign of a sleep problem requiring a doctor’s attention is inappropriate sleepiness, such as dozing off at the dinner table, during conversation, or while driving. Even dozing off in front of a television can be a warning sign that something is amiss with the body’s internal clock.
Millions of people have trouble getting to sleep due to a condition commonly known as restless leg syndrome (RLS). For reasons unknown, when people are in bed, their legs jerk, twitch, and kick involuntarily. Restless leg syndrome has also been linked to the painful nighttime leg muscle cramps that afflict so many people. A deficiency of magnesium may be involved in RLS, and some research strongly suggests that anemia may play a major role in this annoying disorder.
Sleep apnea affects 20 million Americans and is potentially serious sleep disorder. This problem is commonly associated with snoring and extremely irregular breathing through the night. In sleep apnea, breathing actually stops for as long as two minutes at a time while the individual is as sleep. When breathing stops, the level of oxygen in the blood drops, resulting in oxygen deprivation. The individual then awakens, startled and gasping. A person with sleep apnea may awaken as many as two hundred times throughout the night. The affected individual may not remember these awakenings, but anyone else who is awake at the time can be naturally become alarmed when the person with sleep apnea stops breathing. In the less common form, central sleep apnea, breathing is stopped, not because the airway is closed, but because the diaphragm and chest muscles stop working.
Aside from disrupting normal sleep and causing extreme sleepiness during the day, sleep apnea associated with other, more serious. health problems. People who have sleep apnea tend to have higher than normal blood presure and are more likely to have strokes than the general population, and they also face an increased risk of heart disease, although the reason or reasons for these links are not known. People with sleep apnea also seem to have a higher-than-normal incidence of emotional and psychotic disorders. Experts attribute this to what they call a “dream deficit” – a lack of adequate rapid-eye-movement (REM) sleep, the stage of sleep in which dreaming occurs. A person with sleep apnea often cannot settle into REM sleep for even the eight to twelve seconds it takes to have a normal, healthy dream. While there is much about the phenomenon of dreaming that is not understood, it is known that prolonged periods of sleep deprivation can induce various psychoses and other serious emotional disorders.
Unless otherwise specified, the dosages recommended here are for adults. For children between the ages of twelve and seventeen, reduce the dose to three-quarters the recommended amount. For children between six and twelve use one-half the recommended dose, and for children under the age of six, use one-quarter the recommended amount.
|1,500 – 2,000 mg daily, in divided doses, after meals and at bedtime.
1,000 mg daily
|Has a calming effect. Use calcium lactate or calcium chelate form (do not use calcium lactate form if you are allergic to dairy products).
Needed to balance with calcium and relax the muscles.
|Melatonin||Start with 1.5 mg daily, taken two hours or less before bedtime. If this is not effective, gradually increase the dosage until an effective level is reach (up to 5 mg daily).||A natural hormone that promotes sound sleep. Use it ony occasionally and do not give it to children.|
|Vitamin B complex
plus, extra pantothenic acid (vitamin B5)
|As directed on label.
50 mg daily.
100 mg daily, at bedtime.
100 mg daily.
|Help to promote a restful state.
Good for relieving stress.
Enhance REM sleep.
Promote serotonin production.
|Vitamin C with bioflavonoids||500 mg daily.||Very important for reducing stress.|
|Zinc||15 mg daily.||Aids in the recovery of body tissues while sleeping.|
Herbs For Insomnia
- California poppy, hops, kava kava, lemon balm, passionflower, skullcap, and valerian root, taken in capsule or extract form, are all good for helping to overcome insomnia. Valerian root has become the favorite among many experts. It is best not to reply on one herb on a regular basis, but to rotate among several. Take these herbs before bedtime.
- The combination of California poppy and passionflower, and valerian promote sound sleep and benificial REM sleep. California poppy and chamomile will strengthen the nervous system to calm you before bedtime.
- Catnip and chamomile have mild sedative properties. These herbs are safe even for children if taken in tea form. For adults, drinking chamomile tea several times throughout the day helps to calm and tone the nervous system, promoting restful sleep.
Caution: Do not use chamomile on an ongoing basis. Avoid it completely if you are allergic to ragweed.
- Kava kava is a good relaxant. If stress or anxiety is the reason for your insomnia, this herb can help you develop better sleep patterns.
- A combination herbal extract such as Slumber from Nature’s Answer or Silent Night from Nature’s Way can be helpful.
Natural Health Recommendations For Insomnia
- In the evening, eat bananas, dates, figs, milk, nut, butter, tuna, turkey, and whole grain crackers, or yogurt. These foods are high in tryptophan, which promotes sleep. Eating a grapefruit half at bedtime also helps.
- Do not eat large meals within two hours of bedtime.
- Avoid caffeine, alcohol, and nicotine in the four to six hours before bedtime. A small amount can help induce sleep initially, but it invariably disrupts deeper sleep cycles later. While smoking may seem to have a calming effect, nicotine is actually a neurostimulant and can cause sleep problems.
- Avoid heavy meals three hours before bedtime.
- Avoid bacon, cheese, chocolate, eggplant, ham, potatoes, sauerkraut, sugar, sausage, spinach, tomatoes, and wine close to bedtime. These foods contain tyramine, which increases the release of norepinephrine, a brain stimulant.
- Avoid taking nasal decongestants and other cold medications late in the day. While many ingredients in these preparations are known to cause drowsiness, they can have the opposite effect on some people and act as a stimulant.
- Establish a set of habits and follow them consistently to establish a healthy sleep cycle.
- Go to bed only when you are sleepy.
- Do not stay in bed if you are not sleepy. Get up and move to another room and read, watch television, or do something quietly until you are really sleepy.
- Use the bedroom only for sleep or sex – not for reading, working, eating, or watching television.
- Keep a regular sleep-wake cycle. Try to go to bed and wake up at the same time every day.
- Set an alarm clock and get out of bed at the same time every morning, no matter how you slept the night before. Once normal sleep patterns are reestablished, most people find that they have no need for an alarm clock.
- Sleep in a dark, quiet room with a comfortable temperature.
- Do not nap during the day if this isn’t a normal thing for you to do. Especially avoid napping later than 3:00 pm.
- Exercise regularly in the late afternoon or early evening – but not within two hours of bedtime. Physical exersion is an excellent way to make your body tired so that sleep comes about more easily. Exercising five or six hours before bedtime may help you sleep more soundly.
- Take a hot bath (not a shower) an hour or two before bedtime. For further relaxation, put several drops of a soothing essential oil such as chamomile if you are not allergic to ragweed) in the bath water.
- Keep the bedroom comfortable and quiet. If too much quiet is the problem, try running a fan or playing a radio softly in the background. There are also devices available that generate “white noise” sounds like the ocean surf or a steady rain that help people who are “quiet-sensitive” to sleep.
- Learn to put worries out of your mind. If you have occasional trouble getting to sleep, concentrate on pleasant memories and thoughts. Re-create a pleasurable time or event in your life and relive it in your mind. Learning a relaxation technique such as medication or the use of guided imagery is extremely helpful in getting sleep patterns back to normal for many people.
- For occasional sleeplessness, try using melatonin, Calcium Night from Source Naturals, or one of the herbs reccommended above. These are effective and safe sleep promoters.
- One of the best remedies for insomnia is taking 5 milligrams of melatonin one hour before bedtime. If you feel groggy in the morning, reduce the dosage the next time you use it. Certain drugs frequently prescribed for older adults, including beta-blockers (for high blood pressure) and even aspirin, can lower melatonin levels.
Caution: Don not overuse melatonin. According to some recent reports, more than occasional use melatonin can permanently stop the body’s own production of this vital hormone.
- If you snore, try sleeping on your side. Sleeping on a couch for a few nights to become accustomed to sleeping on your side.
Other Considerations For Insomnia
- During sleep, the body’s systems are still controlling basic functions. Nutrients are essential for the body and are used during the sleep cycle.
- A lack of sleep can encourage serious illness and cause premature aging. Experts recommend eight hours of sleep per night.
- Women’s Health Advisor reports that an estimated 10 percent of all Americans suffer from restless leg syndrome (RLS), a disorder marked by uncomfortable urges to move the legs, especially just before falling asleep. Various treatments have been attempted for restless leg syndrome, but nothing seems to work for everyone. The drugs pramipexole (Mirapex) has shown positive benefits for some people with this condition. If you have restless leg syndrome, see your doctor to rule out anemia. We believe that taking proper vitamin and mineral supplements is the best approach to this problem. The supplements that help this condition more than anything are calcium, potassium, magnesium, and zinc. The following nutrients may prevent restless leg syndrome and leg cramps: 400 milligrams of B complex, 1,000 milligrams of magnesium, and 200 international units of vitamin E (d-alpha-tocopherol) per day.
- Regardless of how many hours of sleep you get each night, if you wake up easily in the morning, and especially if you rarely (or ever) need the services of your alarm clock, and if you can make it through the entire day without seeming to run out of steam or feeling drowsy after sitting quietly or reading for a while, you are probably getting enough sleep.
- Research psychologist Dr. James Penland believes that a large number of women are suffering from copper and iron deficiencies, and that these deficiencies can cause insomnia. A hair analysis can reveal whether you have a deficiency. (See HAIR ANALYSIS in Part Three)
- The hormonal shifts that occur during premenstrual syndrome and menopause may trigger insomnia. Estrogen affects the production and balance of the brain chemicals responsible for wakefulness.
- 5-Hydroxy L-tryptophan (5-HTP) and the amino acid tryptophan are helpful for insomnia and depression.
- Dehydroepiantrosterone (DHEA) is a naturally occuring hormone that improves the quality of sleep.
- Anybody who snores excessively should be evaluated for sleep apnea. Many cases of sleep apnea response to such measures as allergy treatment, weight reduction, or a simple laser surgery procedure to remove obstructions in the nasal passages.
- Mild cases of obstructional sleep apnea can sometimes be treated with lifestyle and diet changes. Oral devices are available for mild cases to prevent obstruction of the airway by holding the tongue or jaw forward.
- An effective treatment for snoring is the use of radio waves to reduce the soft palate tissue that obstructs the air passage in the mouth. In this technique, a healthcare practitioner inserts a probe into the back of the mouth and the radio waves are directed at the palate.
- Millions of Americans consciously choose to skimp on their sleep in the mistaken belief that sleeping fewer hours allows them to be more productive. Many people even look on the fact that they can “get by” on so few hours of sleep as a badge of honor. In fact, however, they are likely doing themselves a great deal of harm in the long run. Moreover, the night owls who sleep less to accomplish more are actually less creative and less productive than those who get adequate amount of sleep. Dr. Richard Bootzin, professor of psychology and director of the insomnia clinic at the University of Arizona Sleep Disorders Center, conducted long-term research into normal sleep habits and patterns. He discovered that people who get seven to eight hours of sleep each night live longer, happier, healthier lives than those who skimp on their sleep.
- Sleep therapists and other experts are greatly divided about the virtues of napping. While some maintain that napping is not necessary for people who are well rested, others say it is a natural human tendency and should not be discouraged. There have been studies that seem to demonstrate that productivity is higher and the incidence of accidents lower in countries where napping is common.
- Consistency is probably the most important factor for healthy sleep. While it is usually most advisable to consolidate all sleeping into one time period, if you regularly take an afternoon nap and you do not suffer from any sleeping disorders, then giving up naps might actually cause a disruption in your sleeping habits. If you nap, keep your naps short – less than an hour – and make sure that they are a regular part of a daily routine, not a now-and-then proposition.
- Sleep experts advise that people with insomnia avoid caffeine, but many people who are accustomed to drinking coffee late in the day and in the evening hours have been known to have their sleep cycles disrupted if they give up drinking coffee. This seem to bear out idea that maintaining a steady routine is the most important factor in established a healthy sleep pattern. Of course, this apply only to those who are not experiencing any difficulties with their sleeping habits. Anyone who develops a bout of insomnia should consider eliminating all caffeine from his or her diet.
- Many people who suffer from insomnia resort to taking sleeping pills, whether over the counter or prescription medications. Sleeping pills do not insomnia, and they can interfere with REM sleep. The continued use of pharmacological sleeping aids can eventually lead to disruption of all the deeper stages of sleep. Researchers have found that up to 50 percent of people who take sleeping pills on a regular basis actually find that their insomnia becomes worst. The persistent use of sleeping pills also leads to dependency, either psychological or physical. The use of sleep medications should be therefore be reserved for those who insomnia has a physical basis, and then only as a temporary solution.
- Tranquilizers like the benzodiazepines and similar medications are being prescribed for insomnia because they pose a lower risk of overdose than sedatives. The most prescribed include quazepam (Doral), estazolam (ProSom), flurazepam (Dalmane), temazepam (Restoril), and triazolam (Halcion). Triazolam can cause mental confusion and even amnesia. There have also been reports that drugs such as temazepam, secobarbital (Seconal), flurazepam and diazepam (Valium) may lead to confusion, sluggishness, restlessness, and heightened anxiety, as well as prolonged sedation and drug dependency.
- Zolpidem (Ambien) and Eszopiclone (Lunesta) are a different type of prescription sleep-aid drug. Their manufacturers claim that they do not inhibit or disrupt the deep sleep cycles, like REM.
- People who take sleeping pills on a regular basis are 50 percent more likely than other people to die in accidents. Drowsiness accounts for 200,000 to 400,000 automobile accidents every year and is responsible for two-thirds of all industrial mishaps, most common among shift workers in the early morning hours. Sleeping pills are also the third most commonly used means in suicide and are implicated in one-third of all drug-related suicide attempts and deaths.
- Over the counter sleep aids can cause a wide range of side effects, including agitation, confusion, depression, dry mouth, and worsening of symptoms of enlarged prostate, Check with your doctor before using over the counter sleep medicines for short-term insomnia. These drugs use sedating antihistamines to make you drowsy. Examples include diphenhydramine (in Nytol and other products) and doxylamine (Unisom and others). People with breathing problems, glaucoma, or chronic bronchitis; women who are pregnant or nursing; and men who have difficulty urinating due to an enlarged prostate should not use these medicines. People with sleep apnea should not take sleep-promoting medicine because it could suppress their respiratory drive, making it harder to wake up when they experience episodes of interrupted breathing.