How to Get Better Sleep

Aside from fatigue, there are multiple health consequences associated with poor sleep. Inadequate sleep leads to increased cortisol, a main stress hormone, insulin resistance, higher blood sugar, increased appetite and weight gain!

Stress can elevate cortisol–> interfere with sleep–> perceived as a stress–> raises cortisol levels further.

• Less than 6 hours of sleep doubles risk of weight gain and diabetes due to excess cortisol and its interference with insulin and blood sugar regulation.
• Sleeping less than 5 hours doubles risk for hypertension. 
• The more mini wake ups you get during the night, the more cortisol that is released.
• By the time we are in our 30’s and 40’s we are getting 80% less time in the most restful slow-wave sleep as compared to our teen years, and by our 50’s and 60’s, almost no uninterrupted deep sleep. 
• Therefore the average 50-year old has night time cortisol levels much higher than the average 30-year old.

Women and Sleep

• 67% of women have difficulty sleeping at least a few nights a week.
• 46% experience sleep concerns nightly.
• 30% report using some type of sleep aid, and by the age of 50, this rises to over 40%.
• Obese women were more likely to experience sleep concerns and use sleep aids.

Suggestions for Better Sleep

If you are awakening after approximately 4-6 hours of sleep (commonly around 2-3 am), with feelings of anxiety i.e. racing thoughts, sweating, this is often due to low blood sugar (nocturnal hypoglycemia). Try eating a small meal or snack of slow-acting carbs (higher fiber), protein and healthy fat about an hour before going to bed. An example would be some almond butter on half an apple or on high fiber crackers.

Minimize or Avoid Stimulants

• Avoid alcohol (wine, beer and hard liquor) within 3 hours of bedtime.
• Avoid caffeine-containing beverages or foods after 2 pm; if sensitive to caffeine, avoid it after 12 noon.
• Avoid Sudafed or other decongestant cold medicines at night.
• Some medications may have stimulating effects. Consult your pharmacist and doctor to determine whether any of them might be contributing to sleep problems. Do not discontinue them without permission from your doctor.
• Complete any aerobic exercise before 6 pm (or at least 3 hours before bedtime).

Nighttime Tension and Anxiety

• Avoid watching the news before going to bed.
• Avoid arguments before bedtime.

Sleep Planning and Bedroom Preparation

• Plan your sleep by putting it into your schedule; plan for 8 to 9 hours in bed.
• As much as possible, go to sleep and wake up at the same time each night. This will help train your biological clock.
• Avoid getting in bed after midnight as late-hour sleep is not as helpful as earlier sleep. Melatonin, our main sleep hormone is released in the dark, so we want to take advantage of that.

Strategies to use with Trouble Falling Asleep or Staying Asleep

• Consider reading a good neutral book under low light to help with falling asleep.
• If you awaken early because of recurring thoughts, try writing them in a journal. Simply keep a pen and paper at your bedside to jot down a list of things on your mind before bed. It helps unload so that they don’t keep you awake during the night.

Bedroom Air Quality

• Keep your bedroom air clean, especially if you have nasal congestion or are prone to snoring. Use HEPA or other types of air purifiers/filters to clean the air in your bedroom.
• If your nose is congested, consider Breathe-Easy strips on your nose. Make sure you read the instructions and fit them over the lower third of your nose.

Light, Noise, Temperature, and Environmental Issues

• Turn down the light in the bathroom and in rooms you are in at least 15 minutes before going to bed.
• Decrease the light in your bedroom by using a dimmer switch.
• Use dark window shades or consider a set of eye shades or a black covering for your eyes when trying to sleep or if you awaken too early because of light.
• Decrease irritating noises in your room by closing windows, using ear plugs, or using a white noise generator or a HEPA air filter.
• Turn off or remove any appliances or clocks that make noise.
• Make sure your sleeping area is the correct temperature range (not too hot or too cold).
• Avoid sleeping near electric fields. Try to have your head at least 5 feet away from electric fields. Possible sources of electrical fields include: electrical outlets, clock radios, stereos, computers and monitors. Consider moving these devices or moving your bed or your position in the bed.
• Avoid sleeping on a water bed or using an electric blanket because of the excessive heat and the electric fields.
• Consider replacing your pillows with hypoallergenic pillows. Use allergy pillow and mattress covers.

Further Strategies for Dealing with Nighttime Tension and Anxiety

• Avoid repeated negative judgments about the fact that you are unable to sleep.
• Use positive self-talk phrases regarding your ability to relax and fall asleep:
• “I can fall asleep.” “I can relax.” “Any amount of sleep I get is just fine.”
• Try writing in your journal any disturbing thoughts that are running through your mind.

Supplements and Light and Sound Therapy

• Consider a sound machine or specialized sleep tapes.
• Consider ½ hour exposure of a blue or 10,000 lux bright light (first thing in the morning) if you are going to bed too late and want to go to bed earlier.

Here are some supplements that have been used to support better sleep, but do not start any without consulting with a knowledgeable nutrition professional as all factors, i.e. medications, lab analyses, and allergies, need to be taken into account.

1. Phosphatidylserine which helps lower night time cortisol and also has been proven to enhance memory and immune function. Also helps promote recovery from exercise.
2. Kavinace or other GABA-supporting supplements: Low progesterone in women (this is the 1^st to go before estrogen) can lead to insomnia since progesterone can lead to the release of GABA, one of the neurotransmitters that has a very calming effect. This is especially helpful for night-time awakening.
3. Valerian Root can be used to help with falling asleep. The tea seems to be the best option, but the taste (like dirty socks) is a bit offensive so many people use the capsules or liquid tinctures. Some products combine valerian with lemon balm and hops, which adds additional relaxation benefits. Many people do well with a standardized capsule 30 minutes before bedtime, and may try a tincture form if they awaken and cannot fall back to sleep in the middle of the night. It is not habit-forming and doesn’t result in am drowsiness, but it can be sedating for a few hours after taking it, so not recommended after 3-4am and can interact with certain medications.
4. Passionflower: Often used for sleep disorders, restlessness, and anxiety.
5. Hops: Also effective as a sleep enhancer, especially in combination with other herbs like Valerian and Passionflower.
6. German Chamomile: Used for mild sleep disorders, GI upset, as well as skin and mucous membrane inflammation, ie in facial steamers for sinusitis as well as on inflamed gums.
7. Melissa Officinalis: Especially helpful in individuals who find it hard to sleep due to anxiety-induced palpitations.
8. Magnesium-Can have a calming effect due to its ability to act as a muscle relaxant. It can also help with the muscle cramps that some people experience during sleep and that can be very interruptive.
9. Epsom salt baths are a way to absorb magnesium through the skin and combined with the bath this is often reported to be very helpful.
10. 5HTP, a precursor to serotonin, which is the brain chemical that medications like Prozac work to enhance. Typically used to relieve mild depression, insomnia, promote weight loss, and reduce feeling of stress and pain, such as migraine headaches and general muscle pain.
11. Theanine reduces levels of anxiety-related brain chemicals, during the day and in the evening. This is one of the healthy components of green tea but is destroyed with decaffeination so best taken in supplement form.
12. Melatonin levels can decrease dramatically with age and with disease. Night shift workers are at increased risk for breast cancer due to the effect of their schedule on impairment of circadian rhythm and ultimately impaired melatonin secretion.