Julian Whitaker, MD
Do you have problems falling asleep? How about waking up in the night unable to go back to sleep? If you do, join the club. Nearly one-third of all Americans suffer with some form of insomnia. It’s important to get a handle on this condition, for the consequences of poor sleep go far beyond feeling drowsy during the day.
More Than Being Groggy
Sleep deprivation impairs cognitive function and mental alertness and can actually affect reaction time and judgment to a degree similar to drinking alcohol. In fact, depression, anxiety, low sex drive, hyperactivity, and attention deficit are all linked to poor sleep.
Inadequate sleep may even make you fat. After surveying more than 9,000 Americans, researchers from Columbia University found that people who slept for four hours or less each night were 73 percent more likely to be obese than those who regularly got seven to nine hours of shuteye. People who slept only five hours were 50 percent more likely to be obese than their well-rested counterparts, and those getting six hours of sleep—which is considered to be pretty normal these days—had a 23 percent greater risk.
It gets worse. Sleep deprivation depresses your immune response and increases susceptibility to infection. Poor sleep is also linked with increased risk of diabetes, high blood pressure, heart disease, stroke, and even death. That’s why I urge you to take action now to uncover what’s behind your sleep problem and take steps to correct it.
So Why Aren’t We Sleeping?
For many people, the inability to sleep doesn’t seem to be caused by anything. In fact, a panel formed by the National Institutes of Health recently deemed insomnia a stand-alone condition. However, a number of factors can contribute to it.
First, look at the drugs you’re taking. Many prescription and over-the-counter medications, including some pain medications, drugs for attention deficit disorder, weight loss pills, amphetamines, and nasal decongestants contain stimulants that can keep you awake, especially when taken too close to bedtime. (The same goes for caffeine, alcohol, and tobacco.) Diuretics, commonly used to treat hypertension and heart failure, disturb sleep because they cause frequent urination, and antidepressants count insomnia among their many side effects. All of these drugs can be replaced with safer, equally effective natural therapies that do not interfere with sleep.
Second, rule out medical conditions that may disturb your slumber. Restless leg syndrome, characterized by unpleasant sensations in the legs, makes it hard to fall asleep. Prostate enlargement , which is as common in older men as gray hair, causes nighttime awakenings for trips to the bathroom. For women in menopause, hot flashes and night sweats can ruin sleep. Depression and anxiety can also leave you tossing and turning at night. The good news is that all of these conditions can be addressed, and once they are, you can often say goodbye to sleep problems.
Rule Out Sleep Apnea
The most serious sleep-related medical condition, and one I am intimately familiar with, is sleep apnea. If you snore, chances are you are one of the 12 million Americans who have this problem. Befitting its name (apnea comes from the Greek word meaning “without breath”), obstructive sleep apnea occurs when the fleshy tissues at the back of the throat relax and block the airway, causing you to stop breathing. The brain, sensing oxygen deprivation, sends signals that wake you enough to take a breath.
This not only makes getting a good night’s sleep impossible, but also leads to a number of very serious problems. Sleep apnea triples your risk of hypertension, more than doubles your risk of stroke, and quadruples your risk of arrhythmia. It raises levels of C-reactive protein (an indicator of inflammation) and markers of oxidative stress, and is closely linked with obesity. It also interferes with insulin sensitivity and quintuples your risk of diabetes.
Fortunately, sleep apnea is treatable. I used to snore like a freight train until I discovered I had sleep apnea and got treatment. Now, I use an automatic positive airway pressure (APAP) machine, which gently blows a constant stream of air through a small mask and prevents the tissues in my throat from collapsing. I have to tell you it has changed my life. I sleep like a baby and wake up rested and invigorated. My wife loves it too—no more snoring or worrisome episodes where I would literally stop breathing.
At the Whitaker Wellness Institute, we screen patients whom we suspect may have sleep apnea, or conditions resulting from it, with an inexpensive test that records pulse, blood oxygen, and air flow levels periodically during the night via a small clip-on sensor and mask. If this test is suggestive of sleep apnea, we recommend APAP or CPAP (continuous positive airway pressure) or, in rare cases, refer them to a specialist for a sleep study.
Stay Away From Sleeping Pills
If you don’t have a reversible medical problem underlying your insomnia, your doctor will likely prescribe a drug to help you sleep. Millions and millions of prescriptions are written each year for Ambien, Sonata, Lunesta, and the like. More than six percent of adults over the age of 65 are use prescription sleep drugs—a 16 percent increase since 2000.
Worse still, the number of children and young adults taking these prescriptions has nearly doubled. Frighteningly few of these drugs have been subjected to trials lasting more than six weeks, and many carry labels warning they are for short-term use only. Yet countless patients use them on a regular basis, sometimes for months or even years at a time.
The addiction factor aside, these drugs come with a host of side effects, especially for people over the age of 60. In fact, a meta-analysis published in the British Medical Journal showed that the risks of sedative hypnotic drugs far outweighed the benefits. Particularly disturbing is the significantly increased risk of adverse events such as falls (which land over a million and a half people over the age of 65 in the emergency room annually) and cognitive impairment. For a group of people already susceptible to these events, the added risk simply isn’t worth it.
Natural Sleep Aids
Fortunately, there are a number of natural remedies that have been used for years to battle insomnia with impeccable safety records and unquestionable efficacy. Here are a few of my favorites.
L-theanine is an amino acid derived from green tea. Renowned for its calming effects, L-theanine works by enhancing alpha-wave activity in the brain, which results in relaxation, and by increasing levels of gamma amino butyric acid (GABA), a neurotransmitter that calms the brain down and helps relieve anxiety.
Valerian (Valeriana officinalis) is the most common sleep aid in Europe, and studies suggest that this herb works as well as prescription drugs, without the side effects. Like L-theanine, it helps relieve anxiety by working on GABA pathways, but it also has a mild sedative effect that helps you fall asleep more quickly. In some studies, valerian is used in combination with hops. Although hops is best known as an ingredient in beer, it is an approved therapy in Germany for insomnia and nervousness.
Melatonin has long been one of my top recommendations for sleep. Produced naturally in the pineal gland, melatonin is the hormone that regulates your circadian rhythms, or “body clock.” As darkness falls, melatonin secretion rises, signaling your body that it’s time to sleep. After the age of 40, melatonin levels decline, which is one reason so many older people have trouble falling and staying asleep. In addition to facilitating sleep, melatonin is also useful for jetlag, and it’s a potent antioxidant that protects against disease. The best thing about these natural sleep aids is that, in addition to working, they are safe. You’re not going to wake up feeling groggy, nor are you going to get addicted to them. This approach has helped countless Whitaker Wellness patients improve their energy, mood, concentration, productivity at work, personal relationships, and overall health. That’s how important a good night’s sleep is.
- To set up an appointment for diagnosis and treatment of sleep apnea and other sleep disorders, call the Whitaker Wellness Institute at (866) 944-8253.
- The suggested doses of the natural sleep aids discussed in this article are: 200 mg L-theanine, 250–500 mg valerian, 120 mg hops, and 1–3 mg melatonin. They may be taken individually or in combination. Take 30 minutes to an hour before bedtime, preferably on an empty stomach. You can find these products in your health food store or order by calling (800) 810-6655.
- Glass J, et al. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ. 2005 Nov 19;331(7526):1169.
- NAASO, the Obesity Society. Lack of sleep leads to excess weight. http://www.naaso.org/news/20041116.asp.
Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2000. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.