How To Get A Good Night’s Sleep
A good night’s sleep is not always easy to come by. The secret to feeling happy and rested is not a sleeping pill, or even a good nap. The challenge of stress, sleep apnea and hormones make “Goodnight Sweetheart” impossible. But, sleeping well is a tremendous investment in your health, outlook and productivity. The following treatments will help you schedule your energy cycle and sleep better consistently.
Sleeping pills — sedatives, hypnotics, tranquilizers
Alcohol used to be the “drug of choice” for sleep problems. However, you don’t get restful sleep from passing out! Interestingly enough, most of the prescription “sleeping pills” work in the same area of the brain as alcohol and cause the same problem of crashing without getting a good night’s sleep.
Over-the-counter sleeping pills available today are all antihistamines. They block the wake up neurotransmitter called “histamine” causing people to feel sleepy. One problem with sleeping pills of any kind is that they may knock people out, but they don’t generally provide good sleep. Some of them are even dangerous.
One of my patients who lived alone and was taking sleeping pills wondered if someone was getting into his house at night because he was very meticulous, but began finding tools in the garage moved, food on the kitchen counter and stuff on the floor. One day he woke up on the kitchen floor and realized that he was sleepwalking, eating and who knows what else! His medication Zolpidem caused this. Some have even been known to get in their cars and drive while sleeping
Another issue with sleeping pills is the danger of dependence. The threat is not that you have to use them to live and survive, but rather when you stop taking sleeping pills then you have more problems sleeping.
To get a good night’s sleep, avoid sleep-assisting drugs, if possible.
Stimulants
One of the more common problems I see in my clients with sleep problems is the use of stimulants.
- Amphetamines, like those for ADHD, destroy parts of the brain and can permanently interfere with sleep.
- MSG (monosodium glutamate) is notorious for causing sleep problems.
- Also, stimulants such as caffeine found in coffee, tea, yerba mate, and so forth, interfere with sleep patterns, even if they don’t decrease the time of sleep.
Today, I see many more sleep problems because of “energy drinks.” These are very high in stimulants, while at the same time adding taurine, an amino acid to calm the brain so people aren’t shaky and nervous. The effect of these energy drinks changes the brain in the same way that excessive stress does, bringing out the weakness of the individual yet disrupt sleep patterns.
To get a good night’s sleep, avoid:
- Coffee, tea, colas
- Sugar
- MSG
- “Pep” pills
- Energy drinks
Age
Keep in mind that the need for sleep declines with age. The average teenager needs ten hours of sleep per night, but it declines from there. One elderly man told me he went to bed at 9 PM and woke up at 2 AM and couldn’t get back to sleep. I asked him how he felt during the day and he said, “No problem!” He was never tired, didn’t fall asleep reading, driving, watching TV, or sitting in meetings, and didn’t take naps. I explained that the five hours was enough for him and that he didn’t need any sleeping pills. He became irate! His rhetorical reply was, “What am I supposed to do at 2 o’clock in the morning?!!!”
If you wake up early and can’t get back to sleep, remember that if you aren’t feeling tired during the day, then that amount of sleep is enough. If you are tired, then you will need to find out why you wake up.
To get a good night’s sleep, assess your need for sleep before deciding to treat a sleep problem.
Naps
Many people like to take naps during the day, whether it is habitual, emergency, planned or power napping. There is no problem with this, but remember, the total amount of sleep needed in a day doesn’t change. So, if you find yourself unable to sleep at night, you might want to cut out the naps during the day.
To get a good night’s sleep, remember naps are included in total daily sleep time.
Sleep Apnea
Steven is overweight, has diabetes and hypertension. He comes to the office complaining of being sleepy all the time. He says he could sleep ten hours and then still wake up tired. The biggest problem is that he’s a truck driver and has had difficulty staying awake on the road.
The fastest growing sleep problem in the world is sleep apnea, which is when a person wakes up frequently at night because he stops breathing. This may happen hundreds of times every night, but the person isn’t aware of it happening at all. Usually, when they are breathing, they snore loudly. Even though they may sleep long enough, they are always tired because they don’t get enough deep sleep.
There are several sleep apnea treatments that are useful.
- There is a dental appliance that keeps the jaw forward so the airway remains open; this is helpful for some.
- Most people with sleep apnea are prescribed a CPAP (Continuous Positive Airway Pressure) machine. This is just a blower that keeps a little air pressure in the nose to keep the airway open. This works very well, but some cannot tolerate being connected to machinery all night and don’t sleep well, as a result.
- There are also physical therapists that specialize in the mouth and tongue who have success in treating sleep apnea, as well.
- I don’t recommend surgery for sleep apnea. My patients who have opted for surgery continue to have sleep apnea.
However, the best treatment strategy for sleep apnea is to lose weight. All of the other treatments work better if the patient loses weight. Most of the time, losing weight is all they need to help them sleep through the night without losing their breath. Even those who aren’t obese may benefit from losing weight to reduce or eliminate their sleep apnea. The problem is that sleep apnea also leads to obesity, which is a vicious cycle – so this weight loss must be taken very seriously.
If you want a good night’s sleep, lose weight to treat sleep apnea.
Menopause
I have found many women age 40 and up have sleep problems because of the loss of hormones.
Julia was only 35 when she started having sleep problems. Now, over 6 years later, she was getting worse. She couldn’t sleep because her mind wouldn’t shut off early in the evening. Then, when she finally did get to sleep she would wake up burning up, sweating and kicking off the covers. She came in to see me looking for a sleeping pill, but instead found out that she had a hormone imbalance. She got natural progesterone to calm her mind and natural estrogen to stop the hot flashes, which had her sleeping like a baby again.
Though hormones are sometimes needed, there are many herbal preparations that work very well for helping you get a good night’s sleep. Most contain black cohosh, red clover, and other herbs, as well as B-vitamins and minerals. Herbs work well for some; most need to try different ones to find which works best because everyone is different. Within two weeks of taking a preparation, you should notice a difference; if not, then try something else.
To get a good night’s sleep, try:
- Herbal menopause supplements
- Magnesium, 400mg at night
- Progesterone cream – use in the evening
Restless legs
Mert was in his early seventies and was having trouble sleeping. He had tried many sleeping pills, but they didn’t seem to work too well. It took a lot of questioning during several visits for me to find out that he had “Restless Leg Syndrome.” He couldn’t sleep because he had to move around and just couldn’t keep still.
Restless leg syndrome is when people feel the need to move their legs at night and just can’t relax. It is related to Parkinson’s syndrome, which is a lack of dopamine. The medical treatment is to give dopamine precursors, but these can cause Parkinson’s disease.
On the other hand, there are natural supplements that can be very useful and even diminish the chances of Parkinson’s. Mert was put on these supplements that relieved his restless leg syndrome and helped him sleep.
Restless leg syndrome is bothersome and extremely real. Fortunately, real remedies exist. Here are four natural remedies to try from Dr. Scott Saunders from our January 2011 issue on Restless Leg Syndrome.
To get a good night’s sleep, take the following before bed at night:
- Magnesium, 400mg
- Tryptophan, 500mg
- Tyrosine, 500mg
- Taurine, 500mg
Cramps
Night cramps is another similar problem to restless leg syndrome that prevents sleeping. These are most often treated with mineral supplements, which mostly seem to work well.
One patient, however, didn’t respond to any of the treatments. She had suffered with night cramps for many years, trying everything she could think of. I gave her large doses of calcium, potassium, magnesium, and amino acids, without benefit. I even gave her IV treatments in case she wasn’t absorbing them – but that still didn’t work. One day, her neighbor recommended she put a couple of bars of soap under the sheets of her bed about at the level of her legs. She did, and it worked! She has slept well ever since. When the effect wears off she just changes the soap, and it continues to work. (Many people swear this works, though we’re not sure why.)
To get a good night’s sleep:
- Use coral calcium, 1000mg per day
- Try magnesium 500mg per day, in the evening
- Eat more fresh fruit and vegetables
- Take tyrosine, 500mg at night
- Try the “soap trick”
Anxiety
Anxiety is often a culprit for difficulty sleeping. The adrenal glands make adrenaline when we are stressed which causes heart palpitations, shortness of breath and sleeplessness. The stress hormones actually change the chemistry of the brain, preventing long and deep sleep. The best way to treat this is to decrease stress. The following recommendations may be used together, or individually:
- Exercise every day
- Go to bed early, wake up at the same time every morning
- Eat nutritious food, avoid sugars and artificial sweeteners
- Write in a diary or journal
- Don’t watch television after 8 PM
- Use ginseng, eleuthero, licorice root or other adaptogens
- Take melatonin, 1-6 mg in the evening
- Get acupuncture treatments
- Get a massage
- Try a hot bath or hot tub with lavender oil
- Use 5-HTP, 100mg twice per day
Circadian Rhythm
People who travel a lot often have a hard time sleeping because their sleep-wake cycles have been disrupted, which is often known as “jet lag.” The natural hormone, melatonin, has been shown to restore a normal circadian rhythm. Use the least amount needed to get you to sleep because if you use too much, melatonin can cause grogginess in the morning.
Sleep architecture (stage and cycle components of our sleep) by design gives us more deep sleep and thus more rest in the evening, while we have more REM or light sleep in the morning. They both are needed, but if you feel tired during the day, you probably need more deep sleep. To get more deep sleep, go to bed early and wake up early. To establish this pattern, start by getting up at the same time every morning. Sometimes, this might require taking melatonin at 8 or 9 PM to change the deep sleep pattern.
To get a good night’s sleep:
- Take melatonin, 1-6 mg before bed
- Go to bed early, wake up early
A good night’s sleep
From the list above, you can see that there are many reasons we miss a good night’s sleep. To restore sound sleep, find the cause of the sleep problem before initiating treatment.
For those unable to identify any specific reason for not sleeping, I would first recommend “sleepy-time” tea, which contains chamomile, hops, Kava kava, lemon balm, and other herbs. There are several good supplements for sleep such as CALM, a powdered magnesium supplement. Consider also acupuncture, which has been shown to give better sleep than Alprazolam, a common sleeping pill.
General recommendations for a good night’s sleep:
- “Sleepy Time” tea
- CALM (powdered magnesium supplement)
- Acupuncture
- Any of the above recommendations for anxiety can be helpful.
Sleep problems are complex, and you may need to try several things before finally beginning to sleep well. If you have tried the suggestions above without benefit, consider talking to a doctor about a “sleep study,” where you are monitored all night to determine where the sleep problem is. I rarely order these, but in selected cases they have been useful.
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With the right treatment almost everyone can get a good night’s sleep. And, by the way, you’ve probably realized everything is easier when you’re well rested.