The basic tenets of Naturopathic Medicine include a whole foods diet, pure water, fresh air, exercise, sunlight and adequate rest. Yet, despite one’s best efforts to maintain a healthy lifestyle, consistently good sleep remains elusive for many people who suffer with insomnia.
Insomnia is a disruption of our sleep/wake cycle and can be chronic, intermittent or transient. Some people have difficulty falling asleep or staying asleep. Others simply do not feel rested upon waking or wake too early. Transient insomnia only occurs for a short duration and is usually related to mental/emotional stressors. It may last for a few days to a week before returning to a normal sleep pattern. Intermittent insomnia occurs on and off but occurs frequently enough to be a concern since sleep patterns are noticably interrupted and the effects of sleep deprivation can be felt throughout the day. Chronic insomnia is defined by interrupted sleep on most nights lasting longer than one month.
I always ask my patients about the quality and duration of their sleep. Adequate rest and deep sleep play a crucial role in our health and longevity. We know for a fact that shift workers do not live as long as those who work during the day. Melatonin is highest at night and contributes to the body’s ability to repair and heal itself during sleep. Sleep is vitality important, not only to feel rested the next day, but also to increase the quality and years of our lives.
Melatonin is the hormone most associated with sleep. It is secreted by the pineal gland located in the center of the brain. The pineal gland receives input from the environment through the eyes. As the day dims, melatonin output increases and induces a desire for sleep. When the sun rises, melatonin production goes down and cortisol increases.
In addition to inducing sleep, melatonin is also one of our most potent antioxidants. Unlike many anti-oxidants, melatonin can permeate all cells and provides protection to the nucleus of the cell which is the central structure that contains our DNA. When the nucleus of the cell is protected from free radical damage, it maintains the ability to repair itself. If the nucleus of a cell becomes damaged it can either die or mutate to form a cancer cell. Studies have shown that cancer patients typically have very low levels of melatonin.
So how do we enhance our own melatonin secretion so that we can ease into a state of peaceful slumber? Here are a few suggestions: 1) when the sun goes down, turn the lights down in your home to bring a sense of calm; 2) no computer work late into the evening; 3) eat a small snack containing some carbohydrates one hour before bed – this increases serotonin levels which in turn increases melatonin; 4) remove all ambient light from your bedroom; 5) spend time outdoors in the daylight hours to create a sharp contrast between day and night. If enhancing your own melatonin does not work, you can supplement with melatonin in a variety of different forms. For those who have difficulty falling asleep, taking 1-3mg of melatonin 1 hour before bed may do the trick. For those who have difficulty staying asleep, a prolonged release form of melatonin may be more effective. Melatonin comes in sublingual, chewable and tablet form. Sublingual and chewable forms may have better absorption.
It is also important to assess adrenal/HPA axis function by looking at the cortisol rhythm throughout the day. This is easily done through a salivary test assessing cortisol and DHEA levels. BioHealth Laboratory offers Adrenal/HPA Axis tests measuring cortisol, DHEA, sex hormones and melatonin. The Adrenal or HPA Profile #205 is the best test to start with and will measure all of the steroid hormones and melatonin. Adrenal fatigue or HPA axis dysfunction can contribute to insomnia through a disruption in the cortisol rhythm. Cortisol is highest in the morning and decreases as the day goes on. If cortisol is high during the night, it will be difficult to maintain a good night’s sleep since this is the hormone that prepares us for action. Conditions that can raise cortisol during the night are hypoglycemia, chronic pain, stress and infections. Supporting the adrenals through the use of pregnenolone, DHEA, licorice root, pantothenic acid and other B vitamins, vitamin C, glandulars and adaptogenic herbs can help to bring the adrenals back into balance. There are many adrenal support products that contain a combination of the above listed items.
It is crucial to maintain a healthy diet rich in a variety of fruits and veggies, quality protein and fat, nuts, seeds and high fiber carbs. Eating a lighter meal in the evening followed by a small snack one hour before bed is optimal. Creating a nighttime ritual of taking a soothing bath with Epsom salts, meditation and/or reading can help one transition between day and night allowing the body to disengage from the events of the day. Products containing valerian, passionflower, kava kava, GABA, 5-HTP and L-theanine can also induce relaxation. If you’re dying for a good night’s sleep, try some of these suggestions. I hope you find them helpful.
Tracy Tranchitella, ND is a Naturopathic Physician at Sunrise Complementary Medical Center in Bend, Oregon. If you would like more information about Dr. Tranchitella and Sunrise Center, please call 951-461-4800 or visit our website at www.mysunrisecenter.com
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