APRIL 2013 - Natural Medicine & Insomnia

Over the past century insomnia has become a common problem in Western societies. With the increase of artificial lights, T.V. and computer activities, social and economic pressures, sleep has become disrupted and shortened. Sleep deprivation results in a sleep deficit, which needs to be repaid by the body at a later stage. This ‘sleep debt’ is usually compensated by sleep-ins on weekends or catnaps through the day. However, this causes a change in the body’s normal circadian rhythm, resulting in early waking, broken sleep and difficulty falling asleep (Bittencourt, et al. 2012).

There are many types of sleep disorders including Insomnia, Sleep Apnoea, Narcolepsy, Sleep Walking and Night Terrors. The focus of this article will be on insomnia, its different causes and natural treatments.

Stress and Insomnia:

Cortisol is the hormone secreted by the adrenals (stress organs) and is an important hormone connected with healthy sleep cycles. Its level begins to rise 2-3 hours after sleep onset and will continue to rise into the early morning. Healthy cortisol levels peak at 9am and will begin to decline as the day progresses. With the onset of sleep, cortisol is at its lowest point. Cortisol can act as a stimulator or an inhibitor. During high periods of stress cortisol levels increase, causing a disruption of the body’s circadian rhythm. It can cause frequent waking and increase light sleeping. Night time waking is associated with spontaneous cortisol secretions, followed by cortisol inhibition, which also may play a role in sleep apnoea (Hudson 2011).

People suffering depression tend to have high levels of cortisol in the evening, resulting in high energy levels at night and lower energy in the morning (Hudson 2011).

Nocturnal Hypoglycemia:

Avoid nocturnal hypoglycemia (low blood sugar at night).  When blood sugar levels drop, specific hormones are released that stimulate the brain signaling that it is time to eat (Osiecki 2006).  

Menopausal Insomnia:

Menopausal women often have disrupted sleep cycles due to the decline in oestrogen and progesterone production. Oestrogen is thought to reduce spontaneous sleep arousals, whereas progesterone works as a sedative, due it being a GABA antagonist (Balk 2011). Progesterone has also been demonstrated to be a mild respiratory stimulant, which may be useful in mild obstructive sleep apnoea (Balk 2011). Melatonin levels may decrease prior to the onset of menopause. Normal melatonin circadian rhythms are initiated by darkness and its peak levels are between 2am and 4am. Light inhibits its production and therefore should be avoided from 6pm onwards (Balk 2011).

Prescriptive melatonin is available through some GP’s or alternatively you can try homeopathic melatonin.

Irregular Working Hours (Night Shift or Alternating Shifts):

The problems surrounding night and alternating shift workers are due to three important factors.  These include: an interruption to the body’s biological circadian rhythm and environment cycle (peak in melatonin levels); sleep duration is shorter or fragmented; and prolonged wake cycles causing a propensity for greater sleep debt (De Almondes and Araujo 2011). Night and alternating shift workers are more likely to suffer from high cholesterol and triglyceride levels; susceptible to obesity and cardiovascular disease. Stress, depression, anxiety, social isolation, appetite disorders and gastrointestinal disturbances are also commonly seen in these people (De Almondes and Araujo 2011).

Sleep Management:

·         Establish a set of habits and follow them consistently. These include setting regular hours or a relaxing bedtime routine that will allow you to unwind.

·         Exercise regularly, a minimum of 30 minutes daily or 3 hours per week. However, avoid stimulating exercise before bed.

·         Avoid exposure to bright light before bed time

·         Have a relaxing warm (not hot) bath with Epsom salts and relaxing essential oils.

·         Avoid using your bed for anything other than sleep. Your bed should be associated with sleep. (No T.V. and eating in bed)

·          Consider your sleep environment. Make your bedroom a private sanctuary including comfort, darkness, temperature and quietness. Limit or eliminate disturbance by others and pets

·         Go to bed only when you’re sleepy

·         Rise at a consistent time each day (use an alarm clock but face it away from you)

·         Avoid eating too close to bed time.

·         Increase daylight exposure, a minimum of 3 hours.

·         Avoid alcohol, stimulating drinks, tobacco and excessive liquids before bed.

·         Consume no more than 2 serves/cups of coffee, tea, cola drinks and chocolate daily; avoid after 3pm.

·         Keep a sleep diary: note time spent asleep verses time in bed.

Aromatherapy:

·         Bedtime Remedy: 1 drop of chamomile, 1 drop of Lavender, 10ml base cream. Massage into soles of feet.

·         Aromatherapy Sleeplessness: 2 drops of Lavender, 1 drop of sandalwood, 10ml of vegetable glycerine.  Add to a warm bath and agitate water to disperse. Combine with soothing music for highly effective results.

Nutritional Supplementation:

·         Supplementation of the amino acid l-tryptophan can help increase serotonin levels and thus melatonin production (Balk 2011). Foods containing l-tryptophan are also beneficial, however will not provide a therapeutic result. Some of these foods include: beef, legumes, cottage cheese, fish, lentils, oats, pumpkin seeds and sesame seeds (Osiecki 2009).

·         Vitamin B6: low levels of B6 have been shown in some people who suffer from insomnia. Vitamin B6 is required to synthesize hormones including serotonin, GABA and dopamine. Dreaming has also been associated with healthy B6 levels (Osiecki 2009).

·         Magnesium: works as a muscle and nervous system relaxant. Low levels of 250mg taken daily can help aid in sleep (Osiecki 2009).

Herbal Medicine:                 

·         Passiflora incarnate (Passionflower): is a wonderful herb to use to aid in sleep. It has demonstrated sedative effects and contains the active constituent harmine. Harmine is thought to inhibit the breakdown of serotonin, therefore regulating melatonin production (Bone 2003).

Homeopathic Medicine:

·         Coffea cruda 6C or 30C: this remedy is particularly useful for people who experience sleeplessness due to excessive mental energy. It is also highly beneficial for people who become wide awake at 3am (Reichenberg-Ullman and Ullman 2010)

References:

• Balk, J. (2011). Melatonin for Menopausal Sleep Disorders and Quality of Life. Alternative Medicine Alert: The Clinician’s Evidence-Based Guide to Integrative Medicine. 14:8; 85-96.
• Bittencourt, L.R.A. Santos-Silva, R. De Mello, M.T. Anderson, M.L and Tufik, S. (2010). Chronobiological Disorders: Current and Prevalent Conditions. Journal of Occupational Rehabilitation. 20; 21-32.
• Bone, K. (2003). A Clinical Guide to Blending Liquid Herbs. Churchill Livingston; Australia.
• Cuthbert, S. and Rosner, A. (2011). Physical Causes of Anxiety and Sleep Disorders. Alternative Therapies. 17:6; 30-34.
• De Almondes, K. M. and Araujo, J.F. (2011). Sleep Quality and Daily Lifestyle Regularity in Workers with Different Working Hours. Biological Rhythm Research. 42:3; 231-245.
• Hudson, T. (2011). Women’s Health Update: Chronic Insomnia and Adrenal Dysregulation. Townsend Letter. October: 99-101.
• Osiecki, H. (2009). The Nutrient Bible, Eighth Edition. Bioconcepts Publishing; Eagle Farm, Australia.
• Osieki, H. (2006). The Physician’s Handbook of Clinical Nutrition. Bio Concepts Publishing; Australia.
• Reichenberg-Ullman, J. and Ullman, R. (2010). Healing with Homeopathy: Homeopathic Treatment of a Sensitive Woman with Insomnia. Townsend Letter. April: 109-111.

 

Written by; Vanessa Laird
Naturopath Calanna Pharmacy Woree

w: calannapharmacy.com.au