Get to the root cause of insomnia
Published Wednesday June 24th, 2009
Fatigue is the most common symptom seen in my practice.
Improving sleep is a great starting point to help people gain energy. But the notion of sleeping a full eight hours is often seen as luxurious. Adding an afternoon nap may even seem a little sinful. Our cultural mentality involves working too hard (and playing too hard), often at the expense of rest and relaxation.
In this column, let's explore how a restorative sleep enables us to enjoy our daytime life more fully.
A full night of restful sleep heals the body by reducing inflammation and balancing the hormonal and nervous system. Correcting insomnia, therefore, is an excellent adjunctive tool in treating any chronic disease. More specifically, in addition to increasing daytime energy levels, improving sleep is effective to enhance memory, assist in weight loss, and reduce the risk for depression and cardiovascular disease.
Sleep medications can be helpful during a temporary period of insomnia. But, sleep aids can prevent the body from entering the deeper phases of sleep (i.e. delta sleep), even though your eyes are closed and you are unconscious for the whole night. Waking up groggy and non-refreshed can commonly occur since the apparent night of sleep did not reduce inflammation or heal the body in ways that sleep usually provides.
Try as many of the following techniques below as possible. Circle ones that you are interested in and try one this week.
* Find the cause: The most important way to improve sleep is to first figure out what is keeping you up. Work with your medical doctor or naturopathic doctor to investigate why. The timing of impaired sleep provides good clues.
In my practice, patients usually fall into one or more of the following categories:
1) those who just can't fall asleep
2) those who wake up many times during the night
3) those who wake up at a specific time each night, surprisingly common is between 1 a.m. and 4 am
4) those who wake up early and can't fall back asleep.
The hormonal balance between cortisol, growth hormone and melatonin is a very important consideration. Cortisol, for example, is normally lowest at bedtime, enabling our body and mind to shut down for the night. But prolonged periods of stress during the day, eating late, arguing with your spouse, watching an intense movie, overdoing mentally challenging work, or exercising too late can all cause raised cortisol levels leading to insomnia.
Other causes may include an overactive bladder, muscle or bone pain, excess caffeine consumption, medication side-effects, leg cramps or restless legs, repetitive or excess thoughts, vivid dreams, low blood sugar levels, and night sweats and other hormonal imbalance.
Many of these can be corrected with the proper treatment.
* Address the basics: Find ways to keep your room quiet.
Keep the temperature in the bedroom no higher than 21°C. Open the window for fresh air.
Avoid drinking any fluids within two hours of going to bed if you are prone to getting up to urinate at night.
Work with your medical doctor to reduce or avoid drugs (both prescription and over-the-counter) with side-effects that affect sleep.
Decrease or avoid caffeine.
Avoid excess alcohol as it may keep you from falling into the deeper stages of sleep, where the body does most of its healing.
* Recognize that insomnia is a 24-hour issue: Health changes during the day can significantly improve sleep at night. Eat balanced meals. Get outside during the day, and aim to lower stress levels.
Aim for routine. Try to go to bed and wake up at the same time every day as this helps balance hormone levels.
* Avoid foods that you may be sensitive to: Food intolerances may affect sleep by causing excess congestion (one cause of sleep apnea), gastrointestinal upset, and gas, among others.
If you are prone to indigestion at night, avoid eating before bed. Sugars and grains are especially important to avoid before bed as it can raise blood sugar and inhibit falling sleep. Blood sugar may then drop too low (hypoglycemia), causing you to wake up during the night.
* Get to bed as early as possible: Our systems, particularly the adrenals (glands that pump out hormones in response to stress), do a majority of their recharging during the hours of 10 p.m. and midnight. As to what constitutes 'enough' sleep, it's different for everyone but eight hours appears to the norm. Aiming for a 10 p.m. to 6 a.m. sleep is a good target.
* Daily exercise improves sleep quality: Just by slightly increasing your exercise level, you can help yourself get to sleep quicker at night and sleep more soundly. Avoid intense exercise in the late evening as this can have the opposite effect.
* Mellow out for an hour or so before bedtime and save your worries for another time: Worrying about bills, health, or loved ones before bed is not conducive to sleep. Rather, take an hour of quiet time before you try to sleep.
Taking a hot bath, shower or sauna before bed raises body temperature, which facilitates sleep. Alternatively, read or talk about pleasant things at bedtime. Try playing a soothing and relaxation CD before bed.
* Take a nap if you feel sleepy: Weekends are excellent opportunities. Parents should aim to lie down when their children do. Short naps during the day actually can shorten the lag time to enter deep sleep during the night. Set a limit of 20-30 minutes to avoid going into deeper phases of sleep that can leave you groggy.
* Turn the clock away from view: It will only add to your worry when constantly staring at it...2 a.m....3 a.m... 4:30 a.m...
* Check your bedroom for electro-magnetic radiation: EMR comes from alarm clocks, electric blankets, cellphones, TVs, and computers. These can disrupt the pineal gland and the production of melatonin and serotonin.
* Melatonin supplements: Exercise caution in using it, and only as a last resort, as it is a powerful hormone. Ideally it is best to increase levels naturally by adopting many of the guidelines described herein.
* Sleep in complete darkness. Exposure to sunlight in the daytime (along with full spectrum fluorescent bulbs in the winter) and absolute complete darkness at night increases melatonin at night. One should get blackout drapes so no light is coming in from the outside. If light hits the eyes at night, it disrupts the pineal glands production of melatonin. If you get up in the middle of the night, use as little light as possible.
* Keep your bed for sleeping (...and the other thing). Watching TV or doing work in bed can make it harder to relax.
Addressing the root cause of insomnia and adopting the recommended sleep-promoting tips that suit you is paramount.
Choose whatever way works best for you.
* Dr. Martin Gleixner, MSc, ND owns the Moncton Naturopathic Medical Clinic located at 90 Weldon Street in Moncton (382-1329). Fluent in French and in English, Dr. Gleixner offers professional health care for the whole family. Using his deep understand about how the body works, Dr. Gleixner devises a workable treatment plan that will that help you achieve your health goals. Additional information can be found on www.monctonnaturopathic.com. His column appears every fourth week on Wednesdays in Life & Times.
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