Good Night, Sleep Tight...Naturally

Unsettling side effects from prescription sleep aids are causing many to turn to natural sleep solutions

Weird things were happening to Theresa… and they were happening at night. Clues to her strange nocturnal behavior were left behind in the mornings. “I would get up and find empty food containers sitting around. One night I ate a whole bag of Oreos, another night I opened a can of peas and ate the whole can.” The strange behavior didn’t stop at raiding the cupboards – “I would clean,” she says. “I would wake up to find the vacuum cleaner in the middle of the floor, when I knew it wasn’t there when I went to bed; one night I sprinkled Comet cleanser all over the bathroom – the next morning the toilet, the sink, and the bathtub were all covered.” And she has absolutely no memory of doing any of these things.

Debbie was experiencing weird episodes of her own – waking up in a chair on the deck in the dead of winter; finding all of her dinner plates stacked on the kitchen counter with dish towels between each plate; unexplained bruises.

The bizarre obsessive-compulsive like behaviors these women experienced were the side effects of two very common, and very popular, sleeping pills, Ambien® and Lunesta®. And while raiding the kitchen or doing some midnight cleaning doesn’t sound so bad, this “zombie effect” can be tragic. In 2009, a Texas woman hit and critically injured a toddler while “sleep-driving” on Ambien®.[1] And these aren’t isolated events; earlier this year, after receiving a number of reports of car accidents connected to Ambien® and its generic form, zolpidem, the FDA required the makers of the drug and similar sleeping pills to cut the dose in half for women, who metabolize the drug differently from men.[2]

Insomniac Nation

Sleepless nights have become epidemic. It is estimated that 50 to 70 million Americans suffer from some chronic sleep disorder, including insomnia, sleep-disordered breathing, narcolepsy, restless leg syndrome, sleep-related psychiatric and medical disorders, and circadian rhythm sleep disorders.[3] It doesn’t help that our days are filled with multitasking, constant going and doing, endless exposure to electronic gadgets, and diets that are often devoid of real nutrition. People are desperate for sleep. Many of them have turned to prescription and over the counter sleep aids searching for the bliss of a full-night’s sleep – Americans filled 60 million prescriptions for sleeping pills in 2011.[4] And too many people have grown dependant on these sleep aids, even though they are only approved for short-term use (usually three to four weeks) and generally their safety has not been evaluated beyond about a month.[5] [6] [7]The exception is Lunesta®, which was evaluated for six months.[8]

Research published in 2012 in the medical journal BMJ Open found that people who regularly took prescription sleeping pills were nearly five times as likely to die compared to non-users. They were also 35 percent more likely to develop cancer. Even those who took 18 pills or less a year had 3.5 times the risk of dying compared to non-users. The study included 10,531 people who took prescription sleeping pills and 23,674 matched non-user controls. They were followed for an average of 2.5 years. Surprisingly, the researchers also found that regular sleeping pill use was a greater risk factor than smoking for developing lymphoma, lung, colon, and prostate cancers. The authors of the study estimate that in 2010 320,000 to 507,000 deaths in the United States may have been associated with prescription sleep aid use.[9]

Critics argue that the study is flawed because it doesn’t reveal the causes of death or if the sleeping pills were prescribed related to another health problem that could have lead to death; however, the research is certainly food for thought.

But I Need Sleep!

Sleep is crucial for good health and a chronic lack of sleep can increase your risk for a number of serious health problems, including heart disease, heart attack, high blood pressure, stroke, diabetes, obesity, depression, and even death, particularly from cardiovascular disease.[10] [11] Often insomnia or trouble sleeping is a symptom of another serious health problem, so it is important to work with a health care practitioner to address any underlying health issues. It is also important to work with a doctor if you have a diagnosable sleep disorder, or if you want to stop taking a prescription sleep aid. That said, there is a myriad of natural solutions to support healthy sleep patterns, including vitamins, minerals, herbs, flower essences, and lifestyle habits. Below are a few to consider.

Supplements to promote healthy sleep

Just like every other biochemical process, sleep is fueled by nutrients. A quality multivitamin will provide the foundation of nutrients necessary for your body to produce the neurotransmitters and hormones needed for healthy sleep patterns. In addition to your multi, consider the following nutrients to promote healthy sleep.

The B vitamins have long been used to support a healthy stress response, but they are also important for supporting healthy sleep patterns. Vitamin B3 (niacin) has been shown to enhance REM sleep and lead to a decrease in nighttime wakings. Vitamins B6 and B1 (thiamin) are involved in the production of serotonin and melatonin, hormones that help regulate sleep. [12] [13] And people with insomnia are often deficient in folic acid, which also supports the body’s production of melatonin and serotonin. [14] Note: Like most nutrients, the B vitamins aren’t confined to only one role in the body. While they are necessary for supporting healthy sleep patterns, the B vitamins are also involved in energy production and may have a stimulating effect on some people; therefore, they should be taken early to mid-day.

A lack of calcium and magnesium can cause you to wake up after a few hours of sleep and not be able to go back to sleep.[15] Calcium is a natural relaxant and has a calming effect on the nervous system.[16] It has also been shown to normalize sleep patterns, specifically REM sleep.[17] The complicated conversion of tryptophan to 5-HTP to serotonin and melatonin requires not only the B vitamins, but also sufficient levels of magnesium and vitamin C.[18]

L-theanine is an amino acid found in tea (especially green tea) that helps maintain a calm alertness during the day and a deeper sleep at night. A Japanese study found that 200 mg of L-theanine improved the quality of sleep in adult men[19]; theanine has also been shown to increase alpha brain waves, which are associated with deep relaxation.[20]

Melatonin is a hormone made by the pineal gland that helps regulate the body’s internal clock, or circadian rhythm. When it gets dark, the pineal gland releases melatonin into the bloodstream, signaling the brain it’s time for sleep. Bright light (including artificial indoor light) and blue light (from fluorescent light, computer screens, TVs, Kindles, etc.) inhibits the release of melatonin, which is why it is important to dim the lights and reduce exposure to television and computers before bedtime.[21]

Melatonin supplementation is especially helpful for those who have circadian rhythm sleep disorders, work night shifts or swing shifts, or travelers who experience jet lag – melatonin helps reset the internal clock, which is disrupted in these situations. Start with the lowest dose and only increase to the dose that works for your body – taking a higher dose doesn’t mean it will work more effectively.[22] It is also important to note that melatonin supplementation is only effective if you are not producing, or not efficiently producing, the hormone. If supplementation doesn’t help promote sleep, then it’s probably not going to.

Herbal sleep aids

A number of studies have confirmed that the herb valerian improves the quality of sleep and can reduce the time it takes to fall asleep without causing grogginess or a “hungover” feeling in the morning.[23] [24] [25] [26]  A cup of passionflower tea before bedtime has been shown to improve quality of sleep in adults with “mild fluctuations” in sleep quality (i.e., this may not the be the best choice for chronic insomnia).[27] Compounds in passionflower bind to the same receptor sites in the brain as the anti-anxiety drug Valium.[28] Lemon balm also helps to reduce anxiety and promote healthy sleep, but seems to work best in combination with other calming herbs such as valerian, hops, and chamomile.[29] To avoid developing a tolerance, it is best not to rely on one herb on a regular basis, but to rotate among several.[30]

Flower essences

It doesn’t occur to most people to turn to flower essences – dilute, unscented extracts of various flowers and plants – when they are having trouble sleeping, but in fact, they can be quite valuable in promoting healthy sleep. Often sleep issues are rooted in emotional disturbances and nervous or anxious states of mind. Flower essences can help balance these emotional “agitations.” Cherry plum helps you to relax and allows the mind to “let go” and surrender to sleep. Most of us have had the experience of lying in bed, waiting for sleep to come, becoming more anxious as the hours creep by, moving closer to morning, but still not bringing sleep. Impatiens helps calm the impatience and anxiety that come with the inability to fall asleep, allowing the mind to release tension and become calm. It’s often at night, when we are trying to sleep, when all of life’s problems (big or small) seem to flood the mind… and don’t those problems always seem worse in the middle of the night? White chestnut can calm and quiet the mind, helping to get rid of those chattering thoughts and worries that are keeping you awake. When using flower essences, best results seem to come from taking them in combination and on a regular basis, several times throughout the day, not just before bedtime, to have a positive effect.[31] These flower essences directly address sleep issues; however, other emotions that are seemingly unrelated to sleep – whether it be sadness, anger, fear, etc. – can potentially affect your ability to sleep without you even realizing it. It is important to take stock in all of your emotions and address them with a combination of specific flower essences tailored to you.

Lifestyle

While supplementing can be helpful in supporting healthy sleep patterns, it probably won’t be useful if you continue to practice negative sleep habits. It is crucially important to practice what experts call good sleep “hygiene.” Follow a set bedtime each night and get up at the same time every morning; adopt a quiet pre-sleep ritual like reading or soaking in a warm bath; do not watch TV or use your computer before going to bed – and keep electronics out of the bedroom; avoid strenuous exercise, caffeine, alcohol, and nicotine (a neurostimulant) too close to bedtime; block out light (an eye mask or blackout curtains can be helpful) and noise (with the exception of a white noise machine, which can promote sleep), and keep your bedroom cool. Regular exercise (at least three hours before bedtime), yoga practice, and/or meditation can also lead to a better night’s sleep.

Finding a good night’s sleep is clearly a problem for many Americans, with tens of millions desperately seeking sleep through prescription sleep aids. But with these sleep aids comes dependence, and bizarre, sometimes tragic, side effects. If you are dealing with an underlying health issue that is affecting your sleep or if you have a diagnosable sleep disorder, it is important to work with a doctor. But for the average person trying to get a good night’s sleep, there are a number of natural ways to support your body’s ability to sleep. Instead of dreading bedtime, support your body with the right nutrients, supplements, and healthy sleep hygiene so you can actually look forward to “hitting the sack.”


References

[1] www.kens5.com/news/Jury-decides-fate-of-SA-woman-who-admitted-to-running-over-18-month-old-151609875.html

[2] http://www.cbsnews.com/8301-204_162-57563277/fda-tells-drugmakers-to-lower-doses-for-ambien-other-sleeping-pills/

[3] Kripke D, Langer R, Kline L; Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open; 2012;2:e000850 doi: 10.1136/bmjopen-2012-000850

[4] Rabin, Roni C. “New Worries About Sleeping Pills.” March 12, 2012; The New York Times online: www.well.blogs.nytimes.com/2012/03/12/new-worries-about-sleeping-pills/

[5]http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=5916#section-6

[6] http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=c8a6c478-1d05-47b2-c98d-99177395b762

[7] http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=48770

[8] http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=66613

[9] Kripke D, Langer R, Kline L; Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open; 2012;2:e000850 doi: 10.1136/bmjopen-2012-000850

[10] http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/10-results-sleep-loss

[11] http://www.ncbi.nlm.nih.gov/books/NBK19961/

[12] http://www.ncbi.nlm.nih.gov/pubmed/18250494

[13] http://nutritionwonderland.com/2009/06/understanding-bodies-serotonin-connection-between-food-and-mood/

[14] Breus, Michael MD; “Vitamin D for Sleep?” The Huffington Post online; 1/22/11; http://www.huffingtonpost.com/dr-michael-j-breus/vitamin-d-for-sleep_b_810543.html

[15] Balch, Phyllis CN. Prescription for Nutritional Healing, Avery 2006; pg 525

[16] Breus, Michael MD; “Vitamin D for Sleep?” The Huffington Post online; 1/22/11; http://www.huffingtonpost.com/dr-michael-j-breus/vitamin-d-for-sleep_b_810543.html

[17] Fukuyama Y, Hayashi M. “Sleep Electroencephalograms and sleep Stages in Hypoparathyroidism.” Eur Neurol 1979;18:38:;38-48 (DOI: 10.1159/000115052) http://www.karger.com/Article/Pdf/115052

[18] http://total-health-magazine.com/articles/diet/nutrition-and-depression-the-role-of-dietary-constituents-on-mood.html

[19] http://www.ismh.org/en/scientific-spotlight/l-theanine-and-sleep-quality/

[20] http://www.ncbi.nlm.nih.gov/pubmed/18296328

[21] http://www.sleepfoundation.org/article/sleep-topics/melatonin-and-sleep

[22] http://www.futurescience.com/melatoni.html

[23] Balch, Phyllis CN. Prescription for Nutritional Healing, Avery 2006; pgs 138-139

[24] http://www.ncbi.nlm.nih.gov/pubmed/21775910

[25] http://www.ncbi.nlm.nih.gov/pubmed/22766307

[26] http://www.ncbi.nlm.nih.gov/pubmed/21399726

[27] http://www.ncbi.nlm.nih.gov/pubmed/21294203

[28] Balch, Phyllis CN. Prescription for Nutritional Healing, Avery 2006; pg 106

[29] http://www.umm.edu/altmed/articles/lemon-balm-000261.htm

[30] Balch, Phyllis CN. Prescription for Nutritional Healing, Avery 2006; pg 527

[31] http://www.flowersociety.org/insomnia.htm