Insomnia and sleep disturbances have become a very common occurrence with all the pressures and stimulation of modern-day living. It is estimated that 50% of Australians are experiencing sleep disturbances, while 20% suffer from insomnia presentations. Those experiencing a sleep issue will find that they are more prone to mental health disturbances such as anxiety and depression, while mental health issues also predispose them to sleep problems. Sleep is a vital but elusive function for some and breaking the cycle of sleep disturbances often takes some thoughtful intervention, of which naturopathic medicine can be a very useful tool.
Sleep quality is not just about what happens when your head hits the pillow. It’s a complex interplay between our hormones, neurotransmitter and at times metabolic function. Cortisol, known as our stress hormone helps us feel wakeful in the morning and consistently feel energized through the day, however, when it is produced in excess or consistently stays elevated for too long it creates mood changes and potential physical symptoms we know to be a stress response. Cortisol that is too high in the evening will block our sleep hormone melatonin from being released, as they provide a counterbalancing effect. This alternating cortisol and melatonin production is what comprises the circadian rhythm and is controlled by light. When we wake and light hits our retina the adrenal gland releases cortisol and opposing darkness stimulates melatonin release from the brain. There is a very similar seesaw function in the brain with our adrenaline and GABA neurotransmitter function. GABA is calming and peace-inducing and aids in sleep initiation, while adrenaline is stimulating and helps us survive in life-threatening situations. It’s all pretty fine-tuned when life is peaceful, just add in some deadlines and personal life pressures and cortisol and adrenaline release can dominate through the day and into the bedtime arena.
For those experiencing onset sleep issues, it’s best to consider the function of the circadian rhythm, stress and anxiety levels throughout the day and into the evening and the bedtime routine. With those experiencing maintenance insomnia, stress levels are still a big consideration but furthermore blood sugar regulation is also a focus. If blood sugar drops too low through the night the body wakes itself up as a coping mechanism, it won’t always be easy to fall back to sleep if this is occurring. If your sleep disturbance is more of a sleep quality issue where you wake feeling tired after what appears to be a full nights sleep then sleep apnea may be your issue. Sleep apnea is a complex presentation requiring a sleep study and or respiratory and cardiac function review. For men, this is especially noted if you snore or wake intermittently with gasping or choking, in women the presentation is often silent and fatigue and or depression may be the only symptoms.
Magnesium deficiency is very common, and it is required for GABA production while also having a generally calming effect on the nervous system. It also aids in blood sugar regulation so is a great nutrient to supplement with sleep disturbances. The magnesium glycinate form is the best for this function as the amino acid glycine also serves as a calming neurotransmitter. If supplementing for sleep quality, you want to be getting 300mg-400mg about an hour before bedtime and also in the morning for stress and blood sugar regulation throughout the day.
Coffee or caffeine is not metabolized by all equally. Some of us have a genetic mutation affecting caffeine metabolism, meaning that coffee has a stronger and longer-lasting effect for some. This is true for many anxieties and insomnia presentations, if you haven’t yet, a coffee reset where you remove coffee for 2 weeks and observe your sleep quality is in order. Some individuals may be so sensitive that cacao from chocolate and tea are also too stimulating but this isn’t the case for the majority.
It’s important to use light altering apps for all screens to filter out the cortisol stimulating blue light tones. These should be set to the time it gets dark outside. Blue light altering glasses are even better if you feel up for trying those. Using dimmers, lamps and lower light in the evening is also less stimulating and aids in the body producing sleep hormone. For circadian rhythm regulation, it is also important to be getting enough daylight exposure in the daytime. This doesn’t need to be full sun, just outside natural light exposure for at least 30minutes each day. Light control is most relevant in onset insomnia presentations.
Sleep hygiene is all about your bedtime routine, not sanitation. Set a sleeping and waking time and try to stick to it wherever possible, particularly through the week. Avoiding using your phone or doing stimulating exercising too close to bedtime. Reading, taking a bath or hot shower, yin yoga or meditations (sleepscapes or calming meditations in bed) are all good sleep preparation activities. The bed should be a place for sleep only, avoid working and studying in your bed as this creates confusion around the purpose of the bed space.
This is useful for those experiencing maintenance insomnia as it stabilizes blood sugar levels overnight. It’s a quick fix so if it works for you it’s better to work with a practitioner on blood sugar regulation moving forward rather than relying on the snack long-term. Your snack can be something small but should contain healthy fat and complex carbohydrate from fruit or vegetables. Examples are healthy nut butter with apple slices or banana, coconut or cow yoghurt with berries or smashed avocado and carrot sticks.
Hopefully implementing these at-home interventions is enough to guide you to optimal sleep quality. If you find a good nights sleep is still eluding you after correcting the appropriate interventions above, it’s time to enlist the support of a practitioner. Unfortunately, sleep issues are connected to numerous chronic health conditions in addition to the reduced quality of life they bring. Naturopathy and herbal medicine contain many wonderful tools for sleep optimization so don’t be missing your Z’s when support is accessible.