Insomnia and other sleep related issues are epidemic in this country.  Whether you have difficulty falling asleep, staying asleep, or simply don’t feel well-rested when you awaken in the morning, sleep problems can have a profound effect on your health and well-being.  In fact, chronically insufficient sleep has been shown to promote clinical depression, obesity, diabetes, arthritis, and numerous other degenerative conditions.

So what causes sleep problems and what can we do about them?   Well, there are several different causes of sleep disorders and many are related.  Likewise, there are many different solutions…many of them natural.  Although there are plenty of over-the-counter and prescription medications that provide simple solutions, their benefits are generally short-lived.  Opting for medication as a long-term solution ignores the fact that sleep disorders are merely a symptom of a greater problem.  This means you will need more and more of the medication for it to remain effective.   And drugs typically come with disruptive and often harmful side effects.  These side effects can range from prolonged drowsiness to dizziness, diarrhea, memory problems, and chemical addiction. In some cases, the long-term effect of these drugs can be hormonal imbalance, which is ironically one of the most common causes of sleep problems in the first place.  This may be why some of these medications actually make the problem worse in many people.

Here is a summary of the various causes of sleep issues along with some more natural, non-drug solutions.  These items appear in order of most to least common.  Similarly, the recommendations are listed in order of most to least likely to be effective for the majority of people.  If the first one doesn’t work, go to the next, and so on.  If you are currently taking prescription medications, check with your physician before trying any of the supplements recommended here. 

The Solutions: 

1. Full Spectrum Lamp or Sun Lamp – these lights replicate the infrared (IR) and ultraviolet (UV) wavelengths of the sun.  This is a way of supplementing natural sunlight indoors and thereby stimulating more optimal serotonin/melatonin production.

2. Sleep in Total Darkness – Sleep in total darkness or as close as possible to promote more melatonin production.  This includes removing any LED display clocks from view.

3. Get to Bed Early and Consistently – Try to get to bed by 10:30-11:00 p.m. and keep your bedtime consistent to allow your body to establish a rhythm and reset your biological clock. 

4. L-Tryptophan – This amino acid is a precursor to serotonin/melatonin. It is found in meat proteins and some people, especially vegetarians, are quite deficient in this essential amino acid.  Supplementally, it can be found in capsule form and should be taken in 500-1000mg doses within one hour of bedtime for optimal results.

5. 5-HTP – This nutrient is what L-Tryptophan converts into.  It is always best to supplement as close to the beginning of the hormonal chain as possible to increase the chance that your body will eventually learn how to make these conversions on its own. So if L-Tryptophan does not work, try the 5-HTP in 50-100mg doses within one hour of bedtime.

6. Vitamin D – There is a plethora of recent research on this nutrient, which is technically a hormone.  It plays a key role in the production of other hormones, including serotonin and melatonin.  Although vitamin D is fat soluble, the research indicates most of us are deficient and the minimum daily needs is much higher than the 400 IU’s suggested by the RDA.  In fact, the recommended minimum dose is 3,000 IU’s daily with food.  For peace of mind, get your levels checked through a blood test.  The proper test is 25 (OH) D and the optimum reference range is 45-60 ng/ml.

7. Melatonin – When the above steps are not enough, the melatonin hormone can be taken as a supplement.  Hormones are always a last resort because there is always the risk of becoming dependent for life.   3mg of melatonin taken near bedtime is usually sufficient.

 The Cause:  Adrenal Fatigue/Chronic Stress – The adrenal glands are essentially our stress glands.  Their activity level is directly related to the level of stress we are under.  Stress of any kind—be it physical, mental, or emotional—triggers the same response from the adrenals.  The adrenals are responsible for the production of many hormones and work with the hypothalamus in maintaining our circadian rhythm.  The adrenal hormones we are concerned most with when it comes to sleep are cortisol and DHEA.  When these two hormones are out of balance, our bodies cannot relax and sleep is disturbed.  Cortisol is released at decreasing levels as the day wears on, but it spikes under periods of stress.  When cortisol is high, the body cannot relax.  And when stress is chronic, the adrenals get fatigued.  Repeatedly elevated night-time cortisol levels are the first stage of adrenal fatigue and a common cause of insomnia or interrupted sleep.  The most reliable test for adrenal fatigue is a saliva test, which measures tissue levels of the relevant hormones and tracks the 24-hour cycle of the adrenal glands. 

The Solutions: 

1.      Phosphorylated Serine – This nutrient is the activated form of phosphatidyl serine, which can be found in the fatty tissue of animal based foods, such as egg yolks.  This is essential in regulated cortisol levels, and actually has a cortisol dampening effect in cases of elevated cortisol.  The best source of this nutrient in supplemental form is in a product called Seriphos, which provides 1000mg of phosphorylated serine per capsule. If elevated night-time cortisol is suspected or confirmed through a saliva test, take 1000-2000mg of phosphorylated serine before dinner and/or within one hour of bedtime.   

2.      Electrolytes – The adrenals are nourished by essential minerals like sodium, magnesium, potassium, and calcium.  When you are under stress (physical or emotional), these are some of the first nutrients your body uses up. Likewise, when these minerals are out of balance, it puts strain on the adrenals.  This is why iodized (table) salt can create problems. A good source of sodium and the other electrolytes is Celtic raw sea salt, which naturally contains over 80 different minerals. 

3.      B Vitamins – Specifically, B5, B6, and Biotin. More fuel for the adrenals.  Good doses are 250mg of B5, 25mg of B6, and 1,000mcg of Biotin. 

4.      Vitamin C – It’s difficult to do too much vitamin C.   One way to find your body’s need is to do a vitamin C flush for bowel tolerance.  Get the ascorbic acid powder form and take a tsp in water every hour until diarrhea occurs.   Then back off by ½ tsp and calculate the dose. 

5.      Herbs – There is a family of herbs referred to as adaptogens because of there therapeutic effect on the adrenals.  Specifically, Rhodiola (100mg), Licorice (20mg), Ashwaganda (100mg), Siberian Ginseng (250mg), and American Ginseng (100mg).  There are products that contain combinations two or more of these herbs.  Because these herbs are intended to address the overall problem of adrenal fatigue, they do not directly induce sleep, so they should not be taken after 3:00 pm. 

6.      Keep Room Temperature between 65-70 degrees – Body temperature also impacts hormonal levels.  Use blankets and air temperature control to regulate this one.

The Cause:  Hypoglycemia – This issue is directly related to the adrenal issue.  When blood sugar drops to low, the body senses it as a stress on the system and cortisol kicks in.  As explained above, this can interfere with sleep. This is why it’s essential to maintain a balanced blood sugar level throughout the day by eating small balanced meals every 3-4 hours.  The theory that eating close to bedtime will promote fat storage is a myth.  If you go to bed hungry, your blood sugar will drop and cortisol will elevate, which not only keep you from getting a good night’s sleep, it will promote fat storage.  If your problem is waking up in the middle of the night and you are hungry at that time, low blood sugar is certainly one of the factors contributing to your problem.

The Solutions: 

1.      Exercise – Exercising daily promotes proper glucose and insulin regulation.  This includes both cardiovascular and resistance/strength training.  If you are suffering from adrenal fatigue, just keep the exercise intensity to a moderate level to avoid exacerbating the problem. 

2.      Eat small, frequent, balanced meals throughout the day – Eat every 3-4 hours and make sure each meal contains protein, fat and carbs, including snacks.  This will promote proper blood sugar regulation throughout the day and make you less likely to have drops at night.

3.      Don’t go to bed hungry – If you are hungry, have a small protein snack within an hour of bedtime, such a handful of raw walnuts or almonds, an egg, or even a small protein shake.  If your pre-bedtime snack is high-glycemic or predominantly carbs, you are more likely to promote a blood sugar spike followed by a blood sugar drop. 

4.      Chromium – This nutrient play a key role in regulating glucose utilization.  Specifically, chromium picolinate or chromium GTF at 800-1,000mcg per day with meals.

5.      B Vitamins – Specifically, B1 (50mg), B2 (25mg), and B6 (30mg).

6.      Omega-3’s – These essential fats effect blood sugar levels indirectly by promoting proper hormone production, such as insulin.  Omega-3’s are rich in free range eggs, raw walnuts, flax seed oil, fatty fish like salmon, and organ meats.  Cod liver oil is probably the best source because it also contains naturally occurring vitamins D & A.  Start with 1 Tbsp daily.

7.      Other nutrients – Some other nutrients to consider in supplement form:  Garcinia Combogia, Bitter melon, Fenugreek, and Vanadium.

The Cause:  Allergies – Allergies are more common than you think.  In fact, just about everyone is allergic to something.  Allergies affect sleep because they promote inflammation and muscle tension.  This frequently translates into sinus congestion, which affects breathing, and tight, restless muscles. There are two kinds of allergies.  The one most of us are familiar with is the Type 1 allergy, which is characterized by very obvious symptoms such as sneezing or rashes fairly immediately after ingesting the food or being exposed to the offending inhalant.  Type 1 allergies are more commonly associated with environmental substances such as pollen or pet dander. 

The more common, but less known allergy is the Type 2 or delayed onset allergy.  These reactions can occur within hours or even days after ingesting an offending food. The most common food allergies things we eat too much of, like wheat (bread, pasta, cereal, etc.) and milk (cheese, yogurt, etc.).  Other common ones are soy, corn, and eggs. There are blood tests for these allergies, but the best way to identify one is by eliminating the suspected food entirely from the diet for 3-4 weeks and reintroducing it to look for reactions. 

The Solutions: 

1. Avoid foods that contain gluten – Gluten is one of the more common food allergens.  It is the protein in wheat, oat, rye, barley, and spelt.  This includes most foods made with flour, such as bread, cereal, crackers, bagels, pasta, cous cous, and many packaged foods, including some salad dressings.

2. Avoid milk and products containing milk – This includes yogurt, cheese, many dressings, and packaged foods.  Read your labels.  Look for milk powder, skim milk powder, and casein—a milk protein.   Generally speaking, the other protein in milk—whey—is rarely problematic.

3. Rotate Your Foods – Avoid eating the same foods every day to reduce the chance of developing a Type 2 food allergy.   Variety is the key.

4. Keep windows closed at night – This will reduce the amount of pollen and other offending pollutants that promote your allergic response.

5. Keep your bedroom clean – Vacuum and dust your sleeping space frequently to cut down on airborne pollutants.  You can also get hypoallergenic pillow cases that create an impermeable barrier between your head and the mites and dander that can hide out in your pillow. 

The Cause:  Acid Reflux – This is another way of saying Gastrointestinal Esophageal Reflux Disorder (GERD).  This condition affects sleep because it irritates the esophagus and promotes breathing difficulty and restlessness.  It is not always heartburn.  Heartburn is a common feeling or symptoms associated with GERD, but this condition is often more subtle and sometimes unrecognizable.  In fact, many people have acid reflux and don’t even feel it or know it.  Basically, GERD occurs when gastric juices from the stomach are kicked back up into the esophagus, causing irritation and eventually damage to the esophageal lining. 

Despite the typical medical response, the cause is typically not excess stomach acid.  It is insufficient stomach acid which leads to undigested food that sits in the stomach too long and the juices from that food, combined with the gastric juices produced by the body to attempt to break down that food refluxes back up past the lower esophageal sphincter muscle or valve. 

Doctors will commonly prescribe antacids and proton pump inhibitors to neutralize the stomach acid, but that only deals with the symptom and actually exacerbates the cause, which is stomach acid deficiency.  Without that stomach acid, you can’t break down your proteins and fats.  

The Solutions: 

1.      Drink Plenty of Filtered Water – We all know water as the most essential nutrient.   But most of us are not drinking enough water, and this disrupts the body’s ability to produce adequate gastric juices and to enhance motility of the foods we eat through our gastrointestinal tract.  The minimum daily requirement for water should be ½ ounce per pound of body weight.  This means a 150 pound person needs at least 75 ounces per day.  And tap water should be avoided because it contains excess minerals and other irritants to our digestive tracts, such as chlorine and fluoride.

2.      Avoid processed grains and refined sugars – These foods inhibit digestion by disrupting the mucosal lining of the stomach and small intestine and promoting gut flora imbalances. 

3.      Betaine Hydrochloride – Hydrochloric acid (HCL) is essentially what our stomach naturally produce whenever we eat primarily to break down the proteins and fats in our food.  It also is essential for neutralizing harmful bacteria that may be present in the food we eat.  When our body’s ability to produce adequate stomach acid is compromised, as with chronic stress or an unhealthy diet, our foods are not properly digested and GERD is one of the many complications associated with indigestion.  This can be taken in supplemental for with meals.   Increase the dose until the discomfort subsides.  Do not take HCL on an empty stomach.

4.      Fresh Garlic – Many people with GERD are also infected with H.Pylori, which can lead to stomach ulcers and exacerbate the reflux issue.  Garlic is a natural anti-bacterial and anti-viral, but only when eaten fresh and slightly crushed.   The garlic pills aren’t the same.  

5.      DGL – This is short for deglycyrrhizinated licorice.  This form of licorice extract promotes mucus production in the stomach lining and can prevent the stomach burn that often accompanies reflux.  Glycyrrhizin is the component of licorice that can raise blood pressure in people with already high blood pressure.  DGL does not contain this substance.   It comes in a chewable tablet and should be taken 20-30 minutes prior to meals. 

6.      Probiotics – People who suffer from sleep disorders often have an imbalance in gut bacteria (flora).  The good bacteria in our GI system is essential for proper digestion, immune function, and the production of essential nutrients like B vitamins.  These can be supplemented in many forms, but capsules appear to be best.   Take the does recommended on the label with breakfast and dinner and keep these supplements refrigerated.  

7.      Orange Peel Extract – This has been shown in recent studies to prevent GERD and even heal the esophageal lining.  It need only be taken for a short period.

The Cause:  Sleep Apnea – This is when airflow from the nose and mouth to the lungs is restricted during sleep, causing the person to stop breathing for up to one minute, sometimes hundreds of times a night.  And most people who have it don’t know it until someone else points it out.   Kind of like snoring, and actually they sound very much alike.  There are many theories as to its cause, including depression (psychological) and obesity.   While it is true that these are contributing factors, the more common cause is probably diet related.  In fact, many cases of apnea are related to food allergies.

Apnea is often treated with the prescribed use of a CPAP machine (Nasal continuous positive airway pressure), where the patient wears a mask over the nose during sleep, and pressure from an air blower forces air through the nasal passages, preventing airway closure.  While this tool is effective, it is very awkward and only works when used properly and constantly. 

The Solutions:

1.      Eliminate Food Allergens – Especially grains and milk.  See above section for more on food allergies.

2.      Reduce Body Fat Composition – This requires a combination of regular exercise and proper diet.

3.      Use a Cervical Neck Pillow – Sometimes it’s simply a matter of head position and the cervical roll, which slips right inside your pillow case, supports the natural curve on your neck while you sleep, allowing for optimal airflow. 

The Cause:  Acute Stress/Anxiety – Unlike chronic stress (see above), acute stress is more of a temporary, situational condition.  Tough day or week at work, performance tests, family in town, financial woes, etc.  However, if acute stress levels get intense or high enough, they can be overwhelming, resulting in panic or anxiety attacks.  While there are plenty of drugs on the market, like valium and prozac to address this condition, there are some natural alternatives, which get to the cause.   You see, even acute stress can promote chemical imbalances in the brain, and a preexisting chemical imbalance can make one more susceptible to bouts of anxiety.  In any event, when one is stressed, the entire body is affected, from bowel function to muscle tension.

The Solutions:

1.      GABA – Gamma-aminobutyric acid is the chief inhibitory neurotransmitter of the central nervous system.  It is the body’s natural anti-anxiety substance.  Many people are deficient in this substance.  One cause is the inability to convert from L-Theanine, the primary amino acid precursor to GABA.  The best way to take GABA is in a sublingual form (a lozenge), which means under the tongue.  Simply dissolve a lozenge under the tongue so it goes directly into the bloodstream and is less likely to get lost in the GI system.  This will also be more useful to fend off an acute anxiety attack.

2.      Magnesium – This essential mineral is a natural muscle relaxant.  In fact, magnesium can be so effective that in higher doses it can cure constipation.  Start with 300mg near bedtime and increase dose to bowel tolerance, just like vitamin C (see above).

3.      Journal – Journaling can help you to empty your head of stressful thoughts or to-do lists, allowing your brain to take a break. 

4.      Avoid Watching Television Near Bedtime – T.V. actually has an excitatory effect on the brain.  Avoid it for at least one hour before bedtime, and by all means get the T.V. out of the bedroom. 

5.      Read non-stimulating material at bedtime – The murder mysteries and horror novels are not helping you relax.

6.      Meditate – Practice at least 10-15 minutes of meditation or conscious breathing near bedtime.  This will slow respiration, pulse, blood pressure and calm the mind.  If clearing your mind of conscious thought is difficult, use a guided meditation CD or tape to assist you.

            If none of these suggestions bring you better sleep, than you may have unresolved emotional issues that may be causing your stress and promoting insomnia.  In this case, there are various other, less direct, methods of dealing with the issue or issues, but they should be attempted only under the supervision of a qualified mental health professional. Of these are Emotional Freedom Technique (EFT), Eye Movement Desensitization Reprocessing (EMDR), acupuncture, cranial sacral therapy, reiki, dream therapy, traditional psychotherapy, and a fast-growing field called ecotherapy.  No matter what other factors may be contributing to your sleep problems, if the emotional issue is not addressed, any success reached by incorporating other techniques described in this article will be short-lived. This is by far the most significant factor. 

Good luck and sweet dreams!

 By Michael A. Sallustio, CNC, PFT, JD