We all know that getting a good nights sleep is essential for cellular healing, preventing Alzheimers, regulating blood sugar, depression, and just plain feeling good. Yet getting restful sleep is a problem patients bring to me every day.
The usual advice for getting exercise, having a sleep schedule, avoiding caffeine, heavy meals and alcohol late at night, turning off TV and electronic devices, making sure temperature is good, removing distractions (that dog sleeping next to you) are essential first steps. If you are having trouble sleeping or staying asleep all night, each of these needs to be done. Not one but all.
Sleep changes at 3 key points in our lives. During infancy, adolescence and older age. A newborn baby needs about 18 hours of sleep broken up into small periods (as all new parents know). At about 4-6 months of age their sleep regulates into longer cycles.
Teenagers experience a circadian shift that delays night sleep. Their melatonin levels don't begin to rise until later in the evening and they may feel more awake at 11PM. Left to their own, teens would sleep the morning away naturally.
As a person ages the internal sleep clock begins to lose its consistency, causing early morning wakening that results in less sleep overall and daytime and early evening sleepiness. The problematic cycle gets perpetuated with napping. How many times to we see grandpa nodding off in front of the evening news? It's just his internal time clock that has changed and is out of whack.
The key to adult insomnia is first to optimize every one of the sleep rules in the first paragraph. Once diet, exercise and sleep environment are taken care of, restoring the sleep drive and circadian rhythm is the next step. Limiting exposure to artificial light outside of daytime hours can help. Our Suprachiasmatic Nucleus (SCN) in the hypothalamus responds to light and dark signals and produces a number of hormones and peptides. The retina in the eye directly connects to the SCN. As long as our eyes perceive light, the SCN responds by suppressing melatonin and cortisol production. Blue light from a computer or TV make it harder to fall asleep and to stay asleep.
Of note is that people who are totally blind have difficulty sleeping because there is no light perception. It is estimated that 70% of blind people have a condition called Non-24, causing sleepless nights and chronic fatigue.
Natural supplements can help promote sleep and get the body back into a regular sleep/wake cycle. Melatonin, l-theanine, chamomile, valerian and GABA have all been studied and are safe, not habit forming ways to get the body back into sleeping through the night.