Insomnia

This can be a difficult problem and can drive people a bit crazy. Sleeping tablets have a place for short-term use but are addictive and should be used with care.

Herbs and Supplements

Many people have tried other remedies. Herbal remedies are not as strong as sleeping tablets but they are not addictive. Passiflora is especially good if you have an overactive mind. Valerian is more for a restless body (also helps certain types of pain or spasms). These are often available in health food shops or can be ordered from a herbal supplier. Natrasleep, which contains valerian, is widely available, from health food shops and some chemists.

Melatonin can be useful but takes a while to kick in and doesn’t give the sedative effect of a sleeping tablet. This is the hormone we normally produce during sleep but it decreases with age. It can be prescribed. Most people produce will need between 3 and 9mg of slow release melatonin but the maximum dose that can be given is 20mg. If you take too much it will work for the early part of the night but sleep is worse later so the dose may need adjusting.

Melatonin needs a prescription in the UK. The body also adjusts its melatonin output naturally so supplementing it may not be the perfect option.

One option is to use tryptophan which is now available as a supplement (use 1-3 grams daily). It is converted into 5HTP and then serotonin and then melatonin. Avoid tryptophan if you take an antidepressant. However, another strategy is to eat foods high in tryptophan (see Nutrition and Depression leaflet) as few people eat enough of these. There are two other problems with tryptophan. One is the conversion to 5HTP is poor and the other is that it is also used to produce niacin (vitamin B3) so if you are short of niacin the body will favour producing more of this rather than producing serotonin and melatonin.

A better option is to use 5 hydroxytryptophan (5HTP 100-3000mg) as this is converted directly into serotonin then melatonin. It needs Vitamin B6 and zinc to this. Start with 100mg before bedtime and increase 100mg at a time until you can easily get off to sleep.

There is another benefit. About 90% of serotonin is produced by gut bacteria but this may not be able to cross the blood-brain barrier into the brain. 5HTP does cross the blood-brain barrier and therefore is able to produce serotonin and melatonin in the brain.

Magnesium is a key mineral as it relaxes the body. Most people are short of it as we only get about half as much magnesium in our food as we did 100 years ago. I would suggest starting with about 200mg twice daily and doubling it if needed (see magnesium leaflet for more details).

L Theanine works for some people as it aids relaxation. Take 200mg 30 minutes before bedtime.

CBD Oil can help in some people. Use full-spectrum CBD oil. Start with a small amount and increase gradually and can fall asleep easily and stay asleep for 7-9 hours.

Other Approaches

Stop coffee for most of the day (although morning coffee may be beneficial). Taking exercise is very important otherwise you will have an overactive body when you go to bed (however exercise in the evening raises body temperature and can worsen sleep).

It is well documented that a cooler core body temperature at night enhances sleep. So keep the temperature in the bedroom low.

A few people get sleep apnoea where they stop breathing at night for up to a minute. It is usually the spouse who notices this. Often this happens to people who are overweight and snore. This can need a specific treatment.

Eating within a time window so no food it taken for at least 12 hours, say from 6pm to the following morning, often helps. This is good for health and aids weight loss. It also avoids the sleep-disrupting effect of a drop in blood sugar during sleep which occurs after eating carbohydrate-rich foods or alcohol late in the evening. These often lead to early morning wakening.

The Gominak Protocol

Dr Stacha Gominak is a neurologist specialising in sleep disorders. In deep sleep the body becomes temporarily paralysed and repairs itself. This is an essential function. She found some people failed to do this. Often they slept badly, felt tired in the morning or had pain when they woke up. She found this was very common. These people failed to trigger the deep sleep switch.

      Almost by accident she discovered that Vitamin D made a difference to these people and their sleep improved as long as their Vitamin D levels stayed on the high side (between 150-200 mmol/l). (She later found this stimulated the microbiome –see below).

However often this would work for a year or two and then many would relapse. She found the answer to this relapse was giving B vitamins. Normally most B vitamins are produced by gut bacteria (the microbiome) but many things in our world damage the microbiome so many people simply don’t produce enough B vitamins.

   The answer was to give a B50 vitamin supplement (that’s with 50mg of most B vitamins –these are widely available) and a B12 tablet (if levels were below 350). This should be continued for 3 months. These should then be stopped as the microbiome should then have been repaired and should be doing its job and making enough B vitamins. Paradoxically some B vitamins (mainly B5) could make sleep worse if levels were too high so this is the reason for stopping taking them after 3 months.

Body Rhythms

Our body have evolved to work in a natural cycle in rhythm in tune with natural light. Our use of artificial light has changed all this. When we live under natural light or spend more time outdoors we secrete the right amount of hormones such as melatonin which helps us sleep. The use of computers, mobile phones, pads and TVs which emit a blue light and stimulates us makes our body thinks its morning or midday when it isn’t. The way to get round this is to make sure you get exposure to natural light outdoors in the morning. We receive vastly more light stimulation when we are outdoors than indoors. A walk in the morning for 15 to 20 minutes is ideal so the body thinks it’s time to wake up. In the evening put phones, pads and computers away one or more hours before bed times. Keep the TV off or at a distance and turn other lights down. Keep the bedroom as dark as possible and don’t use TVs or phones in the bedroom. Glasses are available for about £20 which filter out blue light and some people have found using these for the hour before bedtime makes a real difference. There are also apps to reduce blue light on phones and pads. One study showed that people who used iPads before going to bed slept worse than those who used books.

Another strategy is to get up half an hour earlier than your normal time every day. Do this regularly for two weeks however tired you feel. Although this is counter-intuitive, research has shown this can be effective.

Electromagnetic Stress

Electromagnetic fields can cause problems – don’t have mobile phones charging near the bed as they emit microwaves which interfere with sleep. Don’t use mobile phones for alarms as they will be too close and particularly don’t put them under the pillow. Switch wifi off at night.

A few people are affected by geopathic stress –this is due to harmful energy patterns often from underground water. The clue to this is if you sleep better at another site, such as on holiday (although it can take a few days to improve). If you suspect this sleep in another room for a week or change the position of the bed.

Mental Techniques

     Because people can get so understandably hung up about lack of sleep they sometimes think about it all the time. This is a mistake because, as the saying goes, “You get what you focus on”. So deliberately focus on the days you slept well – maybe even recording them and perhaps giving thanks for them helps and put the bad nights out of your mind as much as you can.

Experiment with these, none will work every time. Find out what works for you.

  1. Whenever you have any thoughts imagine you have a blackboard eraser and just keep rubbing them out over and over again
  2. Try keeping your eyes open and looking at one area in the room until you want to close them.
  3. Visualise the letter A on one side and the number 1 on the other. Keep going slowly through the alphabet and numbers (ie next go to 2 and B) noticing if they change colour. Ideally do each number and letter with each breath. When you get to the end of the alphabet go backwards with the letters. Another version of this is to start with number 300 and just go backwards.
  4. Regard all the extra time you don’t sleep as bonus time and think of all he good times you’ve had and all the good times you’re going to have.
  5. If you wake up –remember what you have been dreaming –helps in getting back to sleep.

Using relaxation or sleep CDs or use free apps like Insight Timer which have which have many sleep programs which you can listen to help sleep or if you wake up in the early hours.

Remember the biggest problem is usually worry about how you will be the next day rather than the actual sleep loss. Many of the great achievements of mankind have been done after a poor night’s sleep – how many people have slept badly before a big event and come through it fine? As long as you are resting in bed your body is getting rest of a kind. Tell yourself that the loss of sleep won’t matter – and then it most likely won’t.

Sleep Aids

          These are a more expensive solution but are worth considering for those with severe sleep problems.

          One is the Alpha-Stim which is a cranial electrotherapy device which puts out a microcurrent of electricity and produces alpha waves in the brain. This is associated with calmness and relaxation. This typically allows people to fall asleep quickly. It is now approved by NICE for anxiety disorders. The advice is to use it between 20 to 60 minutes a day for 4 to 8 weeks and then reduce to three times a week. It costs £480 but can also be rented.

          Another device is the Sleep Hub. These play sounds which retrain the brain to produce the brain waves of sleep. Research found 92% of people experienced an average of 2 hours and 35 minutes extra sleep per night and it reduced night time wakening. These cost about the same as the Alpha-Stim.