Do You Have Difficulty Sleeping?

Healthy sleep provides many benefits, including improved immune function, maintaining a healthy body weight, good memory and improved blood glucose regulation (lowering the risk for Type 2 diabetes).

Unfortunately, the use of pharmaceutical agents (hypnotics) to allow people to sleep is associated with an increased risk of death (Kripke, DF, Langer, RD, et al. BMJU Open 2012: 2(1):E000850).  The Kripke study compared the mortality and cancer risk of benzodiazepine type drugs (e.g. Xanax) to older drugs prescribed for the same use.  Their surprising finding was that use of any prescription hypnotic carried a substantially elevated risk of dying compared to individuals who used no drugs.

The statistics are startling:

• Less than 18 doses per year increased the risk of dying 3.6 times
• 18 to 32 doses per year increased the risk 4.4 times
• More than 132 doses per year increased the risk 5.3 times
• At the higher end was associated with a significant increased risk of cancer and was not attributable to pre-existing disease

So, what to do? Fortunately, there are a number of excellent herbal products that improve sleep quality.  The trick is to determine what kind of disrupted sleep pattern each person experiences. The classification of types of insomnia include the following:

• Difficulty falling asleep (technically called sleep onset insomnia)
• Awakening during the night and experience difficulty falling asleep again (sleep maintenance insomnia)
• Early morning awakening with an inability to go back to sleep for hours, if at all (sleep offset insomnia)
• A sense of not having enough sleep (non-restorative sleep). This has no correlation with how long a person actually sleeps; it is a subjective sense of fatigue and is often associated with chronic fatigue syndrome.

Do you recognize yourself in any of these categories?

Factors that contribute to sleep onset insomnia include anxiety, pain or discomfort, caffeine and alcohol.

Sleep maintenance and sleep offset insomnia are often linked to depression, anxiety, sleep apnea, hypoglycemia, pain or discomfort (as in fibromyalgia) and alcohol.  Oftentimes hypoglycemia is the unrecognized culprit. As blood sugar levels drop, the adrenal glands secrete cortisol to raise the sugar level in the blood; however, cortisol also stimulates the brain causing sleeplessness.

Non-restorative sleep is often associated with the poor adrenal function that is the hallmark of chronic fatigue syndrome.  Supporting adrenal function often results in a much more satisfying night’s sleep. Paradoxically perhaps, using adrenal tonics improves sleep quality. They “tonify” your sleep pattern.

Another symptom that can interfere with getting a good night’s sleep is restless leg syndrome.  The diagnosis is made based upon symptoms:

• Do you have unusual sensations in your legs? Some people describe the sensation as “electric shocks.”
• Are these sensations stronger at night, sometimes awakening you from sleep?
• Is your response to move your legs to relieve the discomfort?
• Does walking around relieve the symptoms?

A number of lifestyle factors have also been associated with restless leg syndrome, including heavy smoking, advanced age, obesity, hypertension, loud snoring, use of antidepressant drugs, diabetes and a lack of exercise. Long-term antihistamine use can result in refractory (or untreatable) restless leg syndrome.

One study found that people with varicose veins had a very high incidence of restless leg syndrome. After vein stripping, 98% of patients reported immediately improvement in their symptom pattern.

However, the good news is that there are very safe and effective herbal and nutritional supplements that provide relief for all of these problems.

Medi-Herb founder Dr. Kerry Bone gave an extremely interesting seminar relating to the scientific evidence that supports the use of herbal remedies for sleeplessness.

Anxiolytic and hypnotic herbs are the mainstay of support for improved sleep.  In severe cases, the herbs can be taken at a low dose throughout the day to avoid the build up of tension or mental excitability, which might lead to insomnia.  In mild cases, a single dose at bedtime is sufficient.

• A mainstay for insomnia is Valerian.  It has been demonstrated in a double blind study that Valerian extract was at least as effective as benzodiazepines in improving sleep quality without the detrimental effect on cognitive processes and psychomotor performance the prescription drugs cause. (Hallam KT, Olver JS, McGrath C, et al., Hum Psychopharmacol 2003:18(8): 619-625) Valerian acts as a “sleep trainer.” It resets the sleep/wake cycle and is therefore most effective when taken for a minimum of 3 weeks.  The study mentioned above lasted for 6 weeks.  If you find no effect after 3 weeks, it is probably not the right formula for you.  I recommend Medi-Herb’s Valerian Complex for this use.  The dose will depend upon your personal symptoms, but in general it is dosed at 1 in the morning and 2 before bed. Valerian Complex also contains passionflower and spiny jujube, which also promote restful sleep.

• When the problem is anxiety (including panic attacks), Kava Forte is the formula of choice. I can only recommend the Medi-Herb product, because they are using water extraction and are only using traditionally recognized strains – so-called “noble cultivars.” In the next newsletter I will detail how corporate greed injured the reputation of this valuable herbal tool.

• For those of us who suffer from fibromyalgia and central nervous system pain issues, the choice is Nervagesic.  This formula contains California Poppy, Cordyalis and Jamaican Dogwood. Personally, I have found it to be the most effective for dealing with fibromyalgia pain and pain in my hip from my post-concussion syndrome. St. John’s Wort, Skullcap, Damiana and Schizandra are nervine tonic herbs that are also useful for fibromyalgia and problems with sleep maintenance.  These are found in a Medi-Herb product called Nevaton.

• For patients with chronic fatigue syndrome and non-restorative sleep, Withania sominifera is particular useful.  Its Ayurvedic name is Ashwaganda, and Medi-Herb provides a liquid that can be used just before bed to improve sleep. 4 ml is an adequate dose for most people.

• There are other adrenal tonics that help with sleep maintenance insomnia, as well.  Adrenal Complex contains Licorice and Rehmannia; these herbs help maintain blood sugar levels during the night.  Rhodiola and Ginseng can also assist in tonifying the adrenal glands and improving sleep maintenance; as does Chaste Tree.

• With regard to Restless Leg Syndrome, there are a number of therapies available.  First of all, increasing your magnesium intake has been shown to provide benefit.  At least 300 mg daily seems to work well. Also, a double blind study indicated that Valerian improved both RLS symptoms and daytime sleepiness.  (Cuellar NG, et al, Altern Ther Health Med 2008; 25(2): 22-28) For those with problems with blood circulation (i.e. varicose veins), Horsechestnut Complex, which is venotonic, offers benefit.

As you can see, there are a wide variety of possibilities to help you improve your personal sleep issues.  To obtain a customized protocol, please call me and schedule a consultation appointment to optimize your restful sleep.

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