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ZooScape Health Newsletter
Tuesday, November 10, 2009
How Can I Get a Really Good Night's Sleep?
"People who say they sleep like a baby usually don't have one." - Leo J. Burke
How many nights of the year do we go to sleep feeling like we have accomplished everything we had hoped to for the day?
If your life is anything like mine, your answer is likely very close to zero. When did life become so busy that reading leisurely and sleeping in on weekends often leaves us feeling guilty? Our lives are so highly structured that our time awake determines the time permitted for sleep, and not usually the reverse. As such, we force as many productive minutes into our day as we can to justify maximal productivity levels to others and ourselves, and often sacrifice a good night's rest in the process. And when we finally do retire to bed for the night, our minds frequently race with distracting thoughts of today and tomorrow and prevent us from being able to sleep well, leaving us more tired and sleep-deprived the following night. And so the vicious cycle continues! Of non-sleep, that is.
Sleeping Disorders
Sleeping disorders are medical disorders characterized by sleep pattern disturbances that quite often interfere with one's usual mental, physical and emotional functioning. Using a recording device known as a polysomnogram, sleep technicians can test for sleeping disorders. Polysomnograms are multi channel ("poly") tools that record ("gram") sleep ("somno"). Important body movements, heart and chest activity and oxygen and airflow are detected while sleep onset and efficiency are carefully assessed during sleep stages. (1)
4 Stages of Sleep + 1
Sleep studies reveal that the act of sleeping is much more complex than we understand it to be. It can be broken down into stages that are experienced cyclically and can be simply categorized as either REM sleep or non-REM sleep. Sleep cycles take approximately ninety to one hundred and ten minutes to complete and are repeated sequentially over the course of a night. REM sleep is usually shorter in duration earlier in the night and lengthens later at night as deep sleep time is reduced.
... When our head finally hits the pillow...
-> Stage 1
Light sleep is experienced in this stage as "drifting in and out" of consciousness and reflects slow eye movement and decreased muscle motion. In this stage of sleep, one tends to experience abrupt muscle contractions followed by falling sensations. Accordingly, individuals in this stage can be easily woken up. (2)
-> Stage 2
Light sleep continues in the second stage as eye movement ceases and brain waves slow down.
-> Stage 3
Deeper sleep begins as very slow brain waves (delta waves) combine with smaller, faster waves. In these stages of deep, refreshing sleep, it is difficult to wake someone. (2)
-> Stage 4
Deep sleep continues as slow delta waves take over in the fourth stage. Deep sleep stages are typically when children will sleep walk, wet the bed and experience terrors at night. (2)
-> REM Sleep
"Rapid Eye Movement" sleep consumes approximately 20-25% of total sleep time and is the stage in which memorable dreaming occurs. In this stage, breathing speeds up and becomes more irregular while muscles of the limbs paralyze momentarily. Brain waves restore to levels that mimic those in wake stages, and heart rate and blood pressure increase. When awoken from REM stages of sleep, individuals can usually remember dreams quite vividly. (2)
Types of Sleeping Disorders
Broad categories of sleep disorders often include: dyssomnias (insomnia- difficulty sleeping, hypersomnia- excessive sleepiness, circadian rhythm sleep disorders), parasomnias (abnormal movements, behaviour, perception, emotion and dreams), psychiatric/medical conditions as precursors to sleep disorders, sleep sickness and snoring. (1)
- Insomnia, a common disorder, is a symptom/ type of sleep disorder that is manifested when an individual has trouble falling asleep or staying asleep. Other types of sleep disorders include:
- Narcolepsy: extreme daytime tiredness often resulting in sporadic and unwilling sleep onsets in inappropriate contexts
- Cataplexy: spontaneous muscle weakness resulting in collapse
- Bruxism: uncontrolled clenching or grinding of the teeth while asleep
- Advanced Sleep Phase Syndrome (ASPS): early/advanced evening tiredness coupled with early morning rising
- Delayed Sleep Phase Syndrome (DSPS): delayed tiredness coupled with delayed rising
- Sleep Apnea: breathing pauses during sleep whereby episodes are referred to as apneas
- Circadian Rhythm Sleep Disorders (situational), Shift Work Sleep Disorder (SWSD) & Jet Lag: sleep disorders affecting the timing of sleep
- Rapid Eye Movement Behaviour Disorder (RBD): violent or spectacular dreams acted out during REM sleep
- Restless Legs Syndrome: irresistible urges to move one's legs to reduce uncomfortable, unusual (prickly, tingly) feelings in the body (1)
"A ruffled mind makes a restless pillow."
Sleep Patterns over the Life Cycle
Not only does the type of sleep that we experience vary within our sleep periods and across sleep disorder categories, but sleep can also change quite significantly as we age. The general trend is a decrease in sleep time as age increases.
-> Infancy & Childhood
Babies need incredible amounts of sleep and reasonably spend most of their busy days (you guessed it) sleeping! On average, newborn infants sleep for 16 to 20 hours a day and reduce sleep time to about 13-14 daily hours by their first year of life. The incredible amount of sleep time required in infancy and childhood is logical, considering the amount of growth and development that occurs in these delicate life stages. It is not surprising that quantitatively speaking the most REM sleep (approximately 50% of total sleep time) is experienced by children.
-> Adolescence
Teenagers need less sleep than children but are still encouraged to sleep about eight to eight and a half hours a night. They tend to share a common biological interest in staying up late at night and sleeping in in the morning. Teenagers are generally active and experience significant growth and development in these formative years of the life cycle. Thus, adolescents require ample sleep time and high quality sleep.
-> Adulthood
I use the term "most" loosely in this context in stating that most adults sleep about six and a half to eight hours daily. Naturally, there is variance existing in the adult population with respect to total daily sleep time. Adulthood reflects a diversity of lifestyles and family experiences, and these backdrops directly influence adult sleeping patterns. Adults experience about 20% REM sleep and increased time spent in the second stage of light sleep, perhaps reflective of their responsibilities, stresses and distractions.
-> Late Adulthood
Typically, older adults sleep less and experience a progressive reduction in REM sleep. It is important to consider the reasons for decreased total sleep time in this stage of life. Older adults sleep less because of factors that disturb/affect their ability to sleep comfortably, not usually because of a perceived need for less sleep. They are often afflicted with dyssomnnias, parasomnias, (ie. Restless Legs Syndrome) and other sleep disorders that directly influence their sleep quantity and quality. While REM and deep, recuperative sleep (delta sleep stages three and four) decrease in older age, light sleep (stage one) increases. (4)
What else influences sleep?
A Recent Statistics Canada report based on Canadian Community Health Survey data revealed that sleep is influenced by and large by lifestyle and gender.
On average, women sleep more than men but experience more difficulty falling asleep and staying asleep. Further, a wide range of lifestyle factors affect sleep patterns, some of which include:
1. Income (higher income employees tend to sleep more)
2. Job Status (full-time workers tend to sleep less)
3. Commuting Time (individuals with longer commutes tend to sleep less)
4. Marital Status (married and common-law living Canadians tend to sleep less)
5. Dependent Status (Canadians with children tend to sleep less with further sleep time decreases experienced as the number of dependent children increased) (5)
"The Daily" Insomnia Study identified other factors contributing to insomnia such as:
1. Stress
2. Pain
3. Chronic conditions such as arthritis, back/ neck pain, sciatica, incontinence
4. Middle-age
5. Widow Status
6. Educational Status
7. Weight
8. Drug and Alcohol (use and withdrawal)
9. Work Schedule (ie. shift work changes)
10. Life Stress (6)
"When you have insomnia, you
're never really asleep, and you'
re never really awake." (from the movie "Fight Club")
Melatonin: Essential in Sleep Pattern Regulation
Melatonin
Melatonin, N-acetyl-5-methoxytryptamine, is a natural hormone (specifically a neurotransmitter- "neural/neuron cell" "transmitting agent") that acts as a chemical messenger in the body and relays, adjusts and magnifies nerve impulse signals between neural cells across a synapse (space).
Melatonin is a neurotransmitter produced in the pineal gland found at the base of the brain that regulates circadian rhythms, our body's natural biological (time) clocks. Since melatonin is directly associated with our internal time clock functioning, one can reason that adjusting melatonin levels in the body by virtue of consuming supplemental melatonin can help re-balance and support functional sleep patterns that are highly dependent on internal time control mechanisms. Melatonin helps "reset" our internal (time) body clock, allowing sleep-wake cycles to normalize in the body. (7)(8)
Many studies have explored the effect of supplemental melatonin on sleep processes and have discovered the significant impact that melatonin has on regulating sleep mechanisms in the body. Further, melatonin supplements avoid the irritable side effects and risks common to prescription sleep medications such as addiction. Double blind studies conducted in young adults indicate that melatonin directly aids sleep by reducing the amount of time that it takes for an individual to fall asleep, decreasing the frequency of night awakenings and contributing to an overall improvement in sleep quality. (15)
In particular, melatonin is recognized as a valuable sleep aid for travelers and for individuals suffering from mild sleep disorders. For example, Jet Lag, the physiological consequence of one's biological clock having been interrupted in crossing time zones can manifest in symptoms such as fatigue, insomnia, grogginess, irritability, headaches, nausea, digestive issues and irregular sleep patterns. (16) Double blind trials reveal that when compared to a placebo dose administered to study subjects, melatonin doses given to international flight crew prior to and following extended flights led to decreased jet lag symptoms, increased mental alertness and expedited energy recovery time in these subjects. (15)
There is debate as to whether or not melatonin levels actually decrease in old age. Regardless of contradictory claims that exist around these ideas, there is strong support for reduced sleep hours in older age and similarly for the prevalence of insomnia. Melatonin, structured to amplify the sleep-wake cycles of our biological clocks can be helpful in improving sleep quantity and quality.
Other Indications for Melatonin:
- Depression
- Alzheimer's
- Headaches
- Immunity
- Anxiety
- Panic disorder
- Menopause
- Schizophrenia
- Osteoporosis
- Heart disease
- ADHD
- Arthritis
- Epilepsy
- Tinnitus
- Cancer (15)
Herbal Sleep Aids
1. Valerian Root
Valerian Root (Valeriana officinalis) is well recognized for its sleep promoting properties and has thus been used as a medicinal herb since the times of ancient Greece and Rome. It is a perennial plant common to Europe and Asia that bears pink and white sweet odorous flowers. Clinical trials have been conducted with Valerian preparations and have shown that Valerian was more effective than the placebo in inducing sleep after having been used for about twenty-eight days of treatment. (11)
Other Names:
- Wild Valerian
- Blessed Herb
- Capon's Tail
- Garden Heliotrope
- German Valerian
- Tagara
- Setwall
- Vandalroot
- All-Heal
Sleep Promotion:
The active compounds in Valerian Root are valepotriates, which have recognized sedative properties and are thus considered useful for individuals suffering from chronic insomnia. Following use of Valerian root, insomniacs are able to fall asleep faster and feel more relaxed in the morning when they rise. Since Valerian root also acts as a muscle relaxant, it can be used to help control hypertension as well. Valerian is said to help calm the overactive mind and is not reported to interfere with concentration levels. (11)
Above and Beyond: Other Uses for Valerian Root
- Stress disorders (nervous excitability etc.)
- Neck and shoulder tension (ie. asthma, IBS, muscle spasms, colic, menstrual pain)
- Hypertension (high blood pressure)
- TMD
- Incontinence
- Phobias
- Epilepsy (11)
2. Lemon Balm (Melissa Herb)
Lemon Balm's botanical name Melissa is derived from the word "mel," meaning honey, and is suggestive of its connection to bees. (12) Ancient beekeepers were said to have rubbed lemon balm on beehives so as to increase the affinity of bees to the hives and retain increased bee populations for their purported healing benefits. Like Valerian Root, Melissa is a perennial plant. It has leaves that have a strong lemon scent and is commonly used for its sedative properties. (13)
Other Names:
- Melissa
- Garden Balm
- Bee Balm
- Cure-All
- Dropsy Plant
- Honey Plant
- Sweet Balm
Sleep Promotion:
Volatile oils (specifically Citral and Citronellal) are considered the active basis of Melissa and are said to stimulate relaxing effects on the body muscles and help quiet the central nervous system. These calming effects help expedite sleep onset and improve sleep quality. Polyphenols found in lemon balm have recognized antiviral properties and can thus be considered useful for cold sores and the herpes simplex virus. (13)
Above and Beyond: Other Uses for Lemon Balm
- Stress-related digestive problems (ie. colitis, dysentery, colic)
- Pain
- PMS
- Headaches
- Vertigo
- Hypertension
- Coughs
- Asthma
- Colds & Flu
- Overactive thyroid
- First Aid Remedies (insect stings, cuts) (13)
3. Passion Flower
As the name might otherwise suggest, functionally, Passion Flower has no association to strength and excitement that the word "passion" may speak to. Instead, Passion Flower's name lends to its fringed flower that bears a resemblance to the crown of thorns in the passion of Christ. Like Valerian Root and Lemon Balm, Passion Flower is traditionally used as a natural sedative.
Other Names:
- Passiflora
- Apricot Vine
- Passion Vine
- Purple Passionflower
Sleep Promotion:
Passion Flower is indicated as a central nervous system sedative that is functionalized through the concerted efforts of its active flavonoids, alkaloids and 8-pyrvone derivative components. The flavonoids found in Passiflora are said to act as antispasmodics, anti-inflammatories and thus explain Passion Flower use for hypertension and mild palpitations in addition to sleep promotion. (13)
Above and Beyond: Other Uses for Passion Flower
- Pain
- Anxiety
- Colic
- Asthma
- Hypertension
- Neuralgia
- Sciatica
- Shingles
- Parkinson's disease
- Headaches
- Panic
- Heart palpitations
- Toothaches
- Cramps (14)
The Power of Synergy
Valerian Root, Lemon Balm and Passion Flower are all well recognized for their value in calming the nervous system. These herbs help provide antispasmodic action by acting on tense muscles and are thus considered quite useful in relaxing the body and mind, particularly for those suffering from insomnia, anxiety and hypertension.
Insomnia Formula (with Valerian, Lemon Balm & Passion Flower)
Other supplements and herbs associated with Insomnia
Chamomile
5-HTP
Vitamin B6
Magnesium
Calcium
Hops
What can be done?
"There is only one thing people like that is good for them; a good night
'
s sleep"- Author Unknown
So, what exactly can we do to remedy the restlessness and anxiety that we experience, and improve our sleep quantity and quality to a level that allows us to be able to perform our best? While I would love to be able to report that the answer can easily be found in a magic pill, this is not simply the case.
It is essential for us to realize that our health issues are an expression of our complex body systems. And so, these imbalances in our bodies are as multifaceted as our selves. They simply cannot be appropriately understood by considering a single angle, or corrected by taking a single capsule out on the market. I strongly believe that we must consider the layers of complexity involved in health. We must seek to address contributing factors from our contexts that are intricately involved in the process of modifying and restoring proper functioning of our systems. Natural herbs and supplements may be a step in the right direction when other health disparities are considered just as carefully.
Additional options...
- Sleep diaries
- Relaxation techniques (ie. breathing exercises)
- Stretching
- Yoga
- Meditation
- Music therapy
- "Decaffeinating" (especially before bed)
- Drinking calming teas
- "You" time
Though we may not all be employed as airline crew, nurses or other professionals working shift work on a regular basis, juggling multiple roles and commitments in life can leave us feeling the repercussions of strenuous work shifts. When sleep is framed as a task and devalued as a time to relax, meditate, recuperate and restore in the hustle and bustle of everyday life, it can become a challenge. The value of sleep ought to be communicated and honoured, especially in these challenging times.
"The best bridge between despair and hope is a good night's sleep." - Author Unknown
Sweet Dreams!
Tanya
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
Third-Party Research References:
1. http://en.wikipedia.org/wiki/Sleeping_disorder
2. http://www.sleepdex.org/stages.htm
3. http://en.wikipedia.org/wiki/Valerian_root
4. Herbs for the Mind: What Science Tells Us About Nature's Remedies for Depression, Stress, Memory Loss, and Insomnia Marjorie Baier. Journal of Psychosocial Nursing & Mental Health Services. Thorofare: Sep 2003. Vol. 41, Iss. 9; pg. 56
5. http://www.statcan.gc.ca/daily-quotidien/080422/dq080422b-eng.htm
6. http://www.statcan.gc.ca/daily-quotidien/051116/dq051116a-eng.htm
7. http://www.melatonin.com/melatonin-faq-general.php
8. http://en.wikipedia.org/wiki/Circadian_rhythm
9. Melatonin agonist tasimelteon (VEC-162) for transient insomnia after sleep-time shift: two randomised controlled multicentre trials Shantha M W Rajaratnam, Mihael H Polymeropoulos, Dennis M Fisher, Thomas Roth, et al. The Lancet. London: Feb 7-Feb 13, 2009. Vol. 373, Iss. 9662; pg. 482, 10 pgs
10. Chronic insomnia: A practical review Vijay Rajput, Steven M Bromley. American Family Physician. Leawood: Oct 1, 1999. Vol. 60, Iss. 5; pg. 1431
11. http://www.herbs2000.com/herbs/herbs_valerian.htm
12. Lemon Balm (Melissa)
13. http://www.herbs2000.com/herbs/herbs_lemon_balm.htm#lemon_balm_body
14. http://www.herbs2000.com/herbs/herbs_passion_flower.htm
15. http://www.herbs2000.com/h_menu/melatonin.htm
16. http://en.wikipedia.org/wiki/Jet_lag#Symptoms
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