The Necessity of Good Sleep
Sleep is necessary to repair damage done to the body during an active day. It is when the healing systems of the body work at optimal efficiency. It is also when the files inside your brain are resorted and put back in order for optimal cognitive function. Without at least 7-9 hours of good sleep every night (including at least 4 hours of deep sleep), all systems of the body suffer and the incidence of all diseases increases.
Every time you go to sleep, you are making a deposit into your health safety deposit box. This is a very stingy bank, however, and at least 7 to 8 hours of sleep are required out of every 24 hours to keep from drawing down reserves.
If your body has been stressed, sleep is especially important because reserves are already low. Ironically, people suffering who are chronically stressed often find sleep hard to come by. Though stress is frequently a factor in poor sleep, inflammation of brain tissues causes irritability and excessive wakefulness. Unlike normal people who get sleepy as they get tired, people with chronically suppressed immune systems typically become agitated as they get tired and sleep is less likely.
Restoring normal sleep is essential for feeling your best. Generally this does take some effort, but the reward is feeling better.
What Prevents Normal Sleep?
A few lucky people in the world seem to never experience difficulty sleeping, but most people will be touched by not sleeping well at some point in their lives. People who are naturally alert will have greater difficulty sleeping than most. For those people, just the thought of something stressful is enough to keep them awake at night.
Poor sleep is not actually a disease. Instead, it is a manifestation of neurotransmitter imbalances in the brain, most commonly occurring as a reaction to stressful situations. Stress disrupts hormone balance and suppresses neurotransmitters in the brain necessary for sleep.
When stress becomes chronic, poor sleep can be a nightly aggravation; the nervous system becomes wound up, causing extreme tiredness, but at the same time, agitation that prevents sleep.
Beyond the day-to-day stress associated with modern life, the modern world is saturated with artificial light. Clinical studies have demonstrated that artificial light at night is associated with suppression of normal melatonin levels and disruption of normal sleep.
Many natural processes, including aging, can also adversely affect sleep. People tend to struggle more with sleep as they grow older. Menopause, a natural process, is almost always associated with disrupted sleep, Fortunately for most women, the disruptions caused by menopause gradually resolve and sleep does return to normal.
Sleep disturbances are common for individuals with chronically suppressed immune systems. Though chronic stress is a common culprit for sleeplessness, inflammation of brain and nerve tissues may also be a contributing factor. Numerous clinical studies have linked inflammatory markers of systemic inflammation in the body with sleep dysfunction. This may explain why poor sleep can occur with a chronic health condition, even when the body and mind are in a relaxed state.
Reversible causes of disrupted sleep include:
- Artificial lighting and computer screens
- Gastrointestinal issues (reflux, IBS)
- Working long hours
- Rebound sleeplessness from taking sleeping pills
- Environmental factors (noise, light, bed partners)
- Pain or restless legs
- Stress and anxiety
- Stimulants in food and drink
- Working odd day/night shifts
Dr. Rawls’ Tips for Better Sleep
- Adjust the thermostat – Being overly hot or overly cool can adversely affect sleep.
- Get a sleep test – If your partner reports that you snore excessively, you may have sleep apnea. See a neurologist or visit a sleep center for testing.
- Don’t exercise late – Vigorous exercise during the day is excellent therapy for insomnia, but should be avoided after 8pm except for relaxing routines such as yoga or Qigong. The gentle relaxing movements of Qigong are perfect for promoting a relaxed state before going to bed.
- Take a warm bath before bedtime – Warm water is both soothing and relaxing.
- Avoid excessive light stimulation – Use low lights and turn off televisions and especially computer screens after 8pm. This will help stimulate natural melatonin levels. Always sleep in a very dark room. If you work an odd shift, use darkening shades to completely darken the room where you sleep.
- Avoid blue light computer screens – Blue light suppresses melatonin and keeps your brain alert. If you read from a tablet, buy a tablet that allows reading without blue light or download an app for removing blue light from the screen. There are several programs available for download. The most popular is f.lux (justgetflux.com).
- Sleep on a comfortable mattress – “Memory foam” mattresses or tops are especially conducive to a good night’s sleep and allow for sleeping on the side. Sleeping on your back encourages sleep apnea.
- Limit noise pollution – Try to limit noise like outside traffic, snoring bed-partners or restless pets. Consider obtaining an electronic device that produces “white noise” to drown out surrounding sounds. A HEPA air filter unit by the bedside is a great option.
- Isolate yourself – Be aware that your bed partner may be keeping you awake. Movement and snoring from a person or pet in the room may be contributing to sleeplessness. Consider sleeping in an isolated location until your sleep quality improves.
- Learn how to turn your brain off – Become a master of the simple breathing and relaxation exercises. There are almost unlimited options for accomplishing this goal, but if you want to overcome sleeplessness, consider it essential.
- If you choose to supplement with melatonin – Use melatonin 1 mg sublingual tablets (under the tongue). This dose will stay in your system only about 30 minutes and mimics natural melatonin secretion. The dose can be repeated if awakening occurs during the night. Large doses of melatonin (3-5 mg) taken orally may actually disrupt deep sleep and should be avoided.
Support for Normal Sleep
In addition to anti-inflammatory properties, use of SAMe is associated with positive mood and normal sleep. SAMe should be avoided if taking antidepressant medications. The dose for achieving beneficial effect, however, is 1200 mg daily – making SAMe an expensive choice.
Lavender essential oil – Put a few drops on your pillow to support a calm state.
Chamomile tea – The most well known of all calming teas. Note that chamomile works great for some people, but causes stimulation in others. Look for a bedtime tea blend that contains lemon balm and other sedative herbs.
5-HTP – 5-HTP is a precursor of serotonin in the brain. For some people this a link to better sleep and sleeping through the night. The standard dose is 100-300 mg in the evening.
Be careful of products containing valerian root or kava. Both of these substances have been associated with inducing liver damage. Kava is habituating if used chronically.
In general, the ingredients in these supplements will not interfere with any type of drug therapy, but you should consult your healthcare provider before taking these supplements with medical therapy.
When to Call Your Doctor
When occasional sleeplessness becomes a nightmare of nighttime wakefulness, it’s time to see your doctor. Before you go, however, you should know something about medical therapy options that may be offered. When sleeplessness is severe and unrelenting, medications can play an important role in breaking a vicious cycle. Even so, potential side effects associated with drug therapy and the potential for habituation and dependence must be respected.
It should also be noted that certain medications can actually cause sleeplessness. Serotonin-reuptake inhibitors (Prozac, Zoloft, Effexor, Wellbutrin, many others), taken for anxiety and depression, are notorious for disrupting sleep in certain individuals.
Consult with your physician if you experience:
- Chronic Sleeplessness
- Restless Legs
- Sleep Apnea (Commonly associated with excessive weight)
- Chronic Pain
- Habituation to Sleep Medications
*Statements on this page have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. For medical concerns, please consult a qualified healthcare provider.
1. Zhang et al, Differentiating Nonrestorative Sleep from Nocturnal Insomnia Symptoms: Demographic, Clinical, Inflammatory, and Functional Correlates, Sleep. 2013 May 1; 36(5): 671–679.
2. Irwin, Olmstead, Carol, Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation, Biol Psychiatry, June 2015, in press
3. Cappuccio, D’Elia, Strazzullo, Miller, Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies, Sleep. 2010 May;33(5):585-92.
4. Kline, et al, Sleep Hygiene Behaviors Among Midlife Women with Insomnia or Sleep-Disordered Breathing: The SWAN Sleep Study, J Womens Health (Larchmt). 2014 Nov 1; 23(11): 894–903.
5. Lee et al, Cytokine Polymorphisms are Associated with Poor Sleep Maintenance in Adults Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome, Sleep. 2014 Mar 1; 37(3): 453–463.
6. Hall et al, Association between Sleep Duration and Mortality Is Mediated by Markers of Inflammation and Health in Older Adults: The Health, Aging and Body Composition Study, Sleep. 2015 Feb 1; 38(2): 189–195.
7. Drake et al, Stress and Sleep Reactivity: A Prospective Investigation of the Stress-Diathesis Model of Insomnia, Sleep. 2014 Aug 1; 37(8): 1295–1304.
8. Pillai et al, Moderators and mediators of the relationship between stress and insomnia: stressor chronicity, cognitive intrusion, and coping, Sleep. 2014 Jul 1;37(7):1199-208.
9. Bittencourt et al, Chronobiological disorders: current and prevalent conditions, J Occup Rehabil. 2010 Mar;20(1):21-32.
10. Bjorvatn, Pallesen, A practical approach to circadian rhythm sleep disorders, Sleep Med Rev. 2009 Feb;13(1):47-60.