Hello readers! Sorry for the lengthy absence — I went on vacation for awhile, and have been nose-to-the-grindstone on various projects since I returned.
The vacation was a blast — five families went in on a mansion rental in Truckee and we all played around in the snow. Five families under one roof leads to some interesting conversations — both frivolous and serious. One topic that came up a few times was sleep. Not everyone was getting some. Why is it that so many adults sleep poorly? In our case maybe it was the copious amounts of booze being consumed, but even teetotalers sometimes sleep poorly.
Chronic sleep deprivation is one of the worst states of consciousness. Insomniacs are wide awake at night, groggy and irritable during the day, and miserable most of the time.
Insomnia can be triggered by any of the following:
- emotional trauma (loss of a loved one, money stress, health worries, etc.)
- physical trauma (injury, surgery, chronic pain, stroke, etc.)
- breathing problems, including asthma and sleep apnea, which lead to frequent awakenings
- poor sleep conditions (room too hot or too cold, noise, light, mattress or pillow too hard or too soft, biting insects, etc.)
- disruption of circadian rhythms (from working a night shift, traveling through multiple time zones, or even watching TV or using digital devices in the evening)
- overuse or sensitivity to physical stimulants (coffee/caffeine, B-vitamins, high doses of zinc, some medicinal herbs, raw garlic, many street drugs, many pharmaceuticals, some nootropics)
- too much alcohol
- depression or mania (a vicious cycle, because sleep deprivation can also cause depression or mania)
- nutritional deficiencies that may affect calcium metabolism and/or melatonin production
Insomnia can manifest either as sleep-onset (difficulty falling asleep), nocturnal awakenings, and/or poor sleep quality.
My Own Experience
I experienced several years of poor sleep quality when I was suffering from asthma symptoms. Changing my diet and taking certain supplements (notably vitamin D) got rid of my chronic lung inflammation and led to much better sleep quality.
I also didn’t sleep well for the first couple years of my daughter’s life, even though my wife did much more nighttime care-giving than I did. Kia seemed to be able to fall back asleep more easily after comforting our daughter back to sleep.
My sleep greatly improved during our 30-day experiment with no artificial light. The takeaway from that experiment was to dim the lights much earlier in the evening, and to install f.lux on my laptop.
While I have been fortunate enough to never experience severe, chronic insomnia, I have learned a fair amount about which supplements and lifestyle habits influence sleep. And in the last few months, I have added a supplement which has taken my sleep quality from “pretty good” to “very good.”
Here’s what I’ve learned so far:
Seven Point Plan for Better Sleep
1. Don’t panic, and embrace quiet wakefulness.
If you are unable to fall asleep or fall back asleep, practice enjoying the in-between state of quiet wakefulness. Not sleeping eight consecutive hours is not necessarily pathological, and insomniacs often underestimate how much they are sleeping. There is nothing wrong with lying peacefully in the dark for a few hours while your mind wanders and you get in touch with your subconscious mind. Instead of “trying” to fall asleep and worrying about not getting enough sleep, experiment with relaxing and being comfortable. Even if sleep does not come (or stay), you can still experience a restorative rest cycle (and, according to the study linked above, you may be sleeping without knowing it).
If you are truly restless and obsessing about something, get up and write down what’s on your mind. Use candlelight or a red-spectrum light so that you don’t disrupt melatonin production.
2. Improve your sleep environment.
Ideally, your bedroom should be dark and relatively quiet at night, with some natural light coming into the room at dawn. If you can’t control your sleep environment to this degree, wear earplugs and a sleep mask.
3. Get emotionally clear.
If you owe someone an apology, then apologize. If you’re in the wrong, make it right. If you’re depressed, then do something about it. If your life is on the wrong path, then find the right one. If you have seen things that no person should see and you are suffering from PTSD, consider MDMA-assisted therapy.
4. Improve your calcium metabolism and strengthen your bones.
Good sleep is related to the absorption and utilization of calcium. Unfortunately, just taking a calcium supplement rarely helps — there are too many cofactors to consider. From a dietary perspective, here’s what you need to do:
- Get enough dietary calcium — here’s a link to recommended intakes and sources. Dairy products (full-fat, organic) are a good option for people who are able to digest lactose and who are not allergic to casein; otherwise whole sardines, canned salmon, cooked greens, and almonds are good sources.
- Take supplemental vitamin D3 — enough to get your blood levels into the recommended range. This will increase calcium absorption, reduce your risk of cancer, and improve asthma symptoms. Most MD’s seem to be recommending about 1000IU a day, but this may not be enough if your levels are very low (I take between 2000 and 4000IU most days simply as a maintenance dose). Note: I take fat-soluble vitamins like vitamin D with breakfast, as I’ve noticed vitamin D in particular can have a slight stimulating effect.
- Take supplemental magnesium — a chelated form such as magnesium glycinate — at least 200mg a day. Magnesium works synergistically with calcium, helps promote deep sleep and relaxation, reduces tics and twitches, and promotes regular elimination.
- Take supplemental vitamin K2. Vitamin K2 increases bone density, reduces risk of heart disease, and prevents cavities. Dr. Mercola calls vitamin K2 the “traffic cop” for calcium, controlling where calcium goes in the body via modulation of the hormone osteocalcin. I take a small daily dose of supplemental K2 (50mcg of the MK-7 form), and also eat foods high in the MK-4 form of K2 (aged cheeses, poultry liver, butter from grass-fed cows). I have noticed a significant improvement in sleep quality since I started taking supplemental K2, in addition to dietary sources.
Nutrition is extremely important, but the right kind of exercise is equally important for dense bones and deep sleep (which tend to go together).
The ideal kind of exercise for strengthening bone is “high impact”; motions that actually cause the bone to slightly bend. This includes sprinting, jumping, and very fast walking. Exercises like swimming, slow walking, slow jogging, and most weight-lifting won’t benefit bone strength in the same way.
Why do bone health and deep sleep go together? I don’t completely understand the relationship on a hormonal level, but my layman’s interpretation is that bone density decreases slightly during sleep (because of lack of weight/impact on the bones — similar to life in space), and having strong healthy bones provides a buffer against this natural effect, in essence telling the body that it’s “OK” to sleep deeply and for a long time.
5. Reset your circadian rhythm and encourage melatonin production.
A whole post on this one. Artificial light, which we generally take completely for granted, is both highly convenient and horribly disruptive of natural circadian rhythms. If you “try to go to bed earlier” you will generally fail in the long-term. Turning lights way down or completely off in the evening is the only way to get to sleep earlier unless you are a freak of nature whose melatonin production is not disrupted by artificial blue-spectrum light.
6. Avoid stimulating foods and supplements in the afternoon and evening.
This sounds obvious, but which foods and supplements count as “stimulating” can vary greatly from person to person. I learned from my 23andMe data that I’m a fast caffeine metabolizer, which confirmed the results of my no coffee experiment (cutting out caffeine didn’t notably improve my sleep quality).
On the other hand, I’ve noticed B-vitamins, zinc, and a number of herbal supplements prevent me from falling asleep easily. If you are having sleep issues, take a break from all supplements for awhile and see if that helps (then add them in one by one, starting by only taking the supplement in the morning).
7. Reduce sinus congestion.
Sinus congestion leads to snoring and sleep apnea. Reducing or eliminating commonly allergenic foods (cow’s milk, wheat), and reducing immune “twitchiness” (by optimizing vitamin D levels, taking probiotics, and getting plenty of exposure to good old dirt) can reduce sinus congestion and improve sleep. A cool temperature in your bedroom can also help. Here’s more on this topic.
That’s my list. I hope it helps a few people out there get some deep restful Z’s!
It’s important to realize that getting older doesn’t necessarily mean you won’t sleep as well. If you’re over forty and you drink scotch every day and never break a sweat (and this has described me at times), the last two factors are going to negatively affect your sleep much more than the first. After some lifestyle and supplement adjustments, I often sleep better now than I did in my twenties (and certainly better than I did in my thirties, when I was partying more, heavier, and less fit than I am now).
And as a bit of a curiosity, here’s a map of sleep disturbances.
If you found this post to be helpful, please share it.
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OneHotMess
Thank you, J. D.! Don’t forget menopause, and peri-menopause. Hot flashes all night, cold sweats to alternate. I haven’t sleep well in years.
J.D. Moyer
Ah … I know nothing about menopause … but this author seems to know what she’s talking about:
http://www.huffingtonpost.com/rebecca-booth/menopause-sleep-menopause_b_443902.html
According to the author the brain experiences a “fight or flight”/noradrenaline reaction to estrogen/reproductive hormone withdrawal … that’s an interesting idea. It sounds like very low dose HRT is effective for many women.
nekurahn
Hello JD,
Excellent post, as always. Here are a few points I’d like to add:
1) Although Calcium metabolism is very important, the two main nutritional deficiencies in relation to sleep are Magnesium & Zinc (and perhaps B6 to a lesser degree). These also happen to be extremely uncommon elements in the modern North-American nutrition. I’ve never had a patient who didn’t benefit from at least more Magnesium. And don’t forget to always take mineral supplements with food, unless they are in ionic form.
2) It’s important to keep a sleep journal (ie: bed time, subjective evaluation of how long it took to fall asleep, number of times woken up & what for, morning energy level, etc). This information can become invaluable to determine the real culprit of poor sleep, especially when analyzed alongside nutrition patterns. Times at which you woke up at night can also be important to look for patterns. Waking up at the same time every night is very often nutritional.
3) Not everyone can perform high-impact physical activity and it has been a point of high contention in the community over the last decade to say that they are the best way way to increase bone density. The top two contenders at the moment seem to be PowerPlate technology (2nd) and high-intensity strength training (1st).
Keep up the great work!
J.D. Moyer
Thanks and agreed. I mentioned magnesium in the post but not zinc … I agree that zinc is an extremely important nutrient but I favor food sources if possible (oysters, beef, pumpkin seeds) because too much supplemental zinc can be harmful (leading to fatigue and suppressed immune function).
OneHotMess
Thank you, J.D. Menopause was one of the easiest things that I have ever done, so I have never considered HRT. I will talk to my doctor about it next time, because I have tried everything else.
catzrat
So, speaking with the voice of authority (even though it’s somewhat querulous and cranky sounding because I slept like **** last night), I can attest to the truthiness of JD’s blog and its excellent pointers. In my case, it was knowing that I had to get up today and, for the last time, see the sweet, affectionate and loving nine cats and one dog that I’ve been caring for since their owner died over a year ago. It’ll be great for the critters – someone is moving into the house – serious separation pains on my end, though, and yes, I cried myself to sleep and now I’m having a pity party! You’d think when you’re as old as I am, you’d be more philosophical about these things. Now, to say that you should enjoy your quiet wakefulness at 2:14 AM is all well and good – unless you know you have to get up and go to work in three hours. Toss, turn, toss, turn…..4:30, back to sleep….5:15, alarm goes off and you wake up stupid. The truth is, though, anyone can survive that cycle for a night – or even two. Trust me, I’ll sleep tonight! Dear OneHotMess, if you have also developed some mild-to-moderate restless leg syndrome (RLS) with the onset of menopause, try taking some ibuprophen before you go to bed (400 mg or so). All of the women in my office hit menopause within a few years of each other, so we’ve had lots of time to compare notes – every one of us never had RLS prior to onset of menopause, but we all have it now. Be careful with HRT. If you have anything that’s already compromising your immune system or anything that might be considered a co-morbidity, be very, very careful. Hormones can stimulate abnormal cell activity. BTW, Tums have pretty readily absorbable calcium (for those who are not crazy about milk or other dairy products).
Thanks, J.D. 😉
Kristi
just throwing this info out there as i’ve had some experience with ibuprofen, bioidentical hormone replacement and tums/antacids/calcium. from experience: ibuprofen is awful stuff for your gut; ulcers. from research: awful stuff for your heart and kidneys. for RLS: 400 – 800 mg of magnesium glycinate should do the trick. magnesium is also good for sleep.
with regard to HRT: estrogen by mouth is bad for you. it’s a synthetic and that should be enough to steer you clear. also, any hrt taken by mouth has to go through the liver… enough said. topical bioidentical hormones (bhrt), however, are made from plants/nature and closest to what our body would produce; they are absorbed through the skin. pills, on the flip-side, have to go through your intestine and liver, meaning higher doses and more work for your liver. the longer you wait to be on hrt/bhrt, the longer you put off feeling better and aging better. progesterone is great for our skin (all over the body, ahem) and estrogen (small amounts) protects our heart, breast and uterus. testosterone is great for weight issues and libido. dhea decreases as we get older, and is good for mood and weight issues, so that is included in the topical cream i take. **cancer is a whole other issue with regard to hormones and that is best left to the doctor and patient to discuss.
and tums…. oy. this is a TERRIBLE source of calcium. the manufacturer even states that because it doesn’t have vitamin d in the mix that it shouldn’t be used as a “good” source. this is the kind of calcium that, if you take too much of it, gets deposited all over your body; kidneys, heart, brain, ovaries even. too much calcium can cause osteoporosis. yes, that’s a fact. not to mention that antacids do exactly what they say, but…. you are reducing the very acid that you need to digest properly; and given that as we age the acid in our stomach is reduced all by itself, we end up with leaky gut and this leads to disease.
emily
Hello everybody ! I read the post avidly, being a chronic insomniac…some nights (and sometimes weeks) are better than others, but I’ve never been able to find a pattern, other than the fact that my father suffered from the condition for years. The fact is….I feel great, I hardly ever feel tired!! I’m so full of energy it’s scary…aahh ahh…seriously, my only worry is for the future. I’m 39 now, but will this sleep deprivation affect me in the long run? there seems to be a lot of conflicting information out there. Will feeling great now with only 4 hours of troubled sleep lead to a huge downfall in the future? Will my health deteriorate even if I haven’t yet experienced any negative symptoms?? I’ll try some of the tips suggested! I’ve tried reducing coffee but that only makes me feel like crap during the day and doesn’t improve my sleep……Thanks J.D !!
J.D. Moyer
Some people sleep less than others and feel fine, but it sounds like sleeping that little is bothering you, and that seems reason enough to experiment. Also, sleep studies have shown that people overestimate their alertness when they are sleep deprived, so that’s another reason to try to improve your sleep (to avoid accidents and mistakes).
If any of these suggestions work for you, please report back!
Hollis Pickett, Redding CA
Emily…..you worry too much……;-)
Marcus Lundy
I get a big vibration feeling in my headache when listening to music sometimes and I oversleep constantly; I fall asleep at 3:00am-8:00am and wake up at 3:00pm. Got any advice JD. By the way do you know of two plugins/software that tempo stretch real good like Serato pitch n time (I’m trying to time correct like BT) and a plugin that can glitch/reverse/bitcrush/stutter like drum n bass stuff (http://www.youtube.com/watch?v=q4iAXofyAjw). I’m creating a drum n bass EP for myself that incorporates alternative metal.
J.D. Moyer
Just the advice I gave above … try turning off lights and devices in the evening and see if your sleep pattern changes.
J.D. Moyer
A therapist I know who commented on Facebook recommended EMDR for trauma recovery — here’s some info:
http://consults.blogs.nytimes.com/2012/03/02/the-evidence-on-e-m-d-r/
MDMA therapy may work, but it isn’t readily available as a treatment option.
Marcin
I have one little thing to add, maybe it works just for me, but anyone can try. I usually don’t have sleeping problems, but if I’m a bit nervous or have a lot of things going in my life and have to fight with my thoughts I use this method: curl up in the fetal postion but with the spine up, not lying on the side. I lay my head on my forearms and immediately calm down. It clears my head and regulates breathing so I can fall asleep in no-time. Works 90% of the time. I figured out it may be some evolutionary mechanism as hibernating animals usually do it in the fetal position. It also helps a bit with pain!
Cheers
J.D. Moyer
The hibernating bear method — I will try that sometime!
J.D. Moyer
Interesting article/study … exercise did not immediately improve sleep quality in people with insomnia, but eventually did (after four months). http://well.blogs.nytimes.com/2013/08/21/how-exercise-can-help-us-sleep-better/
qslincoln
This is really neat, I am going to try vitamin K. I do notice methylcobalamin in the morning seems to help sleep, as well as zinc (in moderate doses).