Insomnia
Tonight, up to 10 million adults will go to bed knowing they will spend the next eight hours tossing and turning and wondering when they will ever get another good night’s sleep. Insomnia is one of the more common everyday problems and is estimated to affect one in every three adults at some point in their lives.
Each year doctors prescribe more than 20 million sleeping pills (hypnotics), and researchers have now identified some 80 different sleep disorders. If you are one of those people who will lie awake most of the night, knowing your particular disorder has a special name will be of no comfort to you, especially if you are among the 15% of the population believed to suffer from chronic insomnia.
The condition is chronic if it continues for longer than three weeks. If you cannot sleep for just a few nights, your insomnia is said to be transient; if you cannot sleep for a week or two, it is deemed a short-term problem. The latter two types of insomnia are almost always prompted by an outside event. Worrying about giving a presentation at work, for example, may cost you one or two night’s sleep. The death of a parent may disrupt your sleep patterns for a few weeks.
The underlying causes of chronic insomnia are more difficult to pinpoint and tackle - they can include depression, a dietary overload of stimulants, especially caffeine, drinking too much alcohol, chronic pain due to other causes, muscle cramps, and other physical ailments. Researchers suggest that at least 50% of all cases of chronic insomnia are caused by psychological factors, especially depression and anxiety.
The body’s circadian rhythm, which determines when you sleep and when you wake, is controlled by a hormone called melatonin - which is, in turn, released by the pea-sized pineal gland buried deep in the brain. As with other hormones, levels of melatonin decrease with age, so that by 60 your body produces half the amount of melatonin it did when you were 20.
It has been shown that tiny doses - just 0.3mg - of replacement melatonin taken at bedtime can quickly bring blood levels of the hormone back to normal and help induce a good night’s sleep. Patients taking melatonin report they have less trouble getting to sleep in the first place - they drop off in less than half the time it takes without a melatonin supplement. They sleep longer and they wake up feeling alert and refreshed.
Lots of travellers use melatonin to re-regulate their body clocks and avoid the worst disorientations of jet-lag. The supplement is perfect for shift-workers and businessmen and women who regularly travel long haul for short periods of time and have to be alert enough to shift into a new time zone and attend meetings. Its short-term use, for up to a week, has been deemed safe and without side-effects
What a nuisance then that the over-the-counter sale of melatonin in the UK, for instance, is illegal and that it is only available by private prescription and is not an NHS licensed drug either.
The way around this problem is to take a step back in the biochemistry of the brain and, instead of boosting levels of melatonin with melatonin, increase levels of this sleep-controlling hormone by stepping up your intake of serotonin; a neurotransmitter involved in the manufacture of melatonin. You can also easily boost levels of tryptophan, an amino acid that is critical for the manufacture of serotonin.
Researchers have found, for example, that people who find it hard to get off to sleep are usually deficient in their levels of serotonin, the synthesis of which also requires large amounts of vitamin B6 (pyridoxine) which is found in carrots, cheese, avocado, fish, lentils, peas, potato, spinach, sunflower seeds, and wholemeal flour.
If you suffer from insomnia, you should eat more of these foods and cut out the high sugar foods such as white bread and white rice, which can cause fluctuations in blood-sugar levels. Stick instead to a high carbohydrate diet, which maximises the presence of L-tryptophan, a form of tryptophan, in the brain. In fact, those who eat a carbohydrate-based diet of quality wholefoods are found to be calmer, rarely depressed, and better to sleep soundly than those who do not.
Turkey contains a large amount of tryptophan, which might explain why adult members of the family fall asleep straight after the traditional Christmas meal; combining it with a complex carbohydrate, say a spoonful of honey, will enhance the effect. It does this by increasing blood sugar levels, which in turn causes the pancreas to release more insulin. This then has the knock-on effect of chasing several of the amino acids that would normally compete with tryptophan for receptor sites in the brain from the blood into the liver, leaving the coast clear for tryptophan to dominate. This is one of the finest examples of psychonutrition - using food to influence mood - that I can think of.
Most of us only get a third of the optimum daily dose of calcium our bodies need, and calcium deficiency has long been linked with increased tension and sleep disturbances. Calcium is a potent sleep inducer - this explains why drinking a glass of warmed milk at bedtime can help - and should be taken as calcium citrate or calcium hydroxyapatite, which are the forms the body can most easily absorb. In Russia, the folk remedy is to grind anise and serve it with warm milk and honey. Milk is not only high in calcium but also rich in tryptophan, and so has a doubly powerful tranquillising effect.
The list of herbal remedies that can help promote a good night’s sleep is impressive and ranges from everyday store cupboard offerings such as mint, rosemary, valerian, and the antispasmodic, muscle-relaxant, thyme, to the more exotic passionflower (for chronic insomnia) and saffron. Chamomile, once planted on graves in ancient England as a symbol that the deceased would be reborn, is an excellent natural sedative and safe to give to children. You can make a tea from the flowers or, for super-potency, juice the herb in the same way you would juice wheatgrass to make a nutritional drink.
In the East, a hot foot bath is a traditional remedy for insomnia - the logic is that it draws the blood from the brain to calm a racing mind - and if you enjoy using essential oils when bathing, both lavender and lemon balm will help relax you.
If you prefer a homeopathic remedy, Lycopodium is the one most frequently prescribed for anyone who spends half the night going over the previous day, drops off in the small hours of the morning only to wake and start worrying again at around 4am.
Sleeplessness is a natural feature of ageing, and the majority of sleeping pills are prescribed to the over 65s who may find a late night snack will help. Researchers at the Massachusetts Institute for Technology (MIT) in Cambridge, Boston, have shown that an English muffin or a banana before bedtime, for example, can greatly improve the quality of sleep.
Too much stress produces too much adrenaline in the body, high levels of which overpower the serotonin that would normally help you get a good night’s sleep - so bringing your stress levels under control is important. The technique that has proved the most effective in bringing the disturbed sleep patterns of pilots under control is a technique called Autogenic Training.
Said to work at the deepest levels, it alters the body’s stress chemistry to encourage deeper relaxation and to reduce anxiety and lower stress levels. Autogenic means self-generated and the technique teaches a series of simple mental exercises that help you to switch off at will.
Certain drugs, including oral contraceptives and beta-blockers, can play havoc with sleep patterns; caffeine, which stimulates the production of more adrenaline, is a major culprit in the sleep wars. If you are drinking around 12 cups a day, you are ingesting a gram of caffeine - which is more than enough to keep you awake and counting sheep. You also need to eliminate cola drinks, chocolate, tea, cakes, and biscuits.
It is also a mistake to use alcohol to help you get off to sleep. Although it may appear to do the trick, it actually destroys the B vitamins, which are important for maintaining normal sleep rhythms.
What to take for insomnia:
*Serotone 5-HTP is a popular supplement prescribed by nutritionists to help people suffering from insomnia. It can also be used for jet lag but may take some time to kick in. It is particularly effective if your insomnia is caused by depression or stress. Higher Nature sells tablets which provide 100mg of the active ingredient, 5HTP. 30 veggie capsules cost £9.90. Take one at bedtime.
* Vega makes a calcium citrate supplement which will provide 100mg of elemental calcium. 30 capsules cost £4.59. Take two at bedtime.
* The medical herbalists at Farmacia (London’s first pharmacy with on-site complementary therapies) get asked so often for insomnia remedies they have now formulated the new Farmacia Sleep Mix. The exact ingredients are a trade secret, but they include valerian and chamomile. The mix costs £6 for 100ml. You can also mail order Schoenenberger Oat Juice from this store. This is an excellent bedtime tonic if you are feeling over-wound and stressed out. For children, the Chamomile Juice from the same manufacturer is safe and can be frozen in ice-cube trays and dissolved in a warm drink when the child is fractious and cannot sleep. Both juices cost £5 for 160ml. To mail order call 020-7831 0830 and add £1.50 p&p. You could also try a herbal tea which contains scullcap, passionflower, vervain, and St John’s Wort. It costs £5.50 for 100g.
*To learn the techniques of Autogenic Training, you book eight weekly sessions and a later refresher session with a trainer. Expect to pay in the region of £200. In London, contact Vera Diamond (020-7723 2184), who pioneered the technique in the UK. To find a local trainer, send an SAE to The British Autogenic Society at The Royal London Homeopathic Hospital, Great Ormond Street, London WC1N 3HR.
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