One would think that either
either "Insomnia" or "Fatigue" would be an adequate title: why
both? The reason is simple.
- Some people are tired because they cannot
sleep.
- Others cannot sleep because they are too
tired.
- And still others get adequate sleep, but are STILL tired.
The cost of insomnia does not stop at lack of
energy and mental fog. Stress affects blood sugar metabolism, the immune system,
and inflammatory factors which contribute to heart disease.
Interestingly, a 2008 study at Duke University finds that this
goes double for women. Adding all kinds of confounding
factors, such as age, race, smoking made no difference to the
outcome: while insomnia is bad for us all, it is especially
bad for women.
| "Fatigue is epidemic because so many of us are knackered from
working too hard. We don't listen to our bodies, expecting them
to do our bidding." Dr Jim Keely and his colleague are in
practice in Malahide, Co Dublin, and have recently decided to
end their weekday surgery at 6 p.m., rather than 8 p.m., because
they have been spending too much time in the office and not
enough time with their families.
"That's the kind of decision more of us are going to have to make
if we want to stop feeling tired all the time," Dr Keely says. "Tiredness," he explains,
"is a genuine problem for a lot
of people: Somebody will say to you, 'I'm feeling tired, I can
hardly cope, I can't get up in the morning to go to work'. Then
you find out that this person is at work all the hours God
sends, getting up at 6 a.m., getting home at 9 p.m. with 10
small deadlines every day and one big deadline every week. There
are others in more ordinary jobs, who are working very hard by
doing a lot of overtime."
"These people are tired because they are overworked, not resting
enough and not getting a good night's sleep, yet rather than
face the obvious they feel that there must be something
medically wrong with them. They tend to resist the advice that
the only solution to their fatigue is a major life restructuring
with more sleep and the occasional lie-in. Those who persist on
the treadmill lifestyle end up with chronic sleeplessness, which
in turn leads to anxiety, heart palpitations and panic attacks,
followed by depression, one symptom of which is a lack of
insight. 'They blame everybody else and will tell you the kids
are too much, that the spouse is nagging. It's a slippery slope
and goes on and on, until people learn to stand back from their
situation," says Dr Keely. |
The villain here is stress, and I
recommend you also read my article on
Stress. High cortisol levels lead to
difficulty sleepeiong, and to sleep that fails to refresh.
A circular distress
pattern is set up: high cortisol makes sleep difficult, and lack of
sleep causes high cortisol.
|
If, on the other hand, you have trouble
getting to sleep at all,
or wake up frequently during the night,
there are some measure you can take that may
help.
|
-
Take adequate
exercise during the day.
-
Do not drink
anything with caffeine in it after noon. The effects in
the body really do last that long!
-
Don't drink alcohol within 2
or 3 hours of your bedtime. While it may make you fall
asleep initially, it will wake you up during the night.
-
Remove clocks and unplug the
light next to your bed: actual measurements show
electric force fields that may interrupt sleep.
-
Avoid eating a
large meal late in the evening, or snacks that contain fat.
-
If you cannot fall asleep,
or if you wake up and your mind is active, get up and do
something until you feel sleepy again. Don't lie there
and toss and turn.
-
Take a gentle
walk before going to bed.
-
Use your bedroom only for
sleep.
-
Keep your bedroom on the
cool side
-
Have a warm
milk drink before going to bed. Milk products contain
tryptophan, which relaxes you.
-
Take a warm
(NOT HOT) bath (not a shower) before going to bed.
-
Don't nap during the day.
-
Consider limiting
carbohydrates, particularly sugar.
-
Drink plenty of water during
the day. Stay hydrated.
-
Consider liver support: a
toxic liver can cause insomnia.
There are natural
supplements that can improve sleep quality. Melatonin
is helpful for many. Here is an extract from a longer article on
Melatonin:
| Does it really work to resolve
insomnia? In my experience, yes. I went through a lengthy bout of
sleep problems, which I could not resolve with any of the natural
therapies at my disposal, but with a combination of Melatonin and
5-HTP, (called SEROTAIN ) I slept through for the first time
in almost three years. It does not help everyone, however, and I
would not recommend that anyone under the age of 40 try it without
the guidance of a health professional. I have, however, suggested a
homeopathic form of melatonin for some young people, who have
benefited from its use. In 2001, Israeli researchers reported that
controlled-release melatonin (CRM) improved sleep quality in
type 2 diabetics with insomnia and also facilitated discontinuation
of benzodiazepines (see RESOURCES at
right) in an elderly population.
"Melatonin is secreted in response to darkness," said Dr. Doron
Garfinkel, who is from the department of Aging Research and Internal
Medicine at E. Wolfson Medical Center, in Holon. "It induces sleep
through its synchronizing effect on the internal biologic clock."
I used, and recommend, a 3mg
formulation: and I found that after a week or two, I needed only
half that amount. I also found that after using it for a while, my
sleep cycle adjusted itself, and I was able to discontinue its use
for a month or so. Some people who try it and do not immediately
get results, have tended to try again using more. Don't! Usually,
if you do not get results at first, you need less, not more. Try
halving the dose. Then halving it again! Use the sustained release
formula if you have a tendency to awaken frequently during the
night.
Is it safe? Research has shown that
you cannot give enough of it to test animals to cause harm. Long
term, questions have been raised about possible thyroid involvement.
I would definitely not recommend its use for young people with
pineal gland function intact, but for older people whose natural
production has slowed down, it is certainly helpful for sleep, and
possibly also for depressed immune function. Like other natural
hormones, however, I strongly advise using the saliva test to
check and monitor your levels if you are using it long term. See
RESOURCES at right.
In light of the fact that it has no
recorded side effects, and bearing in mind the addictive nature of
most prescription sleep medications and the unpleasant side effects
of some of the OTC remedies, Melatonin is certainly worth trying. |
|
Tryptophan
is also useful for relaxation
leading to sleep,
together with its metabolite
5-HTP.
|
Although I have throughout my life been blessed with
the ability to maintain remarkably good health, one distressful constant
has plagued me: insomnia. I recall how grateful I was in the mid 70's
when I first came across the research on the amino acid L-tryptophan,
and found that it appeared to hold the key to restful sleep for me. Then
disaster struck: a Japanese manufacturer of amino acids attempted to
make a cheaper formula using a new procedure, and a batch of the end
product was contaminated: this resulted in serious illness for a number
of unfortunates, and even some deaths. The FDA reacted (quite correctly)
to the emergency by removing L-tryptophan from the market. Sadly once the shape of the crisis had become clear and it
was obvious that a contaminant was at fault and not L-Tryptophan
itself, they did not remove the ban, and tryptophan has been
unavailable, except by prescription, from that day to this. Now,
however, I have found a source of absolutely pure, FDA
accepted L-Tryptophan - see the recommended products at
right.During the ban on
L-Tryptophan, advances in
research made available a metabolite of Tryptophan called 5-HTP, a
truly natural substance, extracted from the seed of an African shrub
called Griffonia Simplicifolia. 5-HTP has an affect serotonin levels, helping
sleep, weight control
and mood.
The hormone melatonin, which has helped so
many people sleep, is the end product of Tryptophan,
(Tryptophan→5-HTP→Serotonin→Melatonin) and
many diseases which are connected with low levels of Tryptophan show low
melatonin levels as well. It is therefore possible that people who
hesitate to use melatonin, as well as those who find it doesn't totally
answer their sleep needs, might benefit from trying the more natural
amino acid originator of the cascade.
There is also the usual cast of relaxing herbs for
sleep, such as valerian, hops,
kava kava (the latter currently rather hard
to find!) which can be found in pill form as well as in teas:
brewing a cup of tea using these herbs can be a helpful strategy,
both for their effects and because a ritual before bedtime can
prepare one mentally for sleep. The same is true for
some of the beautiful aromatherapy blends, a few drops of which
in a ring on one's bedside lamp can scent the rooms with an
irresistibly relaxing aroma.
When women are nearing or going through
menopause, insomnia and sleep deprivation can be a serious
problem: nearly 40% of women complain of these
problems at that stage in their life, double the number of
younger women! While hot flashes are obvious causes of
sleep problems, and can be helped by progesterone
supplementation, low estrogen levels can also interfere with
sleep patterns without any temperature changes. I
recommend having your hormone levels ascertained with the handy
saliva test - see
RESOURCES - to know which way you need to
adjust your balance.
When even the hormone adjustments leave you sleepless, two
strategies that seem to produce the most relief are
Magnesium supplementation at bedtime,
L-Tryptophan and/or
PharmaGABA.
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insomnia |
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