Are you one of the 50 million Americans who suffer from a sleep problem? There is nothing more frustrating than lying awake in bed and not being able to fall asleep. The more you try — the worse it is! There are many different causes of insomnia — medical, emotional, dietary and lifestyle.
As a registered dietitian, I see many clients who complain of fatigue due to poor sleep. If it is a chronic problem, I first tell them to check with their physician to rule out any medical causes. Once this has been done, I try to address lifestyle and/or dietary issues that may contribute to insomnia. By making some changes in your diet or lifestyle, you may be able to improve your sleep. I recommend the following guidelines:
- Do not use alcohol to help you fall asleep. Although alcohol may initially induce sleep, once it wears off, the sleep tends to be fragmented.
- Limit caffeine during the 4 to 6 hours before bedtime. Approximately 50% of the caffeine consumed at 7 PM remains in the body at 11 PM. Remember that caffeine is present in many different foods, beverages and medications.
- Limit nicotine prior to bedtime, as it is a stimulant.
- Avoid heavy or spicy foods just prior to bed. These meals can interfere with sleep by causing heartburn or aggravating a hiatal hernia.
- If the hunger associated with an empty stomach keeps you from sleeping, try having a light snack such as crackers, cereal and milk, or yogurt before going to bed.
- Limit liquids of any kind for at least 90 minutes before bedtime if the need to urinate wakes you up in the middle of the night. It takes about 90 minutes for the body to process liquids. This problem is especially common in older men.
- Regular exercise can increase your odds of getting a good night's sleep. But avoid exercise within 3 hours prior to going to bed as this will boost alertness and have a negative effect on sleep. Studies have shown that exercising more than 3 to 6 hours before going to bed has the most positive effect on falling asleep and staying asleep.
- Some of my clients find that foods containing tryptophan aids in sleep. Tryptophan is a naturally occurring amino acid, (the building blocks of protein), which the brain converts to serotonin. Serotonin is a sleep-inducing hormone. Contrary to popular belief, foods high in tryptophan, such as turkey, do not necessarily lead to greater production of serotonin. This is because the other amino acids block the brain's uptake of tryptophan. Carbohydrate-rich foods, such as pasta, bread, cereal, crackers, etc. tend to lead to the greatest production of serotonin. Try a light bedtime snack of crackers or a slice of toast with jam.
Avoid tryptophan sold in health food stores, as there have been problems with contamination of the supplements in the past. In 1990, over 30 people died and more than 1500 people contacted a rare and potential deadly blood disorder from consuming certain tryptophan supplements. It is unclear if the problems were from a contaminant, excess tryptophan, or a combination of the two. It is recommended that supplements be avoided.
Melatonin has been getting a great deal of attention in recent years for its supposed sleep inducing effects. It is a hormone produced by the pineal gland deep in the human brain. Melatonin controls the body's circadian (24 hour) rhythm, which is our internal clock that tells us when to sleep and when to wake up. As we get older, we produce less melatonin, which may account in part for insomnia in older adults. Synthetic melatonin supplements sold in health food stores are used by many people to induce sleep and to promote a sound sleep.
At this time, there have been no conclusive, well-designed studies examining the effects of melatonin on sleep. Researchers are unclear as to what the therapeutic effects of melatonin are or what dosage should be used. In addition, it is unknown if there are any significant side effects of melatonin, if there are any interactions between melatonin and other drugs, or if it should not be used by people with certain medical conditions. Although, some studies have demonstrated that melatonin has a positive effect on sleep, more research is needed before it can be promoted as a safe, effective sleep aid.
My personal observations regarding the effectiveness of melatonin as a sleep aid have been quite variable. I have several patients who find melatonin to be very effective, both in falling asleep and promoting a deep sleep. But I also have patients who report no effect whatsoever. The most common side effects that I have seen at this point from melatonin are a groggy or "hungover" feeling in the morning, headache, and stomach upset. No serious side effects have been reported.
Since melatonin's effect on sleep, its long-term safety, or interactions with other drugs remains to be seen, my advice to patients is that if you choose to take melatonin, it should be used with caution. Do not exceed the recommended dosage and stop taking it if you experience any unpleasant side effects. The dosage ranges from 1 to 3 mg. I recommend starting with a small dose, as too large of a dose may make you feel extremely groggy in the morning. Melatonin should be avoided if you are pregnant, trying to conceive, nursing, or have severe allergies or an autoimmune disease. It should not be given to children.
This is an herb that is believed to have a calming, relaxing effect on the body. It has been used for centuries and is believed by many people to be useful for insomnia, mild anxiety and restlessness. The exact mechanism of action is unknown. However, it may act as a depressant to the central nervous to produce a mild tranquilizing effect.
As with melatonin, it is unknown at this point if valerian is effective or associated with any side effects. The recommended dosage is 50 to 100 drops of tincture, or tea prepared from 1 teaspoon of dried root. There are also supplements standardized to at least 0.5% valerenic acid with added valerian root. The dose is 1 to 2 pills (100 mg. each) before bed. As with all herbs, do not take while pregnant or nursing and discontinue use if you have an adverse reaction. Also, avoid valerian if you are taking any other sedatives or tranquilizers.
There are many reasons why we may have trouble falling asleep or staying sleep. It is certainly worth trying to make some changes in your lifestyle or diet. It may be a simple answer to a better night's sleep.