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Better Sleep - And So To Bed...

By Charlotte Watts Dip.ION BANT – Nutritional Therapist – www.totalbeing.com

In the article The Stress of Getting to Sleep we discussed the relationship between sleep and stress. We also promised you practical advice on the subject and help in getting to the bottom of a sleep-related problem. The reason that we chose to tackle the stress subject first was to highlight the enormous impact that your daily life has on your sleep patterns and quality and of course, vice versa.

As Dr Mark Atkinson of the Complementary Medical Association says, “The key is to get to the heart of the reason you’re suffering from insomnia”. So, did you fit the stress pattern in any way? Remember that stress includes any unresolved emotional issues, anxiety states and any negative coping patterns you can think of and that’s before we even get to the subject of nutrition.

As we mentioned, insomnia can be categorised in two ways; the inability to fall asleep when first going to bed or waking in the night and being unable to go back to sleep. The first, Type I involves an inability to “switch off” or in reality, not enough of your inhibitory as opposed to excitory mechanisms coming into play to send you off to sleep. One of the most important inhibitory neurotransmitters or brain chemicals is GABA or gamma-amino-butyric acid. As Patrick Holford states in his book Optimum Nutrition for the Mind, “the choice of these three drugs (in those with anxiety) – alcohol, cannabis and tranquillisers – is no coincidence. They all promote GABA, which is the brain’s peacemaker, helping to turn off excess adrenaline and calm you down”. Those with the type of anxiety, which can prevent getting off to sleep, may be low in GABA and turn to these substances as a fix, but this will only exacerbate the problem as they eventually impair production of the neurotransmitter.

The pattern of drinking alcohol to get to sleep is set up by the association that the production of GABA causes. One drink makes you feel relaxed and relieves the day’s anxieties as GABA levels rise, but as with any neurotransmitter production that is the unnatural result of a stimulus, these quickly fall, leaving you feeling “irritable and disconnected” ¹. To stop this feeling you have another, but drinking to go to sleep means going to bed before the GABA “come-down” occurs and sleep under the influence of any alcohol affects REM sleep and stops the natural process of dreaming, which can leave you feeling distinctly unrefreshed in the morning, starting the day with the effects of low GABA that perpetuate the cycle in the evening.

The production of GABA relies on magnesium, an essential mineral that works in conjunction with calcium, but has been focussed on a lot less, leading to large consumptions of calcium foods that put the ratio out of balance. We have moved from the ideal 2:1 magnesium to calcium in diets towards 4:1. As we reported in the article “What Are We Like?”, it has been estimated that 7 out of 10 people in the UK are likely to be magnesium deficient². We carry out many Hair Mineral Analyses here at Total Being and certainly see that to be the case. Symptoms such as insomnia, heart disease, anxiety, depression, constipation, fatigue and headaches are all too common signs of magnesium deficiency. We need to obtain calcium and magnesium from food sources where the ratio is correct such as nuts, seeds, green leafy vegetables and fish, not upsetting the balance with a glut of dairy products. The effects on the body of less than ideal dietary magnesium are worsened by other dietary imbalances, such as an abnormally high fat intake, which can intensify magnesium inadequacy, especially under conditions of stress.

It is well known that severe magnesium deficiency leads to disturbed physiology including hyperactivity of nerves and muscles, abnormalities in calcium and potassium balance and disturbances in heartbeat rhythm; all of which can contribute to insomnia as well as other symptoms. Magnesium gets used up in large spoonfuls in the body’s attempts to produce energy, maintain nervous system health, muscle relaxation and bone and tooth development. Raised adrenaline and noradrenaline (stress hormones that act on the nervous system) actually lower magnesium status, causing another vicious cycle as low magnesium stops the correct conversion of B vitamins to their active forms and can make you more anxious in the first place, producing more stress hormones.

The other important sleep neurotransmitter that we mentioned last week and which relies on magnesium for its production, is serotonin. Magnesium is used up quickly by stress, but also by blood sugar imbalances; also at the heart of low serotonin levels. Low levels of serotonin cause the body to panic and self-medicate in the form of craving for sugars and other carbohydrates. This is because the hormone insulin is needed to carry the amino acid tryptophan, from which serotonin is made, into the brain and insulin is produced when we eat carbohydrates to bring down excess levels of glucose in the bloodstream. If this pattern is occurring, rather than a regulated production of serotonin, excessive carbohydrate cravings, the associated weight gain and progressive insomnia can occur. This is often the pattern for those who suffer from Seasonal Affective Disorder (SAD), where depression and mood swings go hand-in-hand with blood sugar imbalances.

Type 2 insomnia is categorised by sudden waking in the night and associated with adrenal stress. Balancing blood sugar is also the answer here to avoid the “highs and lows” which exacerbate the stress cycle. When we are unable to sustain even blood sugar levels throughout the night, because of daytime fluctuations, they can suddenly drop, whereon the body panics and we release a shot of adrenaline to bring blood sugar levels back into healthy parameters. This is why we can sometimes wake with all senses suddenly sharp, with fear and acutely aware of our surroundings.

Whilst one or two sleepless nights can cause irritability and bouts of daytime sleepiness, chronic insomnia may reduce the ability to perform creative and repetitive tasks and even promote premature ageing. Sleep is very important as the body’s recovery time. Reasons may be diet related such as excessive alcohol or caffeine intake, a lack of calcium and/or magnesium, depression, stress or be a secondary cause of another condition such as arthritis for example. You should consider all of the possibilities, but looking for a major underlying cause should always start with balancing blood sugar levels and addressing stress issues. The following recommendations take these into consideration especially in the context of insomnia.

Dietary Recommendations for Improved Sleep

• Increase your intake of the sleep-promoting amino acid tryptophan in the evening to encourage serotonin production. Foods that are high in this amino acid include bananas, dates, figs, milk, lentils, tuna, turkey, wholegrain crackers and yoghurt.
• Limit alcohol consumption. Although it initially induces sleep, alcohol impairs the transport of tryptophan into the brain, depleting serotonin production and may disrupt deeper sleep cycles later on by causing GABA levels to drop.
• Avoid stimulants such as tobacco; nicotine for example is a neurostimulant and may cause/exacerbate sleep problems. Caffeine-containing beverages/foods such as tea, coffee, soft drinks and chocolate are also to be avoided after 7pm. Sometimes, even small amounts contained in decaffeinated coffee may also cause insomnia in some individuals, especially as other stimulatory chemicals such as theobromine and theophylline are still present, even when the caffeine is removed³.
• Avoid heavy meals three hours before bedtime to allow full digestion to occur.
• Avoid tyramine-containing foods later in the day; these include cheese, chocolate, potatoes, bacon and sugar, they can act as brain stimulants.
• Eat plenty of calcium and magnesium from food sources where the ratio is correct such as nuts, seeds, green leafy vegetables and fish.
• Balance your blood sugar levels by eating small and frequent meals and ensuring that protein is eaten at each meal – including snacks and especially for breakfast, which should be substantial. Low blood sugar may cause the release of hormones that regulate glucose levels. For instance, the body can be awoken sharply if adrenaline levels rise while sleeping.
• Avoid all refined foods such as white bread and rice and sugar, even honey – the most important factor in balancing blood sugar levels. Reduce your intake of convenience foods as they are almost always refined and contain hidden sugars that also impair the production of the sleep and mood neurotransmitters.
• B vitamins are important for blood sugar balance, neurotransmitter production and get used up quickly by stress and anxiety. They ensure proper energy production throughout the day, which then leads to proper wind-down and sleep in the evening. Eat good quality sources in good quantities from nuts, seeds, pulses, beans, vegetables, wholegrains, fish, meat, and eggs – the best diet for balancing blood sugar levels. Consider a supplement to help you out of a vicious stress cycle.
• Small bedtime snacks such as oatmeal and wholegrain cereals not only help to maintain blood sugar levels, but may actually promote sleep by increasing the level of serotonin in the brain. They can also help to prevent waking in the night caused by low blood sugar levels, usually the result of adrenal stress.
• Cut out smoking because nicotine acts as a stimulant on the sympathetic ganglia and adrenal glands, which do not help with relaxation and sleep.

Lifestyle considerations for better sleep

• Go to bed or lounge around there only when sleepy and use the bedroom only for sleep or sex; avoid keeping things in the bedroom that you associate with activity, such as computers, exercise equipment and paperwork. Make it your retreat or haven – a true boudoir.
• Try to stick to the routine of waking up at the same time every morning irrespective of the time that you went to sleep the night before. Also try not to take naps during the day.
• Regular exercise may induce sleep, although this should be avoided before bedtime, balance out with relaxing activities that bring down stress hormones.
• Learn to relax. Techniques such as guided imagery and progressive relaxation where you contract and then relax a muscle group for a period of two seconds, working progressively through all the muscles. This can be very effective for inducing a deep state of relaxation. Forms of yoga that calm the nervous system such as Hatha are incredibly effective, as is meditation, both which raise levels of DHEA, the “anti-stress” hormone.
• Take a hot bath an hour or two before bedtime and consider the use of an essential oil such as chamomile (provided you are not allergic to ragweed!).
• Nasal decongestants and other cold medications although known to cause drowsiness, may instead act as stimulants.
• Drugs such as decongestants or antidepressants may also cause insomnia. Sleeping pills themselves while effective in the short term, may lead to significant problems such as addiction and abnormal sleep patterns in the long term.
• Consider the possibility of mercury toxicity (usually from fillings and contaminated fish). Mercury can agitate the brain leading to the excitory state, which can prevent you getting to sleep.

Nutritional Considerations to be discussed with a nutritionist

• 5-HTP or 5-Hydroxy L-tryptophan may be helpful for both depression and insomnia by increasing REM sleep. Take with a carbohydrate drink before bedtime such as fruit juice to enhance its effects.
• Herbs such as valerian, skullcap, hops and passionflower may promote improved sleep quality.
• Calcium and magnesium have a calming effect. B-complex vitamins and Vitamin C are good stress relievers. Niacin promotes the production of serotonin.

Total Being Opinion

It is possible to make both subtle and fundamental changes that will all add up to improved health and wellbeing; many people do not necessarily make the connection between what they do during the day and their subsequent ability or inability to sleep well. Ironically the stress of worrying about sleep or directly caused by sleep deprivation and poor recovery time, can often make it easier to reach for quick-fix convenience foods or use caffeine and other stimulants to keep you going.

To truly tackle the problem, give yourself time and space and start addressing these issues over a weekend when you can devote time to implementing some of the suggestions above. Good quality sleep is important enough to approach as a major project and should always be prioritised to improve your quality of life.

See www.totalbeing.com for a Nutritional Assessment to choose the right diet and supplements to help you get in control of your health!

See www.healthyconvenience.com for help remembering how to get healthy – for posters, shopping guides and recipes.

References

1. Holford P. Optimum Nutrition for the Mind Piatkus Ltd 2003
2. Christie, S. Why all practitioners need to be alerted to the UK’s magnesium crisis. Lamberts Healthcare 2004
3. Geary A. The Food and Mood Project. Thorsons 2001