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.
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) 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.
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.
http://www.naturdoctor.com/Chapters/Research/Insomnia.pdf
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.
Recently, when L-Tryptophan seemed to be losing its effect, it was
suggested that I try GABA, gamma amino butyric acid. Specifically, a
chewable version called PharmaGABA.
I was amazed at its immediate effectiveness.
Here,
from www. wholehealthmd, is a run-down of what GABA can do.
http://www.wholehealthmd.com/ME2/dirmod.asp?sid=17E09E7CFFF640448FFB0B4FC1B7FEF0&nm=Reference+Library&type=AWHN_Supplements&mod=Supplements&tier=2&id=B95B633A01984913A076131F85E884AC
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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