INSOMNIA & FATIGUEInsomnia
by Lynn Hinderliter CN, LDN

One would think that either “Insomnia” or “Fatigue” would be an adequate title:  why both?  The reason is simple.  Insomnia

  1. Some people are tired because they cannot sleep.
  2. Others cannot sleep because they are too tired. 
  3. 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.  Insomnia

“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.  Insomnia

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.  Insomnia

  • Do not drink anything with caffeine in it after noon.  The effects in the body really do last that long!  Insomnia

  • 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.  Insomnia

  • 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.  Insomnia

  • Take a gentle walk  before going to bed.  Insomnia

  • 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.  Insomnia

  • Take a warm (NOT HOT) bath (not a shower) before going to bed.

  • Don’t nap during the day.  Insomnia

  • Consider limiting carbohydrates, particularly sugar.

  • Drink plenty of water during the day. Stay hydrated.  Insomnia

  • 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:  Insomnia

 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.  Insomnia

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.  Insomnia

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.  Insomnia

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.  Insomnia

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.  Insomnia

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.  Insomnia

Find the recommended supplements here

Insomnia – a commonsense synopsis – http://www.mckinley.uiuc.edu/handouts/sleep_guide.html

Relaxation methods for better sleep – http://www.umm.edu/sleep/relax_tech.html

Some Sleeping Tips – http://www.sleeping-tips.com/

Insomnia and the Immune System – http://www.psychosomaticmedicine.org/cgi/content/abstract/65/2/211

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