Although we hear about REM sleep more often than other stages because it is associated with dreams, there are actually five stages of sleep: 1, 2, 3, 4, and REM, which occurs between stages 1 and 2. Stages 3 and 4 are the deepest stages. Without adequate sleep in stages 3 and 4, people wake feeling groggy and “hung over,” and their bodies do not release adequate Growth Hormone, which is necessary for muscle repair. Lack of Growth Hormone may lead to chronic muscle aches and soreness.
In order to address insomnia, Naturopathic Medical Doctors begin with First Line Therapy, meaning diet and lifestyle adjustments. In this case, First Line Therapy would involve good sleep “hygiene”. Here are some tips which may be adequate to restore normal sleep for many patients.
- Try to go to bed at the same time every night and wake up at the same time every morning, even if you’re not tired at night and/or got very little sleep by morning. It is best to wake with the sun in order to reset your biological clock, and go to bed early enough that this will give you as many hours as you need to feel your best. Adequate hours of sleep varies per person, however – it is a myth that everyone needs eight hours of sleep in order to function optimally.
- If you cannot fall asleep, get up and do something else. The anxiety of trying to fall asleep can actually exacerbate the problem.
- The last hour (or at least half an hour) before you go to bed, do something very calming — read a book, listen to music, pray, or meditate in bed until you start to nod off. Try not to watch TV right before bed. Do not take any stimulants or engage in stimulating activities before bed.
- Have a cup of tea (chamomile is my favorite) while you do this, and try to slow down your breathing.
- Consume little or no alcohol before bedtime. Alcohol may help you fall into a light sleep, but it maintains only lighter stages and prevents REM and deeper stages of sleep. This means you can be awakened more easily. This is why drinking alcohol before bed is associated with waking in the middle of the night.
- Give up smoking. Like those who have night caps right before bed, smokers tend to sleep very lightly, and wake after 3-4 hours of sleep due to the nicotine withdrawal.
- Avoid caffeine after 2 pm. Although the half life of caffeine in the bloodstream is four hours in theory, this depends on the individual’s metabolic rate. Some people process caffeine faster and some slower. It’s best to err on the side of caution.
- Get enough exercise: 20-30 minutes per day.
- Keep your room cool – you lose your ability to regulate body temperature during REM, so abnormally hot or cold temperatures in the environment can disrupt this stage of sleep.
- Some people have difficulty sleeping due to an overabundance of thoughts. If you find that you cannot help but continue to problem-solve, get out of bed and write them down on a piece of paper until you can think of no more.
- Resist getting up to go to the bathroom if you wake up in the middle of the night. Bladders are always full at night, but it shouldn’t wake you up, nor should it keep you awake. Usually when you feel like you have to go, if you ignore it, you will drift off to sleep anyway.
- Put the bedroom clock out of arm’s reach and facing away from you so you can’t see it. This may help for two reasons: one, it decreases the anxiety associated with the hour, and two, some people are especially light sensitive and need total darkness to sleep their best.
- Have a light snack before bedtime so you’re not hungry. Hunger is a cause of insomnia in many animals, including humans.
- Try not to nap much after 2 pm if possible.
If these approaches do not work, try having a cup of warm milk right before bed with a pinch of nutmeg or turmeric (instead of or in the tea). If you are sensitive to dairy, try warm soy milk, almond milk, rice milk, or hemp milk instead.
If you still have difficulty sleeping, there are a few other natural solutions available before prescription medications, but it is best to see your Naturopathic Medical Doctor for a full work up. Simple insomnia can often be corrected with good sleep hygiene. If it is not, it’s possible you’re your insomnia may be part of another process, and it is important to rule out other causes.
These are some of the supplements I prescribe often for sleep, depending on the case. Click on the supplement for a description of when it is appropriate, as well as dosing instructions.