Help with sleep is one of the most common reasons people come to see me. There are widespread problems with sleep in our society, to the extent that many people accept poor quality sleep as the norm. Yet sleep it is absolutely vital for a strong immune system and overall health and well-being. When we sleep our brain and nervous system detoxify and our body regenerates. This is crucial preparation for the demands of the day ahead. Equally importantly, our subconscious mind processes both the day’s events and where we are at in our lives.
Here is a checklist to work through if you are looking to enjoy a great night’s sleep, every night! My checklists tend to progress from least to most intervention. Society trains us to reach for a pill whenever we have a problem. Yet a truly holistic approach starts with the fundamentals, including diet and lifestyle, and progresses towards medicinal aids.
Are you getting enough sleep?
This might sound obvious but in my experience many people are burning the candle at both ends, especially people with dependent children. Mothers often report staying up late because that final hour or two of the day is the only time they get to themselves! If this is you, I recommend trying to extend your sleep time by any amount possible. Can you re-arrange your day, even slightly, to include some down time/alone time to recharge your batteries (and sanity!) in order to get to bed even 15 to 30 minutes earlier? Persistently running on inadequate sleep may catch up with you in the long run. Some people experience a slow onset of burnout, others are stopped in their tracks by serious illness. One way or another, your body will find a way to force you to rest. This kind of debilitation can take years to recover from and seriously impact on your quality of life, including your working, family and social lives, not to mention your financial security. Other health problems and even premature death are highly associated with lack of sleep. Is it worth the risk?
How much sleep is enough?
I usually find people are aware of the amount of sleep they truly need to feel refreshed and recharged. Think back to a time when you had less responsibilities! And keep in mind that as we age we don’t bounce back from late nights as easily – it’s important not to fight this. For adults it’s somewhere between seven and nine hours per night.
In my clinical experience, I have found the old adage to be true: “sleep before midnight is worth more than after”. An eight-hour sleep beginning at 10 pm will refresh you more than if it began at midnight. Re-arranging your day can work wonders here as well. Is there something you can do in the morning so you can get to bed earlier? Early morning is often a more quiet and peaceful time anyway. You might be surprised how efficiently you can work at this time of day after a good night’s sleep. If you know you are going to have a late night, try to squeeze in a short nap sometime in the afternoon or even evening – this can make a huge difference to how you pull up the following day! Something else to consider here is the fact that eating late can reduce the quality of your sleep.
“I try but I can’t fall asleep!”
This is a very common problem. You have the best of intentions but it’s still not happening for you. Let’s look at some frequent saboteurs and suggested solutions:
Exercise is essential for good health. You don’t have to exercise excessively to build or maintain fitness and strength. In fact, too much exercise can lead to health problems. And happily, exercise is time neutral. The amount of time spent on an appropriate exercise regime more than compensates for itself because you will have more energy as well as need slightly less sleep because the sleep quality will be greater.
Sleep hygiene is a bit of a trend at the moment, but with good reason. Is your bedtime routine setting you up for a good night’s sleep? We need to wind down in the evenings to reduce cortisol, a stimulant. Are you affected by any of the following?
- Exercising too late? This can be too stimulating and has been shown to make it harder to fall asleep (the best time for many people to exercise is in the morning).
- Too hot? Our body expects the temperature to start falling by sundown and keep falling throughout most of the night. We sleep better in a cooler environment so use bed coverings to feel cosy and just right.
- Noisy environment?
- Uncomfortable bed or pillow?
- Screen time? See the next point about light.
- Too much caffeine? Having it too late in the day? Try reducing and/or having it before midday. (Some people need to avoid it altogether until they recover their adrenal health).
Sunlight by day: ensure you have some exposure to sunlight during the day preferably before 3 pm. Sunlight will inform your brain it is daytime. This sets in train a chemical process that allows you to produce plenty of melatonin (our sleep hormone, more on this below) at the appropriate time in the evening. I let sunlight shine on my face, and get even better results when I look directly at the sky, even for just a few minutes. This technique is still effective on a cloudy day because natural light is many times brighter than indoor light, and also contains a broader spectrum of light.
Warm light by evening: On the flipside, reduce your exposure to blue light in the evenings. Reduce indoor lighting to a minimum and avoid screen time before bed or install warm light filters on devices. Warm light is okay and doesn’t disrupt our light receptors in the way blue light does. Is this because we evolved with accompanying firelight in the evenings?
Minimise the effects of stress with strategies
Emotional/social stress is possibly the number one issue my patients are dealing with. Modern life is stressful, there’s no doubt about that. Yet there are many strategies and approaches we can use to reduce the harmful effects on our health and well-being:
- Meditation can do wonders to de-stress. Many studies have now shown it to benefit both mind and body. Attend a meditation course or use an app (these two come highly recommended: https://insighttimer.com/ and https://www.headspace.com/). Rewire Your Brain for Love is a brilliant self-guide to rewire your responses to stress, combining meditation with practical exercises.
- Coping strategies can be learned through good self-help books, or a good counsellor.
- Emotional healing can do wonders. Some counsellors can help guide you along this journey, although many people find invaluable help through healing techniques more focused on accessing the subconscious. Personally, the most effective progress I have made has been through serious work with personal growth books combined with some sessions with local energy healers, all using different techniques, often a unique synthesis of what they have learned in developing their healing gifts.
- Taking control of your life is another effective form of removing stress. A life coach can be a fantastic supportive and guiding partner in this process.
NB Many people do not realise that poor diet places a huge strain on our bodies and is a big source of stress, reducing our capacity to deal with other stressors, over which we have less control.
One of the minerals found in our body in larger quantities, magnesium is required for muscle relaxation and many other essential functions. I wrote about magnesium in this blog article. Tell-tale signs of magnesium deficiency include muscle cramps (for others, see here). Please note: topical Epsom salts (magnesium sulphate) are the best way to supplement with magnesium, bringing you all the benefits of sulphate as well. Have regular baths or make your own inexpensive magnesium ‘oil’ (recipe here).
Without adequate melatonin you will not sleep well. You may experience sleep onset or sleep maintenance insomnia. Some people supplement with melatonin but, despite being a natural substance, this has been associated with problems. It’s best to create the correct conditions in our body for melatonin production. To make melatonin your brain first needs to make serotonin, for which you need a number of nutrients including tryptophan and B vitamins. Tryptophan is an amino acid (a building block of protein) found predominantly in animal foods. Incidentally, serotonin is the neurotransmitter we require to feel happy and content. A lack of serotonin may explain why anxiety and depression is more common in vegetarians, whose diet is lower in tryptophan.
The best source of B vitamins is liver! (make home-made pate – it’s easy, cheap and delicious!). Properly prepared whole grains also contain B vitamins. Good quality supplements are also available, although please work with a practitioner to determine the correct form for you. St John’s wort often helps people with serotonin-deficiency symptoms, although it is not yet known how. And lastly, I have also had clinical success with essential oils in this area.
GABA (gamma-amino butyric acid)
GABA is another neurotransmitter without which we cannot relax, mind or body. Many nutrients are required to produce GABA, which is in turn required to convert serotonin into melatonin (see above). Recent research shows how an unhealthy gut microbiome inhibits GABA production. Along with a wise traditional diet, herbs are a convenient way to promote GABA production in the brain. Two of my favourites for patient prescriptions are Passionflower and Valerian. Many essential oils have also been shown to increase GABA including Bergamot and Lavender (see my blog on the rapidly growing phenomenon of essential oils).
Herbal remedies and essential oils
As I have already mentioned, herbs and essential oils are very affective sleep aids. I routinely receive feedback from people to whom I have prescribed essential oils and/or herbs stating they had their best night’s sleep in a long time. I receive this feedback with great joy! I do, however, encourage you to work your way through this entire list and find the combined holistic approach that works best for you.
A final note on sleep apnoea: if you suspect you have this it’s important to get it checked out. Sleep apnoea is associated with chronic illness and premature death! Many people find it goes away with appropriate weight loss but medical assistance is essential in the meantime.