Sleep Wellness – the overnight remedy
By Professor Avni Sali
Summer 2015/16, Living Magazine
Most people can relate to the feelings of impaired daytime function and fatigue, lack of concentration and memory problems associated with a poor night’s sleep. But did you know that poor or insufficient sleep can also be a major health risk? British researchers have found sleep deprivation affects hundreds of genes involved with inflammation, immunity and our response to stress. Sleep disorders, including insomnia and sleep apnoea/snoring, have been shown in studies to correlate with a range of health issues such as obesity, cancer and cardiovascular diseases including hypertension, strokes and heart attacks. One study suggests that sleep disorders could contribute to up to 70 percent of diseases. Just one night of short sleep duration can induce insulin resistance, a major contributor to type 2 diabetes.
Abnormal sleep patterns predict lower life expectancy, and individuals with insomnia are more likely to develop a mood disorder, substance abuse and other adverse health conditions. Research indicates that young people getting less than five hours sleep per night are tripling their chances of developing a mental illness.
Sleep is an integral part of our biological rhythm and our present culture of sleep deprivation is pushing us past our biological capacity. While we are asleep our bodies repair DNA, build and repair muscles and tissues, and regulate weight and mood chemicals. During sleep there is an increased secretion of growth hormone (GH), which is critical in fat breakdown, liver regeneration and glucose levels.
Tips for getting a better night’s sleep commonly focus on getting to bed earlier, changing bedroom conditions (temperature, darkness, noise), avoiding stimulants such as caffeine and alcohol, maintaining regular sleep times and managing stress.
The average adult needs between six and eight hours sleep every night, although it is difficult to know how much sleep a particular individual should have. Adolescents and children generally require more sleep than adults. Both too little and too much sleep can negatively affect health.
The Australian Sleep Health Foundation 2015 recommends the following sleep:
Newborns – 14-17 hrs
Infants – 12-15 hrs
Toddlers – 11-14 hrs
Pre-schoolers – 10-13 hrs
School children – 9-11 hrs
Teenagers – 8-10 hrs
Adults 18+ – 7-9 hrs
Contrary to popular belief, it is likely that we cannot ‘catch up on lost sleep’ on the weekend, and we are often unable to realise just how mentally impaired we are by our sleep deficit. We need to learn to sleep naturally again, and make it our health goal to awaken refreshed each morning.
Ralph Waldo Emerson said, ‘Finish each day before you begin the next, and interpose a solid wall of sleep between the two.’ His advice not only underlines the importance of good sleep, but also provides us with a terrific mantra for optimal health.
Integrative options for sleep wellness
COGNITIVE BEHAVIOURAL THERAPY (CBT)
CBT is a psychotherapeutic approach and research studies indicate that it can be more effective than sleeping medication for treating chronic insomnia.
Relaxation techniques can be useful when stress and worry causes sleep disruptions. In a recent study, mindfulness meditation had significant benefits for improving quality of sleep. Dealing with the underlying causes of stress where possible, as with CBT, is also advisable.
Many studies show exercise during the day promotes better sleep. Regular physical exercise may promote relaxation and raise core body temperature in ways that are beneficial to initiating and maintaining sleep.
SUNSHINE or OTHER FORMS OF LIGHT EXPOSURE
Increased daytime exposure to the sun (and correlating improved vitamin D levels) and reduced exposure to bright lights in the evening (including TVs, computer screens, smart phones and artificial light) can be used to ‘reboot’ the circadian rhythms and melatonin production in the body.
Diet can play an important role in sleep. Losing weight can improve sleep. Many of the brain chemicals necessary for good sleep can be found in specific foods. Melatonin is a hormone made in the pineal gland in the brain and also in the digestive system. It is produced from the amino acid tryptophan. Sunshine stimulates melatonin production and darkness stimulates its release from the pineal gland. L-tryptophan is a precursor to melatonin that is necessary for the body to produce both melatonin and serotonin. It can be sourced from many foods, particularly proteins. Magnesium is helpful especially when restless leg syndrome (RLS) is affecting sleep.
Both valerian and hops have shown efficacy for the treatment of insomnia. Hops is well known as a bitter agent in the brewing industry and has a long history of use for sleep disorders. Valerian is proven to improve sleep quality without side effects. Taken together valerian and hops may be even more effective.
REVIEW OF OTHER MEDICATIONS
A major cause of sleep disorders can be other medications. Anti-depressants are known to interrupt REM-sleep cycles and while it may be necessary to use medication to relieve pain symptoms that interfere with sleep, this can often create a counter-productive cycle. Alternative pain relief strategies can be explored.
Foods with substances that may enhance sleep
Cherries are one of the few natural foods to contain melatonin, the chemical that helps control our body’s internal clock.
Complex carbs such as quinoa, barley and buckwheat may be good for sleep but generally not before bedtime.
Bananas may promote sleep because they contain the natural muscle relaxants magnesium and potassium.
Hummus, lentils and many nuts and seeds are also good sources of tryptophan, and could make people feel sleepy.
Sweet potatoes provide sleep-promoting complex carbohydrates, and the muscle relaxant potassium.
Valerian tea can promote drowsiness. The root of the valerian plant speeds the onset of sleep and improves sleep quality. Chamomile may also be useful.
Adequate sleep is not only essential for disease prevention, but also for achieving the best result in those who have a disease.
Prof. Avni Sali
(MBBS, PhD, FRACS, FACS, FACNEM)
Professor Avni Sali is often referred to as the father of Integrative Medicine in Australia. In 1996 he was the Founding Head of the Graduate School of Integrative Medicine at the Swinburne University in Melbourne. In 2009 he established the not-for-profit, charitable National Institute of Integrative Medicine (NIIM), and became its founding Director. His lifelong work has been the tireless promotion of bringing evidence-based Integrative Medicine into the mainstream medical model – to become the medical paradigm of healthcare. Professor Avni Sali is a long standing board member of The Gawler Cancer Foundation.