Sleep Improvement Techniques & Supplements

If you are suffering from insomnia, it’s time for you to take control and address the underlying causes. There are many steps you can take to change your behavior and lifestyle to help you get better sleep. What follows is the knowledge and techniques you can use to beat insomnia, enjoy great restorative sleep, and optimize your health.

MINDSET no tagline.png

SLEEP PROTOCOL

Sleep Improvement Techniques and Information

by Jim Meehan, MD

“Without enough sleep, we all become tall-two-year olds.”
Jo Jo Jensen, Dirt Farmer Wisdom, 2002

How Much Sleep Do You Need?

  • There is no consensus in the scientific research that says you need eight hours of sleep to maintain health and prevent disease.
  • Don’t stress about getting eight hours of sleep. That only causes you to lose more sleep.
  • Focus on optimizing your health by adding sleep restoring behaviors and targeted supplements.
  • Eliminate the bad habits that negatively affect sleep.

Are you losing sleep over the idea that you must get eight hours of sleep every night? Well, tonight, rest easier. There is no consensus in the scientific research that says you need eight hours of sleep to maintain health and prevent disease.

Focusing on the quantity of sleep without optimizing the quality of your sleep is off target.

We love to talk in generalities about the need for eight hours of sleep, however, clinical sleep research doesn’t support that claim with anything close to a consensus of the evidence. For example, a University of California–San Diego paper on sleep research and aging reviewed data from 1.1 million people and determined that there is no statistically significant reason to sleep longer than 6½ hours per night. In fact, the people in the research who slept 6½ hours a night lived longer than the ones who slept eight! Therefore, don’t stress out about getting eight hours of sleep tonight. That kind of wrong-thinking and the stress it creates will only cause you to lose more sleep.

Since we are entering a new era of technology enabled, personalized, “precision medicine,” it is time that we dispense with population based generalities. Today’s technology provides us with the ability to measure sleep at your bedside with sleep monitors that cost around $180. These monitors allow a level of precision that was previously unprecedented and invaluable to attempt to become precise about what you need from sleep. What's more important than sleep quantity is sleep quality.

High quality sleep is comprised of complex brain wave pattern changes that cycle through stages throughout the night. All of the stages are important, but the stages of deep sleep are the most restorative and healing. It’s in deep sleep that our bodies release one of the most powerful and rejuvenating forces in human physiology. That force is growth hormone.

It’s important that the brain cycle in and out of these stages. In particular, time spent in deep sleep (stage 3 and 4) is of considerable importance, as it is in deep sleep that the brain stimulates the production of growth hormone.

These cycles create an architecture of sleep that must be respected, not disrupted, as so many sleep medications and bad habits will do. the deep, restorative sleep that promotes growth hormone release, memory consolidation, and the. A lack of high quality sleep increases your risk of heart disease, cancer, and raises your risk of death significantly.

Shop here for Dr. Meehan's sleep supplement recommendations:

Melatonin Supplement

Insomnitol™

Glycine Powder

Magnesium Chelate 120 Tablets

Magnesium Malate 240 vegetarian capsules

Vitamin D Complex 60 capsules

GABA

Wake Up Time

Start with your wake up time, count 7.5 hours backwards from your wake up time and this is the time that you should be going to sleep. The average sleep cycle is 80-90 minutes, and we know that we need 5 sleep cycles; or 7.5 hours

Your sleep number (hours) is how many hours you need to sleep and wake up refreshed. The need for 8 hours of sleep is a myth.

Wake up at the same time each day. It is tempting to sleep late on weekends, especially if one has had poor sleep during the week. However, if you suffer from insomnia you should get up at the same time every day in order to train your body to wake at a consistent time.

MINDSET Key Elements Sleep.png

good habits vs sleep killers

Optimize the Bedroom

  1. Keep it cool: 60-67 F
  2. Keep it dark and quiet
  3. Eliminate Electropollution
  4. Refresh your pillow
  5. Weighted blankets for insomnia and anxiety
  6. Bedrooms are for sleep and sex

Temperature, lighting, and noise should be controlled to make the bedroom conducive to falling (and staying) asleep. Your bed should feel comfortable and if you have a pet that sleeps in the room with you, consider having the pet sleep somewhere else if it tends to make noise in the night.

Keep it cool: 60-67 F

  • Ideal ambient temp: 60-67 degrees F.
  • Growth Hormone (HGH) release is optimized at lower room temp.
  • Temp. disagreement with partner? Try cooling products:

    • Wicking sheets and pillows: Sheex
    • Cool Gelmat, ChillGel, Chilipad

“The thermal environment is one of the most important factors that can affect human sleep.” Journal of Physiological Anthropology 2012, 31:14.

Clinical research has demonstrated that between 60-67 degrees Fahrenheit is the optimal temperature for sleep.

Keep the temperature in your bedroom no higher than 68 degrees F. Many people keep their homes and particularly their upstairs bedrooms too warm. Studies show that the optimal room temperature for sleep is quite cool, between 60 to 67 degrees. Keeping your room cooler or hotter can lead to restless sleep. When you sleep, your body's internal temperature drops to its lowest level, generally about four hours after you fall asleep. Scientists believe a cooler bedroom may therefore be most conducive to sleep, since it mimics your body's natural temperature drop.

Keep it dark and quiet

The darker the better. Nighttime light exposure suppresses production of melatonin, the sleep hormone.

  • Heavy “blackout” curtains
  • Put anything with a digital readout where you can’t see it
  • Consider a sleeping mask

The Nidra Deep Sleep Mask - $13.95

Dr. Mercola’s advice:

Sleep in complete darkness, or as close to it as possible. Even the tiniest bit of light in the room can disrupt your internal clock and your pineal gland's production of melatonin and serotonin. Even the tiniest glow from your clock radio could be interfering with your sleep. This will help decrease your risk of cancer. Close your bedroom door, and get rid of night-lights. Refrain from turning on any light at all during the night, even when getting up to go to the bathroom. Cover up your clock radio. Cover your windows—I recommend using blackout shades or drapes.

All life evolved in response to predictable patterns of light and darkness, called circadian rhythms. Modern day electrical lighting has significantly betrayed your inner clock by disrupting your natural rhythms. Little bits of light pass directly through your optic nerve to your hypothalamus, which controls your biological clock. Light signals your brain that it's time to wake up and starts preparing your body for ACTION.

Sounds/Environment

Ear plugs (foam), white noise, ocean sounds, music without words, and music that is reasonably soothing.

  • Consider earplugs

3M 1100 Foam Ear Plugs, 200-Pair - $22

  • White noise

Eliminate Electropollution

Electronics and electrical devices in your bedroom may be keeping you awake at night.

The bedroom is where you should be spending at least eight hours a night in deep, restorative, regenerative, natural sleep. If instead you’re tossing, turning, and staring at the ceiling, the problem could be caused by the unnatural voltage and electromagnetic fields interacting with every cell in your body—produced by the wiring in your walls, extension cords, electrical appliances, and electronic devices.

Many cases of chronic insomnia or restless sleep (including intermittent wakeups) have been solved by simply unplugging a wireless router or turning off cell phones at night. Everyday new cell phone towers are popping up and we absorb hundreds of frequencies through our bodies and into our brains impacting, possibly disrupting, the pineal gland and more.

Because your body restores itself when you sleep—producing between 80 and 90% of its supply of pineal-producing melatonin at night—you can’t be too scrupulous about reducing the sources of electropollution in your bedroom.

Thermographic imaging demonstrates how exposure to electromagnetic fields (EMF) radiation causes inflammation

Before exposure to cell phone radiation.After a 15 minute phone call.

Alternating current (AC) magnetic fields interfere with your body’s production of the antioxidant hormone melatonin.

Guidelines for Eliminating Electropollution - Clear the Electronic Clutter

  • Get the cell or cordless phone, computer, PDA, sound system, and clock radio out of the bedroom.
  • Keep any “necessary” electronics at least six feet from your bed.
  • Use a battery-powered or wind up alarm clock.
  • Electric blankets and heated waterbeds produce very large AC electric and magnetic fields that have been linked to infertility.
  • Keep children’s rooms as EMF free as possible. Children—with their smaller size and thinner skulls—are far more vulnerable to electromagnetic fields than are adults.

Don’t spend 8 hours each night bathed in electropollution

  • Position your bed so that your head isn’t near electrical outlets.
  • Metal spring mattresses conduct and transmit nearby EMFs
  • Consider the electrical wiring and fixtures in the room below or adjacent to your bedroom.
  • Refrigerators create one of the largest magnetic fields in your house.
  • Consider turning off the power at the circuit box.

Seven Guidelines for Eliminating Electropollution - from Ann Louise Gittleman, Author of “Zapped”

Zapped: Why Your Cell Phone Shouldn't Be Your Alarm Clock and 1,268 Ways to Outsmart the Hazards of Electronic Pollution

Clear the electronic clutter.

  • Alternating current (AC) magnetic fields interfere with your body’s production of the antioxidant hormone melatonin.
  • Get the cell or cordless phone, computer, PDA, sound system, and clock radio out of the bedroom.
  • If you must have a “white noise” sound machine to sleep, keep it at least six feet from your bed.
  • Use a battery-powered or wind up alarm clock. If you forget to wind it or can’t keep up with battery changing, move your electric clock or clock radio at least six feet from your head. Don’t use your smartphone as an alarm clock.
  • Unplug your electric blanket before you crawl into bed. It can produce very large AC electric and magnetic fields that have been linked to infertility. A heated waterbed creates similar problems.

Consider the position of the head of your bed in relation to electrical wiring, outlets, and even electrical appliances that may be on the other side of the wall.

  • Position your bed so that your head isn’t near a power outlet.
  • If your bedroom is on the second floor, you probably can’t escape electrical wiring, which is in the floor. Consider turning off the power entirely, at the circuit box, to the bedroom at night.

To learn more about protecting your family in your own home, go to www.areyouzapped.com and www.buildingbiology.net.

Refresh your pillow

  • Your pillow is an essential element in your perfect sleep system
  • Support your head and neck - align the spine
  • Replace your pillow every year
  • Eliminate flat, lumpy, and bumpy
  • Eliminate nasty, old, moldy, bacteria growing, dust mite filled pillows

Is your pillow gross?

Your pillow becomes a home to bad, allergy causing bugs:

  • Bacteria
  • Mold
  • Dust mites

Sweat, skin cells, and drool are a feast for the bad stuff

  • Replace your pillow at least once a year
  • Use a medical grade pillow protector
  • Machine wash and dry pillowcases at least every 2 weeks
  • Machine wash and dry your pillow (if possible)

Buckwheat hull pillow

  • Naturally adjusts to your ideal position of head, neck, and spine
  • Completely adjustable loft; refillable so you can adjust the amount of hulls to your personal liking
  • Allows air to circulate for natural cooling comfort
  • Buckwheat hulls are naturally resistant to mold and dust mites
  • Anti-allergenic
  • Used for centuries in Japan

Amazon Buckwheat Hull Pillow.PNG

Shop here: ZEN CHI Organic Queen Size Buckwheat Pillow for Sleeping

Weighted Blankets for Insomnia and Anxiety

  • The weight of the blanket acts as deep touch therapy.
  • Filled with plastic poly pellets that are sewn into compartments, distributing the weight properly.
  • Helps the body to relax, feel more grounded and safe.
  • Clinical studies suggest that when these pressure points are triggered, the brain releases serotonin, a neurotransmitter that is known as “the calming chemical.”

Shop here: Weighted Blanket 5lbs-30lbs

In an era of continuous over-stimulation and high stress, a good night’s sleep is becoming increasingly hard to come by. More and more individuals are developing sleep apnea, chronic insomnia, and other sleep disorders, creating a “sleep market” — worth $28.6 billion in 2017 — focused on curing sleepless Americans. Over-the-counter and non-prescription drugs are on the rise, while sedatives such as Ambien and Lunesta remain as the most commonly prescribed drugs for insomnia.

As the side effects of sleep medications can be debilitating, insomniacs are increasingly turning to more natural solutions. Anew, drug-free approach to targeting insomnia and other anxiety-related sleep disorders has been growing in popularity over the past two years. Weighted blankets, or gravity blankets, are being marketed as the latest solution for insomnia, nighttime anxiety, and stress. Filled with plastic beads or pellets, these blankets tend to range in weight from 3 to 20 pounds and are meant to mimic a comforting hug, lulling users to sleep naturally.

Sales of weighted blankets have surged in recent years, although there is little clinical evidence supporting their efficaciousness in treating insomnia.

Weighted Therapy

Whether there are any health benefits to using weighted blankets remains a matter of debate, with some experts even cautioning against their use for children. However, weight therapy has a significant basis in medical practice. Commonly used as a calming strategy for children with autism or behavioral disturbances in psychiatric units, weight therapy relies on “deep touch pressure” which helps calm arousal levels in the nervous system by stimulating the release of serotonin and dopamine.

Weighted blankets attempt to mimic the calming effect of swaddling newborns, increasing feelings of comfort and security through pressure and envelopment of the body. BlanQuil, Gravity Blanket and other companies selling blankets recommend buying one that weighs 10% of your body weight to achieve the maximum soothing effect. Prices can range from $100 to upwards of $250 per blanket, making this potential new solution to insomnia costly despite little scientific backing.

Do They Work?

Few reputable scientific studies have been conducted to evaluate whether weighted blankets can indeed cure sleeplessness and concrete evidence is lacking. Randomized clinical trials testing the efficacy of blankets would be difficult to achieve as a blind comparison is impossible; participants can immediately tell if a blanket is weighted or not.

A study funded by blanket manufacturers revealed calmer, higher quality sleep in 31 adults with moderate insomnia over a 2-week period. The most recent independent research was published in 2016 in the Journal of the Formosan Medical Association and did not examine the correlation between weighted blankets and sleep patterns. Instead, researchers evaluated nervous system activity in participants undergoing wisdom tooth extraction and found that people who wore a weighted blanket during the procedure showed higher activity levels in areas responsible for lowered stress response.

While there is no robust body of scientific evidence to support marketing claims that weighted blankets are a cure-all solution to nighttime anxiety and insomnia, there are few risks associated with trying them. Caution should be advised in individuals who suffer from sleep apnea, certain sleeping disorders, respiratory problems, and other chronic medical conditions as the use of weighted blankets could be detrimental for them. For most other healthy individuals, this new approach may provide a good alternative to sedative medications and their associated side effects. Regardless of sleep irregularities, proper sleep hygiene – which includes turning off electronics at night and keeping the bedroom environment conducive to sleep – is the essential first step in ensuring a good night’s rest.

There are certain people who should not use a weighted blanket or should check with their doctors before doing so, including people with

  • sleep apnea
  • certain other sleep disorders
  • respiratory problems or other chronic medical conditions.

Also, check in with your doctor or a trained therapist if you are interested in trying a weighted blanket for a child.

If you do decide to try a weighted blanket, be realistic about your expectations and realize that results may vary.

Bedrooms are for sleep...and sex

Neither are happening here.

The bed is for sleeping and having sex, and that's it. If you suffer from insomnia, do not balance the checkbook, study, make phone calls, etc. while in bed or even in the bedroom, and avoid watching television or listening to the radio. All these activities can increase alertness and make it difficult to fall asleep.

  • Don't read, watch TV, snack, or listen to music in bed. This is a form of stimulus-control and re-association of the bed and bedroom with sleep, one of the behavioral therapies.
  • Use your bed only for sleeping or lovemaking, never for reading or watching TV. If you can't sleep after 15 to 20 minutes, get out of bed and go into another room. Read quietly with a dim light but don't watch TV, since the full-spectrum light emitted by the tube has an arousing effect. When you feel sleepy, get back into bed — but don't delay your scheduled awakening time to compensate for lost sleep.

good habits sleep

Track Your Sleep: Monitor and measure sleep so you can improve it.

SleepScore Max bedside sleep monitor

SleepScore Max provides the most accurate sleep tracking next to clinical sleep measures. Without requiring you to wear a device or place anything on your bed, the SleepScore Max sensor can be placed on your bedside table. The sensor measures the quality and quantity of your sleep. Every morning, the companion app allows you to view your quality scores, personalized insights, and actionable advice.

Shop here: SleepScore Max Sleep Monitor

sleepscore

  • SleepScore Max sensor + companion app required. No subscription needed
  • Improved sleep by an average of 45 minutes
  • Shown to enhance your sleep quality in 1 week
  • Features SleepScore by ResMed™ technology built on 12 years of research with accuracy validated in over 12 published studies.
  • Provides personalized, science-based advice
  • Recommends sleep products that could help
  • One time cost of $149.99, no subscription needed
  • Bonus: You get the premium version of the SleepScore Official App for free.

The Oura Ring

Shop here: Oura Ring measures the physiological signals of your body, understands your lifestyle, and guides you to make your own optimal daily choices. The ring features scientifically validated sleep tracking and personalized guidance.

oura ring

Daily bedtime routine

  • Prepare your mind and body for sleep
  • The brain is predictive
  • Routines comfort and calm the brain
  • Go to bed and wake up at the same time every day (all week)

bedtime routine

Establish a bedtime routine. This could include meditation, deep breathing, using aromatherapy or essential oils or indulging in a massage from your partner. The key is to find something that makes you feel relaxed, then repeat it each night to help you release the tensions of the day. (Mercola)

Try to keep the same sleep schedule on weeknights and weekends. Limit the difference to no more than about an hour. Staying up late and sleeping late on weekends can disrupt your body clock's sleep–wake rhythm.

Exercise in the Morning

  • Morning exercise is best for nighttime sleep
  • Morning exercise benefits sleep even more when when done in morning sunlight
  • Avoid exercise within 3 hours of sleep
    • Exercising immediately before bed can have a stimulating effect
    • Some Type A personalities find that exercising a few hours before bed can be relaxing

Exercising for at least 30 minutes per day can improve your sleep, both quality and duration. However, exercising immediately before bedtime can have a stimulant effect on the body and should be avoided. Try to finish exercising at least three hours before you plan to retire for the night. Studies show that exercising in the morning is the best if you can manage it.

Some type A personalities find that exercising a few hours before bed can be relaxing. Melancholy personality types get excess energy if they exercise before bed.

“Compared with controls, subject in the exercise training condition showed significant improvement in the [Pittsburgh Sleep Quality Index] global sleep score at 16 weeks, as well as in the sleep parameters of rated sleep quality, sleep onset latency, and sleep duration.” JAMA. 1997 Jan 1;277(1):32-7.

Build healthy muscles

  • Exercise for at least a few minutes each morning
  • Strength training 3-4 days/week. Start low and go slow.
  • Exercise all major muscles groups. Should include squats.
  • Add High Intensity Interval Training (HIIT) as you advance

beginner restart exercise program

“Compared with controls, subject in the exercise training condition showed significant improvement in the [Pittsburgh Sleep Quality Index] global sleep score at 16 weeks, as well as in the sleep parameters of rated sleep quality, sleep onset latency, and sleep duration.” JAMA. 1997 Jan 1;277(1):32-7.

Cognitive behavioral therapy - Psychological and Behavioral Interventions for Insomnia

Behavioral treatment components of CBT

Some of the specific behavioral treatment components of CBT for insomnia 17,18 include:

  • Patient education about sleep hygiene (awareness of sleep-promoting health and environmental factors)
  • Relaxation Therapy (tension release and cognitive arousal reduction)

    • Deep Breathing: 4-7-8 Technique
    • Progressive Muscle Relaxation
    • Guided Imagery and Meditation
    • Biofeedback
    • Worry Management Techniques
  • Stimulus Control Therapy (re-association of the bed and bedroom with sleep)

    • Avoid negative sleep mindsets
    • Worry management techniques
    • Distraction techniques
  • Sleep restriction (mild sleep deprivation to induce better quality sleep)
  • Emotional Freedom Technique (EFT)
  • Sleep Management Tools and Devices

According to the American Academy of Sleep Medicine, 18 psychological and behavioral interventions, such as cognitive-behavioral therapy (CBT), are effective and recommended first-line treatments for chronic insomnia. 19

CBT targets these behaviors with interventions aimed at improving patients’ overall sleep hygiene, addressing their attitudes about insomnia and its treatment and helping them learn behavioral approaches to decrease their arousal levels and improve their homeostatic and circadian drives to sleep.

The overall objectives of psychological and behavioral therapies are to identify the negative thoughts and behaviors that perpetuate the insomnia, alert the insomniac to these actions, use specific tailored interventions to restructure the patient’s behaviors and promote good sleep hygiene, establish a regular sleep pattern, and reduce arousal and anxiety about sleep.17

A randomized, double-blind, placebo-controlled trial20of primary insomnia (N = 75) examined the efficacy of CBT plus stimulus control therapy, sleep education, and time-in-bed restrictions. Results showed that CBT produced greater improvements on most outcome measures than did relaxation therapy or placebo, including reducing wake after sleep onset (WASO), normalizing sleep and subjective symptoms, and increasing sleep efficiency. Another controlled trial21reported that CBT was superior in reducing sleep latency and nighttime wakefulness in comparison to the self-monitoring control. Patients in the self-monitoring group who then went on to participate in CBT had a significant increase in sleep as well.

A meta-analysis22of studies conducted between 1998 and 2004 that examined psychological and behavioral treatment of insomnia confirmed that these therapies reliably improved several sleep parameters in individuals with primary and secondary insomnia. However, evidence of meaningful changes in areas such as quality of life and improved daytime functioning has not been established. Studies are also needed to validate these therapies in primary care settings.

Relaxation Therapies

Relaxation therapies and stress reduction methods are very effective at relaxing the mind and the body before going to bed. Examples include deep breathing techniques, progressive muscle relaxation (perhaps with audio tapes), imagery, meditation, and biofeedback).

  • Deep Breathing: 4-7-8 Technique
  • Progressive Muscle Relaxation
  • Guided Imagery and Meditation
  • Biofeedback

“Both the biofeedback and progressive relaxation groups decreased their sleep-onset times and several physiological measures relative to the control group.” Biofeedback and Self-Regulation, Vol 1, No. 3, 1976.

Deep 4-7-8 Breathing. Hack your nerves.

Back straight. Tip of tongue just behind your upper front teeth (and keep it there). Blow the air out of your lungs.

The 4-7-8 Breathing Exercise is simple, quick, requires no equipment, and can be done anywhere.

  • Sit with back straight. Tip of tongue against the ridge of tissue just behind your upper front teeth, and keep it there through the entire exercise.
  • Exhaling through your mouth around your tongue; try pursing your lips slightly if this seems awkward.

The absolute time you spend on each phase is not important; the ratio of 4:7:8 is important.

Stimulus Control Therapy

Avoid a negative sleep mindset
  • Avoid negative attitudes and beliefs about sleep and sleep disorders, increased frustration, and anxiety about sleeping. Don’t get worked and wound up about being unable to fall asleep. That just makes matters worse. For example, during the course of an insomnia disorder, you may develop negative behaviors that can contribute or worsen your sleep problems:
    • Lying in bed while awake for long periods of time can reinforce an association between the bed and the inability to sleep.
    • Trying to extend time in bed to make up for “missed sleep,” either by sleeping in later or napping during the day can disrupt both the homeostatic and circadian regulation of sleep.17
Worry Management Techniques

Get all your worrying over with before you go to bed. If you find you lay in bed thinking about tomorrow, consider setting aside a period of time at night before you go to bed to review the day and to make plans for the next day. For example, before going to sleep, write down your worries in one column and one thing you can do to solve that problem in the other column. The goal is to avoid doing these things while trying to fall asleep. It is also useful to make a list of, say, work-related tasks for the next day before leaving work. That, at least, eliminates one set of concerns.

Distraction techniques

Count backwards from 300 by 3's

Sleep Restriction

Limit naps

While napping seems like a proper way to catch up on missed sleep, it is not always so. It is important to establish and maintain a regular sleep pattern and train oneself to associate sleep with cues like darkness and a consistent bedtime. Napping too much, or for too long during the day, can affect the quality of nighttime sleep. A short nap (around 20 minutes or so) in the mid- to late afternoon can be helpful, however, and should not interfere with getting to sleep at night.

Emotional Freedom Technique (EFT)

My current favorite fix for insomnia is Emotional Freedom Technique (EFT). Most people can learn the basics of this gentle tapping technique in a few minutes. EFT can help balance your body's bioenergy system and resolve some of the emotional stresses that are contributing to your insomnia at a very deep level. The results are typically long lasting and improvement is remarkably rapid.

References
  1. Schutte-Rodin S, Broch L, Buysse D, et al. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008;4(5):487–504. PubMed
  2. Morgenthaler T, Kramer M, Alessi C, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep. 2006;29(11):1415–1419. PubMed
  3. Espie CA. “Stepped care”: a health technology solution for delivering cognitive behavioral therapy as a first line insomnia treatment. Sleep. 2009;32(12):1549–1558. PubMed
  4. Edinger JD, Wohlgemuth WK, Radtke RA, et al. Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. JAMA. 2001;285(14):1856–1864. PubMed doi:10.1001/jama.285.14.1856
  5. Espie CA, Inglis SJ, Tessier S, et al. The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice. Behav Res Ther. 2001;39(1):45–60. PubMed doi:10.1016/S0005-7967(99)00157-6
  6. Morin CM, Bootzin RR, Buysse DJ, et al. Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep. 2006;29(11):1398–1414. PubMed

Food and Drink

It is better not to eat or drink right before going to bed. Eating a late dinner or snacking before going to bed can activate the digestive system and keep you up. If you suffer from gastroesophageal reflux (GERD) or heartburn, it is even more important to avoid eating and drinking right before bed since this can make your symptoms worse. In addition, excessive drinking prior to bed can overwhelm the bladder, requiring frequent visits to the bathroom.

If you find yourself regularly waking up in the middle of the night, the problem could be caused by low blood sugar. However, the solution is not what you might think.

The brain doesn’t tolerate low blood sugar well and the lack of brain fuel that hypoglycemia represents will disrupt sleep. The reason your sugar deprived brain wakes you up in the middle of the night has more to do with TOO MUCH SUGAR eaten too soon before bed.

Alcohol

Avoid alcohol. Although alcohol will make you drowsy, the effect is short lived and you will often wake up several hours later, unable to fall back asleep. Alcohol may have a sedative effect for the first few hours following consumption, but it can then lead to frequent arousals and a non-restful night's sleep. Alcohol will also keep you from entering the deeper stages of sleep, where your body does most of its healing.

Alcoholic beverages also contain a significant amount of simple carbohydrates and sugar. Therefore, the sugar peak-and-crash cycle described previously also applies. to drinking high carbohydrate and sugar containing alcoholic beverages before bed.

Stimulants

Eliminate nicotine, caffeine, and other stimulants. This includes certain medications such as theophylline, beta agonists (usually as inhalers) and decongestants, especially prior to bedtime. The effects of caffeine can last for several hours, perhaps up to 24 hours, so the chances of it affecting sleep are significant. Caffeine may not only cause difficulty initiating sleep, but may also cause frequent awakenings.

Avoid caffeine. At least one study has shown that, in some people, caffeine is not metabolized efficiently, leaving you feeling its effects long after consumption. So, an afternoon cup of coffee or tea will keep some people from falling asleep at night. Be aware that some medications contain caffeine (for example, diet pills).

Supplements for Sleep

Supplement analysis from Sleep Quality review from Examine.com.

Melatonin

Shop here: Melatonin Supplement and Insomnitol™

Recommended dosage: 3 mg to 6 mg at bedtime. Limit use to one to two days per week.

Melatonin is a hormone secreted by the pineal gland. Under the influence of light, melatonin regulates circadian rhythms (the day-night cycle) and the sleep-wake cycle. Melatonin secretion and activity is strongly influenced by the amount of light energy entering the eye. As the sun and light energy entering the eye goes down in the evening, melatonin levels increase. Levels stay high throughout the night, and then decrease in the morning. In people with insomnia, nocturnal melatonin secretion may be blunted, which negatively affects normal sleep patterns.26

Because melatonin is primarily regulated by light energy entering the eyes, one of the best ways to increase melatonin levels naturally is to control your exposure to light, both natural and artificial. Specifically, you want light exposure that follows natural day to night patterns. For example, rise with the sun and allow the red wavelength light from the horizon to bathe your retinas in the morning. This restarts the daytime hormone and neurotransmitter cascades that create alertness and mental acuity. Then, during the midday allow the bright blue-wavelength light from the overhead sun to do the same. Finally, as the sun goes down, once again allow the longer, red-wavelength light to enter your eyes and begin the stimulation of melatonin production. Allow the complete darkness of night to then maximize the secretion of melatonin and all the beneficial effects it provides.

In an artificial light and electronic device filled world, exposure to natural sunlight and darkness patterns is harder than it may seem. Ideally, you want to experience bright sunlight in the daytime and absolute complete darkness at night. When that isn't possible, you may want to consider a melatonin supplement. When combined with light therapy, melatonin helps minimize nighttime restlessness in elderly dementia patients, according to a 2008 study.

“Melatonin can be used in supplement form as an occasional sleep aid, and is especially effective against jet lag,” Dr. Andrew Weil, founder and director of the Arizona Center for Integrative Medicine, says. Because melatonin helps to rebalance the circadian rhythms (the day-night cycle), as a result deeper REM sleep is improved and the individual feels more refreshed the following day. Melatonin is a completely natural substance made by your body, and has many health benefits in addition to sleep. (Mercola)

A meta-analysis27of primary sleep disorders (insomnia, delayed sleep phase syndrome, and REM sleep behavior disorder) found that melatonin was effective in decreasing sleep onset latency, increasing sleep duration, and improving sleep quality. Additionally, a prolonged release melatonin formulation has been reported to increase sleep quality, decrease sleep latency, and improve the quality of life, without causing withdrawal or hangover effects, morning sedation, or safety concerns in patients 55 years and older.28

The Melatonin Connection - How Electromagnetic Fields (EMF) Diminish Melatonin

Even minimal EMF exposure has been linked to sleep disturbances and immune-system suppression, so what happens during the day also affects melatonin production and your health.

Besides helping to fight insomnia, melatonin bolsters the immune system by increasing the activity of two other potent antioxidants—glutathione and superoxide dismutase (SOD). Recent research suggests a link between low levels of SOD and amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s disease. This fatal disorder of the nerve cells in the brain and spinal cord, which leads to total paralysis, has been traced to occupational EMF exposure, and some researchers suspect the missing link is melatonin.

That’s not all this antioxidant hormone does. People with cancer, AIDS, and other serious diseases have severely depleted levels of glutathione—the other antioxidant that melatonin supports. Like most antioxidants, glutathione gives up an extra electron to free radical molecules, rendering them benign. So you need melatonin to allow glutathione to regain its antioxidant status—helping it live to fight another day.

With less circulating melatonin, the body becomes more vulnerable to free radical damage and a host of related disorders, ranging from cancer (particularly melanoma and malignancies of the breast, ovary, and prostate) and heart disease to neurological conditions like Alzheimer’s and Parkinson’s.

Antioxidant melatonin also stimulates TSH, the thyroid hormones that control your metabolism, which may explain why sleep-deprived people tend to be overweight. Radiation—including that from EMFs—zero in on the thyroid gland as though it were painted with a target. Electropollution from cell phones can diminish the body’s production of thyroid hormones, which leads to depression, fatigue, joint pain, and muscle cramps—symptoms of both thyroid dysfunction and electrosensitivity.

EMFs aren’t the only reason for decreased melatonin production, though.

As a landmark Tulane study shows, levels of this critical antioxidant hormone naturally decline with age. I recommend melatonin in a 3 mg time-released form—particularly if you’re over 60 years of age. Recent research in the journal BMC Medicine reports that prolonged release supplements—as licensed in Europe and other countries for people 55 and older—are both safe and effective.

If you decide to have your melatonin levels tested, be sure to do it at night. Production of this antioxidant hormone peaks between 2 and 4 am, which is why it’s so important to make your bedroom as EMF-free as possible.

Glycine

Shop here: Glycine Powder

Recommended dosage: 3g of glycine an hour prior to sleep

In persons undergoing mild sleep deprivation, 3g of glycine an hour prior to sleep is able to increase sleep quality and improve self-reports of fatigue and well being the next day due to better sleep.

Kava

Recommended dosage: 100-300 mg

Sleep quality is enhanced via reducing the symptoms of anxiety which impair sleep.

Kava is an herb that has traditionally been drunk as a hypnotic and anxiety reducer. It has been shown effective in reducing anxiety, sometimes at a potency similar to pharmaceuticals. May have cognition enhancement effects related to anxiety reduction.

Caution Notice: Kava and Kava containing products are suspected to interact adversely with drugs and other pharmaceuticals, caution should be used when pairing Kava with other compounds.

Lavender (oral and aromatherapy)

Recommended dosage: 80 mg Silexan (Lavender oil) at bedtime or aromatherapy exposure at bedtime.

Shop here: Young Living Lavender Oil

Improvements in sleep quality have been noted in insomniacs and persons with generalized anxiety disorder mostly, with some limited evidence suggesting this may benefit generally healthy persons. Both oral supplements and aromatherapy are implicated in these benefits, but overall the quality of the studies is somewhat less than desirable. The parameters that see benefit are less waking up during the night and reduction in insomnia symptoms.

Red Clover Extract

Shop here: Red Clover Extract

Recommended dosage: 80 mg daily

In postmenopausal women, there appears to be an increase in self reported sleep quality that was quite notable, reaching 70-73 points of improvement on a 0-100 rating scale (placebo at 10-16) although this needs to be replicated (independently) to assure quality of data.

Supplementation of 80 mg red clover isoflavones daily over the course of ninety days appeared to be able to increase skin and hair quality, and the improvement in nail quality was present only in half of the study (crossover design) while all improvements had a high variability. Ocular dryness was reduced, and overall symptoms (libido, sleep disturbances, mood) were all improved with treatment relative to placebo.

L-Theanine

Recommended dosage: 100 mg

L-theanine is an amino acid found in green tea, and it's known to reduce stress and causes relaxation.

  • Crosses the blood-brain barrier
  • Stimulates the production of GABA
  • Balances serotonin and other neurotransmitters in the brain1
  • Suppresses glucocorticoids
  • Reduces stress. Causes relaxation
  • Improves sleep quality, recovery from exhaustion, and refreshed feelings2
  • Yokogoshi H, Kobayashi M, Mochizuki M, Terashima T. Effect of theanine, r-glutamylethylamide, on brain monoamines and striatal dopamine release in conscious rats. Neurochem Res. 1998 May;23(5):667-73.
  • Researchers in Japan gave volunteers 200 mg of L-theanine daily and recorded their sleep patterns. The L-theanine was associated with better sleep. It was documented that sleep quality, recovery from exhaustion, and refreshed feelings were all enhanced by L-theanine. Those taking L-theanine felt like they slept longer than they actually did.

Magnesium Threonate or Glycinate

Shop here: Magnesium Chelate 120 Tablets and Magnesium Malate 240 vegetarian capsules

Recommended dosage: 400 to 800 milligrams (mg) daily

The best forms of magnesium all have chelates that end in -ate. For example, threonate, glycinate, citrate, malate, aspartate, and others.

Oxide and citrate are the most common and least absorbable forms of magnesium. Because of their poor absorption into the bloodstream, they stay in the bowels and are often used to treat or prevent constipation.

Magnesium is an essential mineral required for normal functioning and physiology in more than 300 processes in the body. Without adequate magnesium levels, our body chemistry and physiology comes to an almost complete stop; neurons don’t communicate, muscles don’t relax, hormones and neurotransmitters don’t work, tissues break down, and bones break.

Magnesium is essential to health. Unfortunately most of us are walking around with a serious health diminishing deficiency in magnesium.

Several older studies show that magnesium can improve sleep quality and reduce nocturnal awakenings. One study showed that 320mg magnesium citrate taken daily for 7 weeks was associated with improved sleep in a group of participants over the age of 51 years of age.

Along with contributing to a good night’s sleep, this essential mineral is an oft-overlooked nutrient that is critical to normal muscle and nerve function, heart rhythm, blood pressure, blood sugar levels, a healthy immune system, and strong bones. The full impact of magnesium deficiencies is as debilitating as it is common. I commonly see serious magnesium deficiencies in my clinic. They present as stressed, anxious, nervous, weak, hypertensive, sick, diabetic person with lots of muscle spasms, aches and pain.

Having enough makes the body more resilient to stress.

L-Tryptophan

Recommended dosage: 500 mg to 1500 mg taken at bedtime.

L-Tryptophan is the precursor to serotonin, which in turn is the precursor to melatonin. You may remember that Grandma gave you milk to sleep before bed to aid your sleep, this is due to the content of L-Tryptophan.

L-tryptophan is used to treat insomnia as well as anxiety and depression (among other things).

Take caution with amounts when using this supplement, as too much of it can cause inflammation.

Vitamin D

Shop here: Vitamin D Complex 60 capsules

Recommended dosage: Heavily based on weight, roughly 5,000 International Units per day for adults

Some sleep disorders are tied to vitamin D deficiency, which hurts the amount of sleep you get, the quality of your sleep, and your mood upon waking up. Since most of us work indoors, wear clothes, and use sunscreen, those modern life realities take away from our inherent vitamin D synthesis.

Ornithine

Recommended dosage: 500 to 1,000 mg

"This relaxing amino acid helps the body eliminate ammonia in the gut, and excess ammonia causes feelings of stress," author Dave Asprey explains in The Bulletproof Diet. Ammonia is a cellular toxin, and eliminating it can improve your long- and short-term memories."

Ornithine is especially beneficial when taken to counter the adverse effects of alcohol consumption.

GABA

Shop here: GABA

Recommended dosage: 500 mg at bedtime

GABA is a neuro-inhibitory transmitter. It’s what your brain uses to shut itself down. Taken away from any other protein, it will dramatically calm you. Start with 500 mg.

GABOB: Gamibetal®: A Stress-Reliever with Anti-aging Properties

Recommended dosage: 500mg to 1500mg taken at bedtime.

http://www.antiaging-systems.com/articles/288-gamibetal-a-stress-reliever-with-anti-aging-properties

GABOB, also known as aminohydroxybutyric acid, is the closest legal molecule to GHB. GHB has since been banned because of its ability to put people to sleep within 20 minutes. GABOB does not have that ability, but nonetheless at the dosages referred to can create drowsiness to aid sleep and also appears to have significant HGH release- which in turn has been associated with better, deep (REM) sleep.

Discovered over 50 years ago, gamma-amino-beta-hydroxybutyric acid (abbreviated GABOB) is a natural substance found in the brain that possesses some useful pharmacological properties. Initially studied as an anti-epilepsy treatment, it has broader applications in the areas of anxiety and stress reduction, and growth hormone production. GABOB is marketed as the drug Gamibetal® in Mexico and Italy, but elsewhere is not widely available, despite its therapeutic potential and excellent safety profile.

References

  1. Schutte-Rodin S, Broch L, Buysse D, et al. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008;4(5):487–504.PubMed
  2. Stahl MS. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 3rd ed. New York, NY: Cambridge University Press; 2008.
  3. Krystal AD, Richelson E, Roth T. Review of the histamine system and the clinical effects of H1 antagonists: basis for a new model for understanding the effects of insomnia medications. Sleep Med Rev. 2013;17(4):263–272.PubMeddoi:10.1016/j.smrv.2012.08.001
  4. Kalpaklioglu F, Baccioglu A. Efficacy and safety of H1-antihistamines: an update. Antiinflamm Antiallergy Agents Med Chem. 2012;11(3):230–237.PubMed
  5. Hajak G, Rodenbeck A, Staedt J, et al. Nocturnal plasma melatonin levels in patients suffering from chronic primary insomnia. J Pineal Res. 1995;19(3):116–122.PubMeddoi:10.1111/j.1600-079X.1995.tb00179.x
  6. Ferracioli-Oda E, Qawasmi A, Bloch MH. Meta-analysis: melatonin for the treatment of primary sleep disorders. PLoS ONE. 2013;8(5):e63773.PubMeddoi:10.1371/journal.pone.0063773
  7. Lemoine P, Zisapel N. Prolonged-release formulation of melatonin (Circadin) for the treatment of insomnia. Expert Opin Pharmacother. 2012;13(6):895–905.PubMeddoi:10.1517/14656566.2012.667076
  8. Sarris J, Byrne GJ. A systematic review of insomnia and complementary medicine. Sleep Med Rev. 2011;15(2):99–106.PubMeddoi:10.1016/j.smrv.2010.04.001
  9. Gooneratne NS. Complementary and alternative medicine for sleep disturbances in older adults. Clin Geriatr Med. 2008;24(1):121–138, viii.PubMeddoi:10.1016/j.cger.2007.08.002
  10. Taibi DM, Landis CA, Petry H, et al. A systematic review of valerian as a sleep aid: safe but not effective. Sleep Med Rev. 2007;11(3):209–230.PubMeddoi:10.1016/j.smrv.2007.03.002

Avoid Sleeping Pills

Only use prescription sleep aidsas a last resort.

If you often have trouble falling asleep or staying asleep, you might have thought about trying sleeping pills. Although these medicines can help you drift off to sleep, they also can have side effects, including an increased risk for falls and morning drowsiness that can make next-day driving dangerous. That’s why the U.S. Food and Drug Administration earlier this year began requiring manufacturers to lower the recommended dosage of hypnotic sleep aids containing zolpidem (such as Ambien).

Only use prescription sleep aidsas a last resort. These medicines can worsen sleep apnea. Discuss with your doctor whether you might have sleep apnea.

To take prescription sleep aids safely, start with the lowest-dose, shortest-acting sleep aid possible. As you get older, your body processes and removes medicine more slowly than it did when you were younger. Also make sure you have the number of hours recommended on the package available to sleep, so you’re not groggy the next morning.

Over-The-Counter Medications for Insomnia

Over-the-counter (OTC) agents for insomnia include antihistamines, melatonin, and valerian. According to Dr Benca, the consensus17is that OTC sleep aids are not recommended due to their lack of available efficacy and safety data.

Antihistamines

Antihistamines are a common and convenient OTC modality for people with sleep problems. The active ingredient in antihistamine products is usually either diphenhydramine or doxylamine, both of which are FDA-approved as OTC nighttime sleep aids to relieve occasional sleeplessness or to reduce difficulty falling asleep, respectively.

Antihistamines primarily block histamine H1 receptors; however, their sedative effects appear to be compounded by nonselective binding to other neurotransmitter sites. For example, diphenhydramine is also a potent muscarinic M1 receptor antagonist, which causes anticholinergic effects of dry mouth, blurred vision, memory problems, and constipation.23,24H1and M1 receptors are thought to mediate sedation (in addition to dopamine D2 and α1-adrenergic receptors), so antagonism at both sites theoretically causes an agent to have hypnotic and sedative effects.23

Although these OTC medications are widely available, few rigorous studies have been conducted on the efficacy of first-generation antihistamines such as diphenhydramine and doxylamine in the treatment of insomnia. Data24suggest that sleep maintenance may be more greatly affected by antihistamines than is sleep onset, and tolerance to these agents is likely to develop rapidly. Because older antihistamines are nonselective in their affinity, their efficacy as primary histaminergic antagonists remains uncertain; however, newer second-generation antihistamines may display a greater selectivity for H1 receptors, resulting in fewer side effects.25

Miscellaneous

Bruxism (teeth grinding)

Night guard custom mouthpiece - typically made by your dentist

Although not nearly as low profile and comfortable as a dentist made night guard, a "boil and bite" mouthguard from your sporting goods store may suffice, and cost far less.

Obstructive Sleep Apnea

If you suspect that you have sleep apnea, it is imperative that you get tested! Sleep apnea is destructive and deadly. People with significant sleep apnea are suffocating every night, a process that is slowly destroying the most metabolic and important tissues in the body.


https://meehanmd.ehealthpro.​com/
Shop for high quality supplements recommended by Dr. Meehan at a discount.
Receive 15% OFF your first order:
USE PROMO CODE: FIRST15
Shipping is FREE on all orders and should arrive within 2-3 business days.