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Posted by on in Diet

 

What NOT to eat/drink before bed

 

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Caffeine
It should be obvious, but you should avoid caffeinated drinks and foods — coffee, tea, many soft drinks and chocolate — several hours before bed. Caffeine is a natural chemical that activates the central nervous system, which means that it revs up nerves and thought processes. For people who are sensitive to caffeine, that excitation is not pleasant, making them feel jittery and slightly ill. If you have a caffeinated drink too close to bedtime, chances are it will keep you awake. Of course, what “too close” means is totally individual. Sensitive people should stop drinking caffeine at least eight hours before bedtime (that means by 3 p.m. if you hit the sack at 11 p.m.). You can play with your particular timing, just don’t experiment on a night when you absolutely must get a good night’s sleep.

Alcohol
Although many people use alcohol to help them relax before bed, the effects can wear off so they wake up in the middle of the night. Over time, alcohol-induced sleep becomes less restful, so sleepiness will become a constant fact of life. I’m not saying you need to give up alcohol, but don’t use it like a sleeping pill. And if you have insomnia, I strongly recommend omitting alcohol for a few weeks to see if your sleep problem resolves.

Large meals
Eating a huge dinner, or even a large before-bedtime snack, may make you feel drowsy, but the sleep won’t necessarily take. When you lie down and try to sleep, your digestion will slow down, make you feel uncomfortable, and possibly keep you awake. I recommend eating a dinner that has no more than 600 calories (and optimally at least three hours before bed).

Liquids
The single best piece of advice I can give to those of you who wake up in the middle of the night to visit the bathroom is to not drink water or fluids within 90 minutes of bedtime. It takes that long for your body to process liquid of any type. If you must drink to take medication, take a small sip. If the medication requires a full glass of water, take it earlier in the evening if possible.

What you SHOULD eat for a good night’s sleep

Serotonin-producing bedtime snacks
Among the best natural sedatives is tryptophan, an amino acid component of many plant and animal proteins. Tryptophan is one of the ingredients necessary for the body to make serotonin, the neurotransmitter best known for creating feelings of calm, and for making you sleepy.

However, the trick is to combine foods that have some tryptophan with ample carbohydrate. That’s because in order for insomnia-busting tryptophan to work, it has to make its way to the brain. Unfortunately, all amino acids compete for transport to the brain. When you add carbs, they cause the release of insulin, which takes the competing amino acids and incorporates them into muscle but leaves tryptophan alone, so it can make its way to the brain and cause sleepiness. Bedtime snacks should be no more than 200 calories.

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Good Choices:

  • Low-fat tuna salad served on whole-grain crackers
  • Turkey sandwich made with whole-grain bread
  • Edamame (steamed, podded soybeans).
  • Whole-grain breads and cereals
  • Brown rice or wild rice
  • Air-popped popcorn
  • Oatmeal
  • Sweet potatoes
  • Squash
  • Low-fat milk or yogurt topped with granola, which often contains oats

These are all  valuable bedtime snack options.

Three popular sleep-aid supplements

Melatonin
Melatonin has gotten a great deal of attention in the past few years since this hormone controls the body’s circadian rhythm, our internal 24-hour clock that tells us when to sleep and when to wake up. As we get older, we produce less melatonin, which mayaccount in part for insomnia in older adults. That said, I would not recommend supplemental doses without speaking with your physician first. Studies have not been conclusive in regard to its effectiveness, and these supplements may interact with other medications.

Valerian root
Valerian root is an herb that is believed to have a calming, relaxing effect on the body. It has been used for centuries to treat insomnia, mild anxiety and restlessness. The exact mechanism of action is unknown. However, it may act as a depressant to the central nervous to produce a mild tranquilizing effect. As with melatonin supplements, first speak with your personal physician to find out if it’s an appropriate option, and certainly first try avoiding caffeine, nighttime liquids and experimenting with a light serotonin-producing snack.

RelaxMax

RelaxMax is an innovative formula in the form of a cherry-flavored powdered drink mix. Containing a synergistic blend of ingredients known to regulate cathecholamines and up-regulate the inhibitory neurotransmitter, GABA,the formula aims to promote a calm, relaxed physiological and emotional state.

Resources: Reid, K. Sleep Medicine, October 2010.

News release, Northwestern University.

Phyllis Zee, MD, senior author and director of the Sleep Disorders Center at Northwestern Medicine; professor of neurology, neurobiology, and physiology at Northwestern's Feinberg School of Medicine, Illinois.

 

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Posted by on in Insomnia

 

Scientists at Northwestern University say sleep problems affect millions of adults, who could likely improve their quality of sleep, vitality, and mood with regular aerobic exercise.

The researchers say the study is the first to examine the effect of aerobic exercise on insomnia in middle-aged and older adults. About 50% of people middle-aged and older complain of symptoms of chronic insomnia.

The Study Design

Investigators studied 23 sedentary adults, mostly women aged 55 years and older, who had a hard time falling asleep or staying asleep and also reported impaired daytime functioning.

The participants were randomly placed in one of two groups.

One group exercised for two 20-minute sessions four times a week and the other did a 30-40 minute workout four times a week. This went on in both groups for 16 weeks, with participants exercising to 75% of their maximum heart rate on at least two activities, such as riding a stationary bicycle, walking, or exercising on a treadmill.

In a control group, participants didn’t exert themselves physically but only mentally, taking part in recreational or educational activities, such as attending a cooking class or listening to a museum lecture. This group met for about 45 minutes, three to five times a weeks, also for 16 weeks.

Exercise Helps Sleep Quality

Researchers say the participants who exercised reported that their sleep quality improved, raising their diagnosis from poor to good sleeper. They also reported fewer depressive symptoms, more vitality, and less sleepiness in the daytime.

Lead author Kathryn Reid, PhD, of the Department of Neurobiology and Physiology at Northwestern University, says drug-free treatment is best for insomnia because it eliminates the potential of sleep medications interacting with other drugs a person might be taking.

Sleep Equals More Pep

“Better sleep gave them pep, that magical ingredient that makes you want to get up and get out into the world to do things,” Reid says in a news release.

Phyllis Zee, MD, senior author and director of the Sleep Disorders Center at Northwestern Medicine, says the study is important because it is relevant to “a huge proportion of the population.”

She says insomnia increases with age. Around mid-life, sleep begins to change dramatically, she says.

“It is essential that we identify behavioral ways to improve sleep,” Zee says. “Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better and feel more vigorous.”

Like nutrition and exercise, sleep is an essential ingredient of a healthy lifestyle, says Zee, also a professor of neurology, neurobiology, and physiology at Northwestern’s Feinberg School of Medicine.

“By improving a person’s sleep, you can improve their physical and mental health,” she says. “Sleep is a barometer of health, like someone’s temperature. If a person says he or she isn’t sleeping well, we know they are more likely to be in poor health, with problems managing their hypertension or diabetes.”

The exercise and sedentary groups were told that good sleep hygiene can be improved by sleeping in a cool, dark, and quiet room; going to bed at the same time every night; and not staying in bed too long if you can’t fall asleep.

Zee says that exercise is good for metabolism, weight management, and cardiovascular health. Physical exertion is also good for sleep, according to the study.

“The increase in self-reported sleep duration by 1.25 hours in the exercise plus sleep hygiene education group is higher than what has been reported for other non-pharmacological interventions for insomnia,” the authors write.

 

Resources: Reid, K. Sleep Medicine, October 2010.

News release, Northwestern University.

Phyllis Zee, MD, senior author and director of the Sleep Disorders Center at Northwestern Medicine; professor of neurology, neurobiology, and physiology at Northwestern's Feinberg School of Medicine, Illinois.

 

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Posted by on in Insomnia

 

Part 2: Solutions

How does cognitive behavioral therapy for insomnia work?

The cognitive side of cognitive behavioral therapy for insomnia teaches you to recognize and change beliefs that affect your ability to sleep. The behavioral part of cognitive behavioral therapy for insomnia helps you develop good sleep habits and avoid behaviors that keep you from sleeping well.

Cognitive behavioral therapy for insomnia contains one or more of the following elements:

Sleep education. To make effective changes, it's important to understand the basics of sleep — for example, understanding sleep cycles and learning how beliefs, behaviors and outside factors can affect your sleep.

Cognitive control and psychotherapy. This type of therapy helps you control or eliminate negative thoughts and worries that keep you awake. It may also involve eliminating false or worrisome beliefs about sleep, such as the idea that a single restless night will make you sick.

Sleep restriction. Lying in bed when you're awake can become a habit that leads to poor sleep. Limiting the amount of time you spend in bed can make you sleepier when you do go to bed. That way you're more likely to fall asleep and stay asleep.

Remaining passively awake. This involves avoiding any effort to fall asleep. Paradoxically, worrying that you can't sleep can actually keep you awake. Letting go of this worry can help you relax and make it easier to fall asleep.

Stimulus control therapy. This method helps remove factors that condition the mind to resist sleep. For example, you might be coached to use the bed only for sleep and sex, and to leave the bedroom if you can't go to sleep within 15 minutes.

Sleep hygiene. This method of therapy involves changing basic lifestyle habits that influence sleep, such as smoking or drinking too much caffeine late in the day, drinking too much alcohol, or not getting regular exercise. You may be told to avoid napping and taught to maintain a consistent sleep schedule. It also includes tips that help you sleep better, such as ways to wind down an hour or two before bedtime.

Relaxation training. This method helps you calm your mind and body. Approaches include meditation, hypnosis and muscle relaxation.

Biofeedback. This method allows you to observe biological signs such as heart rate and muscle tension. Your sleep specialist may have you take a biofeedback device home to record your daily patterns. This information can help identify patterns that affect sleep.

Sleep diary. To understand how to best treat your insomnia, your sleep therapist may have you keep a detailed sleep diary for one to two weeks. In the diary, you'll write down when you go to bed, when you get up, how much time you spend in bed unable to sleep, total sleep time and other details about your sleep patterns.

The most effective treatment approach may combine several of these methods.

Alternative medicine options are:

Melatonin. This over-the-counter supplement is marketed as a way to help overcome insomnia. Your body naturally produces melatonin, releasing it into your bloodstream in increasing amounts starting at dusk and tapering off toward the morning. Older people seem to have a greater benefit from melatonin, but no convincing evidence exists to prove that melatonin is an effective treatment for insomnia. It's generally considered safe to use melatonin for a few weeks, but the long-term safety of melatonin is unknown. The dosage is usually between 0.3 and 5 milligrams (mg) a day. Melatonin has also been shown to stop growth of cancer cells. Research suggests that the melatonin made by the body plays a large role in the daily rhythms of sleeping and waking. Some recent studies have found that people who work night shifts may be at increased risk for cancer, which could be linked to melatonin levels in the body. Study results regarding the effect of melatonin supplements on survival and quality of life in people with cancer have been mixed, and further research in this area is needed.

Valerian. This is another dietary supplement that's sold as a sleep aid because it has a mildly sedating effect. But, this supplement hasn't been well studied. In addition, this product has been associated with liver damage in some people, though it's not clear if valerian was the cause of the damage. The recommended dose of valerian is 400 to 900 mg daily with an extract containing 0.4 to 0.6 percent of valerenic acid.

Acupuncture. During an acupuncture session, a practitioner places numerous thin needles in your skin at specific points on your body. There's some evidence that this practice may be beneficial for people with insomnia.

Be sure to talk with your doctor before taking any herbal supplements or over-the-counter products as some can interact with medications, and others, such as L-tryptophan, may be dangerous on their own.

 

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Posted by on in Insomnia

 

Part One: What is Insomnia

Do you suffer from sleepless night due to insomnia, if so you are not alone!

More than one-quarter of the U.S. population report occasionally not getting enough sleep, while nearly 10% experience chronic insomnia. However, new methods for assessing and treating sleep disorders bring hope to the millions suffering from insufficient sleep. Fundamental to the success of all of these efforts is the recognition that sufficient sleep is not a luxury—it is a necessity—and should be thought of as a “vital sign” of good health.


So what is Insomnia?

Insomnia (or sleeplessness) is most often defined by an individual's report of sleeping difficulties.

Thus, insomnia is most often thought of as both a sign and a symptom that can accompany several sleep, medical, and psychiatric disorders, characterized by persistent difficulty falling asleep and/or staying asleep or sleep of poor quality. Insomnia is typically followed by functional impairment while awake. One definition of insomnia is difficulties initiating and/or maintaining sleep, or non-restorative sleep, associated with impairments of daytime functioning or marked distress for more than 1 month.

Insufficient sleep is associated with a number of chronic diseases and conditions—such as diabetes, cardiovascular disease, obesity, and depression—which threaten our nation’s health. Notably, insufficient sleep is associated with the onset of these diseases and also poses important implications for their management and outcome. Moreover, insufficient sleep is responsible for motor vehicle and machinery-related crashes, causing substantial injury and disability each year. In short, drowsy driving can be as dangerous—and preventable—as driving while intoxicated.

What Can Cause Insomnia:

Stress. Concerns about work, school, health or family can keep your mind active at night, making it difficult to sleep. Stressful life events, such as the death or illness of a loved one, divorce or a job loss, may lead to insomnia.

Anxiety. Everyday anxieties as well as more-serious anxiety disorders may disrupt your asleep.

Depression. You might either sleep too much or have trouble sleeping if you're depressed. This may be due to chemical imbalances in your brain or because worries that accompany depression may keep you from relaxing enough to fall asleep. Insomnia often accompanies other mental health disorders as well.

Medications. Many prescription drugs can interfere with sleep, including some antidepressants, heart and blood pressure medications, allergy medications, stimulants (such as Ritalin) and corticosteroids. Many over-the-counter (OTC) medications, including some pain medication combinations, decongestants and weight-loss products, contain caffeine and other stimulants. Antihistamines may initially make you groggy, but they can worsen urinary problems, causing you to get up to urinate more during the night.

Caffeine, nicotine and alcohol. Coffee, tea, cola and other caffeine-containing drinks are well-known stimulants. Drinking coffee in the late afternoon and later can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can cause insomnia. Alcohol is a sedative that may help you fall asleep, but it prevents deeper stages of sleep and often causes you to awaken in the middle of the night.

Medical conditions. If you have chronic pain, breathing difficulties or a need to urinate frequently, you might develop insomnia. Conditions linked with insomnia include arthritis, cancer, heart failure, lung disease, gastroesophageal reflux disease (GERD), overactive thyroid, stroke, Parkinson disease and Alzheimer's disease. Making sure that your medical conditions are well treated may help with your insomnia. If you have arthritis, for example, taking a pain reliever before bed may help you sleep better.

Change in your environment or work schedule. Travel or working a late or early shift can disrupt your body's circadian rhythms, making it difficult to sleep. Your circadian rhythms act as internal clocks, guiding such things as your sleep-wake cycle, metabolism and body temperature.

Poor sleep habits. Habits that help promote good sleep are called sleep hygiene. Poor sleep hygiene includes an irregular sleep schedule, stimulating activities before bed, an uncomfortable sleep environment and use of your bed for activities other than sleep or sex.

'Learned' insomnia. This may occur when you worry excessively about not being able to sleep well and try too hard to fall asleep. Most people with this condition sleep better when they're away from their usual sleep environment or when they don't try to sleep, such as when they're watching TV or reading.

Eating too much late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down, making it difficult to get to sleep. Many people also experience heartburn, a back flow of acid and food from the stomach into the esophagus after eating. This uncomfortable feeling may keep you awake.

We think that Cognitive Behavioral Therapy may be the best solution out there to reverse most cases of insomnia. We will go over these solutions in part two of this blog post next week.

 

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