Insomnia Recommendations and Considerations

Insomnia Recommendations

❑ In the evening, eat bananas, dates, figs, milk, nut butters, tuna, turkey, whole grain crackers, or yogurt. These foods are high in tryptophan, which promotes sleep. Insomnia Recommendations. Eating a grapefruit half at bedtime also helps.
❑ Do not eat large meals within two hours of bedtime.
❑ Avoid caffeine, alcohol, and nicotine in the four to six hours before bedtime. Insomnia Recommendations. A small amount can help induce sleep initially, but it invariably disrupts deeper sleep cycles later. While smoking may seem to have a calming effect, nicotine is actually a neurostimulant and can cause sleep problems.

❑ Avoid bacon, cheese, chocolate, eggplant, ham, potatoes, sauerkraut, sugar, sausage, spinach, tomatoes, and wine close to bedtime. These foods contain tyramine, which increases the release of norepinephrine, a brain stimulant.
❑ Avoid taking nasal decongestants and other cold medications late in the day. While many ingredients in these preparations are known to cause drowsiness, they can have the opposite effect on some people and act as a stimulant.

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❑ Establish a set of habits and follow them consistently to establish a healthy sleep cycle. Among them:

• Go to bed only when you are sleepy.
• Do not stay in bed if you are not sleepy. Get up and move to another room and read, watch television, or do something quietly until you are really sleepy.

• Use the bedroom only for sleep and sex—not for reading, working, eating, or watching television.
• Keep a regular sleep-wake cycle. Try to go to bed and wake up at the same time every day. Insomnia Recommendations.

• Set an alarm clock and get out of bed at the same time every morning, no matter how you slept the night before. Once normal sleep patterns are reestablished, most people find that they have no need for an alarm clock.
• Sleep in a dark, quiet room with a comfortable temperature.
• Do not nap during the day if this isn’t a normal thing for you to do. Especially avoid napping later than 3:00 P.M.

• Exercise regularly in the late afternoon or early evening—but not within two hours of bedtime. Physical exertion is an excellent way to make your body tired so that sleep comes about more easily. Exercising five or six hours before bedtime may help you sleep more soundly.
Caution: If you are thirty-five or older and /or have been sedentary for some time, consult with your health care provider before beginning an exercise program.

• Take a hot bath (not a shower) an hour or two before bedtime. For further relaxation, put several drops of a soothing essential oil such as chamomile (if you are not allergic to ragweed) in the bathwater.

Caution: Do not use chamomile if you are allergic to ragweed. Do not use during pregnancy or nursing. It may interact with warfarin or cyclosporine, so patients using these drugs should avoid it.
• Keep the bedroom comfortable and quiet. If too much quiet is the problem, try running a fan or playing a radio softly in the background. There are also devices available that generate “white noise” sounds like the ocean surf or a steady rain that help people who are “quietsensitive” to sleep.

• Learn to put worries out of your mind. If you have occasional trouble getting to sleep, concentrate on pleasant memories and thoughts. Re-create a pleasurable time or event in your life and relive it in your mind. Learning a relaxation technique such as meditation or the use of guided imagery is extremely helpful in getting sleep patterns back to normal for many people.

❑ For occasional sleeplessness, try using melatonin, Calcium Night from Source Naturals, or one of the herbs recommended above. These are effective and safe sleep promoters. Insomnia Recommendations.
❑ One of the best remedies for insomnia is taking 5 milligrams of melatonin one hour before bedtime. If you feel groggy in the morning, reduce the dosage the next time you use it. Insomnia Recommendations. Certain drugs frequently prescribed for older adults, including beta-blockers (for high blood pressure) and even aspirin, can lower melatonin levels.
Caution: Do not overuse melatonin. According to some recent reports, more than occasional use of melatonin can permanently stop the body’s own production of this vital hormone.
❑ If you snore, try sleeping on your side. Sleep on a couch for a few nights to become accustomed to sleeping on your side. Insomnia Recommendations.


❑ During sleep, the body’s systems are still controlling basic functions. Nutrients are essential for the body and are used during the sleep cycle.
❑ Sleep is needed to restore appetite hormones to their normal levels. Many obese people do not get at least eight hours of sleep a night. In one study, inadequate sleep was shown to increase calorie intake from snacks by 20 percent.
❑ A lack of sleep can encourage serious illness and cause premature aging. Experts recommend at least eight hours of sleep per night.

❑ Two of the most common sleep problems are not being able to fall asleep and waking in the middle of the night. It should take less than thirty minutes to get to sleep, but for many people it takes much longer. Others fall asleep, but wake up and can’t get back to sleep. If you have either of these disturbances and feel tired in the morning, speak to your health care provider. You are not alone.

❑ An estimated 12 million Americans suffer from restless leg syndrome (RLS), a disorder marked by uncomfortable urges to move the legs, especially just before falling asleep.
Various treatments have been attempted for restless leg syndrome, but nothing seems to work consistently for everyone. The drug pramipexole (Mirapex) has shown positive benefits for some people with this condition. If you have restless leg syndrome, see your doctor to rule out anemia. We believe that taking the proper vitamin and mineral supplements is the best approach to this problem. The supplements that help this condition more than anything are calcium, potassium, magnesium, and zinc. The following nutrients may prevent restless leg syndrome and leg cramps: 400 milligrams of B complex, 1,000 milligrams of magnesium, and 200 international units of vitamin E (d-alpha-tocopherol) per day.

❑ Type 2 diabetes and sleep apnea are commonly seen together. In one study, patients who used a device called CPAP (continuous positive airway pressure) while sleeping experienced lower blood sugar levels and less fluctuations in blood sugar.

❑ Regardless of how many hours of sleep you get each night, if you wake up easily in the morning, and especially if you rarely (or ever) need the services of your alarm clock, and if you can make it through the entire day without seeming to run out of steam or feeling drowsy after sitting quietly or reading for a while, you are probably getting enough sleep.
❑ The hormonal shifts that occur during premenstrual syndrome and menopause may trigger insomnia. Estrogen affects the production and balance of the brain chemicals responsible for wakefulness.
❑ 5-hydroxy L-tryptophan (5-HTP) and the amino acid tryptophan are helpful for insomnia and depression.
❑ Dehydroepiandrosterone (DHEA) is a naturally occurring hormone that improves the quality of sleep.
❑ Anyone who snores excessively should be evaluated for sleep apnea. Many cases of sleep apnea respond to such measures as allergy treatment, weight reduction, or a simple laser surgery procedure to remove obstructions in the nasal passages.

❑ Mild cases of obstructional sleep apnea can sometimes be treated with lifestyle and diet changes. Oral devices are available for mild cases to prevent obstruction of the airway by holding the tongue or jaw forward.

❑ An effective treatment for snoring is the use of radio waves to reduce the soft palate tissue that obstructs the air passage in the mouth. In this technique, a health care practitioner inserts a probe into the back of the mouth and the radio waves are directed at the palate.

❑ Millions of Americans consciously choose to skimp on their sleep in the mistaken belief that sleeping fewer hours allows them to be more productive. Many people even look on the fact that they can “get by” on so few hours of sleep as a badge of honor. In fact, however, they are likely doing themselves a great deal of harm in the long run. Moreover, the night owls who sleep less to accomplish more are actually less creative and less productive than those who get adequate amounts of sleep. Dr. Richard. Bootzin, professor of psychology and director of the insomnia clinic at the University of Arizona Sleep Disorders Center, conducted long-term research into normal sleep habits and patterns. He discovered that people who get seven to eight hours of sleep each night live longer, happier, healthier lives than those who skimp on their sleep.

❑ Sleep therapists and other experts are greatly divided about the virtues of napping. While some maintain that napping is not necessary for people who are well rested, others say it is a natural human tendency and should not be discouraged. There have been studies that seem to demonstrate that productivity is higher and the incidence of accidents lower in countries where napping is common.

❑ Consistency is probably the most important factor for healthy sleep. While it is usually most advisable to consolidate all sleeping into one time period, if you regularly take an afternoon nap and you do not suffer from any sleeping disorders, then giving up naps might actually cause a disruption in your sleeping habits. If you nap, keep your naps short—less than an hour—and make sure that they are a regular part of the daily routine, not a now-and-then proposition.

❑ Sleep experts advise that people with insomnia avoid caffeine, but many people who are accustomed to drinking coffee late in the day and in the evening hours have been known to have their sleep cycles disrupted if they give up drinking coffee. Insomnia Recommendations. This seems to bear out the idea that maintaining a steady routine is the most important factor in establishing a healthy sleep pattern. Of course, this applies only to those who are not experiencing any difficulties with their sleeping habits. Anyone who develops a bout of insomnia should consider eliminating all caffeine from his or her diet.

❑ Many people who suffer from insomnia resort to taking sleeping pills, whether over-the-counter or prescription medications. Sleeping pills do not cure insomnia, and they can interfere with REM sleep. The continued use of pharmacological sleeping aids can eventually lead to disruption of all the deeper stages of sleep. Insomnia Recommendations. Researchers have found that many people who take sleeping pills on a regular basis actually find that their insomnia becomes worse. The persistent use of sleeping pills also leads to dependency, either psychological or physical. The use of sleep medication should therefore be reserved for those whose insomnia has a physical basis, and then only as a temporary solution.

❑ People over sixty-five years of age who use sleeping pills have four times the risk of suicide.

❑ Tranquilizers like the benzodiazepines and similar medications are being prescribed for insomnia because they pose a lower risk of overdose than sedatives. However, they become less effective after thirty days of use. The most prescribed include quazepam (Doral), estazolam (ProSom), flurazepam (Dalmane), temazepam (Restoril), and triazolam (Halcion). Triazolam can cause mental confusion and even amnesia. There have also been reports that drugs such as temazepam, flurazepam, and diazepam (Valium) may lead to confusion, sluggishness, restlessness, and heightened anxiety, as well as prolonged sedation and drug dependency. Elderly people need a smaller dose than younger people. All of these products are dangerous if mixed with alcohol.

❑ Zolpidem (Ambien) and Eszopiclone (Lunesta) are a different type of prescription sleep-aid drug. Their manufacturers claim that they do not inhibit or disrupt the deepsleep cycles, like REM.

❑ Over-the-counter sleep aids can cause a wide range of side effects, including agitation, confusion, depression, dry mouth, and worsening of symptoms of enlarged prostate. Check with your doctor before using over-the-counter sleep medicines for short-term insomnia. Insomnia Recommendations. These drugs use sedating antihistamines to make you drowsy. Examples include diphenhydramine (in Nytol and other products) and doxylamine (Unisom and others). People with breathing problems, glaucoma, or chronic bronchitis; women who are pregnant or nursing; and men who have difficulty urinating due to an enlarged prostate should not use these medicines. People with sleep apnea should not take sleeppromoting medicine because it could suppress their respiratory drive. Making it harder to wake up when they experience episodes of interrupted breathing.