Solve problems interfering with restful sleep

The Best Sleeping Aid Isn’t a Prescription Drug

  • Need help falling asleep? Staying asleep?
  • Need to know how to get energy?
  • Need to improve sleep hygiene?
  • Want to know the best all natural sleep aid just for you?

The Best sleeping aid for all:

cute-dogs-sleeping-together-awww-photoWhen I’m asked about the best sleeping aid it’s hard for me to pick just one. Here’s why. This question doesn’t tell me if you have a problem with falling asleep, staying asleep, falling back to sleep when you wake up in the middle of the night or you sleep but feel “unrefreshed”. I’ll cover all of these specific categories of “sleep issues” in the next article “Why can’t I sleep” but for now will give some “generic advice” that applies to everyone who is looking for the best sleep aid. If I were to pick one, it would be what practically no one “does” which is to practice good sleep hygiene. Good sleep hygiene is effective and will help everyone sleep better, no matter what the sleep issue is. So let’s cover that right now.

Sleep schedule:

First of all, let’s review that adults truly do need 7-8 hours of uninterrupted sleep to call it “perfect sleep”. Ideally you should become sleepy at about the same time each night and be able to wake up feeling refreshed without an alarm clock. I know, easier said than done… BUT perhaps you’ve never tried and now is the time to TRY.   Naps: If you are taking a 30 minute or less nap to “refresh” in the afternoon AND it is NOT interfering with getting to sleep, then that’s fine. Naps become a problem when they last for too long and therefore push back bedtime and disrupt the important, nighttime REM sleep. If this is happening, just set an alarm to limit your napping time.

Making your bedroom “sleep friendly”:

  • How old IS that mattress? (8 years is the average “limit”).  IS it truly comfortable?
  • Are your sheets “high-thread”? (these are more comfortable).
  • Is your pillow soft, malleable and supports your head and neck well?
  • Is the room quiet, low-lit prior to bedtime, and completely dark when you turn out the lights including covering LED’s?
  • DO you have a flashlight to use in case you need to use the bathroom so you can get back to sleep more easily?
  • You are NOT using the TV or computer to watch/work on in bed, right? NO TV or computer or tablet use for 2 hours pre-bedtime.
  • Some people are very sensitive to sunrise and need a sleep mask. Silicone earplugs work the best if you have a spouse or dogs (no kidding) that snore. Note that if you are pet-allergic or if your “cuddle pet” wakes you up all night, you need to figure out a solution for “both of you.”

Habits:

  • Some people are highly caffeine sensitive and need to knock that off by noon.
  • Digestion should occur 2+ hours before bed and should not be a “heavy” dinner.
  • Alcohol is tempting to use as a sleep aid but it actually reduces REM sleep and should be avoided for a good 2 hours pre-bedtime.
  • Exercise can inhibit “sleep induction”/”initiation” and should be completed 4 hours pre-bedtime.
  • I HOPE any smokers reading this have stopped, as nicotine will seriously upset sleep patterns. And as you might predict know, that is the least of my concern with people who are smoking.

If you “came looking” for a pharmaceutical sleep aid and do these things listed above many of you will find that these simple “good sleep hygiene” techniques will do the trick. If not, don’t worry because there is a lot more to come in this article, the next article, and my “Sleep book” (which of course I will give you free of cost).  Next we’re going to talk about melatonin. You have likely heard of this but you have not heard “the whole story.” It’s pretty cool, actually!

Why is a Melatonin sleep aid needed for everyone over 30?

You have heard of this as a sleep aid…which it is. But I’m going to tell you a lot more than this.

Melatonin is a neurohormone, not an actual bioidentical hormone. Your levels drop dramatically starting at around age 30, and we can even measure that melatonin levels correlate with the deepness of sleep and amount of REM sleep that you get. The more the better!

Melatonin is found in plants, animals, humans and is believed to be what sets our circadian rhythms (day/night)….even those of animals, and, really…. of plants too! It reduces oxidative stress (free radical damage=damage to our DNA which can cause diseases), thereby decreasing inflammation. It also helps to block the process which shortens telomeres so it has a role is slowing aging. (Sorry-I’m assuming you have read from me that our gene caps called telomeres shorten as we age and that velocity of shortening can be slowed, thus slowing aging.) It also protects your body from the “pro-oxidant” (or oxidizing, rusting effects) on your arteries… by iron… which comes from old red blood cells….

  • It augments immune function by increasing CD4 cells.  It also increases what are known as natural killer cells.
  • It reduces inflammation by decreasing pro-inflammatory cytokines.
  • It will help decrease insulin levels, which means that if you are Type 2 diabetic or pre-diabetic (insulin-resistant = “glycating”), it will help… and remember, a nice low insulin level means minimal, if any, internal inflammation.
  • It preserves brain mitochondria (remember those little cells that make energy: ATP?), slows age related cognitive decline, and inhibits beta-amyloid formation in the brain, a protein found in the brain up to 25 years prior to developing  Alzheimer’s disease.  In addition, an exciting new discovery is that we still have stem cells in our brain even as adults… and that melatonin turns on these stem cells…
  • This means that we CAN still create new brain circuitry as adults! This is a major addition to a good brain health regimen.
  • AND… Melatonin inhibits tumor growth in mice, plus it DOES extend their lifespan!

So, now that you know everything melatonin does besides be an amazing natural sleep product you will understand my recommendation on dosing which is the same as the A4M recommendation. (American College of Anti-aging Medicine). Most A4M doctors consider this to be the best sleep aid supplement we can take.  

Start out with a good pharmaceutical grade supplement of 2-3 mg of long acting melatonin if you have no sleep initiation problems. (And if you do, that will be discussed in a bit.) Then, as long as you don’t have sleep-interrupting dreams,  which occasionally happens on larger doses of melatonin, go up in dose as tolerated once a month until you are taking about 20 mg. Think of all the new brain cells you’ll be sprouting!

New sleep medication or is this something we “knew about” but just found out it WAS great for sleep?

I think I just gave away the punch-line here, LOL. I’m going to talk about 5-OH tryptophan. This is something Anti-aging doctors, like myself, have used over the past few years to elevate the brain chemical (neurotransmitter) serotonin. We have used it for depression, for sugar cravings and even as an appetite suppressant. But more and more we are finding that it is an amazing natural way to help people sleep through the night.

For a variety of reasons, even with the proper sleep hygiene techniques as discussed above, when some people get into the “light stages” of sleep they become  very overly sensitive to their environment. That plus other issues such as daily stress, depression, obesity, injuries, chronic pain and more can cause pesky and energy draining sleep wake-ups. This is where 5-OH tryptophan shines.

For a night time dose, I have people use a pharmaceutical grade supplement of 200 mg and we increase it until they are sleeping through the night. Some people have sensitive lower digestive tracts and it will cause loose stools and even diarrhea at high doses, so that is why upwards dosage titration must be done carefully.

If we get to the point where it is causing “GI issues” but not working through the night due to need to limit dosing, there are other things we can add. Note that if someone is constipated, this is an especially useful natural supplement to help with that too. Now, I just mentioned the other sleeping supplements we could add and that will be the next topic.

The Best sleeping pills do their Job Naturally with NO Side Effects

sleepaidI’m going to cover “them all” so a couple of these will be a little bit of repetition but then you’ll have all of the best sleeping pills I’m recommending in this one section for future reference.

Melatonin

This hormone helps control circadian (day/night) rhythms. Melatonin production, therefore, should peak at night for quality sleep. As we age, our bodies make less melatonin, which might explain why we have more sleep difficulties starting as young as age 30.  If you struggle to drift off, supplementing might help. One meta-analysis about sleep disorders concluded melatonin supplementation “decreases sleep onset latency, increases total sleep time and improves overall sleep quality.”  Ideally, you should take supplemental melatonin about 30 minutes before you want to fall asleep. While supplements contain different amounts, studies suggest 3 mg is the ideal dose for sleep. 

However, here are some suggestions on Melatonin:

For best sleep initiation liquid or chewable melatonin, chewed and put under the tongue will get you to sleep faster. Therefore my recommendation (as stated before) mirrors that of A4M (The American Academy of Anti-aging Medicine) which is to increase melatonin dosing by 1 mg per month until you hit 20 mg or so. Some people have dreams which are so vivid they awaken when they take this much. So of course if this is you, just cut back. It is also not advisable to start melatonin if you are experiencing adrenal fatigue. In summary, if you have issues with initiation, use sublingual liquid or chewable sublingual melatonin and for health and sleep maintenance use a separate dose of either chewable (not placed under the tongue) melatonin or a melatonin capsule in increasing doses as tolerated.

Inositol

This little-known member of the B-vitamin family helps your mind relax. Inositol can significantly improve sleep quality. People who take it report a general relaxed feeling akin to having a few “calming ‘sleepy-time’ teas.” Supplementing with inositol promotes calmness, and studies show it can help to ameliorate a wide range of mental health disorders including depression and anxiety, panic disorder, and obsessive-compulsive behavior. For both initiation issues and difficulty staying asleep, a typical dose would be 500 mg-1 gm, coupled with 1-2 other things on this list.

5-HTP

5-hydoxytrytophan (5-HTP) is synthesized from the amino acid tryptophan and eventually converted to serotonin, your feel-good neurotransmitter.  Compared with supplemental tryptophan, researchers believe supplementing with 5-HTP can better replenish serotonin levels because it is only one metabolic step away and has an easier time crossing the blood-brain barrier. One study found people who took 5-HTP fell asleep faster and slept more deeply than those who took a placebo.  The optimal dose varies and DO NOTE this is the one supplement that truly helps with wake-ups. I have people start with 200 mg and depending on someone’s GI tract, they might need 500, 1000, 2000 or 3000 mg to stay asleep through the night.

We are limited by the GI tract which is where serotonin is made. Those people who tend to be low in serotonin might be a little depressed (or not) and might be constipated-usually are. So we push the dose of the 5-OH tryptophan until or unless there is lower GI cramping, or diarrhea. Often, people with a lifetime of constipation are cured when they take 5-OH tryptophan. Caution: Do NOT take this if you are on anti-depressants or have bipolar illness.   Worth noting: Because it serves as the cofactor to convert 5-HTP to serotonin, look for a supplement that also contains vitamin B6 or be sure you supplement with B6.

L-Theanine

Studies show L-theanine, an amino acid in green tea, can reduce stress. L-theanine works by increasing the production of GABA in the brain. As with meditation, it also stimulates alpha brainwaves naturally associated with deep states of relaxation and enhanced mental clarity. That deep relaxation can also help you drift into sleepy-land easier. Studies show supplementing with 200 mg of L-theanine before bed could improve your sleep quality. Like most nutrients here, manufacturers often combine L-theanine with other synergistic natural sleep aids.

GABA

You need to be careful when you choose supplements to augment GABA which is the anti-anxiety neurotransmitter that is the answer to sleep initiation and daily stress for some. Either a spray or a chewable supplement that can be chewed and put under the tongue is acceptable. An oral supplement will not pass the blood-brain barrier and hence will not work.

Combining Sleep Supplements

While each of these five science-based supplements work well, they can all be “mixed and matched” if needed. I have found that melatonin is needed for all, and then for people having wake-ups the melatonin plus the 5-OH tryptophan is great. For those with high anxiety levels getting into bed, I like to add GABA chewables.   Now for those of you convinced that prescription drugs are “the way to go” let’s talk about prescription sleep aids next.

Prescription Sleep Aids

Plain and simple- these are a really bad idea.

prescriptionpillsSure, if you are going through a period of high stress and no sleep will it hurt you to take a sleeping pill for a week? Most likely not….but that scenario rarely happens. Hundreds of millions of dollars in annual advertising dollars are spent on sleeping pills made by pharmaceutical companies. It’s estimated that approximately 10-15 million Americans are “hooked” meaning they rely on one of these “benzodiazepines” to get to sleep and stay asleep. They will all need higher doses and perhaps another sleeping pill at some point because everyone develops a “tolerance”.

We have known for years that these medications are associated with “odd” potential side effects. These side effects include hallucinations, problems with memory, excessive daytime tiredness, sleepwalking and engaging in other behaviors such as eating and even driving while not fully awake and alert.

However in 2014, a rather startling discovery was made by researchers from the University of Bordeaux, and other research centers in France and Canada. It was funded by the French National Institute of Health and Medical Research (INSERM), the University of Bordeaux, the French Institute of Public Health Research (IRESP), the French Ministry of Health and the Funding Agency for Health Research of Quebec. Note that it was NOT funded by Pharmaceutical companies. This was a case control study looking at whether longer-term use of benzodiazepines could be linked to increased risk of Alzheimer’s disease. Benzodiazepines are a group of drugs used to treat anxiety and insomnia, and it is generally recommended that they are used only in the short term  no more than four weeks, max.

Other (previous) studies have suggested that benzodiazepines could be a risk factor for Alzheimer’s disease, but there was still some debate. This latest study aimed to assess whether there was a true dose-response effect. Researchers say that among 1,796 people with Alzheimer’s disease and 7,184 controls entered into the study, those who had used benzodiazepines showed a 51% higher risk of the neurodegenerative disorder, Alzheimer’s disease.

Among people who took the drugs more than 180 days, the risk escalated to about two-fold higher. It’s not clear why the drugs might increase the risk of Alzheimer’s, although the authors  speculate that the short-term effects on memory and cognitive functions may deplete reserve capacities that might help to offset reduce nerve functions as the disease’s hallmark protein plaques (called amyloid) start to build up.

Those statistics make me want to steer clear – what about you?

So Lastly Lets Discuss Medicine that Makes you Sleep, & First Let’s Define “Medicine”

Modern medicine has its roots as far back as prehistoric days. Prehistoric medicine incorporated plants (herbalism), animal parts and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (magically obtaining the truth). The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related problems. physician

The Greek physician Hippocrates (ca. 460 BCE – ca. 370 BCE), is considered the father of medicine. Early records on medicine have been discovered from ancient Egyptian medicine, Babylonian Medicine, Ayurvedic medicine (in the Indian subcontinent), classical Chinese medicine, and Ancient Greek and Roman medicine. Everything from plants, herbs, aromas, and practices such as blood-letting and ritualistic dancing has been used in various cultures until very modern times and all of this was considered “medicine”. Even now, with all the diverse fields of medicine there are some practices utilized and called “medicine” by some practitioners and not others. So this gives me “latitude” when I present the last topic to you!

Medicine that Makes you Sleep because you are Relaxed:

Aromatic Cotton Ball by Bedside:12555497_f496

Add a drop of Roman Chamomile Oil, Clary Sage or Lavender Oil to a tissue or cotton ball and place that near your pillow at bedtime as they are natural sedatives.

Bed Linen Spray:

Create a calming bed linen spray and lightly spray your sheets before bedtime.

Bathtime:

Plan to finish your bathing ritual an hour before bed to avoid sleep interruption. While bathing, add a drop or two of Roman Chamomile or Lavender. Along with essential oils, you may add Dead Sea salts or Epsom salts to help with muscle soreness and relaxation.

Massage:

Try gently massaging your feet and legs with a calming massage oil or lotion. Like bathing, massage is stimulating to your circulation and should generally be avoided immediately before bedtime.

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About Dr. Kim

Dr. Kim Crawford is an Internist who long ago decided she preferred to prevent diseases rather than treat them with pharmaceuticals. She, or “Dr. Kim” as her patients all call her has re-focused her career to become one of the top Anti-aging doctors in the world, treating the rich and famous as well as people from all walks of life in her private practice. She decided to repeat her focus on disease prevention, treatment of things “ordinary doctors” can’t or don’t know how to treat, as well as “tuning up” the things that “happen with age” which CAN be fixed despite what you are told through her total wellness and anti-aging program. You can read more about her and either email or schedule a free chat with her here.