Sleep is a biological necessity and is essential for optimum health. While you sleep your body is hard at work consolidating memories, and restoring your nervous, skeletal, muscular, and immune systems. A lack of sleep can have an impact on every system throughout the body, leading to decreased immune function, decreased cognitive function, higher levels of anxiety and depression, and a higher risk of diabetes and obesity. These are just a few of the negative effects of poor sleep. (1)
What Will Throw Off Your Sleep and What to Do About It
Temperature: The temperature of your room can play a major role in the quality of your sleep. When you enter the first stages of sleep your body temperature begins to drop. This drop is important so you can reach the deep stages of sleep. If the room is too hot your body will have a harder time reaching these stages. This is why a night of tossing and turning can be quite common. The ideal room temperature for sleeping is 65 degrees Fahrenheit. (5)
Light/Blue light: Light has a huge impact on our ability to sleep, especially blue light. Light is made up of a multitude of wavelengths and each wavelength is associated with a different color. The wavelength that is associated with the color blue has the largest influence on our circadian rhythm (internal clock). When light hits specialized cells in our eyes it tells the brain whether it is daytime or nighttime.
Before the invention of the light bulb, the sun would go down and light would stop hitting these specialized cells in our eyes telling the brain that it was nighttime and the brain would begin producing melatonin to prepare the body for sleep. (6) Now, however, light is a constant and it’s having a huge impact on the quality of our sleep. Exposure to light in the late evening tends to throw off our circadian rhythm and lead us to later and later sleep times. (6) Exposure to light in the middle of the night, even for a few seconds, can have an impact and make it difficult to return to sleep. Even light just hitting your skin can disrupt your body’s production of melatonin, so make sure your room is as dark as possible by covering every light as best as you can.
Use dim red lights for night lights. Red light is less likely to shift circadian rhythm and suppress melatonin production. Also, avoid looking at bright screens beginning two to three hours before bed. If you work a night shift or use a lot of electronic devices at night, consider wearing blue-blocking glasses or installing an app that filters the blue/green wavelength at night. Expose yourself to lots of bright light during the day, which will boost your ability to sleep at night, as well as your mood and alertness during the day. (7)
Caffeine: As a stimulant, caffeine gives a boost of energy to the body by stimulating the adrenal glands to produce adrenaline. Adrenaline increases heart rate, increases blood pressure, and increases breathing rate. All of this is the complete opposite of what happens when the body is going through the four stages of sleep. This creates a tug of war scenario in the body. Also, caffeine being a diuretic (causes water loss from the body) leads to an increased loss of every water-soluble vitamin and mineral in the body. As you will see below, these water-soluble nutrients include magnesium, vitamin B1 and B6 which are extremely important for sleep. Limit caffeine as much as possible the closer you get to bedtime. Even consuming caffeine up to 6 hours before bed can decrease sleep by an hour.
Exercise: This is extremely important for health, but just like everything, there is a need for balance. Getting very little exercise or none at all can leave your body feeling restless and having an excess of energy leading to wakefulness.
Overtraining (too much exercise) can also have a negative effect on your sleep by increasing levels of the stress hormone cortisol (see “stress” section for further explanation).
The timing of when you exercise is just as important as how much you exercise. Training releases adrenaline, your fight or flight hormone, the same hormone that caffeine releases. It also increases your body temperature, which as we’ve seen, body temperature is extremely important when it comes to sleep. For these reasons, I recommend avoiding workouts close to your bedtime. If your workout is too close to your bedtime it doesn’t give enough time for body temperature and adrenaline levels to return to normal. If nighttime is the only time you have to exercise, try to finish at least 3 hours before bed. Also, if you don’t notice late evening workouts having any effect on your sleep then there is no need to necessarily change the time of day you exercise. The best time to exercise is in the morning or afternoon.
Stress: When the body is stressed it releases a hormone called Cortisol. Cortisol plays an important role in your body’s sleep-wake cycle (circadian rhythm). Normal cortisol levels are highest around 9 am and slowly decline throughout the day until they are at their lowest point around midnight. These levels stimulate wakefulness in the morning and continue to support alertness throughout the day while gradually dropping to allow the body to prepare for sleep at the end of the day. (8) If we are overly stressed (i.e. work, over-exercising, relationships, money, life changes, etc.) this gradual decline doesn’t happen and can cause a racing mind and a sleepless night.
It’s important that we find ways to offset this stress if we want to get a good night of rest. There are a multitude of ways to mitigate stress including exercise (30-60 minutes), meditation, hobbies, talking with family or friends. I recommend finding one that works for you and begin to lower your stress levels.
Alcohol: Having an alcoholic beverage before bed, also known as a nightcap, may help you get to sleep, but your sleep will be of lesser quality, and about halfway through the night get disrupted by a process called glutamine rebound (see “Glutamine” section below for further explanation). This same process can occur even if you have drinks earlier in the evening.
Sugar/Simple Carbohydrates: A high intake of processed sugars and simple carbohydrates can throw off your body’s natural rhythm, and lead to a poor night of sleep. Hormones that regulate metabolism like leptin, insulin, cortisol, and ghrelin are closely linked with sleep. (35) These hormones follow a natural rhythm (the same rhythm that regulates your sleep-wake cycle) and when too many simple carbohydrates are ingested that rhythm gets thrown off.
Even without a high intake of simple carbohydrates, inadequate sleep impairs the regulation of your metabolic hormones, increasing hunger and food intake. (34) This creates a vicious cycle of poor sleep leading to increased carbohydrate intake which then leads to more poor sleep, so on and so forth.
Overweight: Being overweight not only increases the risk of a multitude of diseases but also has an impact on sleep. When you have excess energy, your body creates fat and will store it wherever it can, including around your airway. This excess fat constricts your airway making it more difficult to get enough air into your lungs. On top of having constricted airways, the excess weight around the chest and stomach puts pressure on your diaphragm, and other accessory breathing muscles making the amount of air that gets into the lungs greatly reduced, leading to snoring or sleep apnea.
Have a sleep schedule: Going to bed at the same time every night can be highly beneficial for a restful night of sleep. This has to do with your circadian rhythm. Inconsistent bedtimes don’t allow your body to get into a groove and disrupts your circadian rhythm (sleep-wake cycle).
Four Stages of Sleep
Stage 1 (non-REM) - The transition from wakefulness to sleep. Lasts anywhere from 5-10 minutes. Only about 5% of sleep occurs in this stage. (2)
Stage 2 (non-REM) - A light sleep where body temperature begins to drop and heart rate slows down. Lasts about 20 minutes. You spend about 45% of the night at this stage. (2)
Stage 3 (non-REM) - This is where deep sleep occurs. This is also where most of the restorative benefits of sleep happen. In this stage, blood pressure drops, breathing rate slows, and high amounts of HGH (Human Growth Hormone), essential for tissue growth and repair, are released. This stage lasts about 30 minutes and you spend about 25% of the night in this stage. (2)
Stage 4 (REM) - Most dreaming occurs during this stage. Stage 4 is characterized by rapid eye movement (thus the name REM sleep), increased respiration rate, and increased brain activity. During this stage, the brain and other body systems become more active, but your muscles become more relaxed or paralyzed. Dreaming occurs because of increased brain activity, but voluntary muscles become paralyzed as a built-in protective measure to keep you from harming yourself. About 25% of sleep is spent in this stage. (3)
Even though the stages are numbered as if the body goes directly from stage 1 into 2, 3, and then 4, the body actually progresses through stages 1 through 3 and then goes back to stage 2 before entering into stage 4. After stage 4 the body will return to stage 2 and repeat the process another 5-6 times throughout the night. (4)
Natural Supplements That Can Help with Sleep
Supplements work with your body’s natural processes and are most effective when taken consistently. For best results, supplements should be taken for at least two weeks to give your body time to use the nutrients to heal and correct its imbalances.
Glutamine: if you’ve ever been drinking and experienced restless sleep that same night, glutamine is responsible. When your liver processes alcohol it requires glutathione (an extremely potent antioxidant). To make glutathione your liver uses glutamine as a precursor. As glutamine levels drop from glutathione production your body will pull glutamine from your muscles to restore normal blood levels. A portion of this glutamine gets converted to glutamate (an excitatory neurotransmitter that stimulates brain activity), which can result in frequent wake-ups during the night after you drink, this is called glutamine rebound. The suppression of glutamine is one of the reasons alcohol has a depressive/sedative effect. A normal night of sleep averages 6-7 REM cycles. After drinking, this is reduced to an average of 2-3 cycles. Supplementing with glutamine can offset your body’s depletion of glutamine from drinking, leading to a more restful night of sleep. I recommend supplementing with 5 grams if you’ve been drinking. (9)
Melatonin: is a hormone produced in the brain that plays a vital role in the sleep-wake cycle (circadian rhythm). The highest levels of melatonin are produced in the evening hours when the sun has set to prepare the body for sleep and remains elevated until levels decrease as the sun rises in the morning. (10) Even small amounts of light can disrupt the production of melatonin. The body naturally produces on average 0.3 mg of melatonin (production varies greatly depending on age and exposure to light). (11)
The problem with a lot of the sleep supplements on the market today is they give large doses of melatonin (5 mg or more). These large doses lead to a decrease of your own natural production of melatonin leading to a dependency on melatonin supplementation. I recommend supplementing with no more than 0.5 mg. to 1 mg.
Tryptophan: Some supplements use tryptophan in their formulas to increase serotonin levels, which can help in some cases, but for it to work you can’t be deficient in vitamin B3 (Niacin). Tryptophan has two pathways it can take within the body. It can either be converted into niacin or into serotonin. If you’re deficient in niacin then your body will first use the tryptophan to fix the niacin deficiency instead of using it for serotonin production. An easy solution to this problem is to just take 5-HTP instead. If you do take tryptophan or take a sleep formula that includes tryptophan, make sure you are taking niacin as well. Look for a supplement that supplies 1-4 grams of tryptophan.
5-HTP: is an intermediary step of the tryptophan to serotonin conversion process. 5-HTP can’t be reverted back to tryptophan, but only used for serotonin production. The production of serotonin is super important for sleep because serotonin is a precursor for melatonin. I recommend 5-HTP supplementation over supplementing with tryptophan because 5-HTP crosses the blood-brain barrier at a higher rate and is also more efficient than tryptophan. (12) Find a formula that has 100-300 mg of 5-HTP.
If you are taking any SSRIs, SNRIs, or SARIs (serotonin reuptake inhibitors), which are types of antidepressant medications, I recommend you consult with your physician before supplementing with 5-HTP. These antidepressants inhibit the reabsorption of serotonin in the brain and since 5-HTP increases serotonin levels naturally, this can cause an overabundance of serotonin. Too much serotonin can have some pretty serious side effects including confusion, rapid heart rate, high blood pressure, heavy sweating, diarrhea, headache, high fever, irregular heartbeat, seizures, and unconsciousness. (13)
B6 (Pyridoxine): Vitamin B6 is the main co-factor necessary to convert 5-HTP into serotonin. Vitamin B6 has been clinically shown to aid 5-HTP conversion into serotonin, while even a slight B6 deficiency can greatly inhibit the efficacy of 5-HTP. B6 is also necessary to convert glutamate to GABA. (14) If you’re looking for a sleep supplement make sure it includes some B6. I recommend a supplement that includes 50-100 mg.
GABA: is a naturally occurring amino acid that serves as an inhibitory neurotransmitter (decreases the communication between your brain and central nervous system). When GABA attaches to receptors in the brain it produces a calming effect. (15) Find a supplement that includes 100-200 mg.
L-theanine: is an amino acid that is most commonly found in tea, especially green tea. L-theanine works by boosting levels of GABA and other calming brain chemicals like serotonin and dopamine. (16) Increasing levels of these neurotransmitters promotes relaxation and sleep. L-theanine has also been shown to increase alpha brain waves. Alpha brain waves are associated with a state of “wakeful relaxation.” (16) That’s the state of mind you experience when meditating, being creative, or letting your mind wander in daydreaming. Alpha waves are also present during REM sleep. I recommend taking 100-400 mg.
Magnesium (as Magnesium Glycinate): Magnesium glycinate is a form of magnesium that has a molecule of magnesium and two molecules of glycine attached to it. Magnesium is an essential mineral needed for over 300 enzymatic reactions in the body. A common symptom of a magnesium deficiency is insomnia. The reason is magnesium plays an important role in modulating GABA activity in the brain. As seen above, GABA is a neurotransmitter that calms down the brain and central nervous system activity. Magnesium occupies GABA receptors acting as GABA receptor agonists to help facilitate GABA neurotransmission. GABA and Magnesium bind to benzodiazepine receptors resulting in an anxiety-reducing effect. (17)
Magnesium is also a very strong inhibitor of N-methyl-D-aspartate receptors (NMDA receptors), which are a subtype of glutamate receptors (glutamate is an excitatory neurotransmitter that increases activity in the brain). Magnesium is a natural antagonist to calcium and exerts its inhibitory effect by blocking the flow of calcium through the NMDA receptors, preventing an excitatory response in the brain.
Glycine, a non-essential amino acid, like GABA is an inhibitory neurotransmitter. Glycine is also believed to help with sleep by having a temperature dropping effect on the body. (18) As mentioned earlier, the temperature of the body is extremely important for a good night of sleep.
Each nutrient by itself will have a positive effect on sleep, but combined, these two substances are a two-pronged approach to fighting insomnia. I recommend a supplement with 100-300 mg of magnesium glycinate.
Vitamin B1 (Thiamin HCl): One of the symptoms of a B1 deficiency is sleep disturbances. Vitamin B1, along with B6 plays an important role in the production of serotonin and GABA. (19) (32) Caffeine, alcohol, stress, and sugar all deplete B1 and can lead to a deficiency in B1. Since everybody partakes in one of the above, supplementation with B1 would be smart if you are having trouble sleeping. I recommend taking 100-250 mg.
Lemon Balm: is an herb that belongs to the mint family that works by increasing levels of GABA. (20) The recommended dose is 300 mg.
Valerian Root: is an herb that is commonly used to promote sleep. Valerian Root is believed to also work by increasing levels of GABA in the brain. However, studies on its effectiveness in treating insomnia are inconclusive. Also, Valerian Root can have side effects such as headaches, fatigue, dizziness, nausea, and vomiting. (21) Even though very rare and only occurring in a few cases there have also been reports of liver damage from Valerian Root supplementation. (21) For this reason, people with liver problems should consult a doctor before taking valerian. Even though I personally don’t recommend it, the standard dosage for Valerian Root is 300-600 mg.
Passion Flower: is another herb that works by increasing levels of GABA. (22) The recommended dose is 400 mg.
Hops: is a flower that helps induce sleep by interacting with melatonin receptors in the brain and having a hypothermic effect on the body (lowers body temperature). (23) The recommended dose is 500 mg.
Chamomile: is one of the most widely used herbs in the world and is often used as a tea. Chamomile has a compound called, apigenin, which is believed to give the herb its sleep-promoting capabilities. Apigenin works by binding to specific receptors in the brain that actually increase GABA receptors' affinity for GABA. (24) The recommended dose is 400 mg.
Lemon Balm, Valerian Root, Passion Flower, Hops, and Chamomile work best when combined. If you decide to supplement with any of these herbs, I recommend finding a formula that includes all of these, or since all of these herbs increase levels of GABA just take GABA itself.
Ashwagandha: is an adaptogenic herb that is known for its ability to help the body better deal with stress. It is believed that Ashwagandha’s ability to promote sleep is because of its capacity to lower the stress hormone, cortisol. The active compound triethylene glycol found in Ashwagandha is another reason it is thought to give this herb its ability to promote sleep. (25) Studies are few and far between though so it’s not completely understood yet how it promotes sleep. If you decide to supplement with Ashwagandha to promote sleep, the recommended dose is 300 mg of the extract twice daily.
Over the Counter Sleep Aids
Many people turn to over the counter medications to help them get the sleep they need. Just like all medications and drugs, however, they only deal with the symptoms and not the actual problem. Additionally, there are dangers and side effects involved with these medications. Even though these medications will put you to sleep, over time, the body builds up a tolerance to these drugs and a higher dose is eventually required to get the same effect as before. On top of this, your body eventually becomes reliant on the drug to fall asleep. This reliance can also lead to withdrawal symptoms when you try to get off of the medication. Some of these side effects can include nausea, sweating, shaking, and seizures. (26)
I personally would never recommend taking any of these for treating sleep issues. There are so many more options that are far safer and just as effective. These drugs do work, but can have side effects and lead to dependency. Below is some general information about the main types of sleep medications on the market, what they do, and their side effects.
Types of Sleep Medications
Benzodiazepines: are commonly used to treat insomnia but have a higher risk of dependence than other insomnia sedative-hypnotics and are classified as controlled substances. Because of their addictive qualities, suddenly stopping use after a few months of daily use may cause withdrawal symptoms including a feeling of loss of self-worth, agitation, and insomnia. If benzodiazepines are taken continuously for longer than a few months, stopping suddenly may produce seizures, tremors, muscle cramping, vomiting, and sweating. In order to avoid withdrawal symptoms, benzodiazepines need to be weaned off slowly. Examples of Benzodiazepines include Estazolam (Prosom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril), and triazolam (Halcion). (26)
Another downfall of Benzodiazepines is that they can become no more effective than a sugar pill in as few as three to four weeks of use. Also, Benzodiazepines increase the amount of time spent in stage 2 sleep while decreasing the amount of time spent in stages 3 and 4 (the most restorative stages of sleep). This means, even though benzodiazepines can help you get to sleep the quality of that sleep is greatly diminished. (26)
Non-Benzodiazepines: These have fewer drawbacks than benzodiazepines, but work in much the same way as benzodiazepines do so use is still dangerous. Some typical non-benzodiazepines include zalepon (Sonata), zolpidem (Ambien), and eszopiclone (Lunesta). (26)
Sedative-hypnotic medications (benzodiazepines and non-benzodiazepines) can cause severe allergic reactions, facial swelling, memory lapses, hallucinations, suicidal thoughts or actions, and complex sleep-related behaviors like sleep-walking, sleep-driving, and sleep-eating. (26)
Antihistamines as Sleeping Aids: Antihistamines like Diphenhydramine (found as Nytol, Sominex, Sleepinal, Compoz) and Doxylamine (found as Unisom, Nighttime Sleep Aid) have a sedative effect and because of this, some people will use these to treat insomnia. (26) The problem with doing this is the sedating properties of antihistamines can often last long into the next day and have been shown to increase the risk of dementia by 54%. (27)
Melatonin receptor agonist hypnotic medications: These work by mimicking melatonin. Ramelteon (Rozerem) is one of the more common forms of this medication type. It has little risk of physical dependency but still has side effects. Just like benzodiazepines, it is more effective at putting your body to sleep than it is at keeping you asleep. (26) You’re probably asking, that if these drugs just mimic what melatonin does, then why don’t they just prescribe melatonin? The reason being, melatonin is a natural substance, so legally the pharmaceutical companies can’t patent it. As such, there is no money to be made from it. To make Ramelteon, they changed the chemical structure slightly so they could patent it and charge more. Even though the difference between Ramelteon and melatonin is very slight, this little change can have a huge effect on the body. For example, Ramelteon has been associated with having an effect on reproductive hormone levels (decrease in testosterone and increase in prolactin) in adults. A variety of cognitive and behavior changes have also been reported including hallucinations. These things don’t happen with melatonin supplementation. (28)
Take estrogen and testosterone, for example, they are almost identical except for a couple of minor changes, yet, those changes make the differences between males and females.
Antidepressants Used as Sleeping Pills: In spite of not being approved by the FDA or even being proven as an effective treatment for sleeplessness, antidepressants are still prescribed to treat insomnia. Antidepressants can actually worsen or create new sleep disorders. Side effects vary depending on the type of antidepressant, but some of the side effects that they have in common include blurred vision, disorientation or confusion, dizziness, drowsiness, dry mouth, excessive sweating, gastrointestinal upset (such as constipation, diarrhea, or nausea), headaches, increased or irregular heartbeat, sexual dysfunction (such as reduced desire or erectile dysfunction), tremors, urinary retention, and weight loss or weight gain. (29) On top of all these side effects, antidepressants can cause withdrawal symptoms if not gradually reduced over a period of three to six months. As you can see, the negatives greatly outweigh the positives of using these medications for sleep.
Conclusion
If you do anything to improve your health, a good night’s sleep is a great place to start. Sleep plays a huge role in detoxification, cognitive function, tissue repair, regulation of the immune system and so much more. I recommend using the natural method rather than medications. You’d be surprised at how much better your sleep can be just by simply lowering the temperature of your room or getting exposed to less blue light before bed. If these simple tips don’t work then your next best option is a well-balanced supplement that is specifically formulated to help your body fix any nutritional deficiencies that could be leading to your sleepless nights.
The information given here is designed to help you make informed decisions about your health. It is not intended as a substitute for any treatment that may have been prescribed by your doctor. If you suspect that you have a medical problem, we urge you to seek competent medical help.