There is no ignoring the fact that sleep is one of the most crucial elements of health and wellbeing, and yet it is also something that causes so many people stress.
In this blog we have spoken to some of the leading healthcare professionals to get their top tips on how to get good quality, restful sleep. Whether it is to support you personally, and/or your patients.
Blood Sugar Regulation
Mark Bennett looks at a range of different angles. “Poor sleep/insomnia can be caused by a multitude of different biochemical and environmental imbalances ranging from unidentified food sensitivities, to lack of nutrients in the diet, to imbalances in the gut flora, light pollution and stress to name a few.”
“If, however you find that you are able to fall asleep with no issue,” he goes on to say, “but then typically wake up a few hours later (around 2 or 3 am) wide awake and alert (clients often state that they feel like the could clean the house or go for a run) and then find it hard to get back to sleep for the next few hours, eventually falling asleep again when it is time to get up, then this is very likely to be due to a low blood sugar event happening at night - nocturnal hypoglycemia.”
“The brain needs fuel at night and if blood sugar management is not optimal (very common) and blood sugar levels fall too far, the brain will instruct the adrenals to solve this crisis by instructing the release of adrenaline/cortisol which will breakdown fat for conversion into sugar, which solves this issue but also creates a fight or flight response i.e you feel wide awake. It takes a few hours for this effect to wear off, hence the inability to get back to sleep.”
So what's the solution? Mark recommends a small snack containing fish/meat/eggs with some form of complex carbohydrate e.g. sweet potato/rice/carrot/pumpkin/squash/beans eaten an hour or so before bed time, which is usually enough to iron out this blood sugar imbalance and increase levels of melatonin (the sleep hormone).
"Meat/fish/eggs are a good source of tryptophan the precursor to serotonin which then is converted to melatonin," he explains. "The combination of the protein source and the carbohydrate helps with the transportation of tryptophan across the blood brain barrier. Sometimes this approach is all that is required.”
Micki Rose reiterates this. “Sometimes, people need to retrain the blood sugar control over night," she states. "I have often advised they pop another two portions of their complex carb and protein snack in a covered dish next to their bedside and eat some more each time they wake up. It usually works and they gradually need less. Clearly, we then start looking more deeply into their blood sugar control issues. If that doesn't work, then I would test their neurotransmitter levels to check for imbalances, many of which can cause insomnia, I would also check any meds side effects as those can often cause problems; sometimes taking meds earlier in the day, if suitable, can help. In really chronic cases, I will look for excess histamine causes, which I've found in quite a few people."
On a similar wavelength, is Debbie Lewis with her approach of starting from breakfast. “I often see huge changes in people's sleep patterns when we start at the other end of the day - with a good protein and fat based breakfast. Just this simple change can have a large effect on balancing blood sugar levels throughout the day - leading to less waking in the night when blood sugar levels can drop too low.”
A shake up of routines…
Nicky Williams believes that prioritising your bedtime routine is imperative. "Dedicate a good hour and a half before bedtime to calm down from the day," she says. This includes no more food or drink - stop those late night nibbles; turning off gadgets, making sure your room is dark (no artificial light interfering with your melatonin), some relaxation (a relaxing bath, meditation, mindfulness, reading, listening to music, watching a relaxing TV show - not a thriller!), try a calming herbal tea and make sure you get to bed before 11pm so you get that first cycle of deep sleep in."
Victoria Tyler also believes the evening ‘wind down’ plays an important role. “I encourage my clients to avoid all electronics - which means no phones, no-iPads, no computers - for at least one hour before bed, and specifically no work emails. Of course avoiding coffee, alcohol and sugar, and introducing guided meditation from someone such as Deepak Chopra . I also prohibit any form of high intensity exercise in the afternoon or evening and have found Valerian as a supplement can be beneficial."
For Karen Ward , it is hard to pinpoint just one tip. “If I had to choose it would be a combination of a warm Epsom salts bath, followed by some trans-dermal magnesium spray, and as every single one of my clients is time poor, when in the bath I recommend sipping on a herbal sleep tea bag steeped in a warm oat or almond milk, or as a herbal tea. Then once they hit the pillow, I encourage them to finish with 3 rounds of 4-7-8 breathing." (as per the Dr Andrew Weils technique here)
"When I dig deeper DUTCH is my go to test," Karen goes on to say."I will often see elevations of cortisol coupled with poor stress hormone clearance. So a combination of factors may be at play. Finding the root causes and addressing them leads to the most dramatic results with clients that are highly stressed. I have a lot of Female clients who would work as high level executives – and they are dealing with unprecedented levels of unrelenting stress. Testing can be a dramatic trigger for many to change."
Hormonal changes are significant when it comes to sleep, as Tanya Borowski explains. “Women over the age of 50 ( that’s me!) struggle with insomnia more as there is such a shift in our sex hormones," she explains. "Progesterone, which is made predominantly by the ovaries, placenta, and then the adrenal glands has a calming, sedative effect that promotes good sleep via GABA receptors; therefore, as progesterone drops when we cease menstruation there is a correlation to newer levels of anxiety (or things seem to just annoy you faster) and both the quality and quantity of sleep is affected."
"To understand how progesterone impacts mood and sleep, it is important to note that progesterone is, to a high degree, metabolized (broken down) to allopregnanolone which can cross the blood brain barrier and act as an agonist on the GABA-A receptor complex in the brain eliciting calming effects. GABA also helps to balance anxiety and stress by acting like a bouncer on the door at a nightclub on the hormones adrenaline and noradrenaline, the hormones responsible for the stress surge. Without GABA's (the bouncer) modulatory activity in the adrenals, adrenaline and noradrenaline release would become like a drunken brawl in that night club having multiple metabolic knock on effects like insomnia, anxiety and pain."
"The gut (you knew I’d come to this!!!) is also saturated in GABA receptors of all types, and certain strains of Lactobacillus and Bifidobacterium species have been documented to produce, GABA (see paper here) . Thereby positively influencing the central nervous system, via to the vagus nerve. So supporting the gut microbiome to grow these species and strains makes perfect sense."
"Here we are talking about prebiotics and prebiotic type foods, which are a special kind of fibre which acts like fertiliser for the ‘good’ bacteria in our gut to grow. This gained a lot of media coverage in 2017 when Dr Michael Mosley was researching his documentary The Truth About: Sleep in 2017 . The particular fibre that was used by Michael Mosley was inulin. This can be taken as a supplement as Michael Mosley did, but the broader message is that fibres, plants and their polyphenols best build diversity! Jerusalem artichokes, onions, garlic, leeks and asparagus are the main food sources of inulin."
We hope you enjoy some of these tips and they help you, and your patients get a full night of restful sleep.
Many thanks to our contributors…