Herbal Remedy, Lifestyle Medicine, Mind-Body Medicine

Your Holistic Guide to Treating Insomnia

In my previous life as an ER doctor my sleep schedule was erratic. I suffered from insomnia and tried every natural remedy under the sun and moon. Finally, I found relief in my homespun tea starring Valerian root, which I lovingly dubbed “Tranquilizer Tea”. It worked like a charm and I loved its natural, organic aroma. Unfortunately, many people find that Valerian root smells like stinky socks — my hubby included. So, to save him feeling like he slept in a gym locker (he never did complain, bless him!), I tucked my aromatic tea away for special occasions and switched to capsule form instead!

Getting enough sleep is absolutely essential. Without it, your mood suffers, you’re irritable, sick more often, and you may even put yourself at increased risk of heart attack. Many people claim, “I’m too busy — I don’t have time to sleep!” But not getting enough actually reduces your ability to concentrate and makes you less productive.

Whether you’re sleeping too few hours by choice, or can’t sleep despite your best efforts, read on to learn how to develop a positive relationship with sleep, and become a better sleeper — no drugs required. I’ve also provided a list of some of my favourite, and often free, resources and sources (see “products” section at bottom).

So, what causes insomnia?

Insomnia, or trouble sleeping, isn’t actually about not being tired enough; it’s typically due to being too awake or stimulated. It’s often triggered by a stressor, such as relationship turmoil, or troubles with work, finances or health. Insomnia can also creep in because you’ve unknowingly put barriers in place that aren’t allowing your brain and body to settle at night, disrupting your natural production of the sleep hormone, melatonin. Once it sets in, insomnia can become a vicious cycle that’s difficult to break.

What you’ll feel

You may have trouble falling asleep or staying asleep, rouse frequently, or wake feeling completely unrefreshed. However insomnia presents, it usually makes people super tired and irritable, or even depressed or anxious —  and definitely fed up.

What conventional medicine offers

Your doctor can offer you a quick fix for your insomnia in the form of a sleeping pill. If you can’t sleep because of an acute stressor, crisis or grief, sleeping pills can provide you with much-needed rest. However, they can disrupt your normal sleep patterns, depriving your brain and body of restful and restorative sleep. With long-term use, you can become dependent on sleeping pills, finding it almost impossible to sleep without them; they may also increase your risk of dementia.

Integrative medicine: a holistic approach to treating insomnia

Integrative medicine is about combining lifestyle, nutrition, herbal and mind-body remedies with the best of conventional medicine to help you be your healthiest self.

Whether you’re looking for help treating insomnia naturally, or hoping to reduce your reliance on prescription drugs, focus on these “prescriptions” to sleep easier, and reap the overall health benefits too! Remember to get the “ok” from your doc if you have any health conditions, or take regular medications, before making very significant lifestyle changes, or trying new supplements or herbs.

 

Dr. Ross’ Integrative Medicine Prescriptions:

Lifestyle

Reframe how you think about sleep. Many of the notions we have about sleep aren’t accurate or helpful, and can increase anxiety, making it more difficult to sleep. It’s time for a change of perspective.

Instead of thinking… Remember…
“I should fall asleep quickly” On average, people take up to 30 minutes to fall asleep. Keep a good book bedside to pass the time, or try guided meditation. Let your body relax into sleep — trying to force it is counterproductive.
“I should sleep all the way through the night” Waking once or twice is completely normal; you still get the rest you need.
“I need at least eight hours every night” An average of at least seven hours of sleep nightly seems to be the magic number for optimum heart health. Keep in mind, this will vary night by night, and everyone’s needs are different. If you feel rested and energized throughout the day, you’ve probably hit your sweet spot.
“Tomorrow is going to be a nightmare” You’re a resilient creature. An occasional “bad night” needn’t interfere with your ability to function the next day.
  • Exercise regularly. It improves sleep and well-being. Just give your body time to cool down, since being too hot can interfere with slumber.
  • Regulate your circadian rhythm. Wake up at the same time each morning, and go to bed at the same time each night. Expose yourself to natural sunlight and fresh air for 20-30 minutes, as soon as possible after waking. If that’s not possible, consider using a light therapy box. In the evening, dim the lights. These measures help regulate your body’s sleep-wake rhythm and its production of sleep hormones.
  • Limit your screen time. This is especially important in the two hours before bed, as blue light emitted from devices suppresses melatonin and wreaks havoc on your brain and body’s ability to settle. If you can’t unplug, consider wearing amber-tinted, blue-light blocking glasses in the hours leading up to bed. Then, set your phone to “do not disturb”. It can all wait for morning.
  • Get Pavlovian. Train your body to expect sleep when you enter your bedroom. Use your bedroom only for sleep and intimacy. If you regularly work on your laptop in bed during the day, your mind’s likely to head back to those tasks at night too.
  • Eliminate excess noise. This includes stimulation from both sight and sound. Darken your room completely; use an eye mask or blackout blinds where needed. Limit distractions, ditch your bedroom TV, and clear out clutter. Get a  “white noise” machine (or download an app) to limit auditory distractions in the night.
  • Practice gentle yoga or meditation. These relaxation practices help prep your mind and body for sleep. Mindfulness meditation is a research-backed technique that can improve your time to fall asleep, and your sleep quality. Download a free guided meditation then tuck in, plug in and let mellow voices guide you to zzz…
  • Don’t fear your dreams. They’re part of healthy sleep and can provide insight into your subconscious. Wake slowly, spend some time in that morning semi-dream state, and journal your dreams. It can be a revealing, and helpful process.

Nutrition

  • Eat a whole-food, plant-based diet, such as the Mediterranean diet.
  • Avoid caffeine after midday. It can stay in your system for much longer than you think, and its stimulating effects can make sleep difficult. This includes coffee, teas (black, white and green), colas and energy drinks, as well as chocolate.
  • Don’t drink too much fluid in the evening. Some people wake frequently at the insistence of their bladder. Waking up once a night to use the washroom is normal; more, and it may be interfering with getting the rest you need.
  • Limit your alcohol consumption. A nightcap may make you feel relaxed, but it can have a stimulating effect on the body a few hours later, waking you from sleep. It’s also a diuretic and may prompt a visit to the loo in the night. Double trouble.

Remedies from the Garden

  • Valerian root (Valeriana officinalis) naturally increases GABA (a brain hormone) activity, helping bring on sleep and reduce anxiety. It can help you fall asleep faster and improve sleep quality. Studies comparing valerian root to benzodiazepines (examples include Valium and Ativan) found it to be just as effective for sleep. Note: Valerian works best after four to six weeks of regular use.
    • To use in capsule form, choose a product that contains dried valerian root, with a set amount of valerenic acid (VA), which is thought to be the main component of valerian that combats insomnia. Recommended dosing is 300-600 mg of dried root standardized to 0.8% VA (which means you’re getting at least 2.4mg of VA. The math: 300 mg x 0.8% = 2.4 mg). Take your capsule(s) 30-120 minutes before bed.
    • To take as a tea, steep 2-3 grams of dried valerian root, chopped finely or ground coarsely, in 1 cup hot water for 10-15 minutes. Keep covered while steeping, then enjoy your cuppa 30-120 minutes before bed. Remember, its stinky sock aroma makes a capsule a more tolerable choice for some!
  • Lavender (Lavandula angustifoliaprovides a lovely relaxing effect, and improves quality and duration of sleep in people who also suffer from anxiety. Use 8-10 drops of 100% lavender essential oil in a pre-bedtime bath, or add a few drops to your pillow. It may also be taken as a tea or in pill form.
    • To use in capsule form, take 80 mg of Silexen English lavender before bed.
    • To take as a teaAdd 1.5 grams (1-2 tsp) of dried lavender to 150 mL of hot water, steep covered for 10 minutes and enjoy before bed.

These next herbs don’t have conventional medical studies supporting their effectiveness, but herbalists have been using them for centuries with good effect. A few options that work as a lovely bedtime tea:

  • Hops (Humulus lupulus) and lemon balm (Melissa officinalis) are often combined with valerian, as in my “Tranquilizer Tea”.
  • Skullcap and passionflower are especially helpful if anxiety or muscle tension play a role in your insomnia. Steep 1 tsp of dried herbs for 10 minutes in a cup of water, and enjoy.

Supplements

  • Melatonin is your body’s natural sleep hormone, but its production can be dampened by many factors in today’s fast-paced, electronic-based lifestyle. So, it can be helpful to give your body a boost. Take melatonin 0.3-0.5 mg as a sustained release tablet sublingually (doctor speak for “dissolved under the tongue”) each night to mimic your body’s natural melatonin production. If you wake in the night, keep an immediate-release formulation of the same dose in your nightstand that you can take on an as-needed basis if you can’t get back to sleep.
  • Magnesium is a key mineral involved in the synthesis of many hormones in the body, including your brain’s “neurotransmitters” which are involved in regulation of sleep and mood. Ensure you’re getting enough magnesium in your diet though eating magnesium-rich foods such as Legumes, nuts, seeds, fish and quinoa. Alternatively, supplement with 300-600 mg of magnesium nightly, which in small studies was shown to improve sleep, and regulate stress and sleep hormones.

Complementary therapies

Sleep restriction therapy sounds counter-intuitive, but it’s a type of behaviour modification that involves limiting the amount of time that you’re in bed, thereby reducing frustration and setting yourself up for success in sleep. It can be done with a qualified sleep practitioner, or through an online app. Here are the basics:

  1. Keep a sleep log for about 2 weeks and note the amount of time you’re actually sleeping each night. Calculate your average sleep time.
  2. Add 30 minutes to this time. This is your total sleep time. This should be a minimum of five and a half hours, since sleeping less can significantly interfere with your daytime function.
  3. Determine your waking time, and work backwards in order to determine what time you need to hit the sack. Keep a consistent bedtime, and wake time. Even if you’re feeling sleepy, avoid napping and don’t be tempted to go to bed early.
  4. Stick to this schedule for 2 weeks. If you’re feeling sleepy during the day, add 15 minutes to your total sleep time. Increase your time in bed by no more than 15 minutes per week until you feel like you’ve hit your stride, sleeping most of your total sleep time, and feeling rested during the day.

Seek out a sleep guru. Seeing a qualified sleep therapist can help with severe insomnia, assist with sleep restriction therapy, or just provide a bit more guidance and support for anyone who needs it in their journey toward achieving a blissful slumber.

Congratulations on taking this step toward achieving your best health! Enjoy the journey. (I’m honoured to be one of your humble guides).

“The best cure for insomnia is to get a lot of sleep.” — W.C. Fields

 

A side note on when your lack of sleep may be dangerous

Some sleep disorders can be downright dangerous. If you snore, wake feeling like you’re choking or gasping, or your partner notices that you sound like you’re having short pauses in your breathing, you may be suffering from sleep apnea. This is a disorder where people can stop breathing (sometimes hundreds of times an hour!) during sleep, dropping their oxygen to dangerously low levels. You may not even notice these symptoms, but simply feel completely exhausted upon waking, wake with headaches, or feel like you could nap on a dime.

Other disorders that can disrupt sleep include feeling your legs are restless at night, or thrashing your arms or legs in bed (most often noticed by a bed partner). These may require testing to reveal underlying conditions. Finally, narcolepsy is a sleep disorder which causes people to feel excessively sleepy during the day or — dangerously — fall asleep during normal daytime activities. See your doctor if you think you may have one of these conditions. A sleep study may be warranted.

Resources

E-resources: 

Body scan for sleep from UCLA: this free audio download helps relax your brain and body, and ease you into a restful sleep. Drifting off while listening is definitely recommended!

Dream Meditation from the Chopra Center: if you’re someone who ruminates on the day’s happenings, this free guided meditation can help you let go of what’s already happened and start the next day afresh.

White Noise Lite App by TMSOFT: my go-to white noise app is free and because it’s on your phone, it’s always with you — even when travelling. My favourite sleepy-time sound? Extreme rain.

CBT-i Coach App from the U.S. Department of Veterans Affairs: get support in solving your sleep problems using this evidence-based Cognitive Behavioural Therapy for insomnia (CBT-i) programme. Bonus: it can be done in the comfort of your own home, and it’s also free!

Products:

I often find patients get anxious when it comes to buying herbs. It can be hard to know what’s effective and what’s safe. Look for something that’s independently tested and approved to ensure you’re getting what you’re paying for, and herbs that are unadulterated. Valerian root and Lavender capsules by Nature’s Way meet these criteria; for quality dried herbs including Valerian, I use my local organic herb farm.

 

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