I’ve written about insomnia in the past in an article titled “Natural ways to help with insomnia“. And recently I came across an article on YAHOO®HEALTH, written by Barbara Brody entitled “Sleep Routine Makeovers”; so I thought I would comment on it.

Brody discusses how to deal with three different people’s sleeping issues based on tips given by Joyce Walsleben, RN, PhD, diplomate of the American Board of Sleep Medicine and coauthor of A Woman’s Guide to Sleep, and Michael J. Breus, PhD, a clinical psychologist and board-certified sleep specialist. I’m going to review this article as well as add some of my own thoughts. The article addresses the following three common sleeping issues: 1) waking up in the middle of the night and not being able to fall back asleep; 2) sleeping only about four to five hours a night; and 3) nights sweats. I’ll discuss each of these separately.

The first problem is fairly common and a woman who suffers from it is quoted saying, “I wake up in the middle of the night and can’t fall back to sleep”. In order to fall back asleep she reads The New York Times on her BlackBerry, and eventually falls back asleep only to wake up feeling exhausted all day. Walsleben gives the following three tips for this routine:

1) “Ban the BlackBerry from the bedroom. Also cover (or remove) clocks so that you’re not disturbed by the light from them or tempted to stare at the numbers.” Walsleben explains that this is a two-fold problem because reading news articles can be too stimulating, and the light of the BlackBerry “can get in the way of the production of hormones that are essential for sleep”. Presumably, Walsleben is referring to the important sleep hormone melatonin, which is critical for sleep and won’t work properly when the eyes are exposed to light.

2) “Stay in bed. If you wake up, keep your eyes closed and practice relaxation exercises that will hopefully lull you back to sleep.”

3) “Relax during the day, too…so that you’re not overwhelmed by the worries of the day as soon as your head hits the pillow.”

These three tips are great as they discuss both the physiological and psychological aspects of sleeping routines. I’d like to add some nutritional tips at this point. For those who fall asleep and wake up in the middle of night, I find that it is important to look into blood sugar regulation. Typically, I find that a person experiencing this problem will have a drop in blood sugar in the middle of the night, which triggers stress hormones (adrenaline and noradrenaline) to break down stored sugar (or glycogen) in order to bring the blood sugar back up to a normal level. When this occurs, the person wakes up out of sleep and usually has anxiety and can’t stop their mind from racing.

In order to avoid this, it’s best to follow an eating plan that stresses healthy blood regulation. I’ve touched upon this in the past in an article titled, “How to eat to maintain healthy blood sugar levels“. Additionally, I would suggest limiting caffeine to no more than one cup of coffee per day, and avoid all caffeine after 2:00pm. It may also be helpful to have a low-carbohydrate snack sitting next to your bed. Taking a few bites of a snack like this should help to normalize the blood sugar response and help you easily fall back asleep. Nuts or a low-carbohydrate “health food” bar usually work well.

The next routine involves a woman who said, “I only get four to five hours of sleep a night”. Breus gives the following tips in regards to this:

1) “Start “caffeine fading.”… drink most of your caffeinated beverages early in the morning and taper off as the day goes on. If you’re currently used to five or six cups of coffee a day, try having one or two cups of drip coffee in the morning, a latte (which has a higher milk-to-coffee ratio) or half-caf coffee midday, and a tea or cola in the afternoon if you’re still craving caffeine. But after 4 p.m., no more caffeine!”

2) “Set your alarm clock or cell phone to go off 30 minutes before bedtime as a reminder to stop what you’re doing and get ready for bed.”

3) “Take a hot bath or shower right before bed. This should make you sleepy because your temperature will rise and then dip–and body temperature naturally drops when you get sleepy.”

4) “Go to bed and wake up at approximately the same time on weekdays and weekends. (A shift of about an hour is OK.)”

These four tips are great. Personally, I would recommend no more than one cup of a caffeinated beverage per day and no cola whatsoever. Assuming there is sugar and/or corn syrup in the cola, it would be best to avoid it altogether, to prevent unhealthy blood sugar metabolism. Diet colas also pose a problem as artificial sweeteners can cause a host of complications unto themselves. That’s a topic for another article. The second tip is a great one too, because often people stay up and get their “second wind” (as is mentioned in the article). It is important to go to bed when you feel sleepy to prevent that second wind from hitting. For tip number three, you may think about adding some relaxing essential oils if you take a bath. Lavender is a calming one and may help you relax and wind down nicely. Tip four is also invaluable for keeping your circadian rhythm normal.

The last routine the article refers to quotes a woman saying: “I have night sweats–but I’m only in my 20’s!”. In regards to this (and the fact that her husband gets into bed later than her, thus waking her up), Walsleben gives three tips as follows:

1) “Normalize your weekday and weekend sleep routines as much as possible. That might mean going to bed slightly later during the week than you are now, as well as turning in a bit earlier on Friday and Saturday. The goal is to bridge the gap.”

2) “Embrace the darkness. Even if you fall asleep with the light on, it probably won’t be quality sleep–and it’s all too easy to be woken up. If your husband insists on reading in the bedroom after your bedtime, ask him to use a book light or wear an eye mask yourself.”

3) “Talk to your doctor. If you practice these lifestyle changes for a few weeks and you’re not sleeping any better–and still waking up sweating–see your primary care doctor to make sure an unknown medical problem isn’t to blame.”

This last scenario seems a bit more serious than the first two, and I would agree with all three tips. The third tip certainly brings a couple things to mind. I would look to rule-out an infection that may be causing the body temperature to rise, as in a fever. Many times a person can experience a low-grade infection and night sweats will be the only symptom; as a fever is brewing to help fight the infection. Also, despite this woman being in her twenties, I would look to get a full analysis of her hormones (both stress and sex hormones). It’s not likely that this woman is going through menopause considering her age, however, it’s quite possible that there are major hormonal imbalances leading to hot flashes.

If you are interested in reading Brody’s entire article, here is a link to the YAHOO®HEALTH piece titled “Sleep Routine Makeovers“.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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