During these unprecedented times of quarantine, we want to remind everyone about one of the most important things a human can do: SLEEP! Due to drastic changes in lifestyle, a lot of factors that contribute to a great night of sleep are being challenged. This email contains some great sleeping tips, some need to know information about over the counter sleep aids, and a few MUST knows about sleep scripts. Over the counter sleep aids range from hormones and herbal remedies, to antihistamines. We are big believers in the ability to access anything that can improve the quality of life; however, we are also big advocates of education and understanding what people are putting into their bodies. Just because some of this stuff is easily accessible and bought OTC (over the counter) doesn’t mean it's all safe.
The most common over the counter sleep aids are: sedative antihistamines, Melatonin, GABA, and Valerian Root.
Diphenhydramine & Doxylamine – Diphenhydramine and Doxylamine are antihistamines with sedative effects. One problem with sedative antihistamines is that a tolerance to the sedative effects can be devolved quickly, so this can only be used with effectiveness occasionally. According to Mayoclinic.org, “ side effects might include daytime drowsiness, dry mouth, blurred vision, constipation and urinary retention."
Melatonin – Melatonin is a hormone produced in the body by the pineal gland. (more on this to come) Melatonin seems to be relatively safe, taken short term and may help the circadian sleep cycle for shift workers or jet lag. However, according to Webmd, “it can cause some side effects including headache, short-term feelings of depression, daytime sleepiness, dizziness, stomach cramps, and irritability. Do not drive or use machinery for four to five hours after taking melatonin.”
GABA – GABA (Gamma-Aminobutyric Acid) is an inhibitory neurotransmitter that dampens down overactive signaling in the nervous system. Unfortunately, we still need more research to specifically understand the impact of exogenous GABA supplementation past the blood brain barrier. This also leads to dosing questions. However, anecdotal evidence is looking pretty good for GABA in areas of anxiety, sleep, and mood improvement. According to Psychologytoday, “side effects may include: Gastric distress, nausea, diminished appetite, constipation, burning throat, drowsiness, muscle weakness, shortness of breath (at very high doses).”
Valerian– Valerian seems to have studies that go both ways when regarding sleep. In some cases, Valerian root even caused insomnia. People who have taken valerian root for extended periods of time have experienced headaches, excitability, uneasiness, and insomnia. Withdrawal symptoms can occur if you try to quit taking Valerian suddenly; so people need to wean themselves off Valerian over several weeks.
Prescription Sleep Aids
Zolpidem (AKA Ambien) - Zolpidem side effects have ranged from sleep eating and sleep driving to sleep murder! The “Ambien Defense” has been used by celebrities like Roseanne Barr for sleep tweeting, Charlie Sheen for destroying a hotel room while sleeping, and Patrick Kennedy for a sleep car crash. There is an interesting government study on two murder cases both which use the “Ambien Defense.” The fact that Ambien has its own token defense is scary in itself. According to this 2012 study: “Previous research has identified 4 factors that may place a patient at increased risk of zolpidem-associated psychotic or delirious reactions: (1) concomitant use of a selective serotonin reuptake inhibitor (SSRI), (2) female gender, (3) advanced age, and (4) zolpidem doses of 10 mg or higher. In this article, 2 cases are presented in which individuals killed their spouses and claimed total or partial amnesia. Neither individual had a history of aggressive behavior. Both had concomitantly taken 10 mg or more of zolpidem in addition to an SSRI (paroxetine).”
What Can We Do ?
According to the Institute of Neurological Disorders approximately 40 million people in the United States suffer from chronic sleep disorders and another 20 million suffer from occasional sleep issues. This number is probably larger with the current because of the COVID-19. So here are some sleep tips!
Stay active! With the gyms closed and many people out of work it may be hard, and sound unimportant, but work out. Find a way to get it in, or you won’t sleep well.
Avoid reaching stage 3 NREM during a cat nap. Do not nap for longer than 10 to 20 minutes. If you reach deep sleep, it will be difficult to fall asleep at night.
If possible, take a bath before bed. If not, then shower. A hot bath or shower will raise the body temperature. Upon getting out of the bath or shower, the body temperature will drop, relaxing the body and preparing it for rest. Furthermore, people who suffer from allergies should wash off pollen and other potential allergens. Bonus - If you suffer from allergies while sleeping, also try using a silk pillowcase as it reduces bed mites, dust and pollen.
Keep sleep consistent. Go to bed at the same time each night and wake up at the same time. Bright natural light exposure keeps the circadian rhythm healthy. It also helps the pineal gland produce the proper amount of melatonin. When the sun goes down, the pineal gland becomes active and produces melatonin into the bloodstream. Nighty-night folks!
Get a blue filter app on your phone. The bright light from electronics tricks the pineal gland into thinking it is light outside and shuts down melatonin production. Blue light glasses can also be purchased for $20 to $30 for those of us that work late on the computer. These glasses should also be worn for pre-bed TV watching.
Cut back on afternoon coffee.
Supplementation with melatonin can also help people who cannot manage their pineal gland by getting enough bright light. A lot of time this results from a work-related schedule.
Treat sleep like a job. When it's bedtime, it's bedtime! Don’t browse social media and watch TV. Try lying down and visualizing, praying, or meditating. Train your body and mind that when you get into your bed it’s sleepy time.
Make your bedroom a sleep temple. This means the perfect temperature, black out curtains and light ambient noise / no noise. One of the best things I have ever purchased is a Chilipad, which controls the temperature of the mattress on my side and my wife’s side separately. Sleeping at a steady temperature has been a game changer!
Heartburn, sleep apnea or excessive snoring? Slightly raise the head of the bed a couple inches. This can be done with an adjustable bed or a sleep wedge pillow. For you DIY’ers out there, modify the bed frame. I diagonally ripped a couple 2x4s, placed the 4 pieces in the bed frame lengthwise, screwed in some 1x4s crosswise, put a few supports in, and voilà. I don’t remember the exact cost, but it wasn't much.
Don’t eat too late. A high-carb late night meal will affect your sleep. Your body will not be burning too many carbs during sleep, so cut down the carbs before bed. Unless, of course, you’re growing .... oh how we wish we could all eat and sleep like a teen!
Don’t drink too much alcohol.
Try supplementing CBN. CBN (Cannabinol) does not seem to have sedative effects by itself, but when paired with other cannabinoids and terpenes (like Arcanum’s C3) it will produce a great night’s rest. Cannabinoids have been shown to help with an array of sleep disorders from sleep apnea to restless leg syndrome. Cannabinoids control anxiety by bringing overactive neuroreceptors back into homeostasis. This increases time in stage 3 NREM, or deep sleep. Remember, deep sleep is the most restorative stage in the sleep cycle!
Bio-hack yourself. Get a watch or band that tracks your sleep and see what makes the difference!
Until next time, Stay healthy, my friends!