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by Lew Johnson, pharmacist

In our practice we get a huge amount of requests for advice on possible treatments for sleeping disorders.

Many people have tried various treatments including medical prescription medications from their GP. 

Some of the hypnotics prescribed medically such as Zopiclone, tend to work very effectively, but there is a risk of tolerance developing, where the body requires a higher dose to achieve the same effect. Unless there is a requirement to use these medications for severe or disabling insomnia it is always a good idea to get some advice on a more holistic approach to improving sleep quality in the inital stages.

I always look at the patients overall lifestyle first, because many sleep problems occur due to a stressful and hectic lifestyle. I always like to first concentrate on the Adrenals which are heavily involved in our daily lifestyle today and treatment suggestions here are for this particular form of insomnia. The Adrenals are responsible for hormone production and regulation. One of the main hormones produced by the Adrenals is Cortisol. This is an essential hormone to the body and is useful as an anti-inflammatory, and is also released in stress situations where more glucose is released into the bloodstream. It is also useful to the body for fat , protein and carbohydrate metabolism. However in a stress situation, more cortisol is produced than is immediately required by the body, and this may have an influence on sleep quality.

I do often recommend that patients undertake a saliva test to measure the night-time hormone levels. This test is best done at 2am to measure melatonin levels and cortisol levels.

At this time of the day the cortisol levels should be low and melatonin levels should be high.( During the day, the cortisol should be elevated and melatonin decreased). If the level of this 2 am saliva test indicates an elevated cortisol reading and low melatonin level, I would definitely look at the Adrenals.

I would look initially at reducing the night-time cortisol and I often recommend which would be taken 2 hours before bed.(200-400mg) This has been trialled as being beneficial for. (This product is also useful for improving brain activity, with particularly good results being reported for memory improvement-which is a bonus)

Other preparations I recommend for this adrenal induced insomnia.

Melatonin: This used to be available for purchase but has been made a prescription medication. I consider this as being much safer than Zopiclone, without the dependency and tolerance dangers. This is naturally produced in the body by the pineal gland, but the amount produced tends to decrease with age. This has a huge role to play in the sleep cycle. There are fast release and time release forms of this available with prescription, and your GP would decide which form or dose is best for you.

Magnesium Citrate: This very valuable mineral is very useful to induce muscular and nervous system relaxation,at a dose of 200mg to 400mg before bed.

Pantothenic Acid:  This is very beneficial for the adrenals. This is a member of the B group vitamins, and is present in many B-Complex preparations.You need to look at a complex preparation with a higher level of this vitamin (B5).This needs to be taken in the morning.

5-HTP:  Hydroxytryptophan has an influence on the serotonin levels in the brain and can be used at night to induce relaxation. If you are on anti-depressant prescription meds,you need to talk to a Pharmacist about compatability, as it is not recommended for those on MAO inhibitors or SSRI drugs.

Withania (Ashwaganda):  This is an adaptogenic herb with many uses.It is particularly beneficial for stress induced insomnia and can be taken as a twice daily supplement in the morning and the evening.

L-Tyrosine: This is an amino acid useful for adrenal activity and neurotransmitter activity in the body and supports brain function.it is useful in stressful situations.

Vitamin C: Vitamin C levels in the body tend to decrease with stress, so it is a valuable supplement to be taken on a daily basis at a level of 500mg to 1200mg to restore body levels.

There are many causes of insomnia including pain and disease, but the most common form we encounter is stress induced insomnia due to the highly active lives people lead now.

Sleep is a routine procedure and you need to take steps to prepare your body for sleep.

(1) Regular daily exercise is recommended,but it is not a good idea to exercise vigorously in the evening as this may promote cortisol production and excite the body.

(2) Make sure that you get out in the sun periodically during he day, as sunlight through the eyes promotes production of melatonin.

(3) Avoid caffeine products such as coffee in the evening. It is better to have a relaxing herbal tea such as chamomile.

(4) Try not to have your main evening meal close to bedtime.

(5) A hot shower or bath before bed may help to relax muscles prior to sleep.

(6) Don't go to bed worrying about a problem....many therapists recommend that you write down any problems with suggested solutions before going to bed.

(7) Stretching then relaxing while lying in bed helps to loosen muscles.

(8) darkness stimulates melatonin production, so make sure that your bedroom is dark at night with no light sneaking in

(9) Avoid stimulation with computer screens,TV,cellphones etc before bed and relax by reading or doing some other relaxing activity before bed.

There are many other herbs which may be beneficial to help with sleep such as Valerian, Passion flower, Hops,Chamomile,Tart Cherry,Zizyphus,Skullcap and combination products such as sleep drops or rescue sleep.

(3/5, 46 votes) my rating:
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