As we have seen on the previous page about hormonal insufficiency and the circadian rhythm, insomnia can have a very damaging effect on a person's health over a period of weeks, months and years. If you have not read this page, please do so before reading on.
'In mammals and birds the measurement of eye movement during sleep is used to divide sleep into the two broad types of Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) or "Non-REM" sleep. Each type has a distinct set of associated physiological, neurological and psychological features.
Sleep proceeds in cycles of REM and the four stages of NREM, the order normally being:
Stages 1 -> 2 -> 3 -> 4 -> 3 -> 2 -> REM.
In humans this cycle is on average 90 to 110 minutes, with a greater amount of stages 3 and 4 early in the night and more REM later in the night. Each phase may have a distinct physiological function. Drugs such as sleeping pills and alcoholic beverages can suppress certain stages of sleep [i.e. more likely to have stage 1 shallow sleep, and less deep sleep and less REM sleep] (see Sleep deprivation). This can result in a sleep that exhibits loss of consciousness but does not fulfill its physiological functions. Allan Rechtschaffen and Anthony Kales originally outlined the criteria for identifying the stages of sleep in 1968. The American Academy of Sleep Medicine (AASM) updated the staging rules in 2007.
Criteria for REM sleep include not only rapid eye movements but also a rapid low voltage electroencephalogram EEG. In mammals, at least, low muscle tone is also seen. Most memorable dreaming occurs in this stage. NREM accounts for 75Ð80% of total sleep time in normal human adults. In NREM sleep, there is relatively little dreaming. Non-REM encompasses four stages; stages 1 and 2 are considered 'light sleep', and 3 and 4 'deep sleep' or slow-wave sleep, SWS. They are differentiated solely by using EEG, unlike REM sleep which is characterized by observable rapid eye movements and relative absence of muscle tone. In non-REM sleep there are often limb movements, and parasomnias such as sleepwalking may occur. A cyclical alternating pattern may sometimes be observed during a stage.
NREM consists of four stages according to the 2007 AASM standards:
- During Stage N1 the brain transitions from alpha waves (having a frequency of 8 to 13 Hz, common to people who are awake) to theta waves (with a frequency of 4 to 7 Hz). This stage is sometimes referred to as somnolence, or "drowsy sleep". Associated with the onset of sleep during N1 may be sudden twitches and hypnic jerks also known as positive myoclonus. Some people may also experience hypnagogic hallucinations during this stage, which can be troublesome to them. During N1 the subject loses some muscle tone and most conscious awareness of the external environment.
- Stage N2, is characterized by "sleep spindles" (12 to 16 Hz) and "K-complexes." During this stage, muscular activity as measured by electromyography (EMG) decreases and conscious awareness of the external environment disappears. This stage occupies 45 to 55% of total sleep.
- In Stage N3, the delta waves (0.5 to 4 Hz), also called delta rhythms, make up less than 50% of the total wave-patterns. This is considered part of deep or slow-wave sleep (SWS) and appears to function primarily as a transition into stage N4. This is the stage in which night terrors, bedwetting, sleepwalking and sleep-talking occur.
- In Stage N4, delta-waves make up more than 50% of the wave-patterns. Stages N3 and N4 are the deepest forms of sleep; N4 is effectively a deeper version of N3, in which the deep-sleep characteristics, such as delta-waves, are more pronounced. As of new AASM guidelines, the distinction between stage 3 and stage 4 sleep is inconsequential; both may be considered delta sleep or slow wave sleep. Therefore, in order to make the scoring guidelines more precise, a recent ruling by the AASM discontinued stage four sleep (N4) and left only stage N3 to describe delta sleep.
Both REM sleep and NREM sleep stages 3 and 4 are homeostatically driven; that is, a person or animal selectively deprived of one of these stages will rebound once uninhibited sleep is allowed. This finding suggests that both types of sleep are essential.
Sleep timing is controlled by the circadian clock, by homeostasis and, in humans, by willed behavior. The circadian clock, an inner time-keeping, temperature-fluctuating, enzyme-controlling device, works in tandem with adenosine, a neurotransmitter which inhibits many of the bodily processes that are associated with wakefulness. Adenosine is created over the course of the day; high levels of adenosine lead to sleepiness. In diurnal animals, sleepiness occurs as the circadian element causes the release of the hormone melatonin and a gradual decrease in core body temperature. The timing is affected by one's chronotype. It is the circadian rhythm which determines the ideal timing of a correctly structured and restorative sleep episode.
Homeostatic sleep propensity, the need for sleep as a function of the amount of time elapsed since the last adequate sleep episode, is also important and must be balanced against the circadian element for satisfactory sleep. Along with corresponding messages from the circadian clock, this tells the body it needs to sleep. Sleep offset, awakening, is primarily determined by circadian rhythm. A normal person who regularly awakens at an early hour will generally not be able to sleep much later than the person's normal waking time, even if moderately sleep deprived.
Clearly the ideal and healthiest type of sleep a person can have is to sleep very deeply, and not be woken by sounds or by the need to urinate. Even when the bladder is full, this should not interrupt the ideal night's sleep. Upon waking, one may or may not need to urinate a large amount. Clearly any deviation from this reflects worse sleep quality, for example waking once during the night to urinate, and either shallow sleep or shorter periods of deep, regenerative sleep, perhaps reflecting minor hormonal or mineral/vitamin deficiencies.
In the USA, in a 2002 survey, approximately 58% of adults exhibited symptoms of insomnia a few nights a week or more. With CFS patients, this is more chronic, but the root problems of insomnia are present in much of the population, to perhaps a lesser extent.
Insomnia varies from person to person, but in general, those suffering from CFS may well have no serious problems getting to sleep, but the act of staying asleep all night is nearly impossible. A common pattern is to wake up after 2 or 3 hours, after which subsequent blocks of 1-2 hours sleep are harder to achieve. A pattern of waking up every hour may well occur during the night or in severe cases, after the intial block of sleep, the person is completely unable to get back to sleep again. This is usually a result of a drop in melatonin levels during the night. Because of low melatonin levels and too high stress hormone levels in the body during the night, the slightest amount of urine in the bladder may be enough to wake the person from sleep, even if it is not necessary to urinate yet. If a person has had too much stress or overdone things during the day, the body may well not stop producing cortisol and other stress hormones and prevent the person from getting any sleep whatsoever that night or until the early hours of the morning.
Sleep is a biological necessity and we do much of our bodily repair and mitochondrial recovery during deep sleep. If one is not sleeping well, one can take as many supplements as one wants, but is unlikely to see significant progress until one starts to get at least some level of regular sleep each night, and perhaps daytime naps to supplement this if necessary.
As well as the lack of serotonin and inability to relax at night, and the underproduction of melatonin and the over production of cortisol during the night, the lack of water retention can also be problematic, waking the person at regular intervals during the night to urinate.
Magnesium and P5P deficiencies are also contributary factors, and supplementing these nutrients in the diet can assist in restoring proper sleep in the medium term. Also, stimulating the endocrine system as discussed on the previous page will help to restore normal sleeping patterns and energy and ability to cope with stress during the day.
Taking a 5-HTP, L-Theanine and/or a Melatonin supplement may greatly help your sleeping pattern and help you to stay asleep, or at least get back to sleep quickly if you wake up. 5-HTP is the body's natural precursor to seratonin. Between 50mg and 400mg of 5-HTP may help. The dosage depends on the body's deficiency of serotonin and also ability to convert 5-HTP to serotonin.
Melatonin is the hormone that causes a person to feel tired and fall asleep and stay asleep. 3mg to 9mg of Melatonin may also be useful. Some people only require 1mg or a fraction of an mg, so start off with a very low dose and build up slowly and carefully. Both supplements are best taken 1-2 hours before going to bed. For those who cannot get back to sleep at all after waking up the first time, additional doses of melatonin and 5-HTP during the night may help the person get back to sleep again. For example, perhaps taking 3mg to 6mg of Melatonin and 100mg of 5-HTP every 3-4 hours. Alternatively you may wish to try a slow release or sustained release melatonin supplement, like Jarrow Formulas Melatonin Sustain. Or perhaps take one regular melatonin supplement and one sustained release melatonin supplement when going to bed (perhaps together with the 5-HTP and/or L-Theanine), so that some melatonin is immediately available and the rest will become available during the night. Of course some sustained release tablets have a two stage release system already so perhaps there is no need to do this. There are other permutations and options. Be careful however if you are already taking sleep pills and consult your doctor to ensure that there are no contraindications with mixing both. You may wish to try to phase out your sleeping pills and phase in non-habit forming and less harmful alteratives, as mentioned above, and see what happens. Experiment yourself and take a note of your normal pattern of sleep/waking cycles, and at what time you feel you cannot easily get back to sleep, taking the minimum additional melatonin and 5-HTP necessary to do the job and get you back to sleep again.
One should be very careful regarding the dosages of melatonin and serotonin. Please see the Neurotransmitter Supplementation section of the Adrenal page for more information.
Remember that not all supplements are alike in their quality and effectiveness for you. Ideally your consultant would establish which brand works best for you kinesiologically. Otherwise, you could try a reputable brand such as Vital Nutrients. There are slow-release Melatonin supplements, which may help, but my experience is that they still don't provide sufficient Melatonin throughout the entire night.
Melatonin, L-Theanine and 5-HTP are not miracle cures for sleep, they are symptom alleviators, and will assist you to get to sleep and stay asleep for longer, and increase your ability to get back to sleep. They will not 'cure' the underlying conditions that cause your insomnia. They are merely safely plugging holes in the body's underproduction of specific hormones. To cure the endocrine problems that cause insomnia, you have to actively stimulate the endocrine system and overcome one's nutritional element and vitamin deficiencies. This is examined in on the previous page.
I have myself noticed that on some nights when I am very tired, I forget to take any Melatonin or 5-HTP, and sleep just like normal, whereas on other nights when I have deliberately not taken these sleep aids, have not managed to fall sleep at all. Whilst there are different factors at play on each occasion, and it is hard to notice a definite pattern, this may be something you wish to experiment with, to ascertain whether you really do need to take these or not; and if so, when.
Please note that an adaptogenic herb or adrenal supplement taken during the morning and/or early afternoon each day may help to regulate the production of adrenal/stress hormones so that more are produced as and when required during the day, so that they are not still being produced at night when one wants to be asleep. As well as giving the person more energy, such herbs or supplements can also ensure better sleep.
A number of herbs can be taken prior to going to bed to assist in falling asleep, as they can promote relaxation. Such herbs include Valerian (Valeriana officinalis) root extract, Passionflower (Passiflora incarnata) leaf and flow extract, Hops (Humulus lupulus) flower extract, wild lettuce (lactuca virosa) leaf extract (found in some adrenal supplements also) and Jamaican Dogwood (Piscidia piscipula) root extract etc. Products may include Enzymatic Therapy (Fatigued to Fantastic)'s Revitalizing Sleep Formula or the common product Kalms (which also contains sugar!) I have used such formulations in the past, and whilst they indeed did help with relaxation and better quality of sleep, being herbs, they also have energetic qualities (c/f TCM, hot and cold energy), and as a result, when used regularly for months or years, may severely upset the body's energetic system. I personally felt like I had a constant background sense of malaise, like a 'wall' of some kind, and this disappeared immediately he stopped taking Kalms (having taken them continuously for 2-3 years or so). So whilst herbs can help, they should not be used for extended periods in BlackSpy's opinion.
Other than the biochemical problems highlighted above, there are a number of free of charge things that a person suffering from sleep disorders can do to assist his or her condition. These are listed below. Try them and see what works for you.
Get up earlier in the morning, at a regular time each day. Staying in bed as long as possible when one is not sleeping is not necessarily helpful, and it is more psychological, that a person is exhausted and feels awful and that getting up means pain in the short term. It is more about motivation. Getting up at a different time each day is not helpful for one's body clock and sleeping pattern.
Try to go to bed slightly earlier. Practitioners of Traditional Chinese Medicine (TCM) recommend going to bed between 9 and 11pm if one is chronically ill, as it is tied into the body clock and the time at which qi passes through the various organs over a 24 hour period. Going to bed much after 11pm may result in expending one's qi for the next day.
Scientists have found that those individuals who wake up too early and go to bed too early in the evening may assist a return to a slightly later cycle by wearing sunglasses in the mornings, and getting more of their daylight/artificial light in the latter part of the day; conversely those who have problems getting up and are up too late in the evening/early hours of the morning should restrict the amount of light they have in the latter half of their day, i.e. be in darker surroundings.
Sleep Restriction. This is a a variant of the above. It involves making the body tired enough that it falls into a new sleeping pattern. This could be achieved partly through getting up earlier consistently (as mentioned above). This technique works on the basis that those suffering from insomnia spend a large amount of time in bed each night, but only a small portion of it is actually spent sleeping. Increasing the time spent in bed will mostly likely not yield any positive results but disrupt one's sleeping cycle further. So the idea is to reduce the amount of time you spend in bed, so that more of that time is spent being asleep, as the body is more tired. This involves sticking to a regime for one month, where one goes to bed and gets up at exactly the same time every day, and is in bed for no more than 6 hours a night, regardless of whether one has slept or not. During the month, patients may usually feel like total wrecks for the first few days but gradually they spend more and more time asleep during that 6 hours. Daytime napping is forbidden as are lie ins. CFS patients may find this solution a little 'rough', as it may impact energy levels adversely, and they may rely on napping to get through the day. One may wish to meditate or similar during the day, perhaps, to alleviate this problem. Or perhaps experiment with an 8 hour variant of the above (as opposed to 6 hour) for example.
A technique for reprogramming or resetting one's body clock is fasting. After 16 hours of fasting, the body's body clock is said to be overridden by one's food clock. This after this time, if one eats the correct type of meal for the time of day, according to what one usually eats or consumes, then this will suppress the body's desire to sleep and override it. This technique is generally used for those wanting to avoid excessive jet lag, and when riding on long haul flights, the subjects in question will avoid eating any food on the flight, avoid all caffeine on the flight, and indeed alcohol (both of which dehydrate a person anyway and are more likely to contribute to frequent toilet visits and an increased risk of deep vein thrombosis). Many people complain about airline food in any case! The idea is that you have your next meal when arriving at your destination at the next meal time, be that breakfast or lunch, rather than simply eating when you land if it is in between meal times (e.g. 11am or 3pm). This overriding of the body clock will result in the sleep clock perceiving it is that local time and the body clock should better adjust. You are likely to feel much better and get to sleep the next night in addition. This technique seems to work going both ways around the world (gaining AND losing time). It may not be so practical for CFS patients travelling on long haul flights as they may feel faint and having to carry luggage and all the logistics with slightly lower blood sugar levels may result in overstretching oneself. Use your commmon sense. If we apply this technique to CFS patients who are not travelling but merely have a disrupted sleeping pattern (maybe with night and day reversed), then a (preferably) 16 hour fast and getting up at the correct time and eating the next meal at the right time may help to reset a sleeping pattern.
Day time napping. There are two schools of thought on this. Some find it very beneficial, and indeed practitioners of Traditional Chinese Medicine recommend a 30 minute or 1 hour nap during the afternoon every day for the elderly or those with chronic illnesses. It may also assist the adrenal glands. The best time for a nap is between 2pm and 5pm. Try to avoid napping before or after this time. CFS patients, depending on the severity and nature of their condition, may wish to take a slightly longer nap. Those that are against the idea of daytime napping say that it gives one more energy during the afternoon and evening, but at the expense of being able to fall asleep in the evening so easily or staying asleep for as long during the night. However, some people cannot function very well without a daytime nap or at least meditating during the afternoon. The human body's energy levels are known to be lowest some time in the early or mid afternoon, as it is genetically programmed into our body clock. Try both methods and see which works best for you. It may require a large amount of self-discipline to get out of whatever habit one has fallen into.
Avoid activities that stimulate the mind and body too much in the final hour or two before going to bed. This includes television, exercise, studying, working, reading stimulating or disturbing news stories, stressful situations, energetic music, looking at exciting pictures (!) and so on. The body is most accommodating for physical exercise during mid to late afternoon and early evening. Early evening may be the best time for the body clock for sex, rather than last thing at night (or around midnight or 1am as many couples tend to do because of 'normal' routines - which are abnormal for the body). Avoid exercise late at night if at all possible.
Avoid bright lights in the evening and when leaving the bedroom during the night to drink a glass of water or urinate (being careful of course!) Switching on the bathroom light when going for a pee in the night will reduce your melatonin production and cause you to wake up. You may also 'hear' blood rushing through your ears too, as the circulation shifts from the core out to the extremities. If you are going to pee or do a 'dump' during the night, then whilst on the toilet or otherwise, it is best to keep one's eyes closed for as much as this time as is possible or practical (without having an accident), as the more one's eyes are open, the more one tends to wake up. Similarly, one's bedroom should be as dark as possible throughout the night and until the time you are to rise for the day. This can be achieved with blackout blinds fitted to your bedroom windows (as featured in some hotels); or wearing a pair of eye shades (less comfortable and efficient (as light comes in through the corners) but cheaper. If you routinely sleep on your side, you may find the elastic of the eye shades reduces the circulation around the tissues on the outside of the cranium, and that over time may become painful. This is not a consequence of the tightness of the elastic band so much as the fact that you are lying on it and pressing it into the side of your head. I myself had a lump form on the back of the head as a result of this and also had pain on the side of the head. This may be mitigated somewhat by pulling the elastic up onto the top of the back of the head so that it is not immediately behind or above your ears. Also a padded eyeshade may be ideal for sleeping on your back or for plane journeys, but not for sleeping on your side as the padding pushes against your temples area.
It may help to use lower wattage bulbs to light your house in the evening, and slowly wind down the strength of light, if this is practical. It is often tempting to install 100W light bulbs or their equivalent in every room, to have the maximum amount of light possible. However, in certain rooms, like the bathroom or bedroom, or the hall just outside your bedroom, you may want to consider whether you really want 100W or even 60W. 40W or equivalent may provide sufficient light whilst providing the minimum of a shock to the system when switched on in the dark, or when used in the evening, when one's eyes have adjusted to slightly darker surroundings. It ultimately depends on your routine, and you may want to experiment or consider your options.
You may have noticed that you tend to wake up more readily in the summer when dawn comes earlier, and that it is harder to get back to sleep when it is light. Similarly, it is harder to get to sleep at night when it is still light. Bright lights, particularly blue/white light (similar to the colours in morning daylight) are shown to stimulate certain receptors at the back of the retina, which signal the pineal gland to stop producing melatonin. Some people use a bright white and blue desk light in the early morning (if getting up whilst it is still dark) in order to help wake them up properly in the morning, whilst eating breakfast for example. e.g. Philips goLITE BLU. Other options include blue tinted sunglasses, 'jet lag glasses', a blue'moodhalo' light (a blue light on the end of a baseball cap) or using a Blue SAD light. Indeed CFS sufferers or those that suffer from sleep disorder problems may benefit also from exposure to more daylight upon rising or specifically blue light, which seems to be the wavelength that stimulates the Pineal Gland the most to stop melatonin production. Feeling more awake in the morning may well help to get one asleep at night better.
Another option is a mind machine product that is able to produce a variety of different coloured light from the LEDs in the eye pieces. These also provide binaural beats. Such devices can be beneficial in energising oneself in the morning and for relaxation in the evening, depending on the programme selected. It should be noted that certain programmes (focussing on stimulating and entraining Beta waves) may not be suitable for CFS patients, or those with excessively high adrenaline levels already, as it may exaccerbate this problem. Although mind machines tend to have sleep or delta wave stimulating programmes, one may argue that they use flashing LEDs next to the eyes (albeit with the eyes closed), and so are not really best suited for pre-sleep programmes, and one may instead elect to listen to a binaural beats CD focussing on delta frequencies instead, in a dark room, as the less light one has the better. However the overriding effect seems to be one of sleep induction for Delta-based programmes on mind machines in general - although it may be wise not to set the LEDs too bright. On a low setting, less light probably enters the eye than it would with the eyes closed in daylight or standing near a light source. Clearly certain programmes are more suitable than others for assisting with insomnia, and some may make it worse (depending on what types of brainwave frequencies you are looking to entrain)! You may wish to experiment with this.
Try taking a hot shower or short bath a hour before going to bed; or alternatively having a warm foot bath. The idea behind this is that the body's core temperature naturally drops at the point of falling asleep. So by warming yourself up (by taking a shower or bath) and then allowing your body to cool down in the hour or so afterwards (i.e. internal temperature drop by one degree Centigrade), this action can mimmick the trigger for falling asleep, and can fool your body into thinking it should be going to sleep. Of course, not everyone can tolerate hot showers or even baths at night at it wakes them up too much. Try it and see if it helps.
Try breathing exercises, meditation, tai chi, yoga, or anything else that will help you relax. Insomniacs are usually the victims of long term stress, so attempts to reduce stress will help the person to sleep and stay asleep.
If your CO2 levels rise too much when you are in the supine or horizontal position, which may result from too shallow breathing, from sleep apnea, or from poor oxygen and carbon dioxide diffusion in the supine position, then this may interfere with your sleep, causing you to wake up or turn your head frequently. Elevated CO2 levels in the blood trigger the breathing instinct, and as you are already breathing, this may interrupt you from whichever part of the sleep cycle you are in. Supplemental oxygen in such cases may help whilst in bed, for example, the use of an Oxygen Concentrator with nasal cannula.
Try to release muscle tension in the body. Muscle tension can increase stress levels and prevent one's ability to relax properly and indeed sleep properly. Skeletal problems and/or muscular tension is often a factor in disrupted sleeping patterns. See the skeletal page for further information on problems and possible treatments. Please see also the Stress Management page for other exercises to reduce stress, such as the Progressive Muscle Relaxation Therapy. This involves tensing a certain muscle group or muscle area in the body for a few seconds, then releasing and relaxing it, then moving onto the next body part, until one has gone over all the muscles of the body, including the face, pectorals, neck, throat, toes etc. It is reputed to be an excellent tool for relaxation and can be performed prior to taking a nap or prior to going to sleep (depending on how sensitive one is to such exercise). It may take up to 20 minutes. Do not rush the exercise as it may cause stress or become exhausting (particularly if your mitochondrial function is very poor). If your mitochondrial function is very poor, then you may want to make sure you rest a few minutes in between each exertion (for example), and perhaps as mentioned further above, make sure you perform the exercise earlier in the evening (as too much exertion close to going to bed may prevent you getting to sleep). Some people fall asleep immediately after performing this exercise.
Try to adopt a correct sleeping posture, i.e. spinal and neck alignment. The spine and neck should be straight and not bent or twisted. Sleeping on one's side requires a thicker pillow than when one is sleeping on one's back. When sleeping on one's side one should be perpendicular to the bed and not tilted towards the bed. , and also the posture section for tips on correct sleeping posture. A memory foam mattress, such as Tempur, may also help in your ability to stay asleep.
If your kidney area or back tend to get cold at night, it will stop you falling asleep. This tends to affect some people with low adrenal function. Try putting a pillow on your back when you are lieing on your side to keep the area warm.
Try magnetic products and/or complementary energetic therapy treatments that will boost your endocrine system, as outlined on the energetic therapies page and the electromagnetic therapies page. Of particular benefit is the water ionising system by BioPro called I-Water.
Try to resolve your personal affairs so you do not wake in the night trying to think of solutions to problems or about uncomfortable situations, especially those where you have had assertiveness issues etc. and are critical of your own performance or ways of handling situations. Tell yourself you are not responsible for various problems in your life so you can relax. If you feel you have to convince people of your views in various areas of life, or you are trying to save the world, or you want to finish every task in your house, or you have to resolve an ongoing work task before you can relax, or other compulsive perfectionistic self-torture strategy, then this may cause you a great deal of anxiety and thoughts relating to this strategy keep running through your mind all day and all night! A similar psychological technique is part of EFT (Emotional Freedom Technique) which incorporates some physical massage too. If you are the type of person who thinks of tasks whilst in bed, or during the early hours when waking up, keep a notepad and pen next ot the bed so you can scribble these down for attention in the morning and thus forget about them. Otherwise you may be trying to make yourself remember them, and this can result in you focussing your attention on them rather than just forgetting them immediately. Alternatively, they may not be that important, and you should try to let them simply go and ignore them.
Perhaps try reading a book of a spiritual or religious nature in the mid to late evening, if just for a while. This may help to deeply relax and calm you.
If you are having nightmares that wake you up, featuring your 'shadow' in the Jungian sense, you may want to get to grips with the psychological issues that are troubling you, or what the shadow is trying to tell you (i.e. valuable feedback from the subconscious that comes out in dreams to 'haunt you', so that you have more enjoyable and peaceful dreams where you are being more yourself rather than a tortured and unhappy soul. This will help you during the waking hours in terms of your wellbeing and self-esteem as well as during your dreamtime and REM sleep.
Ensure your feet do not get cold in bed. Your circulation to extremities may well be poor. Try wearing a thin pair of socks to sleep. Wearing anything else is optional! Conversely, make sure your feet don't become too hot either, as this may stop you getting to sleep also.
If you are temperature sensitive, in other words, you cannot get to sleep or stay asleep if you are slightly too hot or too cold, then you may need to use a low Tog rating duvet and use a series of duvet covers, sheets or throws over the top, which you can remove or add back easily during the night. For example, night time temperatures may vary from day to day or week to week. This is increasingly the case with mild winters and strange weather patterns. The temperature usually drops during the early hours of the morning. It may help if you don't heat your bedroom very much, so the temperature remains as constant as possible. You may find that the outermost side of your body starts to feel a little cooler, when it is time to put on an extra layer/duvet cover to feel warm enough to get to sleep. Depending on when you last ate, and what you have been doing during the day, your metabolism and endocrine system may be slightly different and thus and body temperature may be higher, meaning you need less layers on during the first half of the night. Temperatures tend to drop most during the night around 4 or 5am before the sun comes up again. It is best to figure out what works best for you, and ensure you can be adaptable. You may also find having a spare pillow handy that you can have on top of your head (when sleeping on your side!) is useful if your head feels cold (especially if you have a ridiculously short hair cut!) I have personally found that simply having one big thick duvet for a specific season may result in being too hot to sleep some nights. You can't remove 5% or 10% of the insulation if you just have one cover! For example, let's imagine you are buying a second hand car from a private seller. You have already seen the car and put down a deposit. You have come back the following week to pay the outstanding balance, sign a bill of sale, see the registration document filled out in your name and posted off, and drive off with your car. However, if you turn up to the seller's house or work with a banker's draft for the full amount, then you are reducing your options if something does not go according to plan. For example, if the car has gained a new dent, scratch or excessive mileage since you paid the deposit, you will feel really annoyed if you have no option but to give the seller the banker's draft you've just paid for, which is written out in his name for the given amount. However, if you turn up with a banker's draft which is £500 short, and have the remainder in cash, then you have the flexibility to haggle on the price if anything has changed since you last visit. That is essentially what we are describing above with regards to sleeping!
Remove clutter from your bedroom. Try to keep your bedroom tidy, and a restful place. Like a sanctuary for you. Having a clutter free house also helps to calm the mind and keep mental clarity and focus. The bedroom is for sleeping only. It is not a late evening/night recreational area. Your brain should be trained to associate being there with sleep, and fall asleep as soon as it enters the bedroom and you get into bed.
Try to reduce activities in the bedroom (!) except sleeping. The bedroom should be a place your mind associates with sleeping, not reading, watching television, eating sweets, drinking cocoa, having sex, drinking coffee, eating breakfast, smoking drugs, etc. In experiements, Pavlova's dogs had a bell rung everytime it was time to be fed. Pretty soon, whenever the bell was rung, at any time of day, they would start salivating. You cannot then ring the bell and expect the dogs not to think about food! The same principle applies here. Do all these activities somewhere else (apart from sweets and cocoa of course)!
Try gentle exercise like walking during the day, within your limits. Try to work on your cardiovascular fitness and make exercise a regular part of your week. Stretch regularly, within your limits. Avoid exercise or stretching late in the evening however.
If you have problems breathing through your nose, it may assist your sleeping to wear a nose bridge.
Wear earplugs to bed if you live in a noisy area or are disturbed during the night by louts or traffic. Good sources of earplugs include Howard Leight Laser Lite (best compromise of comfort and protection) and E.A.R. FX (greatest protection but may hurt your ears after a few nights consecutive use). Try whichever works best for you. A good seal is important, so ear wax or vaseline etc helps. You may need to trim the ear plugs with a pair of sharp scissors if you sleep on your side, so that the ear plugs do not stick into your ear drum. Make sure you do not trim them too much to facilitate removing them! Don't keep re-using them as it may give you an ear infection! You may find if you urinate during the night that the sound of the flush may wake you up slightly, or if you have a noisy boiler set to start in the early hours, that you might wish to set it to start a little later, so it does not interrupt the best part of your sleep in the early morning.
The following foods are high in Tryptophan: milk, eggs, meat, nuts, beans, fish, and cheese. Cheddar, Gruyere, and Swiss cheese are particularly rich in tryptophan. Consuming a glass of warm milk (if your stomach can tolerate it) prior to bedtime may assist in increasing serotonin levels, which may help you to relax and get to sleep.
You may find a long-lasting antioxidant supplement beneficial to take in the late evening or before going to bed, e.g. Fibroboost or SGS. This may help to keep down inflammation levels if present and improve quality of sleep if free radical inflammation is an issue for you.
Avoid drinking alcohol, caffeine and taking nicotene or recreational drugs. They will inhibit some phases of sleep in the most of the sleep cycles during the night, meaning one mainly has shallow sleep (not very regenerating). They will interfere with your body's natural biochemistry and endocrine system, and as they wear off will change the hormonal balance in your body. Factor in an already dysfunctional endocrine system into the equation. It is a bit like taking a slightly confused person, then deliberately confusing them again with contradictions, then spinning them around several times, then expecting him to correctly answer a question. Do not rely on any of these substances to relax your mind or to help you sleep. It is best to avoid such substances completely for a variety of other reasons. Address your sources of stress and try some meditation or other relaxing exercise described above!
Avoid sleeping pills as many do not promote a restful deep sleep. All are bad for the body, especially liver, and interfere with the endocrine system. They are also habit forming and psychologically and often physically addictive.
A number of herbs can be taken prior to going to bed to assist in falling asleep, as they can promote relaxation (in tincture form, in tea form, in capsule form). The smell as well as the chemical action of these herbs may assist in relaxation and better quality of sleep. These herbs may have hot or cold properties and disrupt one's qi balance with long term usage however. Helpful herbs include:
Avoid drinking excessive amounts of water or other liquids late in the evening. Try to drink most of the water you need during the day if possible. This way you won't be woken up by a half-full or full bladder during the night. Waking up because of a semi-full bladder is probably a sign of sleeping in light sleep only, but staying asleep in light sleep is better than having it interrupted to go up and urinate.
If you are prone to urinating during the night, then always urine shortly before retiring for the night, so you are likely to wake up later to urinate (rather than earlier), and hopefully not at all. This is probably rather obvious to you however.
If you feel like there is any excrement you could 'squeeze' out in the late evening or before going to bed, it is probaby wise to go to the toilet and take a 'dump'. This will make you feel more relaxed and there will be less re-aborption of toxins. It is easier to fall asleep when there is little or no excrement in the sigmoid colon, and conversely more difficult if there is. You will get no prizes for holding it in.
If you have a number of tasks that you feel you need to perform, like a ritual, before you go to bed each night, then try to get most of these out of the way earlier so your mind is not on them during the later evening and you can properly relax before going to bed. If necessary, re-evaluate your nightly ritual to see what is really not necessary and make it simpler, so you feel more 'free'.
Try not wearing a watch as you will be too concerned with the time when you wake during the night and will not relax/detach as much. If you go to the bathroom once or more during the night, you may fall into a habit of waiting for certain amounts of time have gone by before you go, or determine whether it is worth getting up to go to the toilet if it is within an hour or so of getting up anyway. Such thoughts are not helpful. If you are regularly scanning what the time is, or are addicted to knowing what the time is all the time, it will prevent you from fully relaxing and letting go, and immersing yourself in the experience of whatever you are doing, be in sleeping, lying in bed, or even resting during the day. This is discussed on Stress Management page, as self-scanning and addictive thought patterns are considered to be as bad as negative thoughts. Whatever the time is is quite irrelevant as knowing it will not help you achieve what you want to achieve in terms of relaxation or getting to sleep. You cannot 'rush' falling asleep as you are aware of what the time is. If a large amount of time has passed whilst you have been resting in bed without being fully asleep, then this is likely a positive rather than a negative as it means you were probably half asleep or getting rest in some form anyway. Try not to have a clock right next to your bed but sufficiently far away so you can't read it - this depends on how good your eyesight is of course! Try to forget about getting up until you actually hear your alarm clock go off. You may find it helpful to use a special kind of alarm clock that has a gradually increasing volume of bird song or similar and produces a gradually increasing light rather than an alarming bell sound, so it gently brings you out of your sleep state rather than yanking you out of it violently so you're first thoughts of the day aren't of alarm and shock! The downside of this is that your brain will be listening out for a bird song and if you do indeed hear birds singing outside your window, you may wake yourself up as you mistakenly think it might be time to get up. Or you start to focus on the time. An alternative to using an alarm clock is a quartz wrist watch with a vibrating alarm. This way you are not conditioning yourself to listen out for noises at all, and so if you are disturbed with loud noises outside or inside your house/flat, then you have not conditioned yourself to wake up in such circumstances. If you hear a noise you will not be asking yourself whether it is time to get up or not. The advantage of such watches is that they are pretty much guaranteed to wake you up, and also you can take them whilst travelling and keep clutter to a minimum; and they can be used for reminders during the day, e.g. a task or taking a supplement etc. Such watches include the Casio A220W-1QY, the Casio G-Shock G-7500-1VER, Casio G-Shock GW-400J (Tough Solar (powered), Radio Controlled - in Japan and USA only), Tissot Silen-T, Almeda Time Multi Alarm Watch, Timex Expedition T-41741 or the MTM Military Ops Silencer (rechargeable), etc. If you do need to check the watch during the night for whatever reason, then bear in mind that luminous analogue hands are preferable, as a backlit digital display may dazzle you and wake you up! The battery on a vibrating alarm watch is unlikely to last longer than 5 months before it needs replacing, which is why solar or rechargeable is preferable. You may not need to actually wear the alarm clock, as having it on the beside cabinet may be enough (in audible and vibration terms). Experiment and see what suits you best and how useful a strategy it is to staying relaxed during the night.
Try to avoid having any expectations about your night's sleep and avoid winding yourself up and getting frustrated if you cannot get back to sleep or what time it is as it gets later and later and what you 'should' have been doing by now (i.e. sleeping). Stop worrying about how you will feel in the morning and coping with the next day. Simply accept your 'fate', resign yourself to not sleeping or whatever the outcome may be, and simply 'go with the flow'. This is easier said than done, but it will become much easier with time. Just try to appreciate the time you have to lie there and do nothing. It really isn't a big deal! Use whatever psychological strategy works for you. If you firmly believe that the act of resting and lying in bed will rest and regenerate the body, and will be just as restful as being asleep, then this will help also to remove this expectation. There will be no emotional reaction to where you are at that given moment in time. Entertaining negative emotions based on your perceived 'performance' in the bedroom (getting to sleep, not sexual!!) serves no purpose and serves to reinforce the negative pattern of insomnia. It reduces your ability to reach those Theta and Delta wave states that you want to be in to fall asleep, and reinforces the more stressful 'fight or flight' mind states that are not compatible with falling asleep or sleeping whatsoever. Any sleep you get on any night is a bonus. If you think of all the times in the day when you would like to simply step back from everything and enjoy some quiet time in bed, then try to adopt the same attitude to being in bed at night when you are not sleeping. Try to enjoy it!
If you are especially worn out in a mitochondrial sense, rather than sleep cycle sense, late in the evening, it may well be a good idea to take some extra ad hoc mitochondrial supplements so that the body can function properly, and thus allow you to fall asleep. Otherwise you may find your biochemistry is too chaotic to promote the correct neurotransmitter production pathways for sleep. Try experimenting if this is something that affects you to see what works best for you. I have found Lipoic Acid (particularly), and also Acetyl-L-Carnitine, Coenzyme Q10 and NAD(H) all very useful. A small amount of Lipoic acid in the late evening may considerably reduce the need for the other mitochondrial supplements during the night, if this is in short supply in the body. For more information on mitochondrial function please refer to the Mitochondrial Dysfunction page.
Adaptogenic herbs and adrenal supplements, when taken in correct dosage (if actually required), often help in maintaining one's energy levels, a general feeling of calm and relaxation (better ability to cope with stress) and better sleep at night. An adrenal supplement may however not be necessary in your particular case, it depends on what the body needs at a particular point in time and what is happening in the endocrine system. If you are taking supplements to stimulate your adrenal glands, make sure that you do not take any such supplements after mid-afternoon. Also experiment with the dosage, as if you are taking too many per day, then you will find that you cannot get to sleep at all at night. Reducing the dosage should resolve this problem. The same applies to supplemental forms of certain neurotransmitters, such as GABA. This may be beneficial in those individuals with a chronic deficit in GABA production, during the day, but some individuals may not tolerate it so well at night (i.e. it may wake a person up, altering the brain chemistry and stimulating other neurotransmitter production, which is not what is desired in the late evening as the body should be preparing for sleep). Too much GABA in addition may exaccerbate this effect. Persons in this position may wish to take less GABA at night, or none at all, and perhaps substitute it for L-Theanine (or not at all), a precursor to GABA and also Serotonin, which may not produce so much GABA at night. Too much NADH (Active vitamin B3 - the mitochondrial supplement) taken during the day may also have a similar effect (i.e. badly affecting one's sleep). Reducing the dosage slightly should alleviate the problem.
Avoid taking Acetyl-L-Carnitine, the mitochondrial and brain chemistry supplement, too late in the evening (if you are taking it), as this may stimulate excessive neurite emission from the neurons in the brain, overstimulating the brain at a time when it should be gearing up for sleep.
Avoid spicy food (in general) especially in the evening.
Avoid big meals in the evening or eating foods that are very hard to digest. Avoid eating too late in the evening. A full stomach will make getting to sleep more difficult. You probably don't want to be in bed feeling hungry, but neither do you want to be feeling full either. If your stomach feels uncomfortable during the night, when you have woken up, then you may elect to take some additional Betaine HCl capsules to aid digestion and enable you to more readily sleep. Please see the digestion page for more information. Be careful not to take too much, as heartburn is uncomfortable and will require you to get up and take something to reduce the heartburn - which isn't going to do your ability to get back to sleep any good.
If you are taking amino acid supplements, then their natural acidity will help your digestion but lowering the stomach contents pH and compensating for a lack of stomach acid - meaning you may not need to take so much Betaine HCl. Conversely, if you are taking amino acid supplements, e.g. 5-HTP, Melatonin and/or L-Theanine, before going to bed or during the night, bear in mind they are slightly acidic, and may cause heartburn. If you do experience this, you can mitigate the acidity by taking a chelated Magnesium supplement or some Chlorella tablets with it. If you do take these supplements during the night (e.g. in the early hours of the morning), then you may find that you don't need any Magnesium or Chlorella with them, as by this time the stomach acid levels have lowered slightly anyway (your dinner still digesting perhaps).
Eat a carbohydrate meal for dinner (with 4 hours of going to bed). This has been shown to promote the increased release of insulin, which may allow more tryptophan to cross the blood brain barrier and be converted into serotonin (and onwards to melatonin to some extent) which will promote the ability to fall asleep. Protein meals may release more amino acids in general into the blood stream, including trypophan, but the net result may be less insulin release and less tryptophan entering the brain. Of course, there are a number of considerations regarding carbohydrates. Ideally they would be complex carbohydrates rather than simple carbohydrates so as not to adversely affect one's gut flora and stimulate candida growth. Also one's weight may also be an issue if eating regular and large amounts of simple or even complex carbohydrates. One other consideration is that eating one's carbohydrates in the evening is counter-intuitive as far as food combining theory goes. According to food combining, one should build up one's meals during the day (content-wise rather than size-wise) and eating a heavy protein meal for dinner (rather than earlier in the day) as it is harder to digest. However, if one eats a carbohydrate meal for dinner, then this would presumably means one eats a protein-rich meal for dinner, which is the other way around. Presumably eating carbohydrate meals for dinner is not something one would do every day (and hence not one's primary tool for getting to sleep)? Or? Food for thought (pun possibly intended).