Sleep

All about sleep.
Suggestions for falling asleep quickly.
Here is a summary of sleep aids from WebMD. Here is another summary from Healthline.
Dr. Hansen’s advice on sleep (good).
Dr. Brad Stanfield’s advice on sleep (also good).

Valerian might help with sleep, but studies have been inconsistent.

Research has shown that maintaining sufficient levels of Vitamin B3 (niacin) will help with sleep via prostaglandin. Here are dietary sources of niacin.
Vitamin B5 deficiency is rare, but may include symptoms such as fatigue, insomnia, depression, irritability, vomiting, stomach pains, burning feet, and upper respiratory infections.

A lack of Vitamin B6 has been linked to symptoms of insomnia and depression. Vitamin B6 aids in the production of the hormones serotonin and melatonin, both of which are important to sound, restful sleep, and also to mood.
Two weeks of cyanocobalamin supplementation (3mg/day) resulted in the expected increase in serum vitamin B12 levels in healthy adults but did not influence their sleep wake activity.

The hazards of sleep deprivation

.This is what chronic insufficient sleep does to you. A new study shows that sleep deprivation and poor sleep quality are associated with a decreased desire to help others. There’s a link between poor sleep and certain negative health outcomes(opens in new tab) — type 2 diabetes, cardiovascular disease, obesity and depression, to name just a few.

Sleep deprivation alters the structure of DNA inside immune cells and increases the number of immune cells, which causes them to overreact and spark inflammation. Catching up on sleep does not reverse this effect. Consistently losing an hour and a half of sleep a night potentially increases the risk.

Chronic insomnia prevents proper disposal of toxins in the brain. Deep sleep is especially good for taking out the trash. Deep sleep is when the glymphatic system most effectively removes waste.

When you are in deep sleep: Your neurons will go quiet. A few seconds later, blood will flow out of your head. Then, a watery liquid called cerebrospinal fluid (CSF) will flow in, washing through your brain in rhythmic, pulsing waves. Cerebral spinal fluid surrounds blood vessels during sleep to remove waste from the brain. Thus, deep sleep may help prevent amyloid buildup.

Older people with insomnia are at greater risk of developing memory decline and long-term cognitive impairment such as dementia. Sleeplessness accelerates the spread through the brain of toxic clumps of tau ­- a harbinger of brain damage and decisive step along the path to dementia. IGF-1 may help one cope with sleep deprivation.

Even one night of poor deep sleep → a 10 percent increase in amyloid-β levels.

When young, healthy men were deprived of just one night of sleep, they had higher levels of tau — a biomarker for Alzheimer’s disease. Sleep deprivation for as little as one night ↑ amyloid beta levels 30%, ↑ tau levels 50%.

When we don’t sleep well or often enough, we function poorly. Sleep is when memories are consolidated. A person’s ability to think and operate effectively can be evident if sleep is disrupted for even one night. As we fall asleep, our brain experiences a pattern of brain waves known as “spine spindles,” which, according to the Sleep Foundation, are not fully understood, but are thought to “play a role in learning and integrating new memories”.


Alcohol is a terrible sleep aid

 This study of 21 participants composed of healthy 18-21-year-old social drinkers who had consumed less than seven standard drinks per week during the previous 30 days showed an increase in frontal alpha power. According to the researchers, this suggested a disruption of the normal properties of NREM slow wave sleep.

This study of 93 healthy adults in their 20s (59 women and 34 men) who were college students or recent college graduates showed that  alcohol disrupted sleep more in women than in men. Women’s total sleep time was reduced by 19 minutes, sleep efficiency decreased by 4%, and there was a 15-minute increase in the time they spent awake during the night after drinking alcohol, compared to the placebo.

150 adults (age 19–89 years) were followed for 60+ days as part of an intensive experience sampling study wherein participants provided daily reports of their alcohol use, sleep duration, and sleep quality. A significant, negative within-person association was observed between sleep quality and alcohol use. Sleep quality was lower on nights following alcohol use.

This study of 10 healthy, male university students with a mean age of 21.6 years showed that alcohol suppresses the high-frequency power during sleep in a dosage-dependent manner. Although the first half of sleep after alcohol intake looked good on the EEG, the result of the assessment regarding the autonomic nerve system shows that drinking leads to insomnia rather than good sleep.

This study of 24 participants (12 female, 12 male), healthy 18- to 21-year-old social drinkers who had consumed less than seven standard drinks per week during the previous 30 days showed that alcohol increased Slow Wave Sleep (SWS) delta power during NREM. However, there was a simultaneous increase in frontal alpha power, which is thought to reflect disturbed sleep.

Alcohol blunts the nocturnal rise in pineal melatonin.
Alcohol promotes brief nightime awakenings that one is not aware of, and it suppresses REM sleep.
Alcohol blocks REM sleep (not good).
Especially injurious is binge drinking.

Ambien, Lunesta, Sonata, and zolpidem caution: sometimes called Z-drugs. The Z drugs don’t even work to promote sleep.
Many sleeping pills increase the risk of death: zolpidem (Ambien), exzopliclone (Lunesta), temazepan (Restoril), and zaleplon (Sonata). Users of as little as 18 pills per year were 3.6 times more likely to die prematurely.
Sleeping pills that may be least risky include: diphenhydramine (Benadryl), ramelteon (Rozerem), doxepin (Silenor), and suborexant (Belsomra), trazodone, and melatonin.
Benzodiazepine sleeping pills are a cognitive hazard.

Ashwagandha had been tested in mice. It may work via triethylene glycol. Ashwagandha may also work via stress reduction. Dr. Brad Stanfield futher pointed out the stress and sleep benefits of ashwagandha in this video. Chronic stress can mess up the circadian oscillation.

Good bacteria (be less hygienic and avoid antibacterial soaps and antibiotics)
Beta blocker blood pressure drugs may interfere with melatonin secretion

Caffeine can interfere with sleep 8-10 hours later.
A warm bath 90 minutes before bed might help one fall asleep.
Calcium helps the brain use the amino acid tryptophan to manufacture the sleep-inducing substance melatonin.

In magnesium deficiency, chronic insomnia is one of the main, central symptoms. A high magnesium, low aluminum diet has been found to be associated with deeper, less interrupted sleep.  These two minerals should be taken together for best results: calcium and magnesium. 

Calcium channel blocker blood pressure drugs may interfere with melatonin secretion.
Calorie restriction prevents the age-related decline in plasma melatonin levels.

The brain is most active during REM sleep and most dreaming is thought to occur during this stage. Numerous studies have shown that using marijuana before bed reduces REM sleep. Researchers believe this is why marijuana users report fewer dreams. In fact, studies show that marijuana lengthens the time the brain spends in deep sleep, which leads to less REM sleep.
Fifteen milligrams THC appears to be sedative, while 15 mg CBD appears to have alerting properties as it increased awake activity during sleep and counteracted the residual sedative activity of 15 mg THC.
Insomnia and greater sleep latency are associated with using higher CBD cannabis.
Cannabis’s effect on sleep may differ depending on whether you have depression or anxiety. In order words, if you have depression, cannabis may help you sleep – but if you don’t, cannabis may hurt.

The acute effects of cannabis use on sleep appear to be a disruption to the sleep cycle reflecting a reduction in time spent in slow wave sleep and an increase in time spent in random eye movement sleep.
(−)δ 9 THC was found to significantly decrease the time it takes to fall asleep in physically healthy insomniacs. Once asleep, interruptions of sleep were not significantly altered over the whole night. The (−)δ 9 THC tended to be associated with some decrease in awakenings in the first half of the night. The most significant side effect was a “hangover” phenomenon, or continued “high” the next day, with some residual of temporal disorganization. It increased in intensity and duration with increase in dosage. Constantly using cannabis for sleep can lead to cannabis use disorder.

Traditionally, chamomile preparations such as tea and essential oil aromatherapy have been used to treat insomnia and to induce sedation (calming effects). Chamomile is widely regarded as a mild tranquillizer and sleep-inducer. Sedative effects may be due to the flavonoid, apigenin that binds to benzodiazepine receptors in the brain (). Studies in preclinical models have shown anticonvulsant and CNS depressant effects respectively.
Oral administration of chamomile extract had sedative properties in sleep quality of 77 hospitalized elderly patients in nursing homes.
A 2016 study(opens in new tab) of new mothers found that volunteers who drank chamomile tea every day for two weeks slept better and tended to have fewer symptoms of depression than subjects who didn’t drink the tea.

A robust, high amplitude circadian oscillation/rhythm

Circadian rhythm disorders are problems with your circadian rhythm, the “internal body clock” that keeps your biological processes in step. Your normal circadian rhythm is set by the cycle of light and dark over 24 hours. It plays a key role in things like when you sleep and when you wake. Patterns of brain waves, hormone production, cell regrowth, and other activities are linked to this cycle. Compelling evidence supports of a link among circadian rhythms, sleep and metabolism, which suggests a role for mitochondria. These organelles play a significant role in energy metabolism via oxidative phosphorylation (OXPHOS) and several mitochondrial enzymes display circadian oscillations.

Either disruption of the endogenous circadian control mechanism or misalignment between internal circadian rhythms with the 24-hour outside environment would result in circadian rhythm disorders with adverse consequences in sleep and many other aspects of human health, including metabolism dysfunction, cognitive impairment, cardiovascular abnormalities, gastrointestinal and genitourinary dysfunctions, .

Circadian rhythm of hormones is extinguished during prolonged physical stress, sleep and energy deficiency in young men. Laughter helped nursing home residents.

This study of 22 healthy children (8.9 ± 2.2 years old) and 20 adults  (41.7 ± 4.4 years old)  showed that subjective sleepiness in children exposed to bluish light was significantly lower than that in children exposed to reddish light. In children, blue‐enriched LED lighting has a greater impact on melatonin suppression and it inhibits the increase in sleepiness during night. Light with a low color temperature is recommended at night, particularly for children’s sleep and circadian rhythm.

Melatonin may help normalize circadian rhythms. Consider temporarily taking melatonin (see below) two hours before bed time. Here is WebMD on melatonin.

A strong circadian oscillation works via a lower skin temperature when it is time for bed.

Here is instructions for resetting the circadian clock.

People with circadian rhythm disorders may have the following problems:

  • Falling asleep
  • Staying asleep
  • Waking up too early and not being able to go back to sleep
  • Getting sleep but not feeling refreshed by it
  • Feeling alert during the day

Things that can cause circadian rhythm disorders include:

The systemic influence of circadian rhythms on tissue homeostasis, sleep regulation, and behavior is well established; with direct links to aging. Older adults may especially benefit from a circadian-friendly lifestyle.

The most powerful  zeitgebers (givers of time) are the photic ones resulting from sleeping in the dark, for example. There is, however, also evidence for non-photic zeitgebers such as smartly-timed exercise, time-restricted feeding, and socialcontacts.
Electronic back-lit devices like cell phones, tablets, readers, and computers emit short-wavelength enriched light, also known as blue light. Fluorescent and LED lights4 also emit blue light, which has been shown to reduce or delay the natural production of melatonin in the evening and decrease feelings of sleepiness. Blue light can also reduce the quality of sleep and the amount of time you spend in slow-wave and rapid-eye movement (REM) sleep, two stages of the sleep cycle that are vital for cognitive functioning. This may reduce next morning alertness. Blue light from LEDs is stronger that from OLEDs. Glasses or clip-ons that filter blue light (make everything a shade of amber) in the evening can help with sleep. There are other options for nighttime computer users. The aged eye may be opaque to blue light.

Conversely, Dr. Satchidananda Panda explains here that timing of food intake overcomes light’s influence on circadian rhythm. Temporal time-restricted feeding  (more than light timing)  may help keep the circadian rhythm strong. Foods that trigger insulin spike late in the day are most likely to disrupt the circadian oscillation. A high-fat diet can disrupt the circadian oscillation.

No late evening snacking!

A study of 49 day-shift office workers (27 in windowless workplaces and 22 in workplaces with windows) showed that, compared to workers in windowless offices, those with windows received 173 percent more natural white light exposure during work hours and slept an average of 46 minutes more per night. Workers who got more sunlight also tended to be more physically active according to this study. And an additional analysis of overall quality of life suggests that they’re generally happier, too.

The circadian clock is “set” primarily by visual cues of light and darkness, social activity, and meal timing. Vigorously exercising too late in the day can also shift the circadian oscillation.


In isolated societies without clocks, the sleep period consistently occurred during the nighttime period of falling environmental temperature. The daily cycle of temperature change, largely eliminated from modern sleep environments, may be a potent natural regulator of sleep. Maybe try exposing a foot. Cooler temperatures (but not cold) promote better sleep.
There is a strong correlation between excessive daytime sleepiness and  vitamin D deficiency, a 2012 study in the Journal of Clinical Sleep Medicine found.

This double blind, clinical trial on  89 subjects (44 in intervention group and 45 people in placebo group) showed that a 50,000-unit vitamin D supplement, one in a fortnight for 8 weeks improves sleep quality, reduces sleep latency, raises sleep duration and improved subjective sleep quality in people of 20-50 year-old with sleep disorder.


Exercise

The effect of exercise on sleep was shown by a study of 21 sedentary participants (16 women aged 44.7 ± 9 years): long-term moderate aerobic exercise training improved sleep, reduced depression and cortisol, and promoted significant changes in immunologic variables.
The effect of exercise on sleep was shown by a study of 17 sedentary participants (mean age 61.6 (SD±4.3) years; 16 female): Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.
The effect of exercise on sleep was shown by a study of 11 women (age M = 61.27, SD 4.15) with insomnia who engaged in 30 min of aerobic exercise 3 times per week: Results suggest that sleep influences next day exercise rather than exercise influencing sleep.
The effect of exercise on sleep was shown by a study of 23 individuals aged 55 years and older who had been diagnosed with symptoms of the sleeping disorder: Aerobic exercise resulted in better sleeping at night and less daytime drowsiness. The regular physical activity also improved symptoms of depression and were able to complete daily responsibilities.
Exercise makes one less likely to wake up to pee (cutting salt also may help).
Exercise does not have to be at the gym.
Exercise in the morning is best. Morning or early afternoon exercise tends to shift the body clock forward. Intense exercise less than 2 hours before bed may interfere with sleep.

 

Exploding head syndrome is not worth worrying about.

A highfat (fast food) diet may interfere with sleep. Eat more fiber, less saturated fat and less sugar.

Omega-3 fatty acids may improve sleep.

Low levels of omega-3 fatty acids are associated with sleep problems in children and obstructive sleep apnea in adults.

Low levels of DHA are also linked to lower levels of the hormonemelatonin, which helps you fall asleep.

Studies in both children and adults reveal that supplementing with omega-3 increases the length and quality of sleep.

Gratitude is associated with greater well-being. That sentiment and those benefits can be cultivated. Those who recorded things that had made them grateful had an improved sense of well-being, slept better and more, felt a greater sense of optimism and connectedness to others.

Scientists investigating the relationship between sleep and the microbiome are finding that the microbial ecosystem may affect sleep and sleep-related physiological functions in a number of different ways: shifting circadian rhythms, altering the body’s sleep-wake cycle, affecting hormones that regulate sleep and wakefulness. Waking up once nightly at least four times a month was significantly associated with pain, nausea, dysphagia, diarrhea, loose stools, urgency and a feeling of anal blockage. Trouble falling asleep was significantly associated with rectal urgency. Associations were independent of gender, age, lifestyle factors and BMI. Changing which microbes are in the gut by altering diet has the potential to help those who have trouble sleeping.

Thriving healthy gut bacteria is linked to better sleep. Bad gut bacteria is linked to poor sleep. Microbes produce sleep-regulating hormones. Poor sleep could be a symptom of irritable bowel syndrome. Diets heavy on sugars, fatty- and highly-processed foods can alter the make-up of your gut microbiome, reducing the abundance of beneficial microorganisms. Limiting these foods, and replacing them with whole, unprocessed nutrient-rich foods like vegetables, fruits, and whole grains, can help restore and protect the beneficial bacteria in your gut. A diet rich in whole fruits and vegetables is the foundation of healthy living, and healthy sleep. The single greatest predictor of a healthy gut is a diversity of plants in one’s diet. This blog post on gut health may help.

Lysine can produce a significant shortening of the time of sleep onset.
Supplementation of magnesium appears to improve subjective measures of insomnia such as sleep efficiency, sleep time and sleep onset latency, early morning awakening, Magnesium may also influence melatonin and serum cortisol, in elderly people.
Magnesium plays a key role in the bodily function that regulates sleep. Insomnia is one of the symptoms of magnesium deficiency. A double-blind randomized clinical trial conducted in 46 elderly subjects showed that supplementation of magnesium appears to improve subjective measures of insomnia such as sleep efficiency, sleep time and sleep onset latency, early morning awakening, and likewise, insomnia objective measures such as concentration of serum renin, melatonin, and serum cortisol, in elderly people.
Supplementation of magnesium appears to improve subjective measures of insomnia, sleep efficiency, sleep time and sleep onset latency, early morning awakening.

Melatonin
Melatonin binds to receptors in the brain to help reduce nerve activity.
A combination of low dose (<.5 mg) before bed with a low prolonged release dose may be most effective. The Cleveland Clinic recommends .5 mg to 3 mg. Alex Dimitriu, MD suggests “For most people, a melatonin dose of 0.5 to 5 mg can effectively help them fall asleep. If you find this dose isn’t effective, you can increase it from there under the guidance of your doctor.” Obese people might need more. When you take higher amounts than 6 mg per night, you are starting to suppress cortisol production in the adrenal glands. This can lead to adrenal gland fatigue or adrenal gland insufficiency and there will not be enough energy for the following day. There are other symptoms of melatonin overdose.
Melatonin supplements work by altering your biological rhythm. They do not make you more tired by inducing sleep, but it regulates when your body begins to feel tired. For this reason, melatonin is not suitable for treating insomnia when your body is tired, but you can not sleep.
Melatonin may reduce levels of dopamine, a hormone that helps you stay awake.
Because melatonin is a potent free radical scavenger, its deficiency may result in reduced antioxidant protection in the elderly which may have significance not only for aging per se but also may contribute to the incidence or severity of some age-related diseases. Administration of melatonin may improve temporal organization in advanced age. Moreover, it has beneficial effects on sleep as well as age-related diseases.
Room light before bed may suppress natural melatonin release.
Melatonin may be best taken 1-1/2 – 2 hours before bed. While deficiency is rare in the young, melatonin may help some kids.

 

Older folks have significantly less melatonin secretion. A study of 1, 354 males and females aged 55-80 years showed that prolonged-release melatonin results in significant and clinically meaningful improvements in sleep quality, morning alertness, sleep onset latency and quality of life in primary insomnia patients aged 55 years and over. Melatonin is safe for older people to take every day. It is not habit-forming. 5 mg of melatonin may be best for older adults.
Melatonin supplements are frequently excessive and contaminated.

 

Restless leg syndrome (RLS)

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you’re sitting or lying down. Moving eases the unpleasant feeling temporarily.

Magnesium may help with restless leg syndrome.
Melatonin exerts an inhibitory effect on central dopamine secretion suggest that melatonin might be implicated in the worsening of RLS symptoms in the evening and during the night. This effect of melatonin is dose-dependent.


Sleep apnea should be suspected if one awakens frequently in the night.
Sleep disorders may be associated with primary mitochondrialdiseases. Mitochondrial oxidative stress may determine the need for sleep. Calorie restriction, protein restriction, and methionine restriction lowers mitochondrial oxidative stress.

Perhaps keep curtains closed when there is a full moon. Sleep cycles in people can oscillate during the 29.5-day lunar cycle: In the days leading up to a full moon, people go to sleep later in the evening and sleep for shorter periods of time.

Minimize sugar and refined carbs. A low fiber and high saturated fat and sugar intake is associated with lighter, less restorative sleep with more arousals. Significantly less slow-wave sleep (S.W.S.) was found after consuming a high-carbohydrate/low-fat diet.

Beware of benzodiazepine sleeping pills, or any sleeping pills.

By Otto

I am a health enthusiast, engineer, and maker.

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