Fatigue

What is Insomnia?

Although it’s common to have the occasional sleepless night, insomnia is the lack of sleep on a regular basis. Before starting any natural remedies, consult your naturopathic doctor. Chronic insomnia can itself be a symptom of another condition, such as depression, heart disease, sleep apnea, lung disease, hot flashes, or diabetes.

Your annual physical exam may or may not show any reason for concern. Wellness Medicine is about looking at the trends that occur slowly and steadily before disease. Many of these conditions are subclinical. When visiting your Naturopathic Doctor consideration will be made to investigate traditional Naturopathic Physical Assessment Techniques and the latest technology for detection of subclinical states such as adrenal weakness, thyroid weakness or hormones that impact sleep patterns.

The different types of insomnia patterning include:

  • Difficulties falling asleep • Difficulties staying asleep with frequent waking • Waking too early in the morning

Why be concerned?

An effective sleep cycle relates to overall cortisol levels which have an effect on all our regulatory systems and how we feel overall. Common symptoms resulting from lack of sleep include: fatigue, headaches, irritability, immune weakness, PMS, blood sugar irregularity, shakiness, dizziness, digestive concerns and aches or pains.

Why is this happening?

When we spend too much time in a sympathetic dominant state producing too many adrenal hormones such as epinephrine, norepinephrine, cortisol, progesterone, DHEA (estrogen and testosterone precursor) our natural cortisol rhythm is disturbed.

Cortisol Patterns:

Normally cortisol should rise about one half hour after rising and then fall as we get ready for sleep. If our adrenal gland is too exhausted it takes longer for cortisol levels to rise in the morning hence the need for that 2nd or 3rd cup of coffee. Once it rises it stays elevated, which can be aggravated through a stressful day and then never gets low enough to fall asleep or cycles in peaks throughout the night to continually wake us or another option is that it rises prematurely in the morning causing early morning wakefulness.

Cortisol Level Chart:

Legend: • Red Normal Patterning- Cortisol highest in the morning after waking and falls off during the day preparing you for sleep • Green Insomnia Patterning- Cortisol highest at night and lowest in the morning creating difficulty getting going in the morning . (Weakened adrenal gland)

What are the Health Connections related to this trend?

Natural approaches are understanding the root cause and the Health Connections in the path that resulted in their outcome. The pathway from beginning to end result in the Health Wellness Spectrum (HWS) © is as follows: (For more details of the HWS © see the April 2008 Newsletter Allergies, Asthma and Eczema)

  1. Nervous System- Balance of states of energy and relaxation II. Adrenal Gland I- Release of hormones including Cortisol, Hyper energy, Reduced Sleep III. Adrenal Gland II- Reduced energy, Need for More Sleep IV. Thyroid Stress-Changes in Metabolism V. Inflammation VI. Digestion Stress VII. Liver Congestion VIII. Hormonal Changes IX. Anxiety, Depression, Headaches more insomnia

A part of our role in preventive health is to understand the pathways that can lead to chronic disease and assist those in making changes early on to optimize their health. As many other conditions can cause fatigue it is important to maintain regular visits with your medical doctor and your Naturopathic Doctor. A Naturopath will address the above pathways through proper organ support. If you have never seen a Naturopath consider the benefits for Optimal Health. You do not need a referral from your MD; you can book an appointment directly.

Natural Remedies for Insomnia

Thus one can see that in treating any one of these conditions layers of support are needed.

A customized Revivelife Wellness Centre Approach would be to:

  1. Fill in your Health Wellness Spectrum (HWS) © Questionnaire- Adult or Kids Wellness 2. Have your Metabolic Urine Tested 3. Assess your score on the HWS 4. Have a New Patient Visit 5. Test for Food and Environmental Intolerances 6. Individual Plan of Management
  2. Sleep Hygiene
  3. Wind Down Time – allow 2 hours from your activities of the day including work, computer work or stimulating TV before bed to wind down your cortisol levels by taking a bath, reading for relaxation or listening to music (for deeper relaxation techniques see below) Your body is like a high performance race car and when the engine revs very high it simply needs time to cool down. 2. Create a relaxing bedroom environment without TV 3. Take a 20 minute relaxation time or mini catnap midday to recharge your adrenals and assist in lowering cortisol levels. 4. Light-If you have trouble falling asleep at night; you may need more light in the morning. Light exposure plays a key role in telling the body when to go to sleep and when to wake up. Try taking a walk first thing in the morning. On the other hand, if you find you’re waking up too early in the morning, you may need more light in the afternoon. Try taking a walk in the late afternoon. 5. Music-Gentle, slow music is another remedy that can help to improve sleep without medication. Music has been found to improve sleep quality, decrease nightly wakening’s, lengthen sleep time, and increase satisfaction with sleep.
  4. Relaxation Techniques- Relaxation techniques are one of the most effective ways to increase sleep time, fall asleep faster, and feel more rested in the morning. They require a minimum of 20 minutes before going to bed. There are many different techniques:
  5. Visualization- involves imagining a relaxing scene. You can try it in bed before falling asleep. Involve all your senses. If you’re imagining yourself on a tropical island, think of the way the warm breeze feels against your skin. Imagine the sweet scent of the flowers, look at the water and listen the waves–you get the picture. The more vivid the visualization and the more senses you involve, the more effective it will be. 2. Relaxation Response – A mind/body technique based on the principles of Transcendental Meditation. 3. Mindfulness – A type of meditation that essentially involves focusing on your mind on the present. A great program is Mindful Meditation taught through specifically trained professionals. 4. Yoga –combines deep breathing, meditation, and stretching. A Harvard study found that daily yoga for eight weeks improved total sleep time, the time to fall asleep. If you’ve never tried yoga there are many beginner programs available 5. Progressive Muscle Relaxation- is a promising natural remedy for sleep.

Aromatherapy

  1. Lavender-The scent of English lavender has long been used as a folk remedy to help people fall asleep.

Research is starting to confirm lavender’s sedative qualities. It’s been found to lengthen total sleep time, increase deep sleep, and make people feel refreshed. It appears to work better for women, possibly because women tend to have a more acute sense of smell.

The good thing about lavender is that it begins to work quickly. Try putting a lavender sachet under your pillow or place one to two drops of lavender essential oil in a handkerchief. Or add several drops of lavender oil to a bath — the drop in body temperature after a warm bath also helps with sleep. 2. Chamomile 3. Ylang ylang

  1. Foods and Nutrition
  2. Detoxification- Can reduce the toxicity and stress on the liver for optimal hormone balance 2. Managing Food Intolerances- By moderating stresses such as food intolerances that you do have management over allows the body more energy to work on the support of the organs put under stress. Reduction of these foods also reduces toxicity levels overall. Digestive dysfunction can be improved by up to 100% by following your food intolerances. 3. Cut out caffeine– caffeine can have a pronounced effect on sleep, causing insomnia and restlessness. In addition to coffee, tea, and soft drinks, look for hidden sources of caffeine such as chocolate, cough and cold medicine, and other over-the-counter medicine. 4. Avoid sweets-although sugar can give a burst of energy, it’s short-lived and can cause uneven blood sugar levels. This can disrupt sleep in the middle of the night as blood sugar levels fall. If you crave sugars then you may need more protein in your diet and or your adrenals and thyroid may need further support. 5. Eat a light snack before bedtime to help produce serotonin (the calming hormone). — 200 calories or less — that’s mainly carbohydrate with a touch of protein. Many scientists claim that by combining foods rich in complex carbohydrates and a small amount of protein (which contains the amino acid tryptophan which is an amino acid that is a precursor to serotonin, which is then converted to melatonin) your brain produces serotonin, which is known as the “calming hormone.” And when we’re calm, we are certainly more apt to fall asleep. 6. Eat magnesium-rich foods-magnesium is a natural sedative. Deficiency of magnesium can result in difficulty sleeping, constipation, muscle tremors or cramps, anxiety, irritability, and pain. It has also been use for people with restless leg syndrome.  Foods rich in magnesium are legumes and seeds, dark leafy green vegetables, wheat bran, almonds, cashews, blackstrap molasses, brewer’s yeast, and whole grains.
  3. Physical Therapies – Bowen Therapy www.bowtech.com – effectively promotes relaxation and reduces cortisol levels. 2. Acupuncture-releases muscle tension balances organ systems and thus aids in reduction of cortisol levels. A University of Pittsburgh analysis concluded that acupuncture may be an effective treatment for insomnia. A preliminary study found that five weeks of acupuncture increase melatonin secretion in the evening and improved total sleep time.
  4. Homeopathy – Enhances the body’s natural healing and encourages your body’s own ability to heal itself. Treatment works to increase the production of endorphins which are the body’s natural pain killers. Treatment is customized to the source of your stress and digestive discomfort. Which type of insomniac are you? For assistance in selecting the correct remedy consult your Naturopathic Doctor. 1. Gelsenium: stress or worry related to up and coming events or performance inhibiting quality of sleep 2. Belladonna: A person needing Belladonna is extremely restless. Frightful images when drifting off to sleep cause the patient to dread sleep. They are awakened by nightmares, or they can experience a throbbing in the brain that prevents sleep. 3. Aconitum napellus: This remedy can be helpful if a person panics with insomnia. Fear and agitation come on suddenly when the person is drifting off to sleep, or may wake them. 4. Arsenicum album: People who need this remedy are often anxious and compulsive about small details and have trouble sleeping if they feel that everything is not in place. They are often deeply weary and exhausted, yet feel restless physically and mentally. Sleep, when it arrives, can be anxious and disturbed, with dreams full of fear and insecurity. 5. Calcarea phosphorica: This remedy is often helpful to children with growing pains, and also for adults who have aching in the joints and bones, or neck and shoulder tension that make it hard to fall asleep. The person lies awake for many hours, feeling upset and irritable—then has trouble waking in the morning, and feels deeply tired and weak. 6. Cocculus: This remedy is often helpful to those who feel “too tired to sleep” after long-term sleep loss: from getting up with an infant, taking care of someone who is ill, a disruptive work schedule, travel and jet lag, or chronic worry and insomnia. The person may feel weak and dizzy, with trouble thinking, and may be sleepy, irritable, or tearful. 7. Coffea cruda: -stress related to a similar feeling of overindulgence in coffee and difficulties falling asleep due to mental excitement and nervous stimulation. Thoughts may be either happy or distressing. The person may be looking forward to something that will happen in the morning, but feels stressed and exhausted as the night wears on. If the person falls asleep, it is usually very light with vivid dreams, disturbed by any noise or motion. (This remedy can also help if overuse of caffeine is the cause of sleeplessness.) 8. Ignatia: If insomnia is caused by emotional upset such as grief or loss, a disappointment in love, a shock, or even an argument, this remedy may be helpful. The person is sensitive and nervous, and may often sigh and yawn in the daytime, but find it hard to relax at night. As the person tries to fall asleep, the arms and legs twitch or itch. If sleep arrives, it is usually light, with jerking of the legs and arms, or with long and troubling nightmares. 9. Kali phosphoricum: A person with insomnia from nervous exhaustion caused by overwork or mental strain, or following a taxing illness, may respond to this remedy. The person is very weak and sensitive to everything (noise, lights, touch, and pain). Irritability, depression, and anxiety with an empty feeling in the stomach are often seen. 10. Lycopodium: People who need this remedy often have no memory of dreams and often doubt that they have slept at all. Insomnia may set in primarily because of worry: lack of confidence can make them doubt their own abilities, although they are usually very capable. Insomnia caused by digestive trouble, especially gas, can also indicate a need for this remedy. The person feels drowsy after meals, but has trouble sleeping at bedtime. Ravenous hunger in the night that wakes a person up is another indication for Lycopodium. 11. Nux vomica: People who have insomnia after over-indulgence in stimulants, food, and drink—or after overexertion, either physically or mentally—may benefit from this remedy. They may be able to drift off, but sleep is light, and they often awaken in the early morning (typically three a.m.) and lie awake for hours. On getting up, they are tense, impatient, and irritable, with a feeling that they still need more sleep. 12. Silicea (also called Silica): This is a useful remedy for nervous people with low stamina who get tired easily but then have insomnia. The person often goes to sleep at first, but awakens suddenly with a hot feeling in the head, then finds it hard to fall asleep again. People who need this remedy usually have anxious dreams, and some (especially children) sleepwalk. 13. Sulphur: This remedy may be helpful if insomnia comes from itching—or an increasing feeling of heat in bed, especially in the feet. The person is irritable and anxious, and often feels a need to throw the covers off. Lying awake between two and five a.m. is typical. Insomnia that develops because of a lack of exercise may also be helped with Sulphur. 14. Zincum metallicum: People who need this remedy often have insomnia from mental activity. They can get wound up from overwork—or be naturally inclined toward nervousness and just have trouble relaxing. Their legs and arms often feel extremely restless, and lying still in bed may be impossible. Even during the daytime, a person who needs this remedy may feel a constant need to move their muscles.

Herbals

  1. Chamomile– can reduce anxiety, calm the digestive system and relieve muscle tension. Consider this as a herbal tea 2 hours before bed
  2. 2. Hops-Promotes relaxation
  3. 3. Passiflora-Relaxes muscles
  4. 4. Ashwagandha– adaptogen normalizing adrenal function
  5. 5. Avena Sativa-nourishes the adrenals and relaxes smooth muscles. Try it in a tea form.
  6. 6. Lemon Balm-great for children in a tea form. Balances adrenals.
  7. 7. Valerian-is a herb that has been long used as a remedy for insomnia. Today, it is an accepted over-the-counter insomnia remedy in Germany, France, Switzerland, Belgium, and Italy. Some studies suggest that like conventional sleeping pills, valerian may affect levels of the calming neurotransmitter GABA. Unlike many other sleep medications, valerian is not believed to be addictive or cause grogginess in the morning.  Valerian is usually taken between an hour before bedtime. It takes about two to three weeks to work. It shouldn’t be used for more than three months at a time. Side effects of valerian may include mild indigestion, headache, palpitations, and dizziness. Although valerian tea and liquid extracts are available, most people don’t like the smell of valerian and prefer taking the capsule form. Valerian shouldn’t be taken with many medications, especially those that depress the central nervous system, such as sedatives and antihistamines. Valerian shouldn’t be taken with alcohol, before or after surgery, or by people with liver disease. It should not be taken before driving or operating machinery. Consultation with a qualified health practitioner is recommended.

Supplements

  1. Melatonin– is a popular remedy to help people fall asleep when the sleep/wake cycle has been disturbed; such as in shift workers or people who with jet lag.

Melatonin is a hormone found naturally in the body. The pineal gland in the brain makes serotonin which is then converted into melatonin at night when exposure to light decreases.

Melatonin is typically taken about 30 minutes before the desired bedtime. Some experts caution that melatonin should not be used by people with depression, schizophrenia, autoimmune diseases, and other serious illness. Pregnant and nursing women should not use melatonin.

The University of Alberta study examined 17 studies with 651 people and found no significant side effects when used for three months or less. The long-term effect of melatonin supplementation is not known.

Traditional Chinese Medicine

In traditional Chinese medicine, insomnia often stems from kidney energy weakness. This syndrome is not necessarily related to kidney disease in Western medicine. A few signs of kidney energy weakness are low back ache, tiredness and fatigue, and a burst of energy at about 11 pm in the evening. Women in menopause often experience this type of insomnia. People who are taking anti-estrogenic drugs such as tamoxifen also experience this type of insomnia, however, they should not take herbal combinations such as the herbal formula liu wei di huang that may increase estrogen levels.

Ayurvedic Medicine

In Ayurvedic medicine, insomnia is often associated with a vata imbalance. Vata regulates breathing and circulation. People with a vata imbalance often notice irritability, anxiety, and fear with insomnia. One Ayurvedic treatment is the application of oil on the head and feet. For the pitta type, room temperature coconut oil is used, for the vata type, warm sesame oil is applied, and for the kapha type, warm mustard oil is often applied.

Exercise

Lack of exercise can contribute to poor sleep. Muscle tension and stress build in the body. Exercise can promote deep sleep that night. However, intense exercise too close to bed can increase adrenaline levels, leading to insomnia.

Feng Shui

Feng shui, which originates in the Chinese philosophy of Taoism, instructs on how to arrange rooms, furniture, offices, houses, and other arrangements to maximize favorable energy flow throughout living spaces. Here are some recommendations that may help promote relaxing sleep:

  • Try not to have the bed in a corner of the room. The corners are where energy tends to be stagnant. • Avoid putting your bed next to a window. Energy can be drained this way. • The bed shouldn’t be positioned so that the soles of the feet, when lying face-up in bed, directly face the doorway. • When lying in bed, you should have full view of anyone coming in the door. If you can’t do this directly, hang a mirror to reflect the entranceway. • Try to avoid facing sharp corners from desks, bookcases, and other pieces of furniture.

Organ Support

Custom products to support organ systems i.e. thyroid, adrenals, liver

What can high-magnesium foods do for you?

  • Relax your nerves and muscles and thus promote optimal sleep • Build and strengthen bones • Keep your blood circulating smoothly

What events can indicate a need for more high-magnesium foods?

Muscle weakness, tremor, or spasm • Heart arrhythmia, irregular contraction, or increased heart rate • Softening and weakening of bone • Imbalanced blood sugar levels • Headaches • Elevated blood pressure

Wellness Books:

Say Good Night to Insomnia: The Only Natural Treatment Scientifically Proven to Conquer Insomnia (Hardcover) ~ Gregg D. Jacobs (Author)

References: ____________________

Buscemi N, Vandermeer B, Hooton N, Pandya R, Tjosvold L, Hartling L, Vohra S, Klassen TP, Baker G. Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis. BMJ. 2006 Feb 18; 332(7538):385-93.

Khalsa SB. Treatment of chronic insomnia with yoga: a preliminary study with sleep-wake diaries. Appl Psychophysiol Biofeedback. 2004 Dec;29(4):269-78.

Lewith GT, Godfrey AD, Prescott P. A single-blinded, randomized pilot study evaluating the aroma of Lavandula augustifolia as a treatment for mild insomnia. J Altern Complement Med. 2005 Aug;11(4):631-7.

Spence DW, Kayumov L, Chen A, Lowe A, Jain U, Katzman MA, Shen J, Perelman B, Shapiro CM. Acupuncture increases nocturnal melatonin secretion and reduces insomnia and anxiety: a preliminary report. J Neuropsychiatry Clin Neurosci. 2004 Winter;16(1):19-28.

Sok SR, Erlen JA, Kim KB. Effects of acupuncture therapy on insomnia. J Adv Nurs. 2003 Nov;44(4):375-84.