Insomnia

How do you support people with insomnia and sleep disturbance at Collective Health Center?

As we all know, sleep is absolutely essential for our health. Impaired/consistent lack of sleep due to forms of insomnia are significant factors to negative health risks. What most people don’t realize though is that there are so many different reasons and factors that contribute to insomnia. With a Naturopathic Doctor and a Holistic approach, I am able to work with my patients individually and uniquely to help find out what is causing their insomnia and how we can work together to combat it.

Insomnia can look like anything from difficulty falling asleep to early morning awakening – it’s so much more than most people assume it to be. Because of the importance of sleep on our health – both mental and physical – there are a lot of other health issues that can come along or are associated with insomnia. Difficulty sleeping or oversleeping can cause peri or menopausal symptoms, acid reflux, anxiety, depression, sleep apnea, or physical pain.

Matthew Walker, Ph.D., one of the leading experts on sleep, published a book that I often recommend to my patients titled Why We Sleep. While his book discusses why we have sleep issues in relation to society as well as alcohol consumption, it goes over a lot of approaches to insomnia that I agree with and use in my own practice. As with most of my practice, I take a holistic approach and want to make sure that I am looking at my client and their health as a whole of their body and lifestyle rather than just their symptoms. For some, this can include a full hormone test – testosterone levels, for example, can contribute to lack of or poor sleep. Here are some of my favorite tips from Walker’s Why We Sleep book and my approach to them.

Slow Down

Cortisol is a hormone that influences our metabolism, inflammation, blood sugar levels, electrolyte balance, and blood pressure in our bodies. Without proper balance, these issues can significantly impact our sleep. When we are in a state of acute or chronic stress, cortisol effects will increase or decrease. Elevated levels – mostly those seen during the evening/late-night hours of the day – not only disrupt sleep but also increase blood glucose and hunger for high fat and high sugar snacks – which can disrupt our digestion system and rhythms of late-night eating. There are several adaptogen herbs that can help modulate cortisol levels and other supplements that can help evening cortisol levels from increasing. One of my favorite herbs is the Ocimum sanctum – commonly known as the Tulsi or Holy Basil. When taken in the form of tea before bed can help us to slow down and relax while giving off a lovely taste and aroma. I have found that mindfulness and meditative practices to be the most effective strategy to help reduce evening cortisol levels. The way we respond to stress in our lives is the root way of dealing with elevated cortisol levels. With some simple meditation or mindful practices, we are providing ourselves with a non-pharmaceutical way to repattern our stress response, and it’s a free practice we can do any time of the day.

Reduce Screen Time

There are so many studies that show that screen time is adversely associated with sleep time. One of those studies looked into over 2,000 children and found that it took more than 2 hours of passive screen time (i.e.. TV, movies, etc.) and over 30 minutes of active screen time (i.e. video games) to cause negative feelings upon awakening. While some screen time can help us to relax and unwind, screen time while in bed only leads to us staying actively awake longer and can cause a burden on our eyes that makes them more tired upon awakening. I recommend my patients have a set end time for their devices, remove all electronics from their bedroom, and avoid active screen time for a minimum of 2 hours prior to bedtime.

Routine Tune-Up

Whether we are early birds who have to hit the gym before starting our day or night owls who have to have an hour of meditation before bed, our routines all impact how we function throughout the day. Some of the most essential routines for our sleep health are consistent wake and sleep time, mealtimes, and exercise. Specifically, our sleep time routine is something that most adults don’t have best practices for. As children, we are taught the before bed mantra: bath, brush teeth, pajamas, and then a bedtime story before drifting off to sleep at a reasonable time. However, as adults, we tend to lose that mantra and try to jump straight into going to bed and attempting to fall asleep without any work. By taking the time to create a “turn-down” type service for ourselves like we had when we were younger, we can create a more relaxing and satisfying sleep. Something as simple as taking the time to turn down the lights, put some slow jams on, and ease into an evening self-care routine that will put us to sleep. Some of the things I, personally, love to do are use diffused essential oils such as lavender, meditation, and Epsom salt baths to create a calming environment for my body and mind before getting into bed.

Get Moving

As I mentioned above, exercise is a great way to keep your sleep cycle consistent and in tune with your lifestyle. Some studies of exercise and sleep have shown promising best outcomes when the exercise is done between 4 to 8 hours before sleep. And for those of us who don’t go to the gym every single day, or even once in a while, moderate exercise can also have benefits to your sleep cycle/health. One form of insomnia that I see is obstructive sleep apnea insomnia that most commonly can occur with people who are overweight. Exercise, while it can help with weight loss, also helps to strengthen the muscles that help to keep the airway open so that air is productively flowing during all stages of sleep. Another form of sleep disruption is restless leg syndrome. By exercising our muscles regularly, we are more in tune with them and able to unconsciously have more control over them while under the paralysis of sleep.

Consider the Stimulants

As with a lot of health concerns, nutrition and diet are important to consider. There are so many different stimulants that we consume daily that can factor into why we aren’t getting enough, or good enough, sleep – the most obvious of them being caffeine. Our genetics play a big factor in how our systems detoxify caffeine in our systems. For some of us, it can take up to 18 HOURS to clear the caffeine from one cup which can extremely mess up our schedules and routines. Other stimulants include the pharmaceutical medications we are prescribed. Frequently folks are prescribed generic medications which work for some people but not everyone. If you are concerned that your medications might be negatively impacting your sleep, I encourage you to have a conversation with your prescribing provider. There are many other natural options to consider to bolster energy and focus, and I always make sure to look into the genetics and specificity of each patient to make sure that what I am prescribing is best for them as a whole.

In addition to lifestyle changes and some herbal supplements, acupuncture is a wonderful approach to helping insomnia! Acupuncture practices can help to produce natural melatonin in our bodies and create a natural sleepy feeling. That’s why it is so easy for some to drift off during their acupuncture sessions! There are quite a few acupuncture points that can be used, but my personal favorite is a point on our necks called an mian – which means peaceful sleep. One of my mentors termed this the “chocolate point” because it really is THAT good!