Q: My sleep isn’t regular. I’m concerned this will have long-term health consequences. What can I do to help without drugs? —Georgiana N., Springfield, Mass.
A: A good night’s sleep will fix a lot of what seems wrong at the end of the day. There are two basic patterns of poor sleep, and both can occur together.
When You Can’t Fall Asleep
First, there’s difficulty getting to sleep (sleep onset), which may be caused by anything from racing thoughts to chronic pain to overuse of stimulants such as
caffeine. Our overuse of artificial lighting, however, may be the biggest culprit.
Melatonin is a calming substance produced by the body when light stops hitting the retinae. When the sun goes down, melatonin production is supposed to kick in. But when we flip on artificial lights, this inhibits our natural production of calming melatonin.
It’s no wonder, then, that supplemental melatonin often works very well for people who have trouble getting to sleep. I recommend starting small, with doses of 1–2 mg taken in the late afternoon or early evening. But up to 10 mg is fine, and won’t suppress your natural melatonin production. Also avoid caffeine and chocolate too close to bedtime—your body doesn’t need the extra stimulation.
If pain is an issue, try a decompression move when you first lie down. If you favor lying on your back, move your bottom a little further away from your pillow than usual. Then lift up your chest, prop yourself up on your elbows, and press down lightly with your elbows, and traction your spine away from the tailbone. Then lie yourself down one vertebrae at a time. When your head goes down, use your hands cupped over the ears on either side of your head and gently pull your skull away from the neck before completely relaxing.
If you’re a side sleeper, it’s the same idea. Place your hip a little lower in the bed, and using your elbows, draw your spine long away from the hips, and then adjust the neck to a slightly longer, tractioned position before settling into sleep.
When You Can’t Stay Asleep
The second major insomnia pattern is poor sleep durability. This means you wake up several times during the night and can’t resume a deep sleep pattern readily. If you get up to pee once or twice but go right back to sleep, that’s fine. If you need to urinate more than 2–3 times per night, this is likely due to enlarged prostate in a man, or overactive bladder in a woman. Both of these problems can be treated naturally, but neither is a quick fix.
If you wake more often during the night, this is usually because you are a “light” sleeper and easily disturbed by noises, light, or even temperature fluctuations. This isn’t necessarily easy to fix, but comfortable eye shades and good earplugs can help. I prefer wax earplugs that, when held in the hand to soften for a few moments, can be molded to fit snuggly but comfortably in the ear canal.
Cortisol spikes during the night are another cause of frequent waking. Cortisol is a hormone that helps keep blood sugar steady overnight when we’re not eating. As we “fast” overnight (12 hours a night is optimal, every night), our adrenal glands secrete a very small, but steady, stream of cortisol to prevent blood sugar from crashing, which would result in our waking up in a panic. But cortisol can also be a “stress” hormone if secreted unnecessarily. If your adrenal glands are easily stimulated (often due to stress or nervousness), it takes very little to trigger an adrenaline response, which, of course, will wake you up.
Although I’m not usually a fan of bedtime snacking, sometimes a small protein or fat snack can help. The proverbial glass of milk is a good idea, because its protein and fat are satiating, which can help you rest easy until morning without the threat of a blood sugar crash. You can also try a spoonful of nut butter or ¼ avocado—it doesn’t have to be a lot to be effective.
If that doesn’t work for you, I recommend herbal adrenal support. Evolutionarily, we developed to respond to stress as though it were immediately life-threatening. Today, most of our stressors are chronic—and no amount of “fight or flight” response can help us escape the news, bills, traffic, or a bad boss.
For that reason, it’s important to nourish the adrenal glands. Some of my favorite tonics include licorice, ashwagandha, astragalus, motherwort, hawthorn, vitamin C, vitamin B (pantothenic acid, 100 mg daily), and Siberian ginseng (Eleutherococcus senticosus). Many adrenal formulas contain some or all of these ingredients. Herbal remedies are fine to take in the evening, but spreading doses throughout the day, for several months, often works better. Herbal tonics are profoundly healing, but don’t have rapid action. Avoid taking B vitamins close to bedtime, as they can be stimulating.
Beneficial Bedtime Botanicals
Herbal medicine is a lovely way to gently encourage relaxation, with no potential for addiction or unwanted side effects. Here’s a classic calming formula that’s safe enough for children:
Combine equal parts of passionflower (Passiflora incarnate), lemon balm (Melissa officinalis), chamomile (Matricaria recutita), catnip (Nepeta cataria), and California poppy (Eschscholzia californica) with about 1/3 dose of lavender (Lavandula officinalis). The herbs can be acquired loose, or in tincture form. The lavender can be added as a few drops of essential oil after the other herbs have steeped for 10 minutes.
If you make this formula in tincture form, take ½ tsp. twice daily until you experience rapid sleep onset. For quicker action, a larger dose such as 2 tsp. can be taken up to four times during the day. These dosing suggestions are based on an adult who weighs 150–175 pounds. Adjust for weight.