Q:I'm in my late 50s and have trouble falling asleep almost every night. How can I get a good night's sleep?
-Julian R., Providence, R.I.
Sleep is a key ingredient to a healthy life. Good sleep is inversely correlated with accelerated aging and weight gain. It helps us stay alert, focused, and calm during the day. It improves memory; reduces risk of heart attack, stroke, and type 2 diabetes; calms stress; and improves stamina. And it doesn't require an expensive visit to the doctor for a refill. So why aren't we getting enough sleep?
In the old days, before light bulbs, it wasn't such a big deal to hit the sack when the fire burned down. Now, there is endless entertainment that keeps us up all hours. So we have to make sleep a priority if we want to enjoy its full benefits.
First, you need to work backwards to figure out your ideal bedtime-and then commit to it. If you have to be at work at 8 a.m. and your commute takes 45 minutes, you probably need to set the alarm for 5:15 a.m. if you want time for breakfast, a quick workout, or other morning activities before you head out the door. This means that you need to be asleep by 9:15 p.m. to get those crucial 8 hours, which means head on the pillow by 9 p.m.
A calming bedtime routine-starting with drinking a little water (no food within 2-3 hours of bedtime); brushing teeth; saying prayers, meditating, or reading (no TV or electronics in the hour before sleep); and telling everyone in your household that you love them-can take 30 minutes or so. So, planning backwards in this scenario, you should ideally have dinner at 6-6:30, and plan on being finished with the evening program by 8:30 so you can start your bedtime routine. This may sound boring, but boring isn't so bad when your goal is healthy longevity.
If you cannot squeeze in 8 hours of slumber every night, aim for 7.5 hours, with the minimum very occasionally being 6 hours. If you do not get a solid 7-8 hours of sleep every night, plan on a 9-hour sleep fest once a week. This needs to be scheduled-usually on weekends. Like any other health measure, sleep doesn't happen automatically. You have to make it happen.
Many folks lose sleep because of varying degrees of anxiety. The experience of anxiety is produced by adrenaline, the dominant chemical of our "fight or flight" sympathetic nervous system. These days we have many chronic stressors (traffic, bills, sensational news, bad bosses) that we cannot easily avoid. Though these stressors aren't immediately life-threatening, we still react physiologically to stress as though it were an imminent danger. The rush of adrenaline produces increased heart rate, maybe a mild sweat, feelings of doom, or even an inability to sit still. All of this inhibits the relaxation that is required for restful sleep.
Luckily there is a counterpart to fight or flight, sometimes called the "feed and breed" or parasympathetic state. The parasympathetic nerves respond to calming neurotransmitters such as GABA, dopamine, and serotonin. These calming neurotransmitters are fed by B vitamins, in particular the fatty B vitamins such as lecithin, inositol, phosphatidylcholine, and phosphatidylserine.
The amino acid tryptophan (5HTP is the best form, 50-100 mg at bedtime) is the precursor to serotonin, and the amino acid tyrosine (500-1,000 mg at bedtime) is the precursor to dopamine. The herb Mucuna pruriens also stimulates dopamine formation. Phenibut, a special type of GABAthat has a phenyl ring attached, is a wonderful way to increase GABA, in the brain. Phenibut is one of my favorite aids for staying asleep (not waking during the night). [Editors' note: You can find Phenibut in products such as MRM's Relax-ALL.]
Melatonin in low doses (e.g., 3 mg) is my favorite aid for getting to sleep. Melatonin typically lasts about 4 hours, so it may not ensure staying asleep all night. High-dose melatonin will fairly often produce wild dreams, which isn't so restful.
CBD (cannabidiol), a phytocannabinoid, is also particularly therapeutic. Although it is still illegal to grow hemp in the U.S., it is not illegal to produce products from industrial hemp, which is generally imported from Canada. Many other plants contain cannabinoids (broccoli, lemon, oranges), and all mammals have receptors for cannabinoids on many of our cells. This receptor network forms what is called the endocannabinoid system-a metabolism-, pain-, and immune-regulating network that is currently the subject of a variety of large-scale studies. A good starting dose if you're unable to unwind at bedtime is 10-20 mg of CBD.
Finally, there are a few commonsense strategies to help promote restful sleep. Meditation with a focus on deep steady breathing is an effective way to prepare your body for rest. Cognitive Behavioral Therapy for Insomnia (CBTI) is another psychological technique that can help achieve restful sleep.
B-complex vitamins can be a little too stimulating for bedtime, so be sure to take these in the morning with food. And be smart about caffeine-if you're a coffee drinker, have your last cup before noon.
To ensure you're getting adequate sleep, you have to figure out your ideal bedtime-and then commit to it.