Natural Ways to Beat Insomnia
Dr. Zoltan Rona MD MSc
"The best cure for insomnia is to get a lot of sleep." From the brilliant archives of Senator S.I. Hayakawa
When I entered medical practice in 1978, there was no such thing as a Sleep Disorder Clinic. The past years have changed all that with waiting lists of people making appointments for help at dozens of such clinics throughout the city. Such clinics and well-meaning doctors have spawned a multi-billion dollar tranquilizer, anti- depressant and hypnotic medications business which flourishes as the quick fix for this increasingly common disorder. In 1998, pharmaceutical sales of anti- depressants in the USA was $4.79 billion and of anti-anxiety drugs $722 million. In the past year, this figure has nearly doubled. It is estimated that about 60 million people in Canada and the USA are taking one or more such prescriptions. Why is all this happening and what can be done about it in a drugless approach?
The Role of Caffeine and Sugar
My belief and observation as a clinician is that the major culprit for any sleep disorder is caffeine combined with sugar. Stress, anxiety, insomnia, depression and other nervous disorders are all made worse by excessive caffeine or sugar intake. With a Starbuck’s, Second Cup or Tim Horton’s on practically every block of all major Canadian cities doing brisk business serving caffeinated beverages and sugar just about 24 hours a day, one should not be surprised to see a growing number of people struggling with insomnia. Even those individuals who have just one cup of coffee in the morning may be suffering from insomnia simply because their liver detoxification of caffeine is too slow. Even if you drink just one cup of coffee in the morning, it may have an impact on sleep up to 24 hours later. Some individuals just have a great deal of trouble clearing caffeine out of their systems through the liver. For such people, drinking only a single, mildly brewed cup will cause insomnia for several weeks or months on end.
Common sources of caffeine include coffee, tea, chocolate, herbs like guarana, cola nut, yerb mate, carbonated soft drinks and over-the-counter medications for the flu, colds, headaches and weight loss. Sugar causes a variety of biochemical changes leading to many nervous system abnormalities commonly referred to as “reactive hypoglycemia.” Caffeine, alcohol and sugar are all hypoglycemic agents. While temporarily elevating blood sugar, the subsequent quick drop in blood glucose levels leads to nervousness irritability, restlessness and insomnia. Low blood sugar reactions caused by a combination of sugar and caffeine are probably the commonest cause of interrupted sleep I see in my practice every day. In those who are genetically susceptible, even one cup of coffee a day will cause the problem. Giving up sugar and caffeine would therefore be the first thing to do if you suffer from insomnia bad enough to require a prescription drug just to be able to sleep.For those who do not have issues with either sugar, caffeine or other addictions, the stresses of life, nutritional deficiencies or toxicities (mercury, cadmium, lead, aluminum, drugs too numerous to list) may be at the root of a deep-seated insomnia problem. Every attempt should be made to diagnose the cause through biochemical testing (blood, urine, hair stools, etc.) so that treatments can be aimed at the cause. Regardless of the cause, many natural remedies can be tried to help people sleep better. The paragraphs that follow here go into these natural alternatives to prescription tranquilizers, anti-depressants and hypnotics.
Green tea, often recommended for its anti-cancer, anti-oxidant and other health promoting effects contains caffeine. Why then does it not cause insomnia? The answer is its content of a lesser known amino acid called L-theanine which renders the caffeine in green tea harmless. L-theanine produces mental and physical relaxation and decreases stress and anxiety, without inducing drowsiness. L- theanine increases alpha waves, which are present in an awake, relaxed state. To achieve such results, one must drink about 8 cups of green tea daily or supplement with L-theanine capsules.
Unlike other anti-stress botanicals, theanine does not make subjects drowsy or sleepy the next day. L-theanine does not produce theta waves in the brain, which occur in a drowsy state. Based on the results of clinical studies, it has been established that L-theanine is effective in single doses in the range of 50-200 mg. It is suggested that subjects with higher levels of anxiety take a dose at the higher end of the effective range (100 - 200 mg) for best results. While not directly causing sleep, L-theanine helps anyone with a sleep disorder by eliminating anxiety but also by boosting the brains levels of GABA (gamma amino butyric acid), an inhibitory neurotransmitter which has anti-anxiety effects. Of course, one could also supplement the amino acid GABA in high doses (1000 – 5000 mgs.) before bedtime to induce sleep. Phytogenics, a Canadian company and Allergy Research in the USA both market a combination product containing 100 mgs. of L-theanine and 200 mgs. Of GABA. For those with internet access, check http://www.highlevelwellness.ca for more information.
Vitamins and Minerals
Insomnia can also often be helped by a trial therapy with high doses of vitamin B3 (Niacinamide) 1000 – 3000 mgs., B6 (100 mgs.) and inositol (100 mgs.). In practice, the combination of niacin and inositol, often used to help lower blood cholesterol levels, is an excellent sleep inducer. Other supplemental nutrients that can induce sleep include calcium, magnesium, potassium, zinc, brewer’s yeast, lecithin, octacosanol and vitamin E. In people with low or absent stomach acid secretion,
injections of B vitamins, especially vitamin B 12 and folic acid, may dramatically improve nervous system function. Magnesium sulphate injections will help nerves relax when oral supplementation fails. Some studies indicate that insomnia may also be related to a deficiency in iron and copper. Blood and hair mineral analysis can be of help to reveal these and other nutritional deficiencies.
Herbs and Homeopathics
Herbal or homeopathic remedies such as chamomile, hops, lady slipper, passion flower, skullcap, wood betony, acid phosphoricum, hypericum (St. John’s wort), kava kava and valerian in tea, capsule or tincture form may also be of help in some cases.
The amino acid, tryptophan, is very effective for insomnia. Although it is a natural substance, it requires a doctor’s prescription in Canada (1000 - 3000 mgs. before bedtime). Foods high in tryptophan include bananas, figs, dates and nut butters. To date, none of these foods require a doctor’s prescription.
An alternative health food store remedy is 5-HTP (5-hydroxy-tryptophan) which is a metabolite of L-tryptophan that gets converted in the brain to the sleep-inducing neurotransmitter, serotonin. The usual effective dose of 5-HTP is 100 - 300 mgs. before bedtime but this is one supplement which can be taken during the day to treat anxiety, depression, obsessive-compulsive as well as eating disorders without causing drowsiness. 5-HTP has been found to be more effective for sleep problems than L-tryptophan in Fibromyalgia and Chronic Fatigue Syndrome.
Foods high in tyramine may prevent sleep by increasing the brain levels of adrenalin. These are cheese, alcoholic beverages, chocolate, sauerkraut, bacon, ham, sausages, eggplants, potatoes, tomatoes and tobacco.
Another sleep remedy that has received a great deal of attention in the past few years is melatonin. Melatonin, interestingly enough, is made in the body by the pineal gland from serotonin mentioned earlier. Melatonin has proven benefits in Seasonal Affective Disorder and jet lag symptoms The usual effective therapeutic dose is 1 - 3 mgs. before bedtime, although some authors believe that even half a mg. is more than enough for sleep induction purposes. Melatonin is not legally sold in Canada but it can be imported from the US for personal use.
Toxic Heavy Metals
In rarer situations, nervous system symptoms can be caused by mercury excess in the body. Sources may include contaminated seafood and the erosion of the common dental silver - mercury filling. High doses of selenium, vitamin C, vitamin E, garlic and N-acetyl-cysteine can help rid the body of toxic heavy metals such as mercury, cadmium, lead, aluminum, arsenic and copper. Getting a mineral analysis (blood, urine and hair) is a good way of determining whether or not toxic heavy metals are present in the body above acceptable levels. See a naturopath or holistic doctor for an assessment aty your earliest opportunity.
Dr. Rona recommends these supplements to his patients
Dr. Zoltan Rona is the best-selling author of several books, including Return to The Joy of Health and Natural Alternatives to Vaccinations (alive Books, 2000).