Overcoming Sleep Disorders Naturally

Introduction

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f you’ve picked up this book, chances are you have trouble sleeping. Perhaps you have difficulty falling asleep. Or, you might fall asleep easily but then awaken during the night and find it impossible to get back to sleep. You might even think you’re sleeping a sufficient number of hours but still wake up tired and groggy in the morning. Any of these situations indicates that you may have a sleep disorder. The most familiar sleep disorder, of course, is insomnia.

If you do have trouble sleeping, you’re certainly not alone. More than one third of adults in the United States experience occasional insomnia and at least one out of ten American adults suffers from chronic insomnia. As you know if you’ve suffered even one night of insomnia, the consequences of sleep impairment or deprivation also affect your waking hours. A lack of restful sleep causes mood disturbances, impairs mental and physical performance, wears down the immune system, and ages you more quickly. It’s all too easy for a sleep disturbance to become a recurring problem. Fortunately, there are many things you can do to break this exhausting cycle.

In this book, you’ll learn about the underlying causes of insomnia as well as other sleep disorders and about the environmental, lifestyle, physiological, and psychological factors that play roles in sleep enhancement and disruption. You’ll also discover a variety of nutritional and herbal supplements that provide safe, effective alternatives to the drugs that are frequently prescribed as sleep-aids. Learning about your sleep problem is an important first step toward resolving it; the information you find here should be everything you need to help you get a good night’s rest.

Why a Good Night’s Sleep Is Essential for Your Health

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leep is a curious physiological phenomenon. Although there’s no question that sleep is essential—as necessary to our health and survival as food, water, and air—scientists still don’t know exactly why we sleep, even after decades of high-tech research. It’s no secret, however, that sufficient sleep is necessary to feel physically energetic and mentally alert. In addition, sleep appears to help restore proper levels of neurotransmitters in the brain and to play a role in emotional well-being. Some scientists theorize that the process of dreaming helps us to organize and preserve memories.

Despite sleep’s enduring mysteries, one thing is clear: we need a good night’s sleep to feel and be at our best. In this chapter, you’ll learn about normal sleep patterns and requirements, problems of sleep disruption, and the costs of sleep deprivation.

THE GROSS ANATOMY OF SLEEP

Carefully conducted studies have shown that most adults seem to need about eight hours of sleep in each twenty-four-hour period. Most people are naturally active during the day and sleep at night and it’s also normal to experience a period of sleepiness at midday, which in many cultures is sanctioned with a siesta. The cycle of sleeping and waking is determined by an internal biological clock that sets circadian rhythms (circadian means about a day). In addition to regulating the sleep/wake cycle, this internal clock controls the timing of hundreds of metabolic and other bodily functions.

The light that enters the eyes plays a key role in setting circadian rhythms. Light travels from the retinas as electrical signals through the optic nerves toward the center of the brain and reaches the hypothalamus, the body’s master clock, which contains a tiny cluster of nerves called the suprachiasmatic nucleus (SCN). As daylight wanes each day, the SCN signals another structure in the brain, the pineal gland, to produce melatonin, a hormone that promotes the onset of sleep. Conversely, at sunrise, the pineal gland is signaled by the SCN to decrease its production of melatonin, thereby promoting wakefulness. The hypothalamus coordinates the sleep/wake cycle with a host of other circadian rhythms, like the rise and fall of body temperature and the release of various other hormones, throughout every twenty-four-hour period.

Various other internal and external factors can impinge on these rhythms and the resulting circadian disturbance may be most noticeable for its impact on sleep. For example, hormonal shifts (such as those of menopause) can wreak havoc with the sleep/wake cycle; traveling across time zones is well known for turning normal sleep patterns upside down; and even light exposure at the wrong time—whether from a full moon or an artificial source—can disrupt sleep by incorrectly resetting the internal clock.

The Stages of Sleep

It’s helpful to understand the progression of normal sleep in order to gain a better understanding of why sleep disorders are so disruptive to health and well-being. Since the 1950s, scientists have used polysomnography, which is the simultaneous recording of electrophysiological and other data during sleep, to probe the activities of the sleeping brain and body. Five distinct stages occur during sleep and each plays an essential role in helping you to feel well rested and alert when you awaken. Four of these stages are classified as non-REM (or NREM) and the fifth as REM sleep. REM, as you may already know, stands for rapid eye movement.

Light Non-REM Sleep

Stage one, also called the hypnagogic state, is a light non-REM stage that is the transition between wakefulness and sleep. During stage one, external stimuli fade into the background and your thoughts become unfocused as you drift in and out of consciousness. Your muscles relax and your body temperature, blood pressure, and heart rate slowly begin to decrease.

Brain waves in stage one are rapid and irregular. The majority are theta waves, at a frequency of 4–7 cycles per second. Intermittent alpha waves, which have a frequency of 8–13 cycles per second and indicate relaxed wakefulness, can also be seen on the polysomnographic recording. Levels of serotonin, a neurotransmitter that enables communication between nerve cells and acts as a natural tranquilizer, begin to increase in the brain during this stage.

For most people with healthy sleep patterns, stage one sleep lasts only for a few minutes. When stage two of non-REM sleep takes over, relaxation deepens. Brain waves in stage two become larger and show erratic bursts of electrical activity such as sleep spindles and K-complexes, which are waveforms named for their characteristic appearance on the polysomnograph. Although not much happens in the way of physical restoration during stage one sleep, some physical repair processes begin during stage two.

Deep Non-REM Sleep

It’s more difficult to awaken a sleeper during the deep sleep that follows stages one and two. As you move into non-REM stages three and four, brain waves become very large and slow and are called delta waves, with a low frequency of ½–4 cycles per second. In general, between 20 and 50 percent of the brain activity recorded in stage three consists of delta waves; during stage four, more than 50 percent is delta waves, with the remainder theta waves.

Although a sleeper in one or the other of these stages appears simply to be breathing slowly and regularly and lying mostly still, deep non-REM sleep is essential for health. This quiet, restorative time provides the opportunity for the brain and nervous system to bring the body’s systems back into balance and for the body to do most of its repair work.

Good-quality sleep is largely defined by the percentage of time spent in stage four, which is also called delta sleep. Researchers have yet to determine the optimal amount of delta sleep but there’s no question that this sleep stage contributes significantly to our health and well-being. During delta sleep, immune function is strengthened, red blood cells are renewed, and growth hormone is secreted; growth hormone is not only critical for the healthy development of children but also for the repair of muscle tissue in adults. People who are chronically deprived of delta sleep often suffer from an increased incidence of illness as well as general aches, pains, and fatigue.

REM Sleep

After about an hour of the non-REM stages, sleep shifts into an active stage characterized by rapid eye movements (REMs). In REM sleep, your brain waves appear very similar to those of wakefulness but you’re actually dreaming. The nerves that control body movement are also temporarily suppressed by the brain’s inhibition of certain neurons in the spinal cord, which prevents you (for the most part) from physically acting out your dreams. During this stage, heart rate, blood pressure, respiration, and gastric secretions increase.

Although infants spend approximately 50 percent of their total sleep time in the REM stage, the amount of REM sleep generally decreases with age. As an adult, you spend about three-quarters of your sleeping time in non-REM sleep and only during the remaining quarter are you actively dreaming. REM sleep occurs several times throughout a normal night, as we enter into a REM period about every ninety minutes while sleeping. A typical REM period lasts approximately twenty to forty minutes but can increase in length to as much as an hour if the sleep session has been several hours or longer.

The exact function of REM sleep is not understood but there seems to be a definite need for it. Studies have demonstrated that it’s during the REM stage that memories are organized and stored, which is an essential component of learning. The dreams that characterize REM sleep also appear to provide an avenue for working out problems on conscious and subconscious levels. Although most dreams are forgotten soon after awakening, deprivation of REM sleep and dreams can lead to irritability, anxiety, confusion, and problems with impulse control.

HOW MUCH SLEEP DO YOU NEED?

In a 2001 poll, the National Sleep Foundation found that 63 percent of American adults were getting less than eight hours of sleep per night; most people were averaging about seven hours a night but 31 percent of adults regularly fell short of even this amount. By comparison, people living in the early 1900s regularly slept nine hours or more per night. The advent of electricity has played a major role in shifting sleep patterns. Prior to electric lighting, people tended to go to bed when it got dark. The availability of bright light at the flick of a switch has undoubtedly shortened the sleep period and also shifted its timing. Without darkness, the brain’s production of melatonin is inhibited, which results in a tendency to stay up far past dusk.

Most of us have been told throughout our adult lives that we need eight hours of sleep per night—but the reality is that some people seem to thrive on only six hours of sleep, whereas others need nine hours or more in order to function optimally. Clearly, there are individual differences when it comes to defining enough sleep. Perhaps the best indicator of whether or not you are getting enough sleep is how you feel when you’re awake. If you wake up in the morning without an alarm clock and feel refreshed and reasonably energetic, then you’re likely getting enough sleep.

Variations in Sleep Patterns

Researchers have found that people who thrive on less sleep, referred to as short sleepers, spend a proportionally larger amount of their sleep time in REM and stage four, which are considered to be the most restorative stages. Long sleepers, on the other hand, who generally require nine or more hours of sleep, spend a proportionally greater amount of their sleep time in stage two, which is a much lighter stage. Women also tend to sleep more than men do, although the reason for this gender difference is unclear.

For most of us, the biological clock operates on a cycle of roughly twenty-four hours. However, not only do people differ in the amount of sleep they require, they also differ in when they naturally want to sleep within that cycle. Some people are most energetic early in the day; these larks consistently rise early in the morning, no matter what time they may have gone to bed. Others are naturally night owls who don’t feel at their best until late evening. But even with these variations in specific sleep patterns, most people do become sleepy at some point after dark, particularly between midnight and dawn.

Although sleep patterns seem to have a genetic basis, many additional factors influence sleep needs. If you’re sick, for example, you need more rest to help your immune system function properly in its fight against illness. Regular physical exercise can reduce the amount of sleep you normally require but rigorous or unaccustomed exercise can increase your sleep need and exercising too close to bedtime can interfere with your sleep (see Chapter 10).

The amount of sleep an individual needs usually changes over the lifespan. Infants and children sleep longer and more deeply than adults; in fact, infants can sleep as much as eighteen hours per day. With age, sleep tends to become lighter and more easily disrupted and people often find that they sleep less than when they were younger. However, these changes often result from the emergence of sleep disorders (particularly in the elderly), not from a decreased need for sleep. On the other hand, if you find that you consistently need more sleep than you did earlier in life, it’s probably because the caliber of your sleep is not as good as it once was. Sleep quality is just as important as the actual number of hours spent sleeping.

Despite individual sleep pattern variations, getting enough sleep—and getting good-quality sleep—is essential for everyone’s optimal physical and emotional well-being. The trend in our society, unfortunately, has been to devalue sleep, packing as many activities as possible into each day and leaving little time for rest. Over the past century, the average amount of sleep time in the United States has been reduced by 20 percent and the result of this deficit is that we are a nation of sleep-deprived people. Even though our way of life has changed, our bodies still need adequate sleep.

SLEEP IS NOT OPTIONAL

Many people believe that if they routinely sleep less, their bodies and brains will then become