I decided to write an article on sleep because I get a lot of letters from people about their sleep problems- and that’s people young and old. It is widely recognized that sleep disorders have reached epidemic proportions, and the sale of sleeping pills has become a multi-billion dollar industry.
The first thing a doctor does when presented with a patient’s sleep problem is to try to figure out if it’s a manifestation of another larger problem. For example, does the patient have clinical depression? or generalized anxiety? or both? There are many more conditions that can interfere with sleep, but those two are very common. And naturally, if there is a larger, overriding health problem- whether physical or mental- the doctor will want to address that problem- as the primary approach to solving the sleep problem.
But, let’s assume, for the sake of our discussion, that there is no other problem- because a lot of people fall into that category. Sure, the patient is depressed about not sleeping well, but he or she is not depressed otherwise- at least, they’re no more bummed out about life in general than the rest of us. (small attempt at humor there) And likewise, he or she may be anxious about what kind of night it’s going to be, but they’re not a textbook case of anxiety.
So, we’re talking about chronic insomnia as an entity in itself- and it applies to a lot of people.
Realize that insomnia can happen at any age- including childhood. But, in childhood, you would always look for an underlying cause- there has got to be one in that case. However, insomnia is, more often, age-related, and it gets more common as people get older. And, the plain truth is that the sleep mechanism becomes faulty with age. Think of it like a switch that goes back and forth between wakefulness and sleep, and it just doesn’t work as well as you get older.
Of course, people do a lot of things that make it worse. They consume drugs, alcohol, and caffeine that interfere with sleep. Faulty diets interfere with sleep. Lack of exercise sabotages sleep. And mental stress is a major sleep wrecker- and there seems to be plenty of that going around these days.
But, the truth is that there are people who follow health programs and try to avoid all those things as much as possible, but they still suffer with sleep problems; they just don’t sleep as well as they used to. So, the first thing to realize is that sleep becomes more delicate, more sensitive, and more problematic with age- and it’s pretty much universal. It is just a fact of life. If you are an older adult, I wish I could tell you that there are things that you can do that will make you sleep like a baby again- or even like a child. But, it’s probably not going to happen. However, that doesn’t mean that you can’t improve your sleep. And it doesn’t mean that you can’t get to where you are getting enough sleep to function well and enjoy your life. A good practical result is all anybody needs, and it is within reach.
The most important thing to realize is that sleep cannot be faked. The worst mistake you can make is to start taking sleeping pills. There are no good ones. There are no prescription sleep medicines that I would use or recommend. You will be falling down a rabbit hole if you do that. Realize that sleep is a physiological process, and it’s vastly different from a drug-induced coma. Your goal is to sleep- not just to render yourself unconscious. So forget about taking any knockout pills. That is not the solution. It just makes the problem worse.
You have to realize that if you start taking a knockout pill, your body will very quickly adapt to it. The normal, physiological mechanism of sleep induction, which can be summed up by the word drowsiness will readily be supplanted by the blunt effect of the drug. I don’t know of any knockout pills that aren’t toxic, but it’s not just that they’re toxic. They also do not deliver healthy, restorative sleep.
There are still a lot of mysteries about sleep, but we do know that the brain goes through certain cycles of activity which can be traced during sleep. And these patterns are known as sleep architecture. It rather looks like a city skyline- with buildings and then open spaces and then more buildings- hence the term architecture. Your sleep architecture is never right when you take a knockout pill. It is always distorted. And most sleeping pills prevent entry into deep sleep, which refers to Stages 3 and 4 slow-wave, non-rapid eye movement sleep- which is the most restorative kind of sleep.
After taking a knockout pill, you don’t feel rested, and you don’t feel right. You might feel relieved to some extent. You might have the psychological sense that you have finally slept- because you know you were unconscious for a while. But, it is not going to last, and it will do no good things for your mind or your mood. And the longer you keep taking the drug, the worse it is going to get. Today, we hear about the “Ambien defense” where in court, defendants justify bizarre and criminal behaviors based on being under the influence of Ambien. And, that defense has actually worked! Ambien is currently the most widely prescribed sleeping pill in the world.
The newer sleeping pills include Ambien, Sonata, and Lunesta, but they all have problems, and many doctors still prefer and prescribe the older benzodiazepines, such as Valium, Ativan, and Xanax. Many doctors lean toward the benzo known as Klonopin because it’s long-acting, which they consider safer. And there are also heavy-duty tranquilizers such as Halcion and Restoril. A few doctors even revert to the more sedating old tricyclics, such as Elavil. Ugh! Nasty drug.
Listen to me: don’t get started on any of that stuff. If you have to wrestle with your sleep, then wrestle with it! But, don’t go down that path. It leads to nothing but ruin. And if you are already taking one of them, then find a doctor to help you wean off of it safely.
I don’t feel any better about the OTC sleeping pills either, most of which are based on anti-histamines.
Fortunately, there is lots you can do to improve your sleep, and it should start with the hygienic factors, that is, your lifestyle. Getting early morning sunlight in your eyes helps to restore your biological clock, so do it. Vigorous physical exercise helps to synchronize the wake/sleep cycle, so get out there and work it. Avoid sleep saboteurs like alcohol and caffeine. Optimize your diet because even subtle nutritional deficiencies can negatively impact sleep. I won’t go into all of them, but I will name a few: deficiencies of taurine, EPA/DHA, magnesium, Vitamin D, and obviously, tryptophan. But, what I have also noticed is that when people eat very low protein diets-as some vegans do, particularly raw-fooders- that sleep suffers. I can only speculate as to why. It’s possibly that it relates to specific amino acid deficiencies, such as tryptophan. However, it’s also possible that eating, digesting, and processing proteins acts like some kind of signal of diurnal passage: telling the brain that another day has gone by. Be sure to know that most people get enough protein, including most vegetarians, so I’m not saying that it’s a common factor with insomnia. But, I have seen it, particularly with extreme raw-food vegans, and extreme caloric-restrictors.
So, without going further into it here, make sure your diet is optimal. Your sleep depends on it.
As always, the hygienic factors come first- before you even think about taking anything for sleep. But, there are things, other than knockout pills, that you may want to consider taking. And, I am not talking about anything toxic, nor anything that is particularly sedating. I don’t believe you can help your sleep directly by taking something. Sleep has to happen naturally by itself. But, you may be able to help your sleep indirectly by taking things that support the process and facilitate a favorable pre-condition for sleep. I am going to discuss a few, and these are based on my own experience, with myself and others. Admittedly, I have wrestled with sleep. I won’t deny it. And fortunately, my sleep is better now than it has been in the past. Most mornings I wake up feeling very refreshed, and my transition to wakefulness is swift. Never do I even think about needing or wanting coffee or any kind of stimulant. And, I don’t have to eat in the morning to feel good either. If I’m not hungry, I wait. And if I do skip breakfast, it has no effect on my performance, physically or mentally. I go about my morning as usual, self-sustained, which is how it should be.
But, in the next blog, I will discuss some of the supplements that I consider useful to aid sleep. I don’t claim that it’s exhaustive. I’m sure there are other safe supplements that have worked for some people. But, I think it will be a good starting point for those who are looking for constructive help with sleep. But, remember the first rule: no knockout pills! There is no help there. And any doctor who wants to give you one, run away from him or her at full speed.