Insomnia is a common disorder that can be managed with lifestyle changes and supplementation.
Sleep, elusive sleep. We all need it and we all crave it, so why is it so difficult for some people to fall asleep and/or stay asleep? There are lots of reasons why people may experience the occasional inability to sleep, not the least of which is stress and an overactive brain, but for some others, insomnia is a nightly affair. Chronic insomnia can raise your risk for other health issues, so it is essential to get any sleep issues under control.
Ideally, adults over the age of 18 should aim for a minimum of seven hours of sleep per night, according to the CDC (Centers for Disease Control and Prevention).
Depending on their age, children need even more sleep than adults, but unfortunately, children can be prone to sleeplessness as well. The CDC recommends that school age children need nine to 12 hours per night, while teens need eight to 10 hours per night.
Still, said Katherine Cole, research and development manager with Childlife Clinicals, a manufacturer headquartered in California, “The total number of hours does not necessarily mean restorative sleep needs are met. This has evolved as science is untangling the complexity that is sleep.”
Why Can’t I Sleep?
If you can’t fall or stay asleep, you have company.
“Sleep deprivation is a national epidemic and is affecting millions of people,” said Tima Ciliberti, CEO of Relaxium Sleep, a manufacturer headquartered in Florida. “According to recent data, eight in 10 U.S. adults have trouble sleeping at least one night a week, and 40 percent report sleep issues five or more nights a week. A similar percentage rank getting enough sleep as the most important factor for maintaining good health and preventing health issues,” added Munzer Sundos, PhD, founder and CEO of Nupeutics Health, headquartered in California.
The 2020 pandemic hasn’t helped matters. “Everybody’s daily schedule, and the entire year for that matter, got thrown off-kilter by the pandemic,” said Laura Fuentes, licensed compound pharmacist and CEO of Green Roads, a manufacturing company headquartered in Florida. She added that because consistency and managing stress are important elements of a good night’s sleep, sleep is thrown off balance when there is a new danger present.
Age and medications taken can contribute to insomnia, along with certain illnesses. “Sleep deprivation is common with depression, schizophrenia, chronic pain syndrome, cancer, heart disease, stroke, Parkinson’s disease and Alzheimer’s disease,” said Charlotte Mosher, director of sales and marketing for Slumber Sleep Aid, a manufacturer based in Colorado.
Consequences of Insomnia
The need for sleep is so crucial that without sufficient amount of good quality sleep, our bodies can rebel. Serena Goldstein, ND, based in California, pointed out some detrimental effects, which include overeating and weight gain, hormonal imbalance, skin breakouts, heart palpitations and inadequate food digestion.
Occasional insomnia is manageable, but chronic lack of sleep can affect other systems.
“It can cause irregularities in blood pressure and heartbeat, and it puts a person at a much greater risk of developing unhealthy heart function. Over time, sleep deprivation can also result in blood glucose and metabolic disturbances, as well as weight gain and a weakened immune system,” said Mindy Pellegrino, education manager with Quicksilver Scientific, a Colorado-based manufacturer.
Dr. Vincent Giampapa, chief science officer with Healthycell, a manufacturer based in New Jersey, said that lack of sleep can even lead to an increased risk of dementia, along with diabetes, heart disease, stroke and cancer.
“Commonly, effects on the immune system are noticed because it’s easier to keep healthy and fight infection when one’s immune system is strongest. During sleep, the immune system undergoes critical maintenance. In order to maintain a strong immune system, it’s important to get adequate sleep each night,” Cole added.
Sleep loss can also affect a person’s mood, mental wellbeing, concentration and memory; insomnia is also linked to an increased risk of depression. “People who don’t get enough sleep are also less able to effectively respond to mental and physical stressors,” said Pellegrino.
Another potential consequence is obesity. “Insufficient sleep is also shown to upset the hormonal balance that controls metabolism. Studies show that people who sleep fewer than six hours per night are more likely to have a higher body mass index,” said Dr. Sundos.
Sleep is vital for the anti-aging process as well. “At night while you’re sleeping, your body releases a natural chemical called human growth hormone (HGH). Its primary role is to undo the physical stress exerted on the body from daily activity. Your body literally heals when you sleep. Unfortunately, HGH production declines significantly as we age, and it’s thought that this decline is one of the primary contributors to the aging process,” said Ciliberti.
Cortisol, our body’s stress hormone, controls our sleep cycle, and when it’s imbalanced, it can wreak havoc. “Cortisol shoots up at around 6 to 8 a.m. to wake us up, drops around 11 a.m. or noon, then decreases steadily throughout the day as melatonin (our sleep hormone) then begins to rise where then we can fall asleep perhaps before 11 p.m., a time when many of these contributing hormones are going to get recycled out and made new. We need cortisol to survive, so ‘stress’ is good, yet poor sleep messes with this cortisol curve and affects hormones like estrogen, leptin, ghrelin, testosterone and thyroid, for example, that get refreshed at night,” said Dr. Goldstein.
On the flip side, sufficient sleep regenerates the cells in our bodies, helps our liver to detoxify and helps our brains process the events of tomorrow. “This clean-up work is needed so we can protect our immune system and remain resilient to face the next day without being exhausted physically or mentally,” said Pellegrino.
Treating Insomnia Naturally
Diet, exercise and lifestyle play a role in helping to establish healthy sleep patterns, and putting your body in a restive state close to bedtime is important, as is shutting off screens. “You really should avoid using any kind of digital devices before trying to sleep because of the blue light they emit from their screens. This blue wavelength is unimpeded as it enters the retina, blocking the sleep-promoting hormone melatonin. At the very least, people should take advantage of the night-mode red shift found on many phones and tablets. And don’t forget to use a sleep mode, too, to avoid being awoken once you do fall asleep,” said Pellegrino.
Cole agrees that screens should be shut off, as circadian rhythm is influenced by light and exposure to bright light suppresses melatonin production.
However, relaxing apps used to facilitate sleep can be helpful.
Zoraida P. Aguilar, PhD, MS, technical officer with Bio-Tech Pharmacal, a manufacturer based in Arkansas, said that yoga followed by mindful meditation before bed is the best natural remedy to healthy sleep.
Deep breathing exercises and meditation before bed and moderate exercise throughout the day is a good approach to help the body wind down from the day. Other approaches, added Dr. Goldstein, include lavender pillows.
Maintaining a consistent, regular sleep schedule is the best defense against insomnia.
Dr. Sundos recommended to limit daytime naps, if taken, to 30 minutes and avoid doing so late in the day. And exercising at least 3.5 hours a week can help make it easier to fall asleep, though exercising too close to bedtime can have a stimulating, rather than a restive, effect, he added.
Dr. Goldstein said she advises her patients to frontload water during the day, as nighttime urination is a common complaint. In addition, people should finish eating three hours before bed, as it takes time to digest, and eating produces energy. She noted that if one does eat before bed, they should aim for lighter and plain foods, like salads or protein, and eat until you’re 70 to 80 percent full. She is also a proponent of a consistent bedtime, ideally at around 10:30 p.m.
“Studies have shown carbohydrates increase serotonin levels, which is important for a night of healthy sleep. Just make sure that with anything you eat before sleeping you consume it two to three hours beforehand so that your body isn’t consumed with digestive work while it’s trying to rest,” added Pellegrino.
The Market for Supplements
The market for over the counter sleep aids is quite large, and the reasons are varied. “First, we’re learning more every day from research on how natural medicine can help restore and enhance sleep. Much of this research, driven by consumer demand that is unique to the anxious times of 2020, confirms many of the theories about natural treatments we’ve had for some time. Environmental factors are impacting the ability to achieve restful sleep, so many consumers are exploring natural medications and supplements to restore sleep and rest during these uncertain times,” said Pellegrino.
Citing a study by Allied Market Research, Dr. Giampapa said that the market for sleep aids exceeded $49 billion in 2016 and is anticipated to reach over $79 billion by 2023.
While some people do take prescription sleep aids, too often they can produce unwanted side effects, such as morning grogginess. “Today, more than ever, consumers are savvy and seek healthier/holistic alternatives to prescription sleep medications,” said Ciliberti.
“People need more natural, plant-based options for sleep support. Everybody’s body is different, and prescription sleep medications—which are often associated with feeling hungover or groggy in the morning—may not always be the best option. I think trends we’re seeing in the market reflect those two factors,” said Fuentes. “Traditional treatments for sleeplessness such as tranquilizers tend to be addictive and coupled with unwanted side effects. For most healthy individuals finding the right natural solutions is the best place to start; it’s all about finding the right combination that works for each individual,” agreed Cole.
Also, people are starting to value sleep more than before, particularly in light of the pandemic. “Because of recent quarantine conditions, there has been an elevation in human consciousness and shift toward people embracing the value a good night’s rest can bring. It’s good to be active but resting is a critical part of growth. When you allow your mind and body to rest, it enables and empowers you to function more effectively,” said Austin Stevenson, chief innovation officer for Vertosa, a hemp and cannabis infusion technology company headquartered in California.
The Role of Supplements
Supplements can play a role in aiding in insomnia, but consumers should discuss the advantages and disadvantages with their practitioners.
“When selecting a sleep support supplement, we recommend to look for evidence about how well the product works, call the manufacturer and ask what studies they have to back up their claims, find out how the ingredients listed on the supplement label are actually in the bottle, and avoid using supplements made outside the United States,” said Dr. Sundos.
Dr. Goldstein commented that supplements should do just that—supplement, rather than replace, an unhealthful lifestyle. She said that supplements do not always fix the problem immediately. “If people are having sleep issues, I consider adrenals, hormones, a ruminating mind, food/water intake and when, urination issues, etc., which perhaps haven’t or couldn’t be addressed with conventional medicine. Then I’ll work with patients in knocking back the clock too in small increments, so they’re much more likely to comply with an earlier bedtime,” she said.
Dr. Sundos agreed. “Natural supplements can do great to manage poor sleep, but they should not be used for chronic sleep problems.”
Dr. Aguilar said that while living a healthy lifestyle is the best way to achieve healthy sleep, which includes a healthful diet filled with necessary nutrients, the next best thing is to take supplements.
For relief of occasional or even regular sleep disturbance, many consumers are turning toward natural ingredients. “Studies indicated that these natural ingredients have anxiolytic effects and promote relaxation. In particular, L-theanine is able to cross the blood-brain barrier where it can be most effective in stimulating alpha brain waves and support relaxation at bedtime,” said Cole.
More ingredients are finding their way into sleep aids.
Dr. Goldstein said that taking magnesium before bed is one of her favorites, calling it nature’s relaxer. “We don’t get enough of it in our soil, and much of it is depleted ironically with stress, caffeine and alcohol,” she said.
Lavender is another favorite because it “activates our GABA receptors, the calming neurotransmitter.”
Another well-regarded ingredient in sleep supplements is melatonin, a hormone produced from the amino acid tryptophan. Others include valerian and hops extract, lemon balm extract, magnolia bark extract, jujube, L-ornithine, L-lysine and L-theanine.
Ashwagandha, an adaptogen, is an overlooked natural sleep aid, said Ciliberti. “Adaptogens are herbs that help increase the body’s resistance to stress and bring the body back into balance once it has been stressed, which is critical to restoring healthy sleep patterns,” she said.
CBD (cannabidiol) is also beginning to be incorporated into sleep aids. According to Vertosa’s Stevenson, sleep is one of the top three reasons consumers seek cannabis. “We’re infusing ingestible products with sedative-inducing cannabinoids like CBN. Cannabinoids such as CBN (cannabinol), CBD and THC (tetrahydrocannabinol) can also be combined with other functional ingredients such as a lot of use of other functional ingredients such as valerian root or chamomile extracts, all blended together to help induce sleep. I have seen the market move away from melatonin and embrace cannabinoids like CBN to help promote better sleep,” said Stevenson.
Green Roads has combined melatonin with CBD and CBN with their new formula called Sweet Sleep. Each ingredient does a different job. “Melatonin is a part of your natural sleep cycle, CBD manages ordinary stress and helps calm a racing mind (a big reason many can’t drift off at the end of the night), and CBN (which is a cannabinoid like CBD) has special properties that make it ideal for a sleep formula,” explained Fuentes.
Slumber Sleep Aid was the first brand to develop a full line of CBN products specifically designed for improving the sleep experience, said Mosher.
Other companies, such as Quicksilver, have developed calming products formulated with a combination of various botanicals and herbs. For example, LiopCalm is the company’s premium sleep formula blend and it contains liquid skullcap herb extract, liquid passion flower extract and blue chamomile flower oil, along with GABA, a neurotransmitter.
Another product is the company’s Liposomal Melatonin. “Melatonin is an antioxidant hormone naturally produced in the body. Melatonin supports a healthy sleep-wake cycle and normal circadian rhythms, and may be beneficial in settings of jet lag, occasional sleeplessness or altered sleep schedules due to shift work. Supplemental melatonin can assist in restoring normal, healthy sleep patterns. By supporting deep restorative sleep, melatonin promotes the nightly repair, regeneration, and detoxification that occur when we sleep,” explained Pellegrino.
Quicksilver has also recently developed a suite of products that leverage CBD and other functional ingredients that support calmness, including its CBD Synergies-SP Sleep Formula and its CBD Synergies-AX Calming Formula, the latter of which was a finality in the 2020 NEXTY Awards.
Nupeutics’ flagship product is Sleep Master, which contains nepetalactone, valerian root, chamomile, linden flower, melatonin and magnesium glycinate.
HealthyCell manufactures REM Sleep; it contains a blend of herbs, amino acids and minerals to support all four stages of sleep, including lemon balm, magnesium, L-theanine and melatonin.
Relaxium Sleep is designed to regulate the natural sleep cycle by relaxing the body and calming the mind. It is a blend of ingredients that include melatonin, L-tryptophan, GABA and several herbal extracts.
How Practitioners Can Help
Complaints of insomnia are fairly common; chronic insomnia may lead to or be indicative of other, more serious sleep problems, such as sleep apnea. Talking with a patient about lifestyle habits, include diet, exercise as well as sleep patterns, is critical for getting to the bottom of the sleep deprivation issue. Depending on the root cause of the sleep issue and the length of time it has been occurring, many can be resolved or alleviated by change in daily and nighttime habits.
When a practitioner talks to a patient about supplements, he or she should do due diligence about the products.
For practitioners who recommend sleep support in the form of supplements, manufacturers offer training, webinars and other educational material and support with respect to their products.
Healthy Take Aways
• Absence of consistent, quality sleep can negatively affect many other physiological and emotional systems.
• Natural remedies should not be relied upon long term for chronic sleep problems without exploring other options, such as lifestyle changes.
• More ingredients for natural sleep solutions are being explored.
For More Information:
BioTech Pharmacal, www.biotechpharmacal.com
Childlife Clinicals, https://childlifeclinicals.com
Green Roads, https://greenroads.com
Nupeutics Health, https://nupeuticshealth.com
Quicksilver Scientific, www.quicksilverscientific.com
Slumber CBN, https://slumbercbn.com