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Give It a Rest

Healthy Sleep and Rest

Lack of sleep is a common problem plaguing many people but there are a number of natural solutions, including simple lifestyle changes and dietary supplements.

Sleep—we crave it. We lose it. We’re deprived of it. We can sleep lightly, deeply or soundly. On a good night, we sleep like a baby, a rock or a log. Sleep can be broken. Sleep can be refreshing. We can be sleepless. We can walk in our sleep or talk in our sleep. Some countries, rather than ask, “How are you?” instead ask, “How did you sleep?” Without adequate or restful sleep, we can be tired, lethargic, sluggish, bleary-eyed or downright cranky the next day. Conversely, a good night’s sleep translates into an energetic and productive tomorrow.

Sleep has the potential to affect every other system that in order for our bodies to properly function on a day to day basis, people need an adequate amount of sleep, and good quality sleep, each and every night.

However, for many people, a consistent, good night’s sleep is as elusive as a dream.

Sleep by the Numbers

The Centers for Disease Control and Prevention (CDC) has said that adults between the ages of 18-60 need at least seven hours of sleep per night; over age 60, seven to nine hours is recommended. Children need more sleep; the amount of sleep needed is in direct proportion to their age—the younger the child, the more sleep they need. Once they hit teenage years, eight to 10 hours is sufficient.

Danna Pratte, founder and CEO of the Arizona-based manufacturer, NB Pure, said that sleep problems affect anywhere from 50 to 70 million Americans, with about 40 to 50 percent of adults ages 20-60 getting less than seven hours of sleep per night.

Srinivas Jayanthi, scientific liaison for Bio-Tech Pharmacal, a manufacturer based in Arkansas, cited similar statistics. “Nearly 70 million Americans have some form of sleep disorder, and 30 percent of this population suffers from chronic insomnia. Various statistics across the globe show 10 to 30 percent of the world population are suffering from insomnia. Approximately 40 percent of the global population aged 65 and older are prone to chronic sleep disorders. Studies show less than 10 percent of adolescents are suffering from insomnia, while a staggering 25 percent of young children suffer from behavioral insomnia,” he said.

And sleep deprivation is not limited to one demographic over another; it can be an across-the-board issue.

“The profile of the typical sleep sufferer used to be a woman over age 50, but now research points to Millennials as the consumer that suffers the most with sleeplessness or restless sleep. This is especially true for those Millennials who have children and are juggling work and life balance. Not to mention today’s 24/7 world, where work blurs into personal time and the overload of social media and always being plugged in,” said Deborah Kelly, director of public relations at Boiron, a manufacturer based in Pennsylvania.

Women are more likely to be affected by insomnia, particularly menopausal women or pregnant women, due to hormonal changes, said Vicky Mak, technical writer for Childlife Essentials, a manufacturer based in California. She added that seniors are more affected than younger people.

Why Can’t I Sleep?

Normal sleep patterns can be impacted by a multitude of factors, from the environment to diet to use of technology before bed and more.

“The surrounding environment or occupation can affect your body’s internal clock called the circadian clock. If you work during the night, travel frequently between time zones, or live with frequent noise and light at night, this can disturb your circadian clock. Living in uncomfortably high- or low-temperature environments may also prevent one from getting enough sleep,” said Mak.

Worrying thoughts or the inability to “shut off your brain” contributes to sleeplessness, particularly as the pandemic has raged on. “People feel like they are constantly ‘on’ or plugged in and feel they can’t really turn off. People can all too often get caught in this seemingly never ending cycle of stress. Factor in poor eating habits and poor exercise habits, and you can have real issues,” said Pratte.

The pandemic has affected every aspect of our lives, including the amount and quality, of our sleep.

“The added stress and the strain on daily schedules that has resulted from COVID-19 has also led to sleeplessness for many Americans. This is especially difficult because proper sleep is important to keeping the body healthy during this immune crisis,” added Joseph Dowling, CEO of CV Sciences, a manufacturer based in California.

Boiron recently commissioned a One Poll survey of 2,000 parents of school-aged children regarding sleep patterns. The study found nearly half of them blamed work stress on their inability to fall asleep at night. “According to the survey, 84 percent said the transition from remote to office work, or vice versa, disrupted their sleep schedule. Not only are people adjusting to a return to the office, but they are also getting used to having less sleep. Thirty-two percent said they slept more when they were working from home,” said Kelly.

Lifestyle habits, such as not exercising enough, napping during the day, or using electronic devices close to bedtime can disrupt the circadian clock since “ … artificial light can give your body false wakefulness cues,” added Mak.

“The added stress and the strain on daily schedules that has resulted from COVID-19 has also led to sleeplessness for many Americans. This is especially difficult because proper sleep is important to keeping the body healthy during this immune crisis,” added Dowling.

Chronic stress can be a culprit, too.

“In a normal and healthy human body, after an acute stress response, the cortisol levels return to a balanced state; this doesn’t happen during chronic stress, leading to various negative effects on the sleep-wake cycle which further impacts the circadian rhythm,” said Jayanthi.

“Sleep and wakefulness are regulated from the brainstem (diencephalon: thalamus and hypothalamus) and basal forebrain by a set of interacting neuronal subsystems identified by specific neurotransmitters like noradrenaline, serotonin, acetylcholine, histamine and hypocretin,” he continued. “These subsystems contribute to the sleep-wake cycle. An impaired expression pattern of these critical molecules due to various age-related medical conditions affects sleep patterns and leads to various neurological disorders,” said Jayanthi.

Laura Fuentes, Rph, co-founder & COSI at Green Roads, a Florida-based manufacturer, also cited stress and cortisol as factors in inadequate sleep. “Poor sleep can lead to weight gain and increased stress. High stress levels cause a release in the hormone cortisol, which can lead to an increase in blood sugar, cholesterol and blood pressure. The combination of these effects can lead to heart disease,” she said.

If you are what you eat, you are also what you sleep, as diet can negatively affect sleeping patterns. “Caffeine is a stimulant and alcohol can impair the quality of sleep. Certain foods and refined carbs have the capacity to overstimulate the nervous system,” said Kelly.

Health Consequences of Sleeplessness

Sleep is crucial to all other systems. “Simply put, sleep is the foundation of wellness. When sleep suffers or lacks, so many issues can arise; the lack of sleep has a snowball effect on so many systems in the body,” said Pratte. These include gut health, cognitive performance, immunity and skin aging.

“Lack of sleep can also affect your heart and circulatory system by increasing the risk of high blood pressure, coronary heart disease and stroke. It can lead to problems with your immune system (impairing your body’s ability to fight infections), respiratory system (worsening asthma symptoms), and metabolism (contributing to overweight and obesity),” said Mak.

“Some of the major health consequences associated with lack of sleep are deregulation of neurotransmitters and hormones that help flip the on-off switch between waking and sleep. Lack of sound sleep (of good quality and duration) disturbs the 24-hour circadian rhythm and management of wake-time energy. Medical complications associated with lack of sleep are allergies, central adiposity, diabetes, hypertension, heart disease, fatigue, and other physical and mental ailments,” said Jayanthi.

Occasional lack of sleep can cause short-term problems, like headaches, inability to concentrate or irritability, but if insomnia becomes a nightly issue, it can affect long-term memory formation, learning and can pose health complications for other systems of the body. “The cumulative effects of long-term sleep deprivation can lead to increased risk for hypertension, diabetes, obesity, heart attack, stroke and depression,” said Dowling.

And adults aren’t the only ones who could suffer. “In children, sleep deprivation is associated with poorer neurobehavioral processes,” said Mak.

Almost everyone experiences occasional insomnia, but there are more serious sleep-related disorders, as well as health consequences of inadequate sleep. For example, Shift Work Disorder, suffered by some people who work nights, said Pratte, adding that business people who travel across many time zones can suffer from a disturbed 24-hour sleep-wake cycle, which can hinder performance and cognition.

Other sleep disorders include sleep apnea, characterized by snoring and brief periods of cessation of breathing throughout the night, and narcolepsy—excessive daytime sleepiness. Another common one is restless leg syndrome. All of these are more serious conditions and require medical assessment.

Natural Solutions

Practicing good sleep hygiene is important for improving sleep quality. “Getting regular exercise can benefit both heart health and sleep quality by lowering stress and improving your mental health. Taking a hot bath or employing relaxation techniques before bed may also help you manage stress and fall asleep faster. Adopting a routine bedtime regimen and a regular sleeping schedule everyday can help maintain your body’s circadian clock. Applying a regular bedtime routine and a set bedtime is especially important for children to learn how to develop healthy sleeping habits,” said Mak.

Pratte added that sleep, diet and lifestyle are intrinsically linked. “Many people’s diets lack key nutrients, like vitamins A, C, D, E and K, most commonly associated with sleep problems,” said Pratte.

On the flip side, there are certain habits to avoid, such as limiting screen time near bedtime, avoiding caffeine and alcohol, and limiting fluid intake before bed.

Snow Xia, LAc is a licensed acupuncturist and owner of Hima Acupuncture in New York, NY. She uses acupuncture on many to address sleep issues. “Acupuncture helps to bring our nervous system back to homeostasis. It gives the nervous system a gentle nudge to modulate back to its parasympathetic state, which can improve not only sleep, but mood, digestion, metabolism and sexual functions. The beauty of traditional Chinese medicine (TCM) is in its ability to treat each patient as an individual. There is no one-size-fits-all solution. Acupuncturists are able to differentiate the root cause of the sleep issue from reading the tongue and pulse of a patient. This ensures each patient is treated as an individual, with a set of unique points that aim to correct the imbalance of the meridians that are out of whack,” she said.

Practitioner Products for Sleep Support

Even despite practicing good sleep hygiene, sometimes another boost is necessary. Some consumers are prescribed sleep medications, but caution is warranted, as some medications of this ilk can be habit forming. Many people are shying away from over-the-counter sleep aids, as they often contain the same ingredients in antihistamines, which can also cause grogginess the next day. And sometimes, prescription sleep medications can cause unpleasant side effects. That is why many consumers are turning to natural supplements for a bit of sleep support.

Many manufacturers believe that the natural category is going to grow, particularly as sleeplessness is very common. “Supplements can help add key nutrients and vitamins to the body that a person may not be getting from their current diet. It is important to remember that some diets can lack certain nutrients because of the foods they either include or prohibit; that is where supplements can play such an integral role,” said Pratte.

Power Down is a melatonin-free product manufactured by NB Pure which supports falling asleep faster and staying asleep, along with boosting the body’s natural immunity. Power Down contains such ingredients as ashwagandha, l-theanine, GABA (gamma-aminobutyric acid), chamomile and rhodiola.

As we age, we lose melatonin, a natural hormone that is produced in response to darkness. Bio-Tech Pharmacal Inc. manufactures a sustained-release form of melatonin, which “ … exhibits a steady release of active melatonin over a period of seven hours, providing a gentle and consistent route towards healthy and restorative sleep,” said Jayanthi.

Green Roads offers Sweet Sleep Oil, a berry-flavor blend of melatonin, CBD and CBN. “CBN is a cannabinoid like CBD with certain qualities that make it ideal for a sleep formula,” said Fuentes. Other products are Sleepy Z’s gummies with melatonin, and Sleep Capsules which contain melatonin and CBD.

Boiron offers SleepCalm, a plant-powered homeopathic alternative for occasional sleeplessness. It is melatonin-free and is available in meltaway tablets or in liquid form. “Homeopathy is a largely untapped resource for sleep issues,” said Christophe Merville, Boiron director of education and pharmacy development.

“The safety profile is a big advantage as there is a very low risk of side effects, no known interactions with other medications, no dependence or addiction concerns, and no next-day drowsiness, dizziness, headaches or nausea. Each plant-based active ingredient in the medicine targets a set of symptoms associated with a disturbed circadian cycle,” he continued.

ChildLife Sleep Essential is a melatonin-free option for children; the ingredients include ETAS (an enzyme-treated ingredient derived from asparagus stalks); lemon balm; passionflower; valerian root; and suntheanine.

CV Sciences offers hemp extracted CBD formulas, which customers commonly take for sleep. For example, +PlusCBD not only supports restful sleep patterns but can also be used to minimize the effects of stress and occasional soreness, both of which can contribute to sleeplessness. The product comes in liquid, soft gel, topicals or gummies. For clinical strength support, an option is +ProCBD, made exclusively for the practitioner market. They feature “….CBD at high levels that are best recommended by a health professional,” said Dowling. And in 2021, CV Sciences introduced +PlusCBD Sleep gummies, part of the company’s Wellness Blends collection of functional CBD products. Along with CBD, other active ingredients include melatonin, magnolia bark and lemon balm.

State of the Market

“Sleep issues are exceedingly common in Americans, and signs point toward a continued upward trend in sleeplessness and serious sleep conditions,” said Dowling. Mak agreed. “Due to rising awareness of the importance of sleep in mental health, physical health, quality of life and safety, global demand for sleep aid products is projected to grow significantly over the next six years,” she said.

“The value of the total sleep market in the U.S. varies depending on the source and the products and services they choose to include. One market research firm values the sleep aid market at $70 million when looking only at immediate sleep supporting products. Another, weighing in with products like smartphone apps, white noise machines and specially designed mattresses and pillows, and the value of the sleep market jumps to almost $30 billion,” added Dowling.

“The sleep category across all retail channels was growing by double-digits prior to the pandemic and exploded during the pandemic due to its negative impact on sleep schedules. Millennials are more likely to seek out products with natural ingredients for sleep and are willing to spend more for safer options. They are also more likely to seek out a sleep aid faster—only waiting one or two nights of sleeplessness,” said Barbara Apps, Boiron category product manager.

Practitioners Role

It may take a lot of digging to get to the root of the “why” someone is consistently having trouble falling or staying asleep. In addition to recommending supplements, practitioners can make a number of recommendations.

“People who have sleep issues may need to try a myriad of different approaches from homeopathy to lifestyle changes to address them. Establishing healthy sleep habits is a good first step. Practitioners can recommend setting a sleep goal of seven to eight hours a night and keeping a sleep diary to look for patterns. Lifestyle changes can also be helpful. Waking up every day at the same hour seems to be the most reliable way to restore a healthy circadian cycle. Eating a balanced diet and avoiding caffeine and screens before bedtime is also recommended, as blue light suppresses the body’s natural production of melatonin. A dark, quiet bedroom at a temperature conducive to sleep—which, for most people, is around 65 degrees Fahrenheit—is a must. A relaxing routine of meditation, breathing exercises, and/or journaling before bed can also be helpful,” said Merville.

“In today’s busy lifestyle every individual should focus on personal health by following good health practices like consuming a balanced and nutritious diet, performing regular physical exercise, practicing spiritual or mindful methods like meditation or yoga to attain psychological calmness,” said Jayanthi.

“Mind and body synchronization is critical for healthy sleep-wake cycles. Recently a new field of study emerged, psychoneuroimmunology, to understand the impact of mental attitudes on the body’s resistance to disease, especially with respect to the links among and between the mind, the brain and the immune system. A number of studies support the communication between the central nervous system and the immune system providing medical practitioners a new perspective by giving attention to the beliefs and feelings of patients. Hence, along with mainstream medical treatments, practitioners should think of using natural methods such as melatonin and other dietary supplements, which can support a healthy immune system, to address problems associated with sleep,” he continued.

Practitioners for pediatric patients need to get to the underlying root cause of the sleep issues; in many cases, the fix can be as simple as limiting screen time before bed, more exercise, and being consistent with bedtime.

“Practitioners can help their patients by emphasizing the importance of having a well-balanced diet, exercise and maintaining a regular routine when it comes to sleep. They should advise patients to have a good attitude toward sleep, finding habits that relax their mind and body, changing bad habits, and minimizing stimulating information and harsh lights from phones, tablets, laptops and other devices,” said Fuentes.

Xia said that besides getting regular acupuncture and taking prescribed herbal supplements, other useful tips for improving sleep include a warm foot bath before bed, which she said has the ability to drain active energy from the head as well as acupressure on the point Kidney 1 on the feet, which can help calm the mind. “Practice good sleep hygiene by taking the time to wind down before bed, keeping electronics out of the bedroom, and going to sleep at the same time every night,” she said.

Healthy Take Aways

• Nearly 70 million Americans have some form of sleep disorder, and 30 percent of this population suffers from chronic insomnia.
• Lack of sleep can also affect your heart and circulatory system by increasing the risk of high blood pressure, coronary heart disease and stroke.
• Simple tweaks, such as the proper pillow, or limiting screen time and caffeine before bed, as well as dietary changes, can make a huge difference, along with acupuncture and supplements.

For More Information:

Bio-Tech Pharmacal, www.biotechpharmacal.com
Boiron USA, www.boironusa.com
Childlife Essentials, https://childlifenutrition.com
CV Sciences, www.cvsciences.com
Green Roads, https://greenroads.com
NB Pure, https://nbpure.com
Zoey Sleep, www.zoeysleep.com