These days, missing out on a good night’s sleep is, unfortunately, not that unusual for anybody. We’ve all experienced those stressful days or weeks when we can’t seem to slow down enough to get the rest and restorative sleep we need.
I think many patients fall into that category, too, and probably have been struggling for a long time. Fortunately, there are supplemental approaches that can help them get the restorative sleep they need. Here are two that I love.
One of my favorites is melatonin. Because of the stresses of the pandemic and simply the times we live in, melatonin use has seen a recent surge in popularity. But even before its current notoriety, there were many good reasons to recommend melatonin. After all, there are many conditions and causes that deplete this natural hormone from the body.
• Age: As we get older, our sleep/wake cycle deteriorates and disrupts our circadian rhythm, throwing off the natural timing of melatonin release. Not surprisingly, this is one reason that insomnia affects up to 50 percent of people aged 60 years and older. Additionally, some experts consider low melatonin levels to be a cause of aging, and not just an effect.1
• Screen Time and Artificial Light: The “blue light” of tablets, smartphones and computers reduces melatonin levels, even in young people (who otherwise would be well-stocked with it). One study showed that two hours of continuous screen time by 20-year-olds reduced melatonin levels by 22 percent.2 The fact that even 20-year-olds are greatly affected by this amazes me.
Of course, that effect is most likely multiplied as we age, especially considering the ubiquity of screens in our lives. There is a good case to be made for recommending no screen time at all for two hours before bedtime. That’s going to be a tough ask for some patients, but it may be necessary to help them re-establish their sleep, too.
• Changes in Schedules, Travel and Working at Night: Travel, of course, throws the circadian rhythms for a loop because a patient’s mind and body are used to a specific day and night cycle. But really, anything that is disruptive of regular sleep is going to have an effect.
Combine a late night with screen time, and a person has definitely set themselves up for brain fog, a weakened immune system, and increased inflammation and oxidative stress. And this can have extremely serious consequences. In fact, women who work in shifts are at greater risk of breast cancer because of their exposure to artificial light during nighttime.3
• Overweight/Obesity: Carrying extra pounds may not just be due to sedentary lifestyles or a slow metabolism, but actually caused, in part, by a decline in melatonin activity in the first place. This can become a vicious cycle, in that fat stores themselves can decrease melatonin. Research suggests that melatonin supplementation may help bring patients who struggle with their weight into a better metabolic balance, as part of a diet and exercise regimen.4
• Various Health Conditions and Diseases: In addition to obesity, other conditions—including systemic inflammation, autism spectrum disorders, polycystic ovary syndrome, heart disease and insulin resistance—may have a cause/effect relationship with melatonin levels. That’s not to say that low levels are necessarily the reason for the disease, but they may be both a contributing factor and effect of many health issues.2
With all of these health factors in mind, I think there’s a strong case to be made for recommending melatonin—and I haven’t even touched on its potential for preserving bone density, cancer prevention, tumor reduction or depression treatment.2
Nonetheless, melatonin needs to be recommended with care. Patients may need to block out some time for extra sleep and plan on getting ready for bed a little earlier than usual. They also may want to limit caffeine and alcohol intake during the lead up and use of the supplement, so that it can work its best to help restore healthy circadian rhythms.
I’m also a big fan of sustained release forms of melatonin. Sometimes the body can rapidly cycle through melatonin, so levels don’t remain consistent to help a patient get better sleep. A 10 mg dose of sustained release melatonin can initially get someone into a healthy cycle.
Reduce Daily Anxiety, Increase Restorative Sleep
Effectively dealing with anxiety during the day can also help prevent sleeplessness at night. Afterall, prevention is the cure! For that, I’d consider a specialized extract of Echinacea angustifolia. While many echinacea species are well known for bolstering the immune system, a specific extract from a specially cultivated plant calms nerves and relieves anxiety.
This clinically tested Echinacea angustifolia (EP107) delivers alkamides—natural compounds with effects on the endocannabinoid system similar to phytocannabinoids from hemp—that ultimately have a “cooling effect” on the way stress and anxiety are felt in the body and mind.5-7
Clinical research has found that Echinacea angustifolia is fast-acting, too. A study published in Phytotherapy Research assessed participants (which included women and men with anxiety, average age of 41 years) using the State-Trait Anxiety Inventory (STAI). Participants were scheduled to use this specialized echinacea extract for one week and evaluate their anxiety before, during and after using the product. But in just three days anxiety levels were significantly lower in both state and trait categories. Plus, the effects remained stable for the duration of the clinical trial and even for two weeks following treatment—all without any undesirable side effects.8
This echinacea extract won’t cause drowsiness. Instead, it will take the edginess off your patients’ daily stressors, and allow them to focus, attend to the tasks at hand, and not feel burdened by anxieties at the end of the day when they’re trying to relax.
Help Your Patients Restore Their Sleep and Their Health
Sleep is more than simple downtime. It is essential to our well-being. For patients who seem to be struggling with getting the rest they need, melatonin has great potential. Along with consistent and healthy “wind-down” time at the end of the day, the right melatonin supplement can make a tremendous difference. And for those stressful struggles during the daytime hours, a clinically studied form of Echinacea angustifolia can help your patients keep anxiety from getting the upper hand.
1 Stepnowsky CJ, Ancoli-Israel S. Sleep and Its Disorders in Seniors. Sleep Med Clin. 2008;3(2):281-293.
2 Ferlazzo N, Andolina G, Cannata A, et al. Is Melatonin the Cornucopia of the 21st Century? Antioxidants (Basel). 2020;9(11):1088.
3 Kubatka P, Zubor P, Busselberg D, et. al. Melatonin and breast cancer: Evidences from preclinical and human studies. Crit Rev Oncol Hematol. 2018 Feb;122:133-143.
4 Cipolla-Neto J, Amaral FG, Afeche SC, Tan DX, Reiter RJ. Melatonin, energy metabolism, and obesity: a review. J Pineal Res. 2014 May;56(4):371-81.
5 Witkin JM, Tzavara ET, Nomikos GG. A role for cannabinoid CB1 receptors in mood and anxiety disorders. Behav Pharmacol. 2005 Sep;16(5-6):315-31.
6 Hájos N, Holderith N, Németh B, et al. The effects of an Echinacea preparation on synaptic transmission and the firing properties of CA1 pyramidal cells in the hippocampus. Phytother Res. 2012 Mar;26(3):354-62.
7 Zanettini C, Panlilio LV, Alicki M, Goldberg SR, Haller J, Yasar S. Effects of endocannabinoid system modulation on cognitive and emotional behavior. Front Behav Neurosci. 2011 Sep 13;5:57.
8 Haller J, Freund TF, Pelczer KG, Füredi J, Krecsak L, Zámbori J. The Anxiolytic Potential and Psychotropic Side Effects of an Echinacea Preparation in Laboratory Animals and Healthy Volunteers. Phytother Res. 2012 Mar 26.
Dr. Holly Lucille is a nationally recognized licensed naturopathic physician, lecturer, educator and author of Creating and Maintaining Balance: A Women’s Guide to Safe, Natural, Hormone Health. Her private practice, Healing From Within Healthcare, focuses on comprehensive naturopathic medicine and individualized care. Outside of her practice, Dr. Lucille holds a position on the American Association of Naturopathic Physicians board of directors and is on the faculty of the Global Medicine Education Foundation. She is the past president of the California Naturopathic Doctors Association, where she spearheaded a lobbying effort to have naturopathic doctors licensed in the state of California. A graduate from the Southwest College of Naturopathic Medicine, Dr. Lucille’s commitment to naturopathic medicine has been recognized with the Daphne Blayden Award and, more recently, the SCNM Legacy Award.