Sleeping Easy
As more Americans struggle with getting a good night’s rest, practitioners are encouraging both lifestyle changes and supplements to help them achieve that goal.
Sleep is a critical biological function that influences a wide variety of physiological processes. Sleep deficiency can affect mood and the ability to make memories and learn, but it also affects metabolism, appetite, blood pressure, levels of inflammation in the body and perhaps even the immune response. Lack of sleep has been linked to stroke, obesity, diabetes, anxiety, depression and the country’s No. 1 killers: heart disease and cancer.
According to the Center for Disease Control and Prevention (CDC), studies show that in the U.S. alone, an estimated 50 to 70 million adults suffer from sleep (or wakefulness) disorders. The National Sleep Foundation says that adults need seven to nine hours of sleep every night while kids may even need 10 or more hours. However, more than 40 million workers get fewer than six hours of sleep per night, or about 30 percent of the country’s civilian workforce.
There are many theories on why Americans don’t get enough sleep. According to Richard Mihalik, director of Innovation and product development of Missouri-based National Enzyme Company, diet and stress are the two main reasons. “We eat an unhealthy diet that can be inflammatory to our digestive systems. This is exacerbated by eating too fast, which results in insufficiently chewed food that causes additional digestive stress.We often eat too fast because we live very fast-paced lives compared to traditional cultures, [putting] us under additional stress. This stress triggers adrenaline, which among other things, slows our digestion.”
All these factors and probably others contribute to a very high rate of indigestion and gastric disturbances for Americans, Mihalik continued. “These often manifest when we lay down in the form of gastric discomfort, delaying and disrupting our sleep. Instead of recovering the next day from the indigestion and sleep disruption, our schedules demand performance, so we compensate by eating more unhealthy food and loading up on caffeine, both of which contribute to additional discomfort and stress in a vicious and unhealthy circle.”
Inadequate sleep scheduling is also a big concern, added Loretta Tafuri, PhD, RN, behavioral director and co-founder of Bariatric Associates of New England, which specializes in nutrition and medical weight-management, noting there are many obvious distractions (television, computers, overwork, etc.). “About seven to nine hours of sleep should be the goal, with variation depending on the individual. For school-age children (5 to 10 years old), the general rule is 10-11 hours. The goal for teens is 8.5 to 9.25 hours. Not scheduling enough sleep is the No. 1 sleep issue in America,” said Dr. Tafuri.
Unhealthy Repercussions
While it is now well known that Americans aren’t getting enough rest, it might not be as apparent that a lack of sleep can lead to greater and more serious issues. “The acute health effect of not getting enough sleep is the increased risk of motor vehicle and industrial accidents,” noted Mihalik. “Long term, the stress of not getting enough rest has been implicated in contributing to cardiovascular disease, some cancers, as well as mental health issues.”
And according to The Division of Sleep Medicine at Harvard Medical School, people with insufficient sleep are at higher risk for a number of health problems and diseases. For example, lack of sleep can:
• Negatively affect the immune system
• Increase the likelihood of getting sick from a virus (ex: common colds)
• Affect how fast a person recovers if they do get sick
• Diminish infection-fighting antibodies and cells
• Increase the risk of obesity, diabetes, and heart and blood vessel (cardiovascular) disease
• Have a negative impact on healthy metabolism, learning and memory, regulating mood and forming emotional memories
• Contribute to weight gain (ex: According to the American Journal of Epidemiology, women who sleep five or fewer hours a night are one third more likely to gain 33 pounds over the next 16 years than those who get seven hours of sleep.)
“At Bariatric Associates of New England, we see a lot of patients struggling with their weight who are also sleep-deprived,” agreed Dr. Tafuri. “That is because sleep loss is linked to an increase in hunger, which leads to excessive calorie intake. Research has shown that just one shortened night of sleep can increase caloric consumption by up to 500 additional calories, which equates to nearly an extra pound a week. So it is easy to see how the pounds can really add up,” she said.
Every disease category one can think of has a component of fatigue attached, added Cathy Margolin, Lac, Dip, OM, president of California-based Pacific Herbs. “When we don’t sleep and are overtired, we often compensate with sugary foods and caffeinated beverages, which can substitute for our natural lack of energy. This type of poor eating then contributes further to the spiral of fatigue. Often times when we’re tired, the last thing we want to do is cook a homemade healthy meal, but that is exactly what we should do. Healthy food will restore the body’s energy and a good night sleep will do the rest.”
Natural Approaches
Although there are many natural sleep aids on the market, practitioners recommend that their patients do the easy things first to help them get better rest. And for some problems, supplements might not be the answer. The first step in treating sleep issues is proper diagnosis, said Robert Tafuri, MD, DABFM, cofounder of Bariatric Associates of New England with his wife, Loretta. “Is there a problem with falling asleep or staying asleep? Is it metabolic, a side effect of a medication, a result of shift changes at work, jet lag, associated with food or alcohol, changes in circadian rhythms, depression or high anxiety? Once a proper diagnosis is made, it is best to start with the most organic approach, such as established sleep routine.”
First, establish consistent times to sleep and wake, have a relaxing bedtime routine, keep a cool, dark room, and use your bedroom only for sleep and sex, advised Dr. Loretta Tafuri. “We often see patients who are watching TV and using a computer in bed, which only adds to wakefulness. Also, two to three hours before bedtime, patients should finish exercising, eating and drinking any caffeine or alcohol. These practices allow the brain and nervous system to transition into sleep easier.”
Good sleep hygiene is the best approach to better sleep, agreed Dr.Margolin. This includes: a consistent bedtime; a darkened and quiet room; a comfortable bed and temperature; no eating at least four hours before bed; plenty of exercise during the day; no caffeine at least five to seven hours before bed; and electronics turned off at least 30 to 60 minutes before bed. Dr.Margolin also recommends yoga or meditation before bed. “A late night dog walk can be therapeutic and a good time to unwind and leave the stressors until tomorrow,” she said.
And according to Larry Lawson, DC, ND, CN, of Florida-based Health and Beyond, turning the clock away from your view is another approach that could work, in addition to increasing exercise, avoiding sugar and caffeine, and using a comfortable pillow and mattress. “People that watch the clock throughout the night create greater anxiety,” he said.
Supplementing for Sleep
As these subtle yet important changes can make a significant difference in the amount of time one sleeps at night, there is also no shortage of natural supplements that are considered beneficial for healthy sleep and rest. GIA Wellness, a manufacturer and marketer of personal care products and nutritional supplements based in California, offers GIA i-rest, a dietary sleep support formula that is the only liquid combination of melatonin plus seven unique, all natural sleep support ingredients (valerian root, hops, skullcap, 5HTP, L-tryptophan, passion flower and chamomile) on the market, said Alfred Hanser, the company’s CEO. “Melatonin is commonly used to address sleep disturbance and insomnia, as it is a hormone produced by the pineal gland in the brain that helps maintain the body’s circadian rhythm, or internal clock, which controls sleep and wake cycles. The GIA i-rest is a convenient, liquid spray to be applied sub-lingually (for rapid absorption) 15 to 20 minutes before going to sleep,” said Hanser, adding that it is preferable for consumers not looking for pills and water during the night.
For patients who prefer a natural alternative, Dr. Robert Tafuri recommends Glysom. Made from an amino acid called glycine, which is naturally produced in the body and present in many healthy foods including fish, meat and beans, Glysom promotes deeper sleep without morning drowsiness. “Unlike Ambien or melotonin, which induces sleep, Glysom reduces core body temperature to promote longer periods of restorative sleep. This helps patients spend more time in deep slow-wave sleep when they first enter the sleep cycle. Our patients report that after taking Glysom, they feel refreshed in the morning.”
Moreover, according to National Enzyme’s Mihalik, for people with digestive discomfort that keeps them awake, a good digestive enzyme can be helpful. The company’s Biocore AR chewable tablets are made to support healthy digestion. They are designed to provide a broad range blend of digestive support enzymes in a flavorful chewable tablet. BioCore AR is effective because of the ingredients selected and the high level of use compliance associated with the convenient and palatable dosage form, said Mihalik.
Additionally, Dr. Margolin recommends Chinese herbs for sleep support.“This medicine is the oldest botanical medicine on earth and has more than 2,000 years of historical use to validate the herbal formulas. Traditional Chinese herbs are safe and can even be used for those trying to reduce or eliminate their need for prescription sleep medications,” she said.While Dr. Margolin highlights ziziphus as one Chinese herb that is a popular sleep aid, she noted that one botanical is rarely used by itself. “History shows most herbs work better when paired with others and for this reason, combinations of herbs are the most common herbal medicine,” said Dr. Margolin, offering that Pacific Herbs’ iSleep Herb Pack is a concentrated extract that gently calms the mind and allows users to stop over thinking and feel calm and relaxed. ISleep is preserved in individual packets which contain 6 g of concentrated extract. “This is a therapeutic dose,” she said. “It would take about 20 capsules to equal just one of our packets. Some may think this is a large dose, but the truth is herbs are needed in a therapeutic dose to achieve the desired result.”
Further, Quietude from Pennsylvaniabased Boiron USA is a proprietary blend of four homeopathic medicines: henbeane, nutmeg, passion flower and throrn apple. Homeopathy is a therapeutic method that uses natural substances in micro-doses to relieve symptoms, said Christina Merville, PharmD, the company’s director of education. “Homeopathic medicine differs from herbs, supplements, vitamins, etc., in both the manufacturing process and principle of how they work. The active ingredients in homeopathic medicine are diluted, yet relieve the same symptoms they cause at full strength.”
Trends
As American’s eating habits and stress levels are continuing to deteriorate, the number of people seeking sleep and rest solutions will only grow. Increased consumer preferences for natural solutions and addressing the underlying factors will also result in growth in this market. Indeed, there is a noticeable shift in consumer demand and behavior, said GIA’s Hanser. “Baby Boomers and other health-conscious consumers favor natural/nature-based supplements as an affordable way to stay healthy compared to costly prescription drugs and preventable medical procedures. [Also], more research and validation is emerging about the benefits of nature-based sleep support ingredients, making them more credible and attractive to millions of sleep-deprived people. In short, the future of this market looks brighter every day.”
There is a growing awareness that health conditions do not exist independently— thus weight affects sleep, lack of sleep can cause diabetes and heart problems, etc., added Dr. Robert Tafuri. “While patients can go to a drugstore and take a gamble on a variety of sleep aids, a qualified health care provider can pinpoint the problem and recommend the best solution.”
And certainly, the public is getting more educated on unnecessary fillers, which may cause allergies or other unintended side effects, offered Dr. Margolin. “Some fillers are not organic, and some are made with genetically modified ingredients. But some practitioner brands are made without any fillers. Although this costs a bit more, the price is well worth it for many.”
Practitioner Responsibility
Patients rely on natural practitioners to educate them and give them the necessary advice to improve and maintain their health. But, it’s not always easy for health care professionals, said Dr. Lawson. “The practitioner has to face many over-thecounter remedies and ancillary programs outside of the office, which is competition. The practitioner has to rise above the competition and arm himself with unique sleep remedies that work immediately on the majority of people. He has to incorporate different type of relaxation programs into his practice and address dietary issues as well,” he said. “Due to the economic chaos in the world and the stress and anxiety around us, the sleep deprivation arena will keep increasing. Each person is unique and has his or her own reasons for not sleeping. The practitioner should give valuable information on nutrition, dietary issues, sleep posture and changing his or her environment at home.”
Practitioners are increasingly acknowledging that sleep is a complex architecture of stages, added Dr. Robert Tafuri. Healthy sleep involves enjoying a deep and restful sleep pattern that includes a balance of sufficient REM (rapid eye movement) and non-REM stages. So there is greater specificity around understanding the type of sleep problem a patient has, he said. “It is not just ‘you are having insomnia; here is a prescription for Ambien.’ There are many sleep products for different challenges. The practitioner must dig deeper to discover the best fit for each patient.”
It is highly recommended that clinicians begin their patient history with a simple assessment of how their patients are sleeping. They should inquire as to any snoring, difficulty getting asleep, daytime sleepiness or any mid-night awakenings, Dr. Tafuri continued, suggesting that a neck circumference be taken and any measurements that exceed currently acceptable guidelines be noted with serious consideration given to performing a screening home sleep test to rule out obstructive sleep apnea and related syndromes.
And sometimes, according to National Enzyme’s Mihalik, it’s as simple as asking one question. “In my opinion, when a patient comes in for any type of visit, ‘How are you sleeping?’ should be a standard question, given the potential long- and short-term impacts on overall health. If the answer is ‘not well,’ they should pursue the root cause and offer healthy natural solutions to correct it.”
In the U.S. alone, an estimated 50 to 70 million adults suffer from sleep (or wakefulness) disorders.
Not scheduling enough sleep is one of the biggest sleep issues in America.
Long term, the stress of not getting enough rest has been implicated in contributing to cardiovascular disease, some cancers, as well as mental health issues.
Clinicians should begin their patient history with a simple assessment of how their patients are sleeping.
FOR MORE INFORMATION:
Bariatric Associates of New England,
(203) 786-5007, www.banellc.com
Boiron USA, (610) 325-7674,
www.boironusa.com
GIA Wellness, (760) 448 2498,
www.giawellness.com
National Enzyme Company,
(417) 546-4796, www.nationalenzyme.com
Pacific Herbs, (877) 818-9990,
www.pacherbs.com
