Insomnia

Insomnia is an inability to fall asleep or stay asleep, resulting in less than 6 hours per night. Insomnia can occur at any age, but it is pretty standard in the elderly. It can be short-term (lasting up to three weeks) or long-term (longer than three weeks). Insomnia can lead to memory problems, depression, irritability, and increased risk of heart disease and automobile-related accidents. Sleeping pills can help insomnia but may lead to substance dependency if used regularly for an extended period. Here are some of our clinical tips for insomnia treatment:

A tip for helping you fall asleep quickly: lay down, open your eyes, look up, stare somewhere and keep your eyes open as long as you can. While staring, don’t blink your eyes. Soon after a few seconds, you start yawning and feel sleepy. You can repeat it 2-3 times and will fall asleep. This tip is much better than counting sheep and breathing meditation. Would you like to try it?

Supplements, Herbs & Aromatherapy

Melatonin: take1 to 3mg one hour before bed for 2-4weeks. The body naturally produces melatonin, releasing it into the bloodstream in increasing amounts starting at dusk and tapering off toward the morning. With aging, melatonin decreases, and the biological clock does not run correctly; the elderly will see a more significant benefit from using melatonin. Typically, it takes a week to see the benefits. At first, some people may feel a little sleepy the following day for a few days, but this side effect will disappear with time.

Note: 1)people with autoimmune diseases cannot use melatonin to increase their inflammation and worsen symptoms. 2) Do not take melatonin for the long term; it may cause the body to produce less natural melatonin. 3) Some patients complained that they had a restless sleep all night long while taking high doses such as 10mg of melatonin at once before bedtime.

GABA (gamma-aminobutyric acid ): take 250 to 500mg in the afternoon or 6 -8 hours before bed. GABA is a chemical messenger in the brain, which blocks the brain signals to promote relaxation. GABA supplement helps to relieve anxiety, improve mood, promote muscle tone, decrease body fat, and stabilize blood pressure.

5-HTP: take 50 to100mg in the afternoon or 6 -8 hours before bed. 5-HTP produces serotonin that can be converted into the hormone melatonin to regulate sleep. 5-HPT also helps with anxiety and depression. Research studies showed that a combination of 5-HTP and GABA significantly reduced the time to fall asleep, increased sleep duration, and improved sleep quality. The two work together that seem to have a synergistic effect.

Note: While taking 5-HTP and GABA at bedtime, some people could sleep like a baby, but others get no sleep all night long. Therefore, the timing of taking 5-HTP and GABA is critical. For some chronic severe insomnia patients, the above two supplements taken in the afternoon or 6-8 hours before bedtime have shown promising results than taking it right before sleep. Taking 5-HTP might cause a temporary spike in your body's serotonin level, which could trigger anxiety, nervous and shivering and worsen insomnia. Some people taking GABA at bedtime might have a paradoxical reaction ( opposite effect) from it, which could lead to patients feeling edgy and anxiety resulting in insomnia.

Case-1 is a 68 years old female insomnia patient who has taken 5-HTP 50-100mg and GABA 250-500 mg daily before bedtime about for two years to help her sleep and anxiety. But she had difficulty falling and staying asleep, and her average sleep was less than 5 hours a night. After she switched to taking 5-HTP and GABA in the afternoon, she could fall asleep quickly and slept up to 7 hours a night.

Magnesium glycinate: take 200 mg once a day before sleep or twice a day ( take 200 mg in the afternoon and the bedtime). Magnesium glycinate helps to calm the mind, relax the body, fall asleep quickly and improve insomnia. It seems to stabilize breathing rhythm and oxygen variation during sleep and ease nonobstructive sleep apnea. Magnesium glycinate has the minor side effect of diarrhea among all magnesium products.

Calcium: take Citrate Calcium 250mg with Vitamin D 400IU twice a day. Calcium helps the brain to produce melatonin that induces sleep. Research studies have shown that calcium and magnesium are effective natural sleep aids that help people fall asleep and stay asleep through the night. Lack of these nutrients will cause people to wake up after a few hours and not return to sleep.

Maca root: It grows in the mineral-rich highlands of Peru. It provides a unique set of nutrients that directly fuel the endocrine system and help the glands to produce vital hormones. Take 500 mg every morning to boost energy in the daytime, regulate the biological clock and balance the signals between alerting and sleeping as the body needs.

Cordyceps: A potent modern version of an ancient Chinese secret, cordyceps is an intriguing substance gaining worldwide fame and recognition as an energy-enhancing, health-promoting tonic (source: swansonvitamin.com). Our clinical experience showed that cordyceps improves sleep just a few days after taking them. Cordyceps provides a powerful energy-enhancing health tonic and helps to fall asleep quickly and get enough deep sleep.

Cordyceps produced through modern culturing techniques have finally made their excellent nutritional benefits available to the western world. It is certified free of yeast, mold, and other harmful microbes (source: swansonvitamin.com). The price is reasonable and affordable.

Common side effects of cordyceps:1)Increased symptoms of autoimmune diseases. 2)slow blood clotting and increased risk of bleeding in people with bleeding disorders or during surgery. (Source:www.rxlist.com/consumer_cordyceps/drugs-condition.htm)

Herbs: Passionflower, Chamomile, Lavender, Lemon balm, Vervain, Rose, Artemisia annua are helpful herbs to improve sleep. You can try either a single herb or some combination of them, such as My Sleep Tea.

Chinese Herbs: many combination herbal formulas help sleep very well, such as An Shen Bu Xin Wan 安神补心丸，Tian Wang Bu Xin Wan 天王补心丸，Suan Zao Ren An Mian Wan 酸枣仁安眠丸. Try one of them to aid sleep and reduce anxiety.

Aromatherapy: Use pure essential oil and topical mist to make a tranquil, resting, and calming surrounding for sleep. One may try Nature's Truth Sleep Aromatherapy Essential Oil Blend Mist Spray--Target.

Besides supplements and herbs, what else can you do?

To check vitamin D intake: Taking high doses of vitamin D could interrupt your sleep. Insomnia patients should check their vitamin D intake to see if they take too much resulting in sleep issues. High amounts of vitamin D may interfere with the body's production of melatonin that helps sleep. Both vitamin D deficiency and overdose could cause weaker bones and insomnia.

Mayo Clinic recommended daily amount of vitamin D is 400 international units (IU) for children up to age 12 months, 600 IU for people ages 1 to 70 years, and 800 IU for people over 70 years. Taking appropriate doses of vitamin D is generally considered safe. However, taking high doses of vitamin D supplements (>4000ID/day) can be harmful. (Source of Mayo Clinic ).

Case-2 is a 65 years old female insomnia patient who has taken 2000-5000 IU of vitamin D daily for a year. Her average sleep was 3-4 hours a night. If she took 5000IU of vitamin D at once, she would have no sleep all night long. A week after she stopped taking vitamin D, she could sleep up to 7 hours a night. This case seemed to show that insomnia patients should avoid taking more than 2000 IU (50mcg) of vitamin D3 at once.

Exercise regularly: Get at least 30-45 minutes of moderate physical activity 3-5 times a week (the more days, the better). Researches found out that moderate-to-vigorous exercise can increase sleep quality for adults by falling and staying asleep easier. Physical activity also can help alleviate daytime sleepiness and, for some people, reduce the need for sleep medications.

Gentle exercises: Taiji, Pilates, and Yoga are low-impact exercises to avoid injury to tendons, joints, and bones. They promote general health, stress management, mental clarity, mood balance, cardiovascular fitness; improve the body's coordination, flexibility, posture, alignment, endurance, energy recharging; help insomnia and hot flashes.

Meditation: some research suggests that regularly practicing meditation may help improve sleep. It also has other positive health effects, such as reducing stress and lowering blood pressure. I saw a patient's blood pressure was 140/80 mmHg before meditation and afterward down to 90/60 mmHg. Qi Gong is a good option as a meditation.

Sleep before 11 pm: It is essential to try to fall asleep before 11 pm. Western medicine thinks that the human immune system recovers during the midnight hours. Chinese medicine believes that the human biological schedule should follow natural law. Before midnight the sundown energy is dominant; the sunrise energy will take over in the body afterward. Therefore, people may have difficulty falling asleep after midnight. Some people even stay up all night long without drowsiness after 2 am.

Try setting the curfew: Using electronic devices before bedtime can be physiologically and psychologically stimulating in ways that can adversely affect your sleep. The more electronic devices a person uses in the evening, the harder it is to fall asleep or stay asleep. All of this is true for kids and adults alike. It's essential to initiate a digital curfew for the entire family to turn off all electronic devices for the night. Try setting the curfew at 1-2 hours before bed; the earlier the evening, the better. One good substitution is reading. Reading an old-fashioned, printed book under lamplight (as opposed to bright overhead lighting) is a great choice. (Source: National Sleep Foundation)

Exposure to sunlight: if your body, face, and eyes are under sunlight, your body will produce more serotonin, a neurotransmitter is regulating mood and sleep. Serotonin is also a precursor to the brain hormone melatonin that helps sleep. In other words, by getting enough sun exposure, you will get good sleep and achieve happiness.

Sleepy-time snacks: The sleep-inducing foods include some combination of flaxseed oil, nuts, oatmeal, and egg white, which increase serotonin and keep the stomach full to help sleep. Eat one of these snacks 30 minutes before bedtime.

Warm milk: is the grandmother's natural insomnia remedy before bed. Almond milk is an excellent source of calcium, which helps the brain make melatonin to promote falling asleep.

If you can't fall asleep after 20 to 30 minutes in bed, get up and try something different. Continuing your attempt to fall asleep is simply wasting time. At this moment, get up and out of your bedroom to read a relaxing book or listen to a piece of slow music until you feel very sleepy and go to bed. If you still can't fall asleep, repeat this process 20 to 30 minutes later, be sure to get out of bed again. Keep doing this for over four weeks, and you'll see your sleep gradually improve.

Acupuncture and Ping's meridian massage: reduce stress, relax muscles and improve sleep. Treatment takes about 1 hour. To achieve the best results for our patients, we do not only give a standard acupuncture treatment just with needles, but we also give Ping's meridian massage (Dr. Lu's techniques) before acupuncture. While acupuncture focuses on deep, specific acupuncture points, the unique massage helps reach a much wider surface area, allowing blood and energy to flow freely like a river. When both techniques work together, the results are more effective than a single one.