Dear Dr. J,Dear iSleepy,
There is an old joke in medical school that goes something like, “We should probably spend a few minutes talking about insomnia for those very few patients that suffer from lack of sleep…” <insert dry laughter here>
The point? You are not alone.
In fact, according to the Centers for Disease Control and Prevention, about 50 to 70 million Americans suffer from some sort of sleeping disorder. Believe me, nobody’s doing “it” and fatigue is a major reason.
Unfortunately, problems with sleep can be due to anything from bladder problems to anxiety to hormonal imbalances to blood sugar abnormalities—and many others. Enter Ambien, Lunestra, or—my personal favorites—any of the Benzo’s. They usually work by drugging the sleepless into oblivion, which has immediate and obvious payoffs. The problem? Addiction, liver disease, psychiatric disorders, not to mention, according to a recent article in the British Medical Journal, an estimated 472 percent increase in the likelihood of death by all causes, from car crashes to cancer (“Hypnotics’ Association with Mortality or Cancer: A Matched Cohort Study,” 12 Feb, 2012).
Yikes!
For most sleep sufferers, these prescription drugs are much less effective than a few simple alterations in daily routines: Kill your television, computer and any other electronics at least an hour before bed; go to bed at the same time each and every night; exercise regularly; drop the caffeine.
If that requires too much discipline, then at least make sure your sleep environment is conducive to rest. Start with a dark room (get rid of those digital and LED clocks!), add a little white noise, open the windows or otherwise keep it cool, invest in a comfortable bed and ask a chiropractor to recommend a pillow that is right for you.
For those who have tried everything, blood sugar levels and high insulin are often the culprit. Insulin is inflammatory which means it increases pain, excitatory so it keeps you awake, and also causes the release of cortisol, which wreaks havoc on sleep cycles by making our brain think it is time to get up—even if it is 3:00 a.m. Get a blood test to check for abnormalities in these areas, deficiencies in B or D Vitamins, minerals like Magnesium, or hormonal imbalances, like low DHEA and progesterone or high estrogens. Since any (or all) of our hormones can be involved, it’s not so simple as to just throw the patient on Prempro and call it a night. (But, oops, sorry about the cancer; Prempro proved to increase it in the Women’s Health Initiative back in the 1980s).
While gathering the info to fix the underlying problems, implement some combination of meditation, melatonin, valerian, kava kava and passion flower. The choice of natural medicines and dosing is very patient-dependent and may involve a little trial and error before the right combination is achieved. The good news is that in most patients, the side effects are few, but be sure to talk to your doc first.
Once you fix deficiencies, remove toxic excesses and restore balance, most patients find themselves sawing logs in no time as well as waking with more energy to work, exercise and tackle anything that might pop up—even if it’s your husband.
Until next time, be well!
When Dr. Jason Bradley isn’t practicing Integrative Nutritional and Metabolic Medicine at Washington Street Wellness Center in Iowa City, he is often playing backgammon or his guitar—but never at the same time. Health questions can be emailed to drjbradley@gmail.com.
