We all know it: high-quality sleep is vital to every client’s healing. While the body appears from the outside to be still and inactive, sleep is a time when the body is quite busy. During the night, we restock our supply of hormones, process significant toxins, repair damaged tissue, generate vital white blood cells for immunity, eliminate the effects of stress, and process heavy emotions. Unfortunately we have an epidemic of sleep disorders – from trouble falling asleep to often-interrupted sleep to actual insomnia. There are, however, several straightforward remedies you can offer your patients in this area. Whenever a new client is struggling with sleep, it is always the first priority I address in their healing journey. Sleeping soundly will increase your patients’ motivation to make further lifestyle changes (e.g. when well rested, it is always easier to eat more healthily). And your help in making it happen will increase your credibility with them substantially.
We fall asleep due to the gifts of the pineal gland, a small ant-sized lobe near the middle of our skull in the interbrain. Following our circadian rhythm, the pineal gland secretes a neurotransmitter and hormone called melatonin. Melatonin suppresses the activity of other neurotransmitters and helps to calm the brain (in part by countering the stress hormone cortisol from our adrenal gland). And as we become more drowsy, the brain slowly begins to turn off our voluntary skeletal muscle functions, so we don’t move around too much and try to act out our dreams or disrupt the body’s internal revitalization work. (Note this is also why it’s so hard to move your limbs or shout out in response to a nightmare.)
For ideal sleep, melatonin should be rising steadily and cortisol should be rock-bottom low at bedtime. But there’s a catch: the pineal gland secretes melatonin largely in response to darkness. And our evening cortisol levels are lowest in environments with low noise. With our addictions to TV, video games, and email in the evening, however, our choices can get in the way of these natural pro-sleep chemical shifts. These devices mostly display full-spectrum light which can confuse the brain about whether it’s night-time or not. We also, unfortunately, tend to watch shows or view email that can be loud and/or stressful (e.g. the evening news, a crime show, work email, or ever-longer to-do lists). Digesting a heavy meal eaten later in the evening can also prevent (or interrupt) sleep.
So the first thing we can offer our sleepless patients is support with their “sleep hygiene”. I am amazed at how often this is all they need in order to get better sleep. Help them to identify more calming, quieter evening activities (e.g. reading a book, taking a warm bath, going for a light stroll outdoors, playing with a pet, folding laundry). I recommend no email, TV, next-day-planning, or stressful conversations in the full hour prior to bedtime. If noise is an issue, I often recommend soft foam ear plugs or the white noise of a fan. It is also important to the bedroom not be too hot, as this can disrupt sleep during the night. Herbal tea (e.g. lavender, chamomile, valerian, passionflower) can also help one to relax and set the tone for sleep. I also recommend no food a full two to three hours before bed and no caffeinated food or drink after 2pm in the afternoon (e.g. tea, coffee, soda, chocolate, mate). Many of my patients are stunned to realize how much a later-evening, heavy meal prevents sound sleep. Here is a helpful patient handout on the power of Sleep Hygiene.
There are definitely many cases, however, where pro-sleep behavior is simply not enough. For some clients, their brains simply aren’t able to make enough melatonin to ensure solid sleep all night long. Or there is a chemical imbalance preventing sufficient relaxation.
There are many sleep medications available to clients today. These can be useful for triage when one is going through short-term trauma or stress. Unfortunately, all of them work essentially as mild sedatives and are not addressing the root cause of any long-term sleep disturbance. They also come with a wide range of side effects that render them unacceptable for long-term use – from dry mouth to stomach ache to a hangover-like fatigue the following day. But it’s also important to make sure your patients understand that many of these medications can increase the risk of both cancer and death – even with just occasional usage. If your clients wish to stop taking these medications, encourage them to do so slowly (weaning) to avoid any chemical backlash from neurotransmitter imbalance.
Without restful sleep, it can be challenging for any of us to consider lifestyle change. Help your clients to be wildly satisfied by addressing poor sleep as an initial priority in your work together. You can do it! Please feel free to be in touch if you have other unusual cases you’d like to share. I am happy to help.
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