Somnia Processus
The Sleep continuum
Have you ever found yourself pondering over the actions of sleep, curious as to why you just don’t seem to sleep like you once used-to? Wondering, how spent you seem to feel and how sleep still evades you. Recalling how great it was and how the days just seemed better when you did?
How about we shine some light on a subject that revolves around darkness by conversing over the actions, touching base on the processes, outcomes, and ways to support our sleep habits.
The impact sleep plays in our lives & ultimately health is postulated through the effects that result from sleep deprivation or the lack of sleep an individual receives. Interestingly enough, sleep is a direct correlation to your current state of health. A theoretical approach with no single location linked to a precise center of sleep [1]. Rather channels of flowing Qi unite to form a series of feedback loops integrated as a regulatory system that mediates the functions of sleep.
Influencing the cardio vascular, respiratory, musculoskeletal, gastrointestinal, endocrine, metabolic, & thermoregulatory bidirectional systems. Self perpetuating, sleep affects the system & the system affects the sleep. Impacting breathing, body weight, thinking, mood, immunity, & energy [2].
Circadian Rhythms
With the setting sun, night approaches, the atmosphere cools prompting bodily temperature to do the same. Akin with the onset of sleep, we become relaxed and prepare for sleep. As we transition from wakefulness to sleep our body’s heat reduces and continues to do so for a number of hours, only to begin to rise again [3].
Aligned with the light of day & darkness of night our Circadian Rhythms are the physiological processes that occur over a 24hr period and relates to the architecture of sleep [2]. “Sleep architecture” refers to the brain waves occurring throughout certain stages and phases of sleep [2, 3].
Without any zeitgebers ie. external stimuli influencing the circadian cycle, typically the physiological rhythm is just over 24 hours [4]. While the cycle of healthy individuals changes throughout life. The sleep duration generally declines by ten minutes every ten years [5]. Ideally a youth’s and young adult’s cycle is longer than that of the middle aged and elderly [3].
Reticular Activating System
When it comes to the Reticular Activating System (RAS), RAS what?, it refers to the neural network that connects involuntary control to voluntary control. In other words it’s a channel of nerves joining the spinal cord, cerebrum & cerebellum to the cerebral cortex to form a modulatory system [6].
Triggered through nightfall the RAS allows homeostatic function to supersede over circadian signals. Together they delegate sleep-wake activity, durning the day the circadian control regulates neural activity while the homeostatic influence puts us to sleep at night. Homeostasis refers to a state of physiological equilibrium durning allostatic change. In the case of sleep, the allostatic load of being awake (ie. sleep deficit) allows for sleep compensation [7].
The RAS also participates in perception, focus & mild attention (multitasking), coordination (physical activity), arousal, pain modulation, sympathetic response, etc [6]. When we are awake and active our brain waves or neural network is signaling with chaotic profusion to the multitude of sensory inputs. Durning rest, meditation, and sleep the sensory stimulus levels out and harmonize. The RAS consciously surveys body condition and mediates sleep / wake transition [2].
“Connecting the seat of unconsciousness to consciousness”, preventing us from acting out our dreams [2].
Sleep Progression
Cascading events set forth enable the release of sleep promoting neural substances such as adenosine. Adenosine accumulates as a byproduct of used physical and mental activities carried throughout the day [2], and gets released at the days end to promote the onset and maintenance of sleep [7].
Melatonin is one particular peptide secreted by the pineal 𓂀 gland with a sleep promoting affect. Primarily participating in sleep / wake synchronicity melatonin is an inhibitor of daytime rhythms [8], setting the stage for sleep by indirectly reducing body temperature and regulating blood pressure. Modulating immune activity, melatonin is a powerful antioxidant that regulates inflammation. A hormone with antiestrogenic and anticancer properties gets produced in the absence of light. In conjunction with circadian secretions over the course of the year, melatonin also coordinates circannual rhythmicity for the season as well [9].
Sleep is a gradual progression from light sleep to deep sleep, occurring over a 7 – 9 hours period. Typified by four stages, three of Non-Rapid Eye Movement (NREM) and one of Rapid Eye Movement (REM). Corresponding to four to six phases of physiological and psychological processes occurring within these four stages of sleep [1, 2]. Each phase is divided into repetitions of 70 – 110 minute increments. The first cycle begins with the onset of sleep and ends after the first REM stage. After which point the 2nd through the 6th phase begins with NREM and ends in REM. As these phases osculate there is a gradual succession while NREM reduces as sleep deepens REM lengthens [2].
Durning NREM sleep, physiological activity reduces, sympathetic (fight-or-fawn mode) response decreases, and metabolism slows. Primarily a dreamless state, ideally 75% of Total Sleep Time (TST) is spent in NREM [3].
When we are quiet, still, and asleep our discernment is also asleep. While judgment rests our imagination runs free and does not sleep when we do. Memory on the other hand occasionally sleeps when we sleep [10].
Sleep typically ends in spontaneity durning the final phase of REM. Though musculoskeletal movements are inhibited, and bodily temps go unregulated. Activity is slowly restored, rapid eye movements happen and dreams occur. Nearly 25% of sleep is spent in REM [2].
Sleep Stages
When we are awake and alert with eyes closed, quiet, and relaxed we find ourselves in “Stage W” (wake). As the mind clears and we become drowsy the brain waves read “Alpha” [2]. Alpha waves are high in frequency (8-12 Hz) and low in amplitude [1].
With “Sleep Onset” we find ourselves in “N1” of Non-Raipid Eye Movement (NREM). The eyes begin to make slow movements as “Theta Waves” (4-8 Hz) begin to form and the majority of the alpha waves have been replaced by Low Amplitude Mixed Frequency (LAMF) activity [1]. This is a brief (1 – 7mins) period of light sleep in which the RAS allows homeostatic drive to dominate enabling the onset of sleep. We are easily awakened in this stage [2].
As we transition from N1 to N2 sleep this is a time of spontaneous fluctuations in neural excitement.
Progressing to a deeper state of sleep. As our brain frequencies continue to drop and the amplitude continues to raise, we find ourselves in “N2” of NREM sleep. Ideally 50% of total sleep time is spent in N2, within its initial phase N2 persist for nearly 20 minutes [3]. While sleep deepens the heart calms, body temps fall, skeletal muscles begin to relax, brain waves slow and become aligned. Not withstanding brief spikes in blood pressure and heart rate set forth by spontaneous fluctuations of neural excitement referred to as “Sleep Spindles” (brain waves that resembles tightly wound spindles) and “K-complexes” (brain waves that are large amplitude occurrences) [1]. These spontaneous fluctuations trigger what is referred to as microarousals.
Typified by these events sleep spindles are believed to play a crucial role in somatic sense, neural plasticity, and memory. While K-complexes inhibit cortical response to external stimuli these events are believed to participate in memory consolidation [12].
As sleep progresses we enter “N3” of NREM otherwise known as “Slow Wave Sleep” (SWS). Typified by “Delta” waves, SWS carries the lowest frequency (.5-4 Hz) with the highest amplitude of all the sleep states [1]. With bodily temperature nearing its lowest point, the musculoskeletal system further relaxes, respiration slows and blood pressure drops. Responsible for tissue repair and growth, the rhythmicity of delta waves coincides with the secretion of Human Growth Hormone (HGH) and ultimately convalescents [2]. Primarily homeostatic driven [13], the greater the sleep need (adenosine accumulation), the slower the brain waves become overall. Accounting for 20 – 40 minutes in the initial phase, N3 sleep ideally occupies around 20% of the total sleep time [2, 3].
With a high threshold for arousal and spontaneous awakenings, N3 deep sleep is not easily disrupted. Awakenings at this time can be extremely disorienting for some and is referred to as “Sleep Inertia”. This is when night terrors, sleep walking & bedwetting usually occurs [1].
Further progression lands us in REM sleep, a state of atonic paralysis, the respiration & heart become erratic and the blood quickens (B.P. +30%) [11]. Typified by “Beta” (12-35 Hz) waves, this is a time of “restless sleep” as beta formation is similar to brain activity of the day. The first REM phase typically occurs 90 minutes after falling asleep and persists for about 10 minutes in its initial phase and lengthens throughout the night to nearly 60 minutes in the last phase[1].
Former studies postulated REM as a time of memory retention [14]. While it may definitely support cognitive organization, and mood regulation. SWS is now presumed to play more of a crucial role in memory consolidation [14]. Which correlates to the cool, dry qualities of memory & retention. Durning the apex of sleep our thermoregulation is at it’s coolest point and corresponds with SWS. “Memory recalls what apprehension coins and that is a dream” as such the REM stage is also when we are most prone to spontaneously awakening [10].
Disturbed Sleep
Taking into account the impact sleep has on our breathing, body weight, thinking, mood, immunity, and physical energy [2]. It’s a matter we all should consider as sleep deprivation is extremely prevalent in todays fast-paced society.
In 2005 the National Sleep Foundation polls indicated 75% of adults surveyed reported having one or more sleep issue. While 96% of them suffer from disordered sleep, a number of them inform that loss of sleep has effected their jobs, relationships and even intimacy [15].
On average it typically takes balanced adults about 10 – 20 minutes to transition from wakefulness to N1 sleep [16]. Anything less is considered pathological sleepiness.
Besides lethargy, in acute situations disturbed sleep may go unnoticed as the fight-or-fawn mode takes over. Although if left unresolved for much more than a nights time, the sleep debt begins to reveal its effects durning seemingly simple tasks [2]. We begin to lose focus and drive becoming distant & impatient.
Teens and mental health are a huge issue currently and about 70% of despondent adolescents feel as though they don’t get enough sleep. While over a quarter of high school students polled can’t stay awake at school, another 22% nod off while doing their homework. Now let’s consider them behind the wheel! As 15% of driving sophomores, juniors, & seniors report driving half asleep at least once weekly [17].
Microarousals are sharp spontaneous fluctuations in brain waves with the potential to disrupt sleep. The disruptive potential is heightened in those with comorbidities. Disruptive microarousals usually occur durning N2 and REM sleep stages [18]. Typically these events are brief and durning SWS are without awakenings. Usually gone unnoticed microarousals lasting 1 – 3 seconds have been associated with daytime sleepiness, while those of >15 seconds are associated with waking up [19]. The longer the arousal the more likely it is you will awaken.
In acute situations normal sleep patterns have the potential for reestablishment referred to as “Sleep Recovery” in just a few nights time. Sleep Recovery may occur after being awake for sustained duration referred to as “Sleep Rebound”. This is a lengthened period of time in SWS & REM [13]. While those with severe sleep deprivation the rebounding REM phase may not occur for a number nights.
Acute conditions typically increase the duration of both slow wave sleep and total sleep time. While long seated imbalances tend to shorten SWS & TST [13].
Those with respiratory issues (ie. hypopnea/apnea) & musculoskeletal conditions (ie. arthritis, fibromyalgia, etc.) are often disturbed by microarousals brought on from the condition itself [18]. These conditions tend to occur with age as does the number of times an individual prematurely wakes up and stays awake after onset, referred to as “Wake after sleep onset” (WASO). Such is the self perpetuating cycle of insufficient sleep or sleep deficit that typically accompanies chronic conditions often contributes to the condition itself [2].
In the case of respiratory involvement coughing is inhibited durning REM and brief stoppages may occur, often disturbing sleep [11]. Things like snoring, coughing, gasping and other forms of hypopnea often go relatively unchecked. When oxygen is low it may result in excessive yawning, headache, high blood pressure, fogginess, confusion, & anxiety [2].
Habitually missing sleep like those individuals with long seated imbalances typified by the older population, has a connection with inattentiveness, slower reaction times, irritability, & depression. As we age we tend to spend less time in deep sleep of SWS, N3 and more time in lighter sleep of N2 [1].
Sleep Conditions
Generally speaking issues with quality, consistency, & duration that negatively effects the days performance (physical, psychological, social, cognitive) may be considered as having a “Sleep-wake” disorder. The Diagnostic and Statistical Manual for Mental Disorders or DSM-V classifies 10 groups of disordered sleep [20].
◉ RLS – A pain like aching that is only momentarily relieved by movement.
— Fallout – Disturbed sleep.
◉ Insomnia – Difficulty with quality, consistency, or duration.
— Fallout – HBP, Coronary disease, Diabetes, Cancer [21].
◉ Narcolepsy – Excessively overwhelmed with daytime sleepiness.
— Fallout – Sudden loss muscle tone (cataplexy), hallucinations, unwilled sleep, & sleep paralysis [22].
◉ Night terrors – Intense fear, alarm & panic.
— Fallout – Disturbed sleep and/or uncontrolled screaming, crying, failing, etc. durning sleep.
◉ Hypersomnolence – Extreme sleepiness day & night.
— Fallout – Excessive sleep (over 10 hrs) & daytime incoherence.
◉ NREM Arousal disorder – Abnormal behaviors readily occurring durning N3.
— Fallout – Night terrors, sexsomnia, sleep eating [23].
◉ REM behavior disorder – Intermittent loss of dream paralysis durning REM.
— Fallout – Self inflicted injury or injury to their sleeping partner [24].
◉ Breathing-related disorders – Abnormal, impeded or obstructed breathing.
— Fallout – reference above.
◉ Circadian Rhythm disorders – Environmentally unsynchronized sleep-wake cycles.
— Fallout – Lethargy, acuity lose, incoherence, extreme daytime sleepiness [25].
◉ Substance/Medication-induced disorder – self explanatory.
Sleep Qualities
Sleep habits have a lot to do with the qualities of warm, cool, dry, & moist. The quantities of these qualities coincides with the essential substances (humors) that abodes us all. Our personal humoral equilibrium relates to us as individuals. This equilibrium is constantly changing in correlation with age & stage of life, season, where we live (environment), the foods we eat, the moods we keep, even the amount we sleep [2].
An overbearing substance often reveals itself in our habits, sleep & dreams included. When digestion is strong (humors are formed from food digested) & the mind is clear, the sleep is sound. When the balance of our own particular humors becomes disproportionate. Or when the mind is racing from the daily grind or circling from studies, or food in the stomach is still being digested, the sleep manifestation is altered [10].
Choler, Safra (hot & dry) substances regularly have the person up late at night as their heat stimulates activity. In that same note, they may have trouble falling asleep & even have trouble staying asleep [2]. Inherent sleep habits of the choleric may look like a heightened state of N2 sleep or REM which are the “restless sleep” stages. As they sleep half-sprawled & sometimes tucked tight like an ember trying to keep light, dreams of choler are of fire & fight [10].
If the hot, dry safra qualities engulf you then cut back on hot, dry foods (e.g. fatty meats, simply sweets, fried foods, liquor, spices, etc), and angry moods.
Melancholic, Sauda, (cool & dry) substances often have the person curled up & tucked in at night and often up with first light. Inherent manifestations of the cool dry humors are that of lengthened N2 & N3 sleep in relation to memory consolidation & actions of HGH. Melancholic dreams are of darkness & fright [10].
If the cool, dry sauda qualities have you in at night then cut back on cool, dry foods (e.g. old foods, over cooked foods, charred foods, dark veggies, coffee (including decaf), tea (black, white, green), liquor) and contemplation.
Sanguine, Dam, (warm & moist) substances typically have the person relaxed with ease held up close with their companion enjoying the evening with delight, regularly asleep after last light. Inherently so, transitions freely from stage to stage, bringing the most from every sleep phase. Sleeping half-sprawled, sanguine dreams colored red are merry & bright, resting & sleeping-in past first light [10].
Longing for the comforting qualities of warmth & moisture? Ultimately this humor stems from pure digestion but warm moist foods are akin with plant proteins (beans, nuts, grains), lean meats (veal, lamb, shellfish), vegetable oils (olive, sesame, coconut) and happiness.
Phlegmatic, Balgham, (cool & wet) substances often have the person feeling lethargic welcoming sleep at night. Inherently manifests a lengthened state of N3 deep sleep accompanied by a slothful REM phase. The person that cool wetness abounds often has loud sleep sounds. Like heavy waters sprawling softly, resting nearly motionless, phlegmatic’s dreams abound by water, gentle & slow. Preferring to sleep in, their morning habits are a swift as a mornings bloom.
If the cool wet balgham qualities has you submerged then cut back on cool, wet foods (e.g. dairy, bread, fish, melons & summer fruits) and laziness.
For more information about the qualities of food, see H.R.’s article “The Medicinal Actions of Taste“
Overall excess substances (from over eating & inertia) may have an effect of sleep paralysis. Akin to narcolepsy with dreams of being weighed down, & burdened by heaviness. If that excessiveness is of poor quality, the sleep may be accompanied by itchiness, burning sensations & noxious bodily emissions. While an absence of sleep in general allows dryness to ensue [10], potentially manifesting in night terrors & disruptive microarousals associated with sleep spindle.
The yang state of an elevated stress response (a choleric condition) and excess hormonal activity from the HPA axis (brain kidney/adrenal connection) interferes with sleep quality [9]. Regularly sweating at night typically hints towards adrenal involvement as the thermoregulatory system is mediated via the kidneys ability to balance yin & yang.
The phase element of the kidney is water & waters job is to control fire. If Jing or kidney essence isn’t stored, the fire prevails & the “hyperactivity of kidney yang manifests in tidal heat sensations & night sweats” [26].
Sleep Debt
Not only does sleep insufficiency seem to plague the U.S. so does diabetes, with 98 million Americans having pre-diabetes you may want to reconsider your sleep habits. That’s 1 out of every 3 people with pre-diabetes [27]. It is reported that individuals receiving less than 5 hours of sleep nightly are more likely to develop the condition [28].
Insufficient sleep has a close affiliation with excess body weight due to leptin inhibition which directly contributes appetite [28]. Durning sleep the leptin informs us that fuel is sufficient for sleep activity. See during the day ghrelin our hunger hormone level is higher to support the days activities in relation to the amount of sleep we’ve had [2]. In other words, the less a person sleeps the hungrier that person will feel.
Associated with melatonin activity sleep insufficiency also has a connection with breast cancer, as studies reveal women sleeping ≤6 hours nightly were 2/3 more likely to develop breast cancer, then women receiving an average of 9 hours of sleep nightly [9].
Caffeine an overly consumed nervous system stimulant often found in dark chocolate, tea (black, green, white,) coffee, and those so called energy drinks are often a participant. Caffeine’s stimulatory effects that interacts with the HPA axis has a broader outcome than the momentary pseudo sensation of energy [2]. One particular effect (other than HPA fatigue) that results from caffeine consumption is the up-regulation of the enzyme MAO oxidase (via glucocorticoids). MAO enzymes catalyze (breakdown) a number of amine substrates such as 5-hydroxytryptophan (5-HTP) and melatonin thereby interferes with homeostasis and circadian control.
Yawning
Take a deep breath and yawn, a primitive mammalian behavior presumed to be an early form of communication. Quite regularly displayed by your little animal buddies upon waking up. We often associate yawning with sleep no matter it be waking up, boredom (inactivity, disinterest), or preparing for sleep. Said to be a stimulating (sympathetic) mechanism [29], manifested durning times of lethargy.
See the vessels residing in the neck are sensitive to substances such as potentials of oxygen, carbon dioxide, and hydrogen. The carotid body (receptors of neck arteries) sense hypoxia (low O2), hypercapnea (high CO2), and acidosis (acidic blood) [31]. These readings may play a role in stimulating respiration (the yawn ie. raising oxygen levels while clearing sooty vapors), blood flow (circulating O2), heart rate and thusly alertness [30]. The same may be considered when it comes to bed time, a response signifying sleepiness in attempt to regain attention.
Adjacent to this region of the neck, our ears have a vessel referred to as the Eustachian tubes. These tubes function to balance air pressure, clear lymphatic secretions, and participate in immune defense [30], as such may also play a role in yawning. Those with migraines, Lou Gehrigs, and multiple sclerosis often experience excessive yawning [32]. Like that of sleep function, yawning is a hypothetical approach [29].
Lifestyle habits to support sleep
The question remains! If the functions of sleep are all perpetuating feed-back loops ‘what do I take’ if I am “only as good, as my condition is in” Right? The infamous “what do I take”! It’s not about taking something. You’ve already got what it takes! But there is a lot you can do.
First & foremost remember you’re tuning a clock, slow & steady sets the pace. It’s helpful to consider the qualities of the prevailing temperament as mentioned earlier.
Earlier we spoke of an elevated stress response interfering with sleep quality. Overall the calmer you are the better you will fall asleep and stay asleep. Steer clear of caffeine and three times weekly partake in relaxation strategies for at least 15 – 25 minutes and build off that. Try some quiet focused meditation, diaphragmatic breathing, guided imagery, massage, tai qi, ashtanga, or the alike.
Remember we mentioned adenosine from physical activity puts us to sleep. Exercise & sleep go hand-in-hand, the more you exercise, the more efficiently you will fall asleep, and stay sleeping. Three times weekly increase your heart rate and respiration. Even if its only for a minute or two – you can build up from there! Go dancing, speed walking, hiking, biking, swimming, aerobics, something, anything.
If you recall, durning the transition from wakefulness to sleep body heat drops and continues to do so for a number of hours [3]. Thusly do not exercise within a few hours of bedtime as the stimulation and residual heat from the workout may impair the ability to fall asleep and stay asleep [9]. For this same reason meals (especially simply sweet & spicy ones) shouldn’t be eaten within 3 hours of bedtime either. It’s also not a good idea to consume any beverages 1 hr. before laying down as waking up to urinate disrupts sleep.
The sleep space is not an area for watching TV, using the tablet or phone, studying, reading or doing TENS. The sleep space should be reserved specifically for sleeping and intimacy. The area should be a quiet, calm, cool, airy (not drafty) space with a clean relatively new spacious bed and a high quality pillow. An extra firm pillow for under or between the knees is helpful [9]. The clock should be out of reach, not illuminated and without a snooze button.
Preparing For Sleep
Remember the bodily processes occurring over a 24 hour period refers to the circadian rhythms coinciding with the warm light of day & the cool darkness of night [3]. A strong sleep regimen always begins at the same time nightly, so pick a time (give or take 30 or-so mins) and stick to it even on days off [9]. When preparing for sleep, support the circadian shift by slightly turning down the temperature (AC or open the windows) 30 – 60 mins before laying down. Along with turning off all electronics (TV included) and dimming all the lights 1 hr. before laying down also proves beneficial. If light is an issue, use UVA & UVB light blocking sunglasses (yes even at night), a blackout sleep mask, or light blocking curtains as sleep should be in total darkness.
Speaking of altered rhythms, being creatures of habit it is easier to disrupt the cycle than it is to regain establishment [2]. For example, if for whatever reason (e.g. kids, pee, pets, aliments) you were to wake up at let’s say 2am on a Monday night, you are likely to do the same at 2am on Tuesday night. Presumably a homeostatic function that starts a circadian imbalance. The key is to stay relaxed as you reset the cycle.
When you can’t sleep, don’t get out of bed, or look at the clock, it’s also not a good idea to turn on any electronics (TV included) or lights (only a dim one if necessary), it’s not the best to drink anything, read, and you sure the heck don’t want to be eating either. Instead, the idea is stay relaxed and divert the focus from the distraction utilizing some simple approaches.
If unusual sounds in your environment (e.g. creaking walls) or racing thoughts keep you from sleeping, try earplugs, focusing on the sound of your breathing, a fan, listen to a sleep sound machine or very light soft quiet tranquil music. Counting, meditating or guided imagery often proves helpful. If breathing issues keep you up, try nasal strips, vaporub, &/or position your head above your stomach so that you’re laying in a reclined position. In the case of RSL, if plausible after sunset go outside for a light stroll.
Try not to use the restroom (unless absolutely necessary), if nighttime urination is necessary try keeping it to a minimum. Remember it’s better not to consume any beverages an hour-or-so before bed. Beyond the means of this article, nighttime incontinence (Enuresis, Neurogenic bladder) requires an in-depth approach as does a number of the deep seated DSM-V groups.
Like the light of day that rises around the same time, you also should get up around the same time every morning. Pick a time (give or take 30 or-so mins) and stick to it, do not go back to bed after unless absolutely necessary. Within 15 or-so minutes of getting up for the day go outside (bare feet if plausible) and take a few deep breaths, stretch and touch the sky, touch the toes, with arms extended rotate the upper body 180°.
Make bedtime a habitual practice, repeated at the same time, every time. Supporting sleep at times can be difficult and cumbersome requiring diligent practice to achieve as it’s usually not the sleep by itself that needs the support it’s the circadian rhythms and the overall physiology.
Foods to support sleep
Be sure to get plenty of potassium it supports a calm mind and a relaxed heart. Foods high in K are apricots, lentils, prunes, squash, cooked mushrooms, and raisins etc.
To help ease the heart and relax muscle tension be sure to consume lots of magnesium. Foods high in Mg are almonds, spinach, cashews, soy milk, edamame, and brown rice, etc.
Amino acids such as tryptophan supply the building blocks for sleep modulating substances like that of melatonin, so be sure to consume plenty of seeds, berries, and mushrooms (cooked) e.g. chickpeas, sunflower seeds, shiitake, and bananas.
Fatty acids, omega-3’s in-particular (EPA & DHA) serve well to support nerve flexibility, reduce blood pressure, and modulate inflammation. Foods high in PUFAs would be salmon, herring, halibut, mackerel, and flaxseed [1tsp. – 1 tbs. 1x/daily soaked over night].
Sleep Supplements
● 5-hydroxytrtophan (5-HTP) [50 – 150 mg, 30 – 45 minutes before retiring] has an effect of increasing REM and SWS without lengthening TST [9].
● L-theanine [100 – 200mg daily] an amino acid that is calming, relaxing, reduces stress while improving sleep quality [9].
● Eicosapentaenoic acid (EPA) 500mg 2x/daily.
● Docosahexaenoic acid (DHA) 250mg 2x/daily.
● Magnesium glycinate/bisglcinate [250mg 2x/daily].
● Potassium gluconate/bicarbonate [3,000mg daily].
Melatonin
When it comes to synthetic supplementation, melatonin’s potential is only effective in those with insufficient production. Be warned, if that’s not the case repetitive use has the potential to down-regulate endogenous production [2]. In other words melatonin’s effectiveness in inducing and maintaining sleep is only in those with insomnia as typified by the elderly population.
Being derived from tryptamine, melatonin participates in the visual content of dreams and those with a normal production may experience lucid, lifelike, potentially disturbing dreams. In fact dream tolerance is a tool in which the therapeutic amount is determined, call it titration. A generalization is that of 0.5 mg +/- within 24 hrs. “Start with 2 – 5 mg nightly for a week, then add 1 mg every 3 days, increasing until you notice overly vivid dreams, then reduce by 0.5 mg. Dreams should normalize” [9].
❗ Do not supplement melatonin concurrently with corticosteroids or other meds used to suppress immune function (e.g., cyclosporine, tacrolimus) [9].
Lifestyle choices, dietary habits, & sleep rituals are at the front line of support.
Especially those with deep seated sleep imbalances. In fact people with chronic sleep insufficiency in association with comorbidities such as obesity, hypertension, depression and the alike should avoid sedatives [2]. Rather the emphasis should be placed on the overall physiology.
Herbs to support sleep
How about a nightcap?, some supportive herbs to aid the reset. Herbal tisanes (nightcap) should not be consumed within 45 – 60 minutes of laying down for the evening. Nightcaps are good for after dinner, while capsules are good for closer to bed time, and EtOH extracts are good in the middle of the night.
Capsules can be consumed with 6 ounces of H2O, as EtOH extracts can be combined with 1 ounce of H2O. With those tisanes, it is a good idea to squeeze out the residual liquid from your herbs, a lot of goodness is hiding in there! Herb to H20 ratios are grams to ounces ie. 2 gram of herb steeped in 10 ounces of hot H20 equals a 1:5 ratio. As for the EtOH extracts, just match the ratio to whats on the bottle.
This first group of herbs serve well to ease the days tensions and worries. A middays cup of brew to get you through. While larger quantities are nice as a nightcap, otherwise in capsules, or an EtOH extract before retiring to prime your Zzzzz’s.
🌿 Milky oats (Avena sativa) green tops [immature seed] are invigorating and revitalizing to the neural branches, useful for nervous exhaustion and depression. A nutritive tonic that supports adrenal function. Large amounts [herb 1:4 ratio H20] steeped over long periods, supports the person driven by the daily grind. Although not the best fit for those with food allergies [gluten]. If going with an extract [4-5mL 4x/daily] be sure its a [milky tops 1:2 ratio glycerol] “Glycerite” made from fresh immature milky tops. A bowl of rolled oats for breakfast and/or dinner is also supportive.
🌿 Lemon Balm (Mellisa officinalis) leaf is generally calming but not sedating, in larger quantities serve well to ease excitement and anticipation. An herb well matched to the qualities of Balgham, though generally well accepted by most. Loose leaf [dried herb 1:5 ratio to H2O]. EtOH extract, [herb 1:5 ratio ABV] @ 2-6mL 1-3x/daily.
🌿 Roman Chamomile (Anthemis nobilis) flowers serve well after meals for those with G.I. upset especially IBS from anxiety. This herb suits well to those of the Sauda, and Balgham qualities but is also generally well accepted by most. As a nightcap [dried flowers 1:3-5 ration to H2O] shortly after dinner, aids digestion, cools inflammation, and calms irritability. EtOH extract, [dried flowers 1:5 ratio ABV] @ 1-4mL 1-3x/daily.
🌿 Skullcap (Scutellaria lateriflora) leaf generally eases nervous irritability. While slowing racing thoughts in larger quantities serves well to subdue not only nerve tension but muscle tension as well. This herb overall requires larger quantities, [dried herb 1:3 ratio to H2O] so go big with this one. An herb that suits those of the Safra and Sauda qualities. EtOH extract, [fresh herb 1:2 ratio ABV] @ 2-5mL 1-4x/daily.
If the former doesn’t seem to get you through, the condition has seated itself. Perhaps check your condition and go with a midday skullcap or milky oats, followed by a nightcap of choice, followed by capsules of choice before bed, and if you awaken have a pre-measured extract of choice ready to go in a bit of water.
Due to the solubility of this next group of herbs, you would want to use capsules or EtOH extracts as H2O may not extrude the active constituents. Falling under the sedative umbrella, this next group of herbs should not be taken before or while operating machinery or driving any automobiles as larger quantities may induce drowsiness and be downright sedating [9]. Powerful enough to potentially cause stupor the next morning, call it a hangover.
❗ Do not use concurrently with other sedatives and antidepressants (e.g., alprazolam, amitriptyline, midazolam, trazodone)
🌿 Hops (Humulus lupus) strobile reduces the sensation of being overwhelmed, easing tension while relieving inflammation, serving well to subdue those tidal heat sensations and night sweats. A sachet of the fresh strobiles placed under the pillow has been traditionally utilized for sleep support. A women’s herb by far, is well accepted by most no matter the gender. EtOH extract [fresh strobile 1:5 ratio ABV] @ 1-3mL 1-3x/daily.
🌿 Lemon Verbena (Lippa citriodora syn. Aloysia citrodora) leaf is refreshing but relaxing, dispersing tension, reducing spasms while supporting sleep integrity. The freshly dried herb is best as a nightcap, otherwise the EtOH [dried herb 1:3 ratio ABV] extract @ .5 – 3mL 1x/daily will suffice. Fast acting, this is a good one to have if waking up in the middle of the night keeps you from sleeping the night through.
🌿 Passionflower (Passiflora incarnata) aerial parts have a long history of use in individuals with hypertension, nerve spasms, and pain. Reducing anxiety, this herb is supportive to the racing mind accompanied by musculoskeletal irritability. EtOH extract [dried herb 1:5 ratio ABV] @ 1-2mL 1-3x/daily.
🌿 Valerian (Valeriana officinalis) root is dispersing and relaxing to the musculature more specifically nerve tension stemming from irritability. Freeing-up the neural paths enabling sleep. Although being acrid, some individuals may find this herb stimulating. EtOH extract [fresh root 1:3 ratio ABV] @ 1-5mL 1-3x/daily.
As always consult with a qualified herbalist to reinsure safety and efficacy.
Somnia Processus
The Sleep continuum
Brought to you from Herbal Restoration LLC, Written By Herbalist S. Reese. All Rights Reserved © 2024 Herbal Restoration LLC.
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Somnia Processus
The Sleep continuum
Have you ever found yourself pondering over the actions of sleep, curious as to why you just don’t seem to sleep like you once used-to? Wondering, how spent you seem to feel and how sleep still evades you. Recalling how great it was and how the days just seemed better when you did?
How about we shine some light on a subject that revolves around darkness by conversing over the actions, touching base on the processes, outcomes, and ways to support our sleep habits.
The impact sleep plays in our lives & ultimately health is postulated through the effects that result from sleep deprivation or the lack of sleep an individual receives. Interestingly enough, sleep is a direct correlation to your current state of health. A theoretical approach with no single location linked to a precise center of sleep [1]. Rather channels of flowing Qi unite to form a series of feedback loops integrated as a regulatory system that mediates the functions of sleep.
Influencing the cardio vascular, respiratory, musculoskeletal, gastrointestinal, endocrine, metabolic, & thermoregulatory bidirectional systems. Self perpetuating, sleep affects the system & the system affects the sleep. Impacting breathing, body weight, thinking, mood, immunity, & energy. Impacting respiration, body mass, cognition, immunity, and physical energy [2].
Circadian Rhythms
With the setting sun, night approaches, the atmosphere cools prompting bodily temperature to do the same. Akin with the onset of sleep, we become relaxed and prepare for sleep. As we transition from wakefulness to sleep our body’s heat reduces and continues to do so for a number of hours, only to begin to rise again [3].
Aligned with the light of day & darkness of night our Circadian Rhythms are the physiological processes that occur over a 24hr period and relates to the architecture of sleep [2]. “Sleep architecture” refers to the brain waves occurring throughout certain stages and phases of sleep [2, 3].
Without any zeitgebers ie. external stimuli influencing the circadian cycle, typically the physiological rhythm is just over 24 hours [4]. While the cycle of healthy individuals changes throughout life. The sleep duration generally declines by ten minutes every ten years [5]. Ideally a youth’s and young adult’s cycle is longer than that of the middle aged and elderly [3].
Reticular Activating System
When it comes to the Reticular Activating System (RAS), RAS what?, it refers to the neural network that connects involuntary control to voluntary control. In other words it’s a channel of nerves joining the spinal cord, cerebrum & cerebellum to the cerebral cortex to form a modulatory system [6].
Triggered through nightfall the RAS allows homeostatic function to supersede over circadian signals. Together they delegate sleep-wake activity, durning the day the circadian control regulates neural activity while the homeostatic influence puts us to sleep at night. Homeostasis refers to a state of physiological equilibrium durning allostatic change. In the case of sleep, the allostatic load of being awake (ie. sleep deficit) allows for sleep compensation [7].
The RAS also participates in perception, focus & mild attention (multitasking), coordination (physical activity), arousal, pain modulation, sympathetic response, etc [6]. When we are awake and active our brain waves or neural network is signaling with chaotic profusion to the multitude of sensory inputs. Durning rest, meditation, and sleep the sensory stimulus levels out and harmonize. The RAS consciously surveys body condition and mediates sleep / wake transition [2].
“Connecting the seat of unconsciousness to the seat of consciousness”, preventing us from acting out our dreams [2].
Sleep Progression
Cascading events set forth enable the release of sleep promoting neural substances such as adenosine. Adenosine accumulates as a byproduct of used physical and mental activities carried throughout the day [2], and gets released at the days end to promote the onset and maintenance of sleep [7].
Melatonin is one particular peptide secreted by the pineal𓂀 gland with a sleep promoting affect. Primarily participating in sleep / wake synchronicity melatonin is an inhibitor of daytime rhythms [8], setting the stage for sleep by indirectly reducing body temperature and regulating blood pressure. Modulating immune activity, melatonin is a powerful antioxidant that regulates inflammation. A hormone with antiestrogenic and anticancer properties gets produced in the absence of light. In conjunction with circadian secretions over the course of the year, melatonin also coordinates circannual rhythmicity for the season as well [9].
Sleep is a gradual progression from light sleep to deep sleep, occurring over a 7 – 9 hours period. Typified by four stages, three of Non-Rapid Eye Movement (NREM) and one of Rapid Eye Movement (REM). Corresponding to four to six phases of physiological and psychological processes occurring within these four stages of sleep [1, 2]. Each phase is divided into repetitions of 70 – 110 minute increments. The first cycle begins with the onset of sleep and ends after the first REM stage. After which point the 2nd through the 6th phase begins with NREM and ends in REM. As these phases osculate there is a gradual succession while NREM reduces as sleep deepens REM lengthens [2].
Durning NREM sleep, physiological activity reduces, sympathetic (fight-or-fawn mode) response decreases, and metabolism slows. Primarily a dreamless state, ideally 75% of Total Sleep Time (TST) is spent in NREM [3].
When we are quiet, still, and asleep our discernment is also asleep. While judgment rests our imagination runs free and does not sleep when we do. Memory on the other hand occasionally sleeps when we sleep [10].
Sleep typically ends in spontaneity durning the final phase of REM. Though musculoskeletal movements are inhibited, and bodily temps go unregulated. Activity is slowly restored, rapid eye movements happen & dreams occur. Nearly 25% of sleep is spent in REM [2].
Sleep Stages
When we are awake and alert with eyes closed, quiet, and relaxed we find ourselves in “Stage W” (wake). As the mind clears and we become drowsy the brain waves read “Alpha” [2]. Alpha waves are high in frequency (8-12 Hz) and low in amplitude [1].
With “Sleep Onset” we find ourselves in “N1” of Non-Raipid Eye Movement (NREM). The eyes begin to make slow movements as “Theta Waves” (4-8 Hz) begin to form and the majority of the alpha waves have been replaced by Low Amplitude Mixed Frequency (LAMF) activity [1]. This is a brief (1 – 7mins) period of light sleep in which the RAS allows homeostatic drive to dominate enabling the onset of sleep. We are easily awakened in this stage [2].
As we transition from N1 to N2 sleep this is a time of spontaneous fluctuations in neural excitement.
Progressing to a deeper state of sleep. As our brain frequencies continue to drop and the amplitude continues to raise, we find ourselves in “N2” of NREM sleep. Ideally 50% of total sleep time is spent in N2, within its initial phase N2 persist for nearly 20 minutes [3]. While sleep deepens the heart calms, body temps fall, skeletal muscles begin to relax, brain waves slow and become aligned. Not withstanding brief spikes in blood pressure and heart rate set forth by spontaneous fluctuations of neural excitement referred to as “Sleep Spindles” (brain waves that resembles tightly wound spindles) and “K-complexes” (brain waves that are large amplitude occurrences) [1]. These spontaneous fluctuations trigger what is referred to as microarousals.
Typified by these events sleep spindles are believed to play a crucial role in somatic sense, neural plasticity, and memory. While K-complexes inhibit cortical response to external stimuli these events are believed to participate in memory consolidation [12].
As sleep progresses we enter “N3” of NREM otherwise known as “Slow Wave Sleep” (SWS). Typified by “Delta” waves, SWS carries the lowest frequency (.5-4 Hz) with the highest amplitude of all the sleep states [1]. With bodily temperature nearing its lowest point, the musculoskeletal system further relaxes, respiration slows and blood pressure drops. Responsible for tissue repair and growth, the rhythmicity of delta waves coincides with the secretion of Human Growth Hormone (HGH) and ultimately convalescents [2]. Primarily homeostatic driven [13], the greater the sleep need (adenosine accumulation), the slower the brain waves become overall. Accounting for 20 – 40 minutes in the initial phase, N3 sleep ideally occupies around 20% of the total sleep time [2, 3].
With a high threshold for arousal and spontaneous awakenings, N3 deep sleep is not easily disrupted. Awakenings at this time can be extremely disorienting for some and is referred to as “Sleep Inertia”. This is when night terrors, sleep walking & bedwetting usually occurs [1].
Further progression lands us in REM sleep, a state of atonic paralysis, the respiration & heart become erratic and the blood quickens (B.P. +30%) [11]. Typified by “Beta” (12-35 Hz) waves, this is a time of “restless sleep” as beta formation is similar to brain activity of the day. The first REM phase typically occurs 90 minutes after falling asleep and persists for about 10 minutes in its initial phase and lengthens throughout the night to nearly 60 minutes [1].
Former studies postulated REM as a time of memory retention [14]. While it may definitely support cognitive organization, and mood regulation. SWS is now presumed to play more of a crucial role in memory consolidation [14]. Which correlates to the cool, dry qualities of memory & retention. Durning the apex of sleep our thermoregulation is at it’s coolest point and corresponds with SWS. “Memory recalls what apprehension coins and that is a dream” as such the REM stage is also when we are most prone to spontaneously awakening [10].
Disturbed Sleep
Taking into account the impact sleep has on our breathing, body weight, thinking, mood, immunity, and physical energy [2]. It’s a matter we all should consider as sleep deprivation is extremely prevalent in todays fast-paced society.
In 2005 the National Sleep Foundation polls indicated 75% of adults surveyed reported having one or more sleep issue. While 96% of them suffer from disordered sleep, a number of them inform that loss of sleep has effected their jobs, relationships and even intimacy [15].
On average it typically takes balanced adults about 10 – 20 minutes to transition from wakefulness to N1 sleep [16]. Anything less is considered pathological sleepiness.
Besides lethargy, in acute situations disturbed sleep may go unnoticed as the fight-or-fawn mode takes over. Although if left unresolved for much more than a nights time, the sleep debt begins to reveal its effects durning seemingly simple tasks [2]. We begin to lose focus and drive becoming distant & impatient.
Teens and mental health are a huge issue currently and about 70% of despondent adolescents feel as though they don’t get enough sleep. While over a quarter of high school students polled can’t stay awake at school, another 22% nod off while doing their homework. Now let’s consider them behind the wheel! As 15% of driving sophomores, juniors, & seniors report driving half asleep at least once weekly [17].
Microarousals are sharp spontaneous fluctuations in brain waves with the potential to disrupt sleep. The disruptive potential is heightened in those with comorbidities. Disruptive microarousals usually occur durning N2 and REM sleep stages [18]. Typically these events are brief and durning SWS are without awakenings. Usually gone unnoticed microarousals lasting 1 – 3 seconds have been associated with daytime sleepiness, while those of >15 seconds are associated with waking up [19]. The longer the arousal the more likely it is you will awaken.
In acute situations normal sleep patterns have the potential for reestablishment referred to as “Sleep Recovery” in just a few nights time. Sleep Recovery may occur after being awake for sustained duration referred to as “Sleep Rebound”. This is a lengthened period of time in SWS & REM [13]. While those with severe sleep deprivation the rebounding REM phase may not occur for a number nights.
Acute conditions typically increase the duration of both slow wave sleep and total sleep time. While long seated imbalances tend to shorten SWS & TST [13].
Those with respiratory issues (ie. hypopnea/apnea) & musculoskeletal conditions (ie. arthritis, fibromyalgia, etc.) are often disturbed by microarousals brought on from the condition itself [18]. These conditions tend to occur with age as does the number of times an individual prematurely wakes up and stays awake after onset, referred to as “Wake after sleep onset” (WASO). Such is the self perpetuating cycle of insufficient sleep or sleep deficit that typically accompanies chronic conditions often contributes to the condition itself [2].
In the case of respiratory involvement coughing is inhibited durning REM and brief stoppages may occur, often disturbing sleep [11]. Things like snoring, coughing, gasping and other forms of hypopnea often go relatively unchecked. When oxygen is low it may result in excessive yawning, headache, high blood pressure, fogginess, confusion, & anxiety [2].
Habitually missing sleep like those individuals with long seated imbalances typified by the older population, has a connection with inattentiveness, slower reaction times, irritability, & depression. As we age we tend to spend less time in deep sleep of SWS, N3 and more time in lighter sleep of N2 [1].
Sleep Conditions
Generally speaking issues with quality, consistency, & duration that negatively effects the days performance (physical, psychological, social, cognitive) may be considered as having a “Sleep-wake” disorder. The Diagnostic and Statistical Manual for Mental Disorders or DSM-V classifies 10 groups of disordered sleep [20].
◉ RLS – A pain like aching that is only momentarily relieved by movement.
◉ Insomnia – Difficulty with quality, consistency, or duration.
◉ Narcolepsy – Excessively overwhelmed with daytime sleepiness.
◉ Night terrors – Intense fear, alarm & panic.
◉ Hypersomnolence – Extreme sleepiness day & night.
◉ NREM Arousal disorder – Abnormal behaviors readily occurring durning N3.
◉ REM behavior disorder – Intermittent loss of dream paralysis durning REM.
◉ Breathing-related disorders – Abnormal, impeded or obstructed breathing.
◉ Circadian Rhythm disorders – Environmentally unsynchronized sleep-wake cycles.
◉ Substance/Medication-induced disorder – self explanatory.
Sleep Qualities
Sleep habits have a lot to do with the qualities of warm, cool, dry, & moist. The quantities of these qualities coincides with the essential substances (humors) that abodes us all. Our personal humoral equilibrium relates to us as individuals. This equilibrium is constantly changing in correlation with age & stage of life, season, where we live (environment), the foods we eat, the moods we keep, even the amount we sleep [2].
An overbearing substance often reveals itself in our habits, sleep & dreams included. When digestion is strong (humors are formed from food digested) & the mind is clear, the sleep is sound. When the balance of our own particular humors becomes disproportionate. Or when the mind is racing from the daily grind or circling from studies, or food in the stomach is still being digested, the sleep manifestation is altered [10].
Choler, Safra (hot & dry) substances regularly have the person up late at night as their heat stimulates activity. In that same note, they may have trouble falling asleep & even have trouble staying asleep [2]. Inherent sleep habits of the choleric may look like a heightened state of N2 sleep or REM which are the “restless sleep” stages. As they sleep half-sprawled & sometimes tucked tight like an ember trying to keep light, dreams of choler are of fire & fight [10].
If the hot, dry safra qualities engulf you then cut back on hot, dry foods (e.g. fatty meats, simply sweets, fried foods, liquor, spices, etc), and angry moods.
Melancholic, Sauda, (cool & dry) substances often have the person curled up & tucked in at night and often up with first light. Inherent manifestations of the cool dry humors are that of lengthened N2 & N3 sleep in relation to memory consolidation & actions of HGH. Melancholic dreams are of darkness & fright [10].
If the cool, dry sauda qualities have you in at night then cut back on cool, dry foods (e.g. old foods, over cooked foods, charred foods, dark veggies, coffee (including decaf), tea (black, white, green), liquor) and contemplation.
Sanguine, Dam, (warm & moist) substances typically have the person relaxed with ease held up close with their companion enjoying the evening with delight, regularly asleep after last light. Inherently so, transitions freely from stage to stage, bringing the most from every sleep phase. Sleeping half-sprawled, sanguine dreams colored red are merry & bright, resting & sleeping-in past first light [10].
Longing for the comforting qualities of warmth & moisture? Ultimately this humor stems from pure digestion but warm moist foods are akin with plant proteins (beans, nuts, grains), lean meats (veal, lamb, shellfish), vegetable oils (olive, sesame, coconut) and happiness.
Phlegmatic, Balgham, (cool & wet) substances often have the person feeling lethargic welcoming sleep at night. Inherently manifests a lengthened state of N3 deep sleep accompanied by a slothful REM phase. The person that cool wetness abounds often has loud sleep sounds. Like heavy waters sprawling softly, resting nearly motionless, phlegmatic’s dreams abound by water, gentle & slow. Preferring to sleep in, their morning habits are a swift as a mornings bloom.
If the cool wet balgham qualities has you submerged then cut back on cool, wet foods (e.g. dairy, bread, fish, melons & summer fruits) and laziness.
For more information about the qualities of food, see H.R.’s article “The Medicinal Actions of Taste“
Overall excess substances (from over eating & inertia) may have an effect of sleep paralysis. Akin to narcolepsy with dreams of being weighed down, & burdened by heaviness. If that excessiveness is of poor quality, the sleep may be accompanied by itchiness, burning sensations & noxious bodily emissions. While an absence of sleep in general allows dryness to ensue [10], potentially manifesting in night terrors & microarousals associated with disruptive sleep spindles.
The yang state of an elevated stress response (a choleric condition) and excess hormonal activity from the HPA axis (brain kidney/adrenal connection) interferes with sleep quality [9]. Regularly sweating at night typically hints towards adrenal involvement as the thermoregulatory system is mediated via the kidneys ability to balance yin & yang.
The phase element of the kidney is water & waters job is to control fire. If Jing or kidney essence isn’t stored, the fire prevails & the “hyperactivity of kidney yang manifests in tidal heat sensations & night sweats” [26].
Sleep Debt
Not only does sleep insufficiency seem to plague the U.S. so does diabetes, with 98 million Americans having pre-diabetes you may want to reconsider your sleep habits. That’s 1 out of every 3 people with pre-diabetes [27]. It is reported that individuals receiving less than 5 hours of sleep nightly are more likely to develop the condition [28].
Insufficient sleep has a close affiliation with excess body weight due to leptin inhibition which directly contributes appetite [28]. Durning sleep the leptin informs us that fuel is sufficient for sleep activity. See during the day ghrelin our hunger hormone level is higher to support the days activities in relation to the amount of sleep we’ve had [2]. In other words, the less a person sleeps the hungrier that person will feel.
Associated with melatonin activity sleep insufficiency also has a connection with breast cancer, as studies reveal women sleeping ≤6 hours nightly were 2/3 more likely to develop breast cancer, then women receiving an average of 9 hours of sleep nightly [9].
Caffeine an overly consumed nervous system stimulant often found in dark chocolate, tea (black, green, white,) coffee, and those so called energy drinks are often a participant. Caffeine’s stimulatory effects that interacts with the HPA axis has a broader outcome than the momentary pseudo sensation of energy [2]. One particular effect (other than HPA fatigue) that results from caffeine consumption is the up-regulation of the enzyme MAO oxidase (via glucocorticoids). MAO enzymes catalyze (breakdown) a number of amine substrates such as 5-hydroxytryptophan (5-HTP) and melatonin thereby interferes with homeostasis and circadian control.
Yawning
Take a deep breath and yawn, a primitive mammalian behavior presumed to be an early form of communication. Quite regularly displayed by your little animal buddies upon waking up. We often associate yawning with sleep no matter it be waking up, boredom (inactivity, disinterest), or preparing for sleep. Said to be a stimulating (sympathetic) mechanism [29], manifested durning times of lethargy.
See the vessels residing in the neck are sensitive to substances such as potentials of oxygen, carbon dioxide, and hydrogen. The carotid body (receptors of neck arteries) sense hypoxia (low O2), hypercapnea (high CO2), and acidosis (acidic blood) [31]. These readings may play a role in stimulating respiration (the yawn ie. raising oxygen levels while clearing sooty vapors), blood flow (circulating O2), heart rate and thusly alertness [30]. The same may be considered when it comes to bed time, a response signifying sleepiness in attempt to regain attention.
Adjacent to this region of the neck, our ears have a vessel referred to as the Eustachian tubes. These tubes function to balance air pressure, clear lymphatic secretions, and participate in immune defense [30], as such may also play a role in yawning. Those with migraines, Lou Gehrigs, and multiple sclerosis often experience excessive yawning [32]. Like that of sleep function, yawning is a hypothetical approach [29].
Lifestyle habits to support sleep
The question remains! If the functions of sleep are all perpetuating feed-back loops ‘what do I take’ if I am “only as good, as my condition is in” Right? The infamous “what do I take”! It’s not about taking something. You’ve already got what it takes! But there is a lot you can do.
First & foremost remember you’re tuning a clock, slow & steady sets the pace. It’s helpful to consider the qualities of the prevailing temperament as mentioned earlier.
Earlier we spoke of an elevated stress response interfering with sleep quality. Overall the calmer you are the better you will fall asleep and stay asleep. Steer clear of caffeine and three times weekly partake in relaxation strategies for at least 15 – 25 minutes and build off that. Try some quiet focused meditation, diaphragmatic breathing, guided imagery, massage, tai qi, ashtanga, or the alike.
Remember we mentioned adenosine from physical activity puts us to sleep. Exercise & sleep go hand-in-hand, the more you exercise, the more efficiently you will fall asleep, and stay sleeping. Three times weekly increase your heart rate and respiration. Even if its only for a minute or two – you can build up from there! Go dancing, speed walking, hiking, biking, swimming, aerobics, something, anything.
If you recall, durning the transition from wakefulness to sleep body heat drops and continues to do so for a number of hours [3]. Thusly do not exercise within a few hours of bedtime as the stimulation and residual heat from the workout may impair the ability to fall asleep and stay asleep [9]. For this same reason meals (especially simply sweet & spicy ones) shouldn’t be eaten within 3 hours of bedtime either. It’s also not a good idea to consume any beverages 1 hr. before laying down as waking up to urinate disrupts sleep.
Preparing For Sleep
The sleep space is not an area for watching TV, using the tablet or phone, studying, reading or doing TENS. The sleep space should be reserved specifically for sleeping and intimacy. The area should be a quiet, calm, cool, airy (not drafty) space with a clean relatively new spacious bed and a high quality pillow. An extra firm pillow for under or between the knees is helpful [9]. The clock should be out of reach, not illuminated and without a snooze button.
Remember the bodily processes occurring over a 24 hour period refers to the circadian rhythms coinciding with the warm light of day & the cool darkness of night [3]. A strong sleep regimen always begins at the same time nightly, so pick a time (give or take 30 or-so mins) and stick to it even on days off [9]. When preparing for sleep, support the circadian shift by slightly turning down the temperature (AC or open the windows) 30 – 60 mins before laying down. Along with turning off all electronics (TV included) and dimming all the lights 1 hr. before laying down also proves beneficial. If light is an issue, use UVA & UVB light blocking sunglasses (yes even at night), a blackout sleep mask, or light blocking curtains as sleep should be in total darkness.
Speaking of altered rhythms, being creatures of habit it is easier to disrupt the cycle than it is to regain establishment [2]. For example, if for whatever reason (e.g. kids, pee, pets, aliments) you were to wake up at let’s say 2am on a Monday night, you are likely to do the same at 2am on Tuesday night. Presumably a homeostatic function that starts a circadian imbalance. The key is to stay relaxed as you reset the cycle.
When you can’t sleep, don’t get out of bed, or look at the clock, it’s also not a good idea to turn on any electronics (TV included) or lights (only a dim one if necessary), it’s not the best to drink anything, read, and you sure the heck don’t want to be eating either. Instead, the idea is stay relaxed and divert the focus from the distraction utilizing some simple approaches.
If unusual sounds in your environment (e.g. creaking walls) or racing thoughts keep you from sleeping, try earplugs, focusing on the sound of your breathing, a fan, listen to a sleep sound machine or very light soft quiet tranquil music. Counting, meditating or guided imagery often proves helpful. If breathing issues keep you up, try nasal strips, vaporub, &/or position your head above your stomach so that you’re laying in a reclined position. In the case of RSL, if plausible after sunset go outside for a light stroll.
Try not to use the restroom (unless absolutely necessary), if nighttime urination is necessary try keeping it to a minimum. Remember it’s better not to consume any beverages an hour-or-so before bed. Beyond the means of this article, nighttime incontinence (Enuresis, Neurogenic bladder) requires an in-depth approach as does a number of the deep seated DSM-V groups.
Like the light of day that rises around the same time, you also should get up around the same time every morning. Pick a time (give or take 30 or-so mins) and stick to it, do not go back to bed after unless absolutely necessary. Within 15 or-so minutes of getting up for the day go outside (bare feet if plausible) and take a few deep breaths, stretch and touch the sky, touch the toes, with arms extended rotate the upper body 180°.
Make bedtime a habitual practice, repeated at the same time, every time. Supporting sleep at times can be difficult and cumbersome requiring diligent practice to achieve as it’s usually not the sleep by itself that needs the support it’s the circadian rhythms and the overall physiology.
Foods to support sleep
Be sure to get plenty of potassium it supports a calm mind and a relaxed heart. Foods high in K are apricots, lentils, prunes, squash, cooked mushrooms, and raisins etc.
To help ease the heart and relax muscle tension be sure to consume lots of magnesium. Foods high in Mg are almonds, spinach, cashews, soy milk, edamame, and brown rice, etc.
Amino acids such as tryptophan supply the building blocks for sleep modulating substances like that of melatonin, so be sure to consume plenty of seeds, berries, and mushrooms (cooked) e.g. chickpeas, sunflower seeds, shiitake, and bananas.
Fatty acids, omega-3’s in-particular (EPA & DHA) serve well to support nerve flexibility, reduce blood pressure, and modulate inflammation. Foods high in PUFAs would be salmon, herring, halibut, mackerel, and flaxseed [1tsp. – 1 tbs. 1x/daily soaked over night].
Sleep Supplements
● 5-hydroxytrtophan (5-HTP) [50 – 150 mg, 30 – 45 minutes before retiring] has an effect of increasing REM and SWS without lengthening TST [9].
● L-theanine [100 – 200mg daily] an amino acid that is calming, relaxing, reduces stress while improving sleep quality [9].
● Eicosapentaenoic acid (EPA) 500mg 2x/daily.
● Docosahexaenoic acid (DHA) 250mg 2x/daily.
● Magnesium glycinate/bisglcinate [250mg 2x/daily].
● Potassium gluconate/bicarbonate [3,000mg daily].
Melatonin
When it comes to synthetic supplementation, melatonin’s potential is only effective in those with insufficient production. Be warned, if that’s not the case repetitive use has the potential to down-regulate endogenous production [2]. In other words melatonin’s effectiveness in inducing and maintaining sleep is only in those with insomnia as typified by the elderly population.
Being derived from tryptamine, melatonin participates in the visual content of dreams and those with a normal production may experience lucid, lifelike, potentially disturbing dreams. In fact dream tolerance is a tool in which the therapeutic amount is determined, call it titration. A generalization is that of 0.5 mg +/- within 24 hrs. “Start with 2 – 5 mg nightly for a week, then add 1 mg every 3 days, increasing until you notice overly vivid dreams, then reduce by 0.5 mg. Dreams should normalize” [9].
❗ Do not supplement melatonin concurrently with corticosteroids or other meds used to suppress immune function (e.g., cyclosporine, tacrolimus) [9].
Lifestyle choices, dietary habits, & sleep rituals are at the front line of support.
Especially those with deep seated sleep imbalances. In fact people with chronic sleep insufficiency in association with comorbidities such as obesity, hypertension, depression and the alike should avoid sedatives [2]. Rather the emphasis should be placed on the overall physiology.
Herbs to support sleep
How about a nightcap?, some supportive herbs to aid the reset. Herbal tisanes (nightcap) should not be consumed within 45 – 60 minutes of laying down for the evening. Nightcaps are good for after dinner, while capsules are good for closer to bed time, and EtOH extracts are good in the middle of the night.
Capsules can be consumed with 6 ounces of H2O, as EtOH extracts can be combined with 1 ounce of H2O. With those tisanes, it is a good idea to squeeze out the residual liquid from your herbs, a lot of goodness is hiding in there! Herb to H20 ratios are grams to ounces ie. 2 gram of herb steeped in 10 ounces of hot H20 equals a 1:5 ratio. As for the EtOH extracts, just match the ratio to whats on the bottle.
This first group of herbs serve well to ease the days tensions and worries. A middays cup of brew to get you through. While larger quantities are nice as a nightcap, otherwise in capsules, or an EtOH extract before retiring to prime your Zzzzz’s.
🌿 Milky oats (Avena sativa) green tops [immature seed] are invigorating and revitalizing to the neural branches, useful for nervous exhaustion and depression. A nutritive tonic that supports adrenal function. Large amounts [herb 1:4 ratio H20] steeped over long periods, supports the person driven by the daily grind. Although not the best fit for those with food allergies [gluten]. If going with an extract [4-5mL 4x/daily] be sure its a [milky tops 1:2 ratio glycerol] “Glycerite” made from fresh immature milky tops. A bowl of rolled oats for breakfast and/or dinner is also supportive.
🌿 Lemon Balm (Mellisa officinalis) leaf is generally calming but not sedating, in larger quantities serve well to ease excitement and anticipation. An herb well matched to the qualities of Balgham, though generally well accepted by most. Loose leaf [dried herb 1:5 ratio to H2O]. EtOH extract, [herb 1:5 ratio ABV] @ 2-6mL 1-3x/daily.
🌿 Roman Chamomile (Anthemis nobilis) flowers serve well after meals for those with G.I. upset especially IBS from anxiety. This herb suits well to those of the Sauda, and Balgham qualities but is also generally well accepted by most. As a nightcap [dried flowers 1:3-5 ration to H2O] shortly after dinner, aids digestion, cools inflammation, and calms irritability. EtOH extract, [dried flowers 1:5 ratio ABV] @ 1-4mL 1-3x/daily.
🌿 Skullcap (Scutellaria lateriflora) leaf generally eases nervous irritability. While slowing racing thoughts in larger quantities serves well to subdue not only nerve tension but muscle tension as well. This herb overall requires larger quantities, [dried herb 1:3 ratio to H2O] so go big with this one. An herb that suits those of the Safra and Sauda qualities. EtOH extract, [fresh herb 1:2 ratio ABV] @ 2-5mL 1-4x/daily.
If the former doesn’t seem to get you through, the condition has seated itself. Perhaps check your condition and go with a midday skullcap or milky oats, followed by a nightcap of choice, followed by capsules of choice before bed, and if you awaken have a pre-measured extract of choice ready to go in a bit of water.
Due to the solubility of this next group of herbs, you would want to use capsules or EtOH extracts as H2O may not extrude the active constituents. Falling under the sedative umbrella, this next group of herbs should not be taken before or while operating machinery or driving any automobiles as larger quantities may induce drowsiness and be downright sedating [9]. Powerful enough to potentially cause stupor the next morning, call it a hangover.
❗ Do not use concurrently with other sedatives or antidepressants (e.g., alprazolam, amitriptyline, midazolam, trazodone)
🌿 Hops (Humulus lupus) strobile reduces the sensation of being overwhelmed, easing tension while relieving inflammation, serving well to subdue those tidal heat sensations and night sweats. A sachet of the fresh strobiles placed under the pillow has been traditionally utilized for sleep support. A women’s herb by far, is well accepted by most no matter the gender. EtOH extract [fresh strobile 1:5 ratio ABV] @ 1-3mL 1-3x/daily.
🌿 Lemon Verbena (Lippa citriodora syn. Aloysia citrodora) leaf is refreshing but relaxing, dispersing tension, reducing spasms while supporting sleep integrity. The freshly dried herb is best as a nightcap, otherwise the EtOH [dried herb 1:3 ratio ABV] extract @ .5 – 3mL 1x/daily will suffice. Fast acting, this is a good one to have if waking up in the middle of the night keeps you from sleeping the night through.
🌿 Passionflower (Passiflora incarnata) aerial parts have a long history of use in individuals with hypertension, nerve spasms, and pain. Reducing anxiety, this herb is supportive to the racing mind accompanied by musculoskeletal irritability. EtOH extract [dried herb 1:5 ratio ABV] @ 1-2mL 1-3x/daily.
🌿 Valerian (Valeriana officinalis) root is dispersing and relaxing to the musculature more specifically nerve tension stemming from irritability. Freeing-up the neural paths enabling sleep. Although being acrid, some individuals may find this herb stimulating. EtOH extract [fresh root 1:3 ratio ABV] @ 1-5mL 1-3x/daily.
As always consult with a qualified herbalist to reinsure safety and efficacy.
Somnia Processus
The Sleep continuum
Brought to you from Herbal Restoration LLC, Written By Herbalist S. Reese. All Rights Reserved © 2024 Herbal Restoration LLC.
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