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Insomnia and sleep cycles

Humans and Sleep Disturbance in Winter

Many people, who would love to hibernate in winter, find that sleep eludes them, or is broken and disturbed, in this season.

This is particularly true for older adults and especially for menopausal women.

People are restless at night, the bed seems too hot or too cold, they have trouble falling asleep, or they feel sleepy too early in the evening then wake too early. Some can lie and ‘ponder’, but others find the effects build up into major health problems.

  

Insomnia and sleep cycles

“Methought I heard a voice cry 'Sleep no more!

Macbeth does murder sleep', the innocent sleep,

Sleep that knits up the ravell'd sleeve of care,

The death of each day's life, sore labour's bath,

Balm of hurt minds, great nature's second course,

Chief nourisher in life's feast,--"

http://shakespeare.mit.edu/macbeth/macbeth.2.2.html

  

‘Insomnia is defined as ‘a perception of inadequate sleep.

Normal sleep varies from 4-11 hrs, and one person’s insomnia is another’s normal sleep pattern. In normal sleep, brain electrical waves cycle though initial drowsy awareness into ‘sleep spindles’ cycling through four progressively deeper states, from light sleep, moving into deep restorative sleep, rapid eye movement  (REM) sleep with dreaming, then back into non-REM cycles. Disruption of any of these stages can cause insomnia, resulting in fatigue, loss of concentration, tension headaches and irritability (see research pages for more information Sleep and hibernation).  

  

Herbal sleeping potions!

1. To improve sleep onset and duration.

Herbs were selected that have been used traditionally and have recent data from clinical trials or experimental work to support their use in treating insomnia.   

Night-time Sleep Liquid formula 1 :

Valerian1:2  40 mL

Passionflower1:2  40 mL

Hops1:2  20 mL

Total =100mls 

Dosage: Take 10 ml nightly 30-60 minutes before bedtime. 

  

Valerian (Valeriana officinalis) has sedative effects and, in combination with hops (see below), was used to treat insomnia in a number of clinical trials (Wheatley 2005). Unlike benzodiazepines there is no ‘morning after’ (residual hypnotic) effect and there is an increase in REM sleep. Traditionally it was used to treat insomnia, headaches, stress and irritability. It’s use dates back to Galen and Dioscorides (first century AD) and was referred to as “All Heal” in medieval times (Grieve 1973).  

Interactions: Could increase the effects of CNS depressants and alcohol (Bone 2013).

Passionflower (Passiflora incarnata),  contains benzoflavone moiety (BZF), effectively to treat addiction, insomnia and anxiety in clinical trials (Dhawan 2002). Traditionally it is  used alone or in combination with hops and/or valerian, to treat sleeplessness and nervous gastrointestinal disorders, neuralgia and headache, having a general relaxing and calming effect on the nervous system (Grieve 1973). No interactions noted (Bone 2013)

Hops ( Humulus lupulus)  Combined with valerian, hops was comparable in effectiveness to benzodiazepines in clinical trials (see above). Traditionally it is used as a bitter tonic and diuretic (characteristics still popular today in the widely used herbal extract known as beer). It is used to treat anxiety and promote sleep onset (Grieve 1973).

Recommended Additional Herbs

Oats: (Avena sativa) traditionally used as a nervine and anxiolytic (Grieve 1973; Bone 2013) oats can be taken in the form of porridge or muesli.

Magnesium supplements: eg, Magnesium phosphate tablets (100mg, Blackmores) 1 three times/day, can prevent muscle cramps and calm restless legs. Chronic magnesium deficiency  due to lack of whole grains in the diet and has also been implicated in depression and insomnia. 

Chamomile tea (Chamaemelum nobile) is widely available in tea bags and should be drunk as a nightcap (Grieve 1973).  

  

2. Formula for insomnia due to Menopause

Many postmenopausal women have reported changes in sleep patterns. Lower estrogen levels can cause hot flashes, change in stress reactions, or overall change in the sleep cycle, which all could contribute to insomnia. 

Night-time Sleep Liquid formula 2:

Shatavari 1:2  50 mL

Hops1:2  20 mL

Chaste tree1:2  30 mL

Total =100mls 

Dosage: Take 10 ml nightly 30-60 minutes before bedtime. 

  

Self medication for insomnia often includes daytime caffeine to stay awake and evening alcohol to induce sleep at night. Although alcohol hastens sleep onset, sleep is fragmented, with early waking following clearance of alcohol from the blood after 3-4 hours (Roth 2007). . 

Recommended treatment for insomnia includes elimination of stimulants and alcohol, a quiet, comfortable bedroom, increased daytime exercise and a regular bedtime. Drugs used to induce sleep include sedatives (that slow cognitive functions) hypnotics, (sleep inducing) and tranquilisers (have a calming effect without drowsiness). Modern “tranquilisers” such as benzodiazepines, have all three effects, depending on the dose given (Upfal 2002). These drugs induce sleep, but do not promote deep restorative or REM sleep, so sleep quality is compromised (Wheatley 2005). Drugs are useful in breaking the vicious cycle of insomnia, but are often ineffective for chronic insomnia (Simon 2000).

Bone, K. and S. Mills, Principles and Practice of Phytotherapy. Second ed. 2013, Sydney, Australia: Churchill Livingstone

Dhawan, K., S. Kumar, and A. Sharma, Suppression of alcohol-cessation-oriented hyper-anxiety by the benzoflavone moiety of Passiflora incarnata Linneaus in mice. J Ethnopharmacol, 2002. 81(2): p. 239-44

Roth, T., M. Franklin, and T.J. Bramley, The state of insomnia and emerging trends. Am J Manag Care, 2007. 13(5 Suppl): p. S117-20.

Upfal, J., The Australian drug guide. 6th ed. 2002, Melbourne, Australia: Schwartz Publishing Pty Ltd.

Wheatley, D., Medicinal plants for insomnia: a review of their pharmacology, efficacy and tolerability. J Psychopharmacol, 2005. 19(4): p. 414-21.

Simon, R. and M. Sunseri, Disorders of sleep and arousal, in Cecil Textbook of Medicine, L. Goldman and J. Bennett, Editors. 2000, W.B. Saunders Company: Philadelphia. p. 2030-2033.

Grieve, M., A Modern Herbal. Edition (unrevised) published 1998 ed, ed. C.F. Leyell. 1973, Twickenham,  UK: Tiger Books International PLC 

 

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