One of the highlights of the physical examination is the exploration of my patient’s sleep pattern. As a general rule, sleep is extremely unlikely to be organically deranged, but very easily altered by our unhealthy habits. An extra cup of coffee late in the day, worry and mind jargon in bed, a partner who snores, a cluttered room, are just a few reasons sleep problems abound in our modern day culture.
Not too long ago, the medical community thought of sleep as absence of action. Quite the contrary, in those golden 7.4 hours (to be exact) a host of brain wave activity, restoration and rejuvenation of total body occurs. Hence, the strongest repair hormone in the body, our growth hormone, rises substantially at nighttime. Growth hormone supplementation has been shown to improve musculoskeletal tone and density by as much 25% more than placebo. Normal sleep patterns generate more cycles of REM and Non REM sleep which allows optimal production of growth hormone, as well as other key hormones, such as cortisol and melatonin. Melatonin weighs 230 g/mol, and rests in the depth of your eye, waiting for its signal, darkness to be secreted. It is a potent anti-oxidant, and present in all life forms, from algae to humans. I prescribe it readily to patients with sleep issues. I use it in those with recent or past head concussions as melatonin also plays a major role in repair and regeneration of brain cells. It’s imperative you have normal cyclic secretion of melatonin to preserve sound sleep and brain function.
Recently, a very intelligent patient came to me with a request to help her come off Xanax, a very addictive benzodiazepine. She had faced a period of high anxiety and stress, leading to chronic benzo use and erratic sleep pattern. It was impossible for her to fall asleep without Xanax, but her sleep was plagued by night time awakenings, sweats, and more anxiety. We arranged for strict sleep schedules, melatonin, audiobooks, magnesium, and a slow taper off the benzo. After 2 months she returned a new person. She had stopped Xanax all together, and slept every night “like a baby”.
When you ignore sleep, it catches up with you. Your cognitive ability diminishes and you’ll fall asleep even while awake. It’s eye for an eye. Every hour you miss, you’re going to sleep an extra hour the next night to make up for it.
If you are experiencing sleep problems, learn these 10 simple rules we have devised for you:
- Stop all caffeinated and alcoholic beverages. You may resume at slower pace after treatment.
- Avoid processed foods and any artificial or natural flavors before bedtime.
- Avoid eating heavy at nighttime.
- Keep your room temperature low and cut back on heavy or synthetic bedding.
- Do not allow light in the room one hour before bedtime. This means no phones or electronic devices, or TV.
- Listen to an audiobook, any title you wish. Set a 8-15 minute sleep timer.
- Take Magnesium (250mg-400mg) and Melatonin (1 mg) before bedtime.
- Keep strenuous exercise away from time of sleep.
- Develop a sleep routine and follow it until you regain normal cycles.
*Of course, for those who prefer a quick fix, and when all aforementioned fails, modern medicine has thankfully given us remedies, such as Ambien, Lunesta, and the latest, Belsomra. I prescribe them mainly for short term use. At times, patients experience a world of difference in their sleep patterns- for the better.
Wishing you a sound sleep tonight,
Daylight Savings: hours change, environment changes. Expose yourself to direct sun every morning for at least 30 minutes. This helps to adjust the time difference.