Do you suffer from insomnia or poor-quality sleep? According to 2018 research, approximately 25% of Americans suffer from insomnia every year,1 and I imagine that statistic is actually much higher in the population of patients with chronic illness.
Sleep hygiene is becoming a catchphrase in the medical world, and it describes the concept of creating good sleep habits on a daily basis. Some of these are a no-brainer, such as avoiding caffeine at night. Others, however, are less intuitive and have more to do with our electronic devices, lighting, functional medicine concepts, and use of certain spaces in the home.
Below are some suggestions based off clinical experience and expert recommendation that seem to assist in reducing insomnia with patients:
- Address viral and bacterial issues that are affecting the entire system with the help of a professional. Many of my patients with MCAS also have chronic Epstein-Barr virus, Lyme disease, and other burdens that stress and deplete the system and create a perfect storm of issues, both during the day and at night.
- Address gut health issues (such as candida, SIBO, etc.) with the help of a professional. Follow a diet that focuses on whole foods like organic fruits and vegetables and avoid processed foods, alcohol, additives, etc. Try taking your probiotic at night.
- Address mold with the help of a professional if it is an issue for you. Many patients with CIRS (Chronic Inflammatory Response Syndrome) from mold toxins experience a high number of neurological symptoms, and insomnia tends to be especially common in this patient population.
- Reduce exposure to EMFs (electric and magnetic fields), especially at night. In some living scenarios this is difficult, but it can help to turn off the wireless internet router, turn wifi/data off the cell phones, and physically remove cell phones from the sleeping area. Consider other sources of EMFs as well. (See this previous blog post for more information on EMFs.)
- Consider stopping all screen time two hours prior to bed. (If this is not possible, invest in a pair of blue light-blocking glasses to use in the evenings.) Also consider dimming the lights in the home for a few hours prior to bedtime.
- Maintain the bed as a sanctuary and avoid doing anything work-related or using the computer or phone while in it. Teach the body to recognize the bed space as solely for sleeping and intimacy. Keep the room dark and use earplugs and/or white noise if needed. Rotate the mattress regularly.
- Get active. Consistent physical exercise can help, as long as it’s not done within a few hours of going to bed. Interestingly, midday light exposure helps the body get into a better rhythm and produce more melatonin at night.(2) So, consider a midday walk or bike ride when able.
- Come up a with a relaxing pre-bedtime ritual. Many people find that a warm bath, hot tea, or reading a book helps with relaxation before bed.
- Breathing exercises to work on vagus nerve stimulation and reducing the sympathetic nervous system “fight or flight” can be helpful too, particularly for patients with POTS and patients who experience adrenaline rushes that jolt them awake as they start to fall asleep.
- Many resources recommend getting into a good routine and going to sleep at the same time every night. The jury still has mixed results on napping as well as whether a light snack before bed is ideal.
- Some patients with MCAD tolerate melatonin supplements well, while others do not. My nighttime supplement of choice is Best Rest by Pure Encapsulations, which has a blend of melatonin with vitamin B6, GABA, L-Theanine, valerian root, passion flower, lemon balm, hops, and chamomile. Obviously, it contains a lot of ingredients, making it tricky when trialing the supplement with patients who are extra sensitive, so many patients prefer to test the different ingredients one at a time first. (Always consult your medical team when considering adding a new supplement, as these ingredients can interact with other supplements and medications.)
- When sleeplessness occurs, try not to get frustrated and make effort to avoid fixating on what symptoms may be keeping you awake (presuming they are non-emergent). If it occurs for more than 10-20 minutes, consider moving to a different space and doing something relaxing in low light until you get sleepy again. I always keep a slightly boring book handy and that usually does the trick. Some patients find that listening to binaural beats (the tones specific to sleep) or recorded meditations can be helpful too. Otherwise, avoid using electronics and your phone when you can’t sleep at night.
References:
- University of Pennsylvania School of Medicine. “One in four Americans develop insomnia each year: 75 percent of those with insomnia recover.” ScienceDaily. ScienceDaily, 5 June 2018. <www.sciencedaily.com/releases/2018/06/180605154114.htm>.
- Hashimoto S, Kohsaka M, Nakamura K, Honma H, Honma S, Honma K. Midday exposure to bright light changes the circadian organization of plasma melatonin rhythm in humans. Neurosci Lett. 1997;221(2-3):89-92. doi:10.1016/s0304-3940(96)13291-2
