Sleeping is as vital to human health as food, water and air. It has been directly connected to weight management, heart health, cognitive health as well as brain detoxification and mitochondrial function. And I think we’ve all had patients that present with a seemingly unbeatable case of insomnia. They’ve tried everything: low dose melatonin, high dose melatonin, teas, going to bed at the same time every night, relaxing music that sounds like the beach, meditation, copious amounts of alcohol and the list goes on. While a number of these strategies work for select patients, I’ve run into many patients that have needed a more complete approach.
When it comes to sleeping habits, everyone has three things in common: they need to set the stage to be able to fall asleep, achieve a deep state of REM sleep and be able to stay asleep. Now whether you are a monophasic sleeper, meaning you have one sleeping session per day or biphasic sleeper, meaning that you have two sleeping sessions per day, those three essential elements of quality, restful sleep have to be present. Polyphasic sleeping habits, meaning 4-6 sleeping sessions per day, are more difficult to execute and takes a tremendous amount of discipline and would rely less on settling in for a long period of sleep (the average amount of time of each sleep session is generally less than 2 hours). Sleep studies on mono vs bi sleepers
The first hurdle in optimizing sleep is setting the stage to be able to actually fall asleep. This is where such staples as lemon balm and GABA come in. Both work at the level of the receptors in the brain in order to support inhibitory neurotransmitter expression. In a 15 day open-label study in persons with mild to moderate stress and anxiety coupled with sleep disturbances, supplementation of Melissa officinalis (7% Rosmarinic acid and 15% total hydrocinnamic acids) was directly correlated to reductions in anxiety-related insomnia by 42%.1
GABA has been studied slightly differently. In 2006 a clinical trial looked at brain wave activity using GABA vs placebo. After 60 minutes of administration, GABA significantly increases alpha waves and decreases beta waves compared to placebo. This is actually taking place in stage one of the sleep cycle where your brain waves are actively shifting from alpha waves to theta waves.2 Since beta waves, often associated with the stress response and even insomnia, block alpha waves that shift to theta (deep sleep waves) becomes virtually impossible. GABA demonstrating an ability to support alpha waves therefore secures it as a definite inclusion to any sleep protocol when there is a need to support falling asleep.
Melatonin and L-theanine have proven to be supportive for achieving deep, quality sleep. If your biphasic, obviously loading up on melatonin or GABA may not be the best choice during the short ‘siesta’ during the day. Melatonin is an obvious choice for the longer stretches of sleep. One clinical trial looked at applying melatonin to patients that suffered from REM disruption. The results of the study revealed that melatonin was significantly more effective than placebo for these patients. The melatonin group experienced significant increases in deep, REM sleep percentage and also noted a subjective decrease in daytime dysfunction.3 L-Theanine was also studied in a randomized, double-blind, placebo-controlled trial was conducted involving boys, ages 8-12 years, who had been previously diagnosed with ADHD. The boys who consumed L-theanine obtained significantly higher sleep percentage and sleep efficiency scores compared to those in the placebo group. 4
The final areas you have to look at are circadian rhythm and blood sugar balance. Other aforementioned compounds can all aid with circadian rhythm, however, the standout circadian ingredient would be ashwagandha. When looking at ashwagandha extracts, I typically rely on the Sensoril® 8% withanolide standardized extract.
The capability of Sensoril® to help enhance sleep has been confirmed in a double-blind, placebo-controlled human clinical trial consisting of 98 subjects. Those individuals taking Sensoril® at the recommended dosage of 250mg daily experienced a 68% reduction in sleeplessness. 5 The mechanism this works on is predominately through balancing cortisol levels, which can in turn support and stabilize blood sugar levels.
There are so many factors involved in sleep habits, from the type of sleep patterns you have to the factors that can prevent a good night’s sleep. However, by providing support for these three key areas (falling asleep, achieving deep, quality sleep and being able to stay asleep) you’ll will go a long way toward helping patients get the sleep they need.
- Cases J,et al Med J Nutrition Metab. (2011).
- J Clin Endocrinol Metab.2004 Jan;89(1):128-34.
- Altern Med Rev.2011 Dec;16(4):348-54.).
Journal of the American Nutraceutical Association Auddy B, et al. 2008;11(1):50-56.