An estimated 50 to 70 million American adults have a sleep or wakefulness disorder. Data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey was used to assess the prevalence of unhealthy sleep behaviors by selected socio-demographic factors and geographic variations in 12 states. The analysis determined that, among 74,571 adult respondents in 12 states, 35.3% reported getting less than seven hours of sleep during a typical 24-hour period, 48.0% reported snoring, 37.9% reported unintentionally falling asleep during the day at least once in the preceding month and 4.7% reported nodding off or falling asleep while driving at least once in the preceding month. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need 9 to 10.5 hours, and adults need 7 to 8 hours. According to data from the National Health Interview Survey, nearly 30% of adults reported an average of six hours or less sleep per day. In 2009, only 31% of high school students reported getting at least eight hours of sleep on an average school night.
Typically, low-cost housing and inner-city apartments are wood construction where noise easily travels across several suites before it becomes attenuated. As a result, the occupants are frequently, partially woken up. It is well known that when people have sleep disruptions, their brain waves slow down, they get foggy-headed and can’t focus or concentrate and become moody and impulsive. One of the best treatments for this type of sleep disturbance is to wear earplugs.
There are two main kinds of sleep problems: sleep-onset latency (trouble falling asleep) and middle-of-the-night-awakenings. The sleep-onset latency (SOL) type is often a result of stress or over-arousal from having too much activity in one’s life. Middle-of-the-night-awakenings (MONA) type of sleep disturbances also result from stress and busyness, but are more typically brought on by neurochemical imbalances such as low serotonin or GABA. They are also the result of a noisy environment or from sleep apnea.
Many adults have sleep apnea, especially if they are not particularly fit and overweight. Some of those with sleep apnea wake up as often as 10 to 20 times per hour – and they wake up exhausted. Another cause of poor sleep may be a simple lack of exercise. People should be getting plenty of exercise, and aerobic exercise is preferred. People who stay fit generally sleep much better than those who don’t. Going for a quick-paced walk for thirty minutes three times a week will be very beneficial for both physical fitness and improved quality of sleep.
Aside from noise, stress and apnea, middle of the night awakenings are usually related to nutrition, hormones and/or neurotransmitters. GABA, vitamin B and D, minerals such as magnesium, calcium, copper and iron, hormones and neurotransmitters all play a role in sleep. An imbalance in one of these generally manifests itself as middle-of-the-night (non-stress related) awakenings, although stress may also play a part.
Always consider lifestyle changes first when attempting to improve sleep. Nutritional supplementation, meditation and meditative breathing can remedy sleep problems quite quickly. Changing a job to a more relaxing one or moving closer to work (and avoiding the freeways) can also improve sleep.
A low vitamin D level is often associated with sleep disorders. Given that oral vitamin D often loses its effectiveness after a few months, tanning will be the most important long-term means to improve sleep and maintain vitality and good energy. Tanning is the best way of acquiring vitamin D and that is because tanning actually makes vitamin D sulfate – a water soluble and highly active form of D, which is much more effective than oral vitamin D. Sun-based D mimics testosterone and affects over 1000 metabolic processes in the body. It settles down neurons and also releases serotonin and dopamine within the brain. Think about the times when you felt mellow and relaxed after being outside and getting some sun. Find a tanning salon with low-pressure bulbs with a minimum ultra-violet B (UVB) content of 5%, although it could be 6 – 7%. Be sure the tanning salon has a bulb replacement program of about 500 hours. Otherwise, the quality of emitted light will deteriorate. Start at four to five minutes and tan exposing as much skin as possible, so you can make as much D as possible. Do not let the salon talk you into any creams or skin “conditioners” and certainly do not use sun-screen. You will need to increase your time to 10 to 15 minutes over the next few months. Research shows that controlled tanning is safe and very beneficial for both brain and body. Sun tanning might be the best way to cut anxiety, improve vitality and get a good night’s sleep.
Aside from tanning, breathing properly is THE MOST IMPORTANT skill to learn for helping to return to sleep. Several breathwork apps are available for smartphones, although I recommend staying with the products from HeartMath. Check out the HeartMath website and order either the hardware or software (EmWave Pro or the iPhone app) to teach yourself meditative breathing. Because the out-breath is parasympathetic, you can put yourself back to sleep with breathing. (I have used this technique for years). When going back to sleep, use a breathing rhythm where your in-breath is about three seconds long and your out-breath is about seven seconds long. This way the brain and body will be mostly parasympathetic and will assist in putting you back to sleep.
Both Audio-Visual Entrainment (AVE) and Cranio-Electro Stimulation (CES) have been shown to help a lot with certain types of sleep issues. AVE is dissociative and reduces the chatter related to a busy day and is quite effective for helping get to sleep when the mind is racing. Both AVE and CES increase serotonin levels, which aids asleep.
The Nutritional Approach
Nutrition can have a significant effect on sleep. When nutrition is off, the brain gets noisy and sleep becomes impaired. With impaired sleep, everything from driving, managing children, working, socializing and pretty much everything else becomes a struggle. This, in turn elevates stress, which in turn further impairs sleep. Some people have nutritional issues due to poor eating habits while others have a malabsorption issue. I have seen people take large doses of minerals only to find that they are lacking a digestive enzyme. After taking the enzyme, their sleep returns to normal. There are a variety of natural supplements which increase serotonin and GABA, two important neurotransmitters involved in sleep. Antibiotics can impair sleep. Recent research has shown that good gut bacteria (flora) stimulates parasympathetic activity and increased serotonin (the calming response) in the brain via the vagus nerve travelling from the gut to the brain. When taking antibiotics, always take a multi-bacterial probiotic as well and continue for one week after the antibiotics are finished.
St. John’s Wort works by increasing serotonin within the brain. Serotonin has a calming effect on the brain and is further broken down into melatonin, an important neurotransmitter for having a good night’s sleep. Serotonin is available in most drug and health food stores and generally sold as 5HTP. In some people, it binds with serotonin receptors in the gut and can produce extreme diarrhea. If this happens to you, discontinue use. The brands "Flora" and "Ferlow" seem to quite effective.
Melatonin is a further processed form of serotonin and is essential for sleep. It may be taken in pill form or intra-orally (absorbed through the oral mucosa - skin in the mouth). Whether or not one form is better than the other is unclear, but both can help with sleep. The Jamieson brand has a two-part, 10 mg tablet (one part quick release and the other part is timed release). The technique will help a person fall asleep and stay asleep.
GABA (gamma amino-butyric acid) enhances the important delta (sleep) brain waves. However, long-term stress, especially childhood stress, strips out the GABA receptors of the amygdala (the emotional and fear center). As a result, a person with GABA issues is always revved up and cannot find deep relaxation. GABA will help considerably for these people. The problem with GABA is that does not absorb through the gut, so one must open the capsule, place some of the powder on the tongue and swish it around in the mouth so that it absorbs intraorally.
Myo-Inositol is sometimes referred to as vitamin B8. It is helpful for people who don’t have good methylation of food. Methylation is a vital biochemical process that is essential for optimal function of almost all of your body’s systems. It occurs continuously as it helps repair DNA, controls homocysteine (an unhealthy compound that can damage blood vessels) and helps recycle molecules needed for detoxification. It plays an important role in boosting mood, reducing anxiety and improving sleep. Take it at night as it can leave one quite fuzzy-headed if taken in the morning.
The Pharmaceutical Approach
Pharmaceuticals are often fine to use for short bursts only and not for longer than a week. They can be hard on our livers and kidneys and the brain habituates quite quickly to them, so in a while, the insomnia will become much worse! I would suggest sun-tanning, meditative breathing, melatonin, St. John’s Wort, GABA, sleeping with a fan on for white noise or anything else before using pharmaceuticals – as drugs will ultimately backfire in time.
When you wake up at 2, 3 or 4 AM, you could try this:
1) Klonopin (Clonazepam) - Boosts GABA which increases delta (sleep) brain waves. Take as little as possible to be effective. I find that a ¼ or less of a 2mg tablet, (500ug) will put me into a deep sleep for four hours. After swallowing the Klonopin, open a 500 mg capsule of GABA and put about a ¼ of the contents of the capsule’s powder onto your tongue. Swish it around your mouth and do not wash it down. Go to bed with it in your mouth. These small doses of Klonopin may be taken twice per week for two months. After that, take no more than once per week or you may develop a tolerance to it.
2) Nytol/Sleep Aid (diphenhydramine) – This is a depressing antihistamine. Therefore it may be used for both allergies and sleep. This is the same chemical that is in Benadryl. Therefore it is unfortunately marketed for both allergies and for sleep. It is an antagonist to acetylcholine (a neurostimulant) thus calming the brain. It is quite habituating, so people who use it for allergies may also develop sleep disorders. As with Klonopin, take as little as possible to be effective. I find that a ¼ or less of a tablet will put me into a fairly deep sleep for four hours. After swallowing the Nytol, open a 500 mg capsule of GABA and put about a 1/4 of the GABA powder onto your tongue. Swish it around your mouth and do not wash it down. Go to bed with it in your mouth. Avoid taking Nytol more than once per week or you may develop a tolerance to it.
New Approaches to Improving Sleep - Audio-Visual Entrainment and Cranio-Electro Stimulation
Assuming that nutrition and hormones are helping, both Audio-Visual Entrainment and Cranio-Electro Stimulation lend themselves well for stress-related sleep problems. AVE uses pulsing lights and tones to drive brain waves, increase calming neurotransmitters such as serotonin & endorphins, and induce deep meditation, all within minutes. CES uses two earclips on the ears and delivers a small electrical pulse into the cranium and mainly the brainstem, thus increasing calming neurotransmitters such as serotonin and endorphins.
If you find that you are generally thinking about the same theme much of the time (work, family, health, news events, a particular relationship or something that you have done and feel bad about) and it is causing stress, then AVE and CES might be well suited for you. These technologies also work well, if your day is just too busy and you lay in bed with dozens of random thoughts and you cannot fall asleep. An AVE study of eight insomniacs, spanning ages from 22 to 76 years old was completed in 1998. It was an ABA design, with a three-week baseline; a two-month treatment period using theta stimulation, followed by a three-week followup had the following results:
Sleep Onset Latency 40 23 minutes
Wakenings After Sleep Onset 65 40 minutes
Frequency Of Night Awakenings 1.9 1.6 nights
Feeling upon Awakening 2.5 3.7 (1-5) Self-rated
Quality of Sleep 2.8 4.1 (1-5) Self-rated
Beck Depression Scale 15.5 9.8 (10 and above indicates depression)
Somatic causes (pain) 2.2 1.7 (1-5) Self-rated
Cognitive causes (noisy brain) 3.5 2 (1-5) Self-rated
AVE generally doesn’t work well for MONA. If you do feel the need to use AVE during the night, then using the blue color on a dim setting is the preferred approach. Sometimes sub-delta is the best session to use at this time. Using the Depression session during the day can help improve sleep. Given that the lights are often found to be annoying during a MONA, CES is a good alternative.
To date, there are roughly 20 studies on CES spanning 700 participants, with average improvement in sleep being about 67%. Results show CES at 100 Hz or in the alpha/theta range works best.
I have sleep issues and almost always wake up sometime between 1 AM and 5 AM. Often I am very wide awake and if I lay there, I might be up for a few hours. Sometimes meditative breathing will put me right back to sleep and sometimes not. So what I do is put a half-dozen drops of St. John’s Wort (Ferlow brand) into my mouth and swish it around for a minute. Then I take apart a capsule of GABA and drop about a ¼ of it onto my tongue and swish this around my mouth with my tongue. I do NOT drink any water at this point. I simply allow the St. John’s Wort and GABA to absorb through my mouth. I generally fall fast asleep in 20-minutes or so and sleep quite deeply until morning, feeling refreshed and ready for a new day. I have been doing this for a few years and have never developed a tolerance to it.
“My sleep was deteriorating over the years to the point of needing sleeping pills, which I have been taking quite a bit over the past three years. I noticed that sometimes when I woke, I could hear my wife snoring, but only on occasion. I finally bought some ear plugs to see if they would make any difference and to my surprise, the snoring must have been more interfering than I had realized because ever since I have been using ear plugs my sleep is great – and I have rarely used sleeping pills since.” – DR (Author’s note: at night, as we relax, the stapes muscle relaxes and quits attenuating the ear. As a result, noises are several times louder in the middle of the night than during the day).
“I love the sun and I sleep great in the summer. But in winter, I really struggle with poor sleep, often waking up at 3:00 AM and feel exhausted by morning. I began sun tanning at a local suntan spa this winter and after two weeks of tanning, I was sleeping like a baby! I also use a little melatonin sometimes, which also helps.” - BK
“My job gets really busy with hundreds of things to do during the day. Then when I get home, I still have to rush dinner and get my kids to soccer, music and whatever other events they are into. My mind is all racy when I try to sleep, so I have been using sleeping pills to get me relaxed enough to fall asleep. After I began using the DAVID products with the blue lights, my mind easily clears itself and before I know it I’m waking up in the morning feeling all refreshed. I don’t even remember falling asleep!” - JS
“I play soccer in an office sports league. Our play times are typically between 9 and 11 PM. Even though we mainly play for fun, I found that I was so wound up after a game that I often could not get to sleep until 3:00 AM. After learning to breathe with the HeartMath program, I now breathe for 10 minutes following a game – and that really calms me down. Then, when I get home, I use the Schumann Resonance program on the DAVID – and it knocks me right out. Now I can play and sleep well when I get home.” - JS
by Dave Siever, C.E.T. -