Conquering the 3 AM wake-up call
Sleep. It is something we all need and yet most of us struggle to achieve. Sleep-deprivation is often used as a tool to torture prisoners, train medical residents and military recruits to overcome their own bodies’ needs supposedly to serve others, and has been known to worsen an array of medical conditions. Studies have shown that circadian rhythm disorders such as those present in night-shift workers have been linked to obesity, heart disease, and many other health conditions. Sleep deprivation can actually make you fat, worsen you quality of life, and literally make you lose your mind.
According to consumer reports, a whopping 70 percent of Americans struggle with sleep once per week. What’s even worse, many turn to over-the-counter medications or prescriptions that can worsen their sleep architecture and cause many side effects. One of the most common over-the-counter medications is Benadryl, which if used long-term can actually increase the chances of developing dementia. Prescription drugs are addictive, have many side effects, and change the amount of dreaming that we do when we are sleeping. This may not seem important at first, but if we miss out on dreaming, we are at greater risk of depression.
Americans are expected to spend $52 billion dollars on sleep aids in 2020. These medications often mask the real problem, cause morning grogginess, and often distort our neurochemistry to cause depression.
Many people use alcohol to relax in the evenings, and there is nothing that could be worse for your sleep. Alcohol causes an initial relaxation, which allows us to go into deeper sleep. After the alcohol wears off, around 3-4 hours later, there is a rebound response and sleep becomes more fragmented. This is why you often wake up at 3 AM after a night of drinking. I believe that people with sleeping difficulties should avoid alcohol altogether if they want to restore normal sleeping rhythms.
I personally came to my own breaking point regarding sleep. Surviving medical school, residency, and several years as a hospitalist caused me to work many night shifts and altered my circadian rhythm to a severe degree. After enduring a five-year F5 tornado of a divorce and custody battle, my nerves were shattered and it was incredibly hard for me to relax. I have literally tried EVERYTHING for sleep and I can safely say that what I learned in my Integrative Medicine Fellowship saved me. I can now sleep 8 hours a night, without waking up, for the first time in 15 years.
I would like to share with you some of my favorite herbs and techniques for getting your sleep, and your life back.
This herb is like nature’s version of the prescription drug trazodone. I tried trazodone at the recommendation of my primary physician after my divorce. Not only did it not work, but it gave me the lovely side effect of feeling dizzy everytime I stood up. However, 5-HTP has been a lifesaver for me because it increases serotonin in the brain, aiding with anxiety. This herb works well for those who cannot sustain sleep, and wake up in the early morning. A side effect can be morning grogginess, although this is certain less than prescription medications.
I have mentioned this herb before in the treatment of anxiety, but I feel it is very useful for sleep as well. This herb that comes from the south pacific islands has many of the same effects on the brain and nervous system as marijuana does, but without the positive drug test. It comes in a tincture, a pill, or a tea, but you can also buy the fresh ground root which can be especially potent.
Like other types drugs in the poppy family, this herb is good for pain. This is an especially helpful herb for those that suffer from chronic pain at night, and is helpful for patients with Fibromyalgia due to the sedating as well as pain-relieving effects.
This herb is known for its effects on anxiety as well as insomnia. It binds to the same receptors as the benzodiazapenes (think Valium, Ativan, and Xanax), only not as strongly so it is not addictive. This herb is also effective for menopausal hot flashes, so it may be a particularly helpful and non-addictive medication for those going through menopause who experience both anxiety and debilitating hot flashes.
This herb is particularly effective when combined with other herbs given its mild effects, however, it can be as useful as Ambien in some studies when it comes to preventing early morning awakening. It is also useful for the treatment of generalized anxiety disorder and the treatment of anxiety related to withdrawal of in substance abuse.
This is one of the most common over the counter medications. It seems to come in doses between 3 mg and 10 mg. However, did you know that this is way too much and can actually disrupt your sleep? Our sleep architecture is disrupted causing us to dream too soon in the night, pushing us away from the deep sleep too fast. A dose of 0.5-1 mg is actually preferable and more consistent with what our brain would naturally secrete if we weren’t all deficient because of the light that we receive from technology. Melatonin is generally very safe, but very high doses can cause crazy dreams, which may cause you to wake up too soon.
Perhaps the most powerful sleep-aide is not a plant at all but instead the rewiring of our brains. Many of us cannot shut our thoughts off at night and our worries abound. Improved sleep hygiene, exercise, avoiding caffeine, apps for improving our sleep, and biofeedback are all helpful. Perhaps the most powerful way to permanently alter our sleep patterns is meditation. By flexing our mental muscle we can create new pathways in our brains and actually change the structure of our neurons in order to create a new reality that does not include insomnia. Learning to focus your attention towards the kind of life that you want instead of your worries is an incredibly powerful tool that works better than any drug or herb.
Personally, my nightly ritual is a tea that I make with Kava Kava, Passionflower, Wild Oats, Holy Basil, Ashwaganda, melatonin, and 5-HTP. I have been taking this for several months now and have slept well for the first time in nearly 15 years. I also meditate, which has helped me immensely with anxiety. I cleaned out my life and got rid of toxic relationships and toxic work environments. I have never slept better and would like to help you with your problems.
Make an appointment with an Integrative Medicine Physician to help you improve you sleep. It is important to discuss you individual struggles as well as other medication that you are taking to avoid interactions. This article is not meant to be health advice and you should consult your individual practitioner.
Dr. Erin Fenstermacher is a Board-Certified Internal Medicine Physician and Fellowship-Trained Integrative Medicine Physician with a practice in Albuquerque New Mexico as well as a Telemedicine practice available in other states.