Download Winter`s Hibernation (From Winter 2006 newsletter)

Dr. Kimberly Hindman, ND, LAc.
1820 SW Vermont, Suite C
Portland, OR 97219
(503) 784-1027
Insomnia (From Late Summer 2007 newsletter)
Many Americans suffer from insomnia, and prescription sleep aids are becoming a very big business.
However, many of these medications can be addictive, cause abnormal sleep patterns, and have
significant side effects. Morning drowsiness is commonly reported, which can lead to further
insomnia, as a person then needs something to get going in the morning (typically coffee), worsening
the insomnia.
While sleep medications can be beneficial in acute cases or for short-term use, they do not address
the underlying causes of insomnia. The most common causes of insomnia are psychological, such as
anxiety, stress, or depression. Other causes include foods, drinks, nutritional deficiencies, or side
effects from other medications.
The causes of insomnia are divided into two types: sleep-onset (i.e., trouble falling asleep) or sleepmaintenance insomnia (i.e., trouble staying asleep). According to the Encyclopedia of Natural
Medicine, causes of sleep-onset insomnia include anxiety, stress, environmental changes/disruptions,
fear of insomnia or of sleep, pain, caffeine, and alcohol. Causes of sleep-maintenance insomnia
include depression, environmental changes, sleep apnea, hypoglycemia, muscle twitching/spasms or
restless-leg syndrome (RLS), pain, drugs, and alcohol. Hormone fluctuations with menses,
pregnancy, and menopause can add to sleep disruption for women.
Natural treatment of insomnia starts with developing healthy sleep habits. First, establish a
consistent bed-time routine, including developing habits before bed (e.g., brushing teeth) and
allowing wind-down time before getting ready for bed. Bed time and waking time should be the
same every day (including weekends) to establish normal circadian and cortisol rhythms. Sleeping in
a completely quiet, dark room, followed by bright light in the morning, will also help establish normal
rhythms. Progressive relaxation and meditation can be a good way to unwind and let go of the day.
Patients should avoid stimulating foods and drinks during the day, including caffeine and alcohol.
Everyone reacts to caffeine differently, and some people are sensitive enough to it that the caffeine in
a cup of decaf coffee in the morning can disrupt sleep that night. Alcohol disrupts serotonin levels,
and serotonin is the neurotransmitter that initiates sleep. Patients with insomnia may benefit from
lab testing to evaluate neurotransmitter and/or hormone levels, especially serotonin or cortisol.
Nutrient deficiencies should also be evaluated. Iron or magnesium deficiencies are commonly seen
with RLS and muscle twitches. In many cases, the iron deficiency is not significant to cause anemia,
and more specific lab tests for iron may be needed.
Hypoglycemia is a very common cause of night-time waking, as the drop in blood sugar stimulates
the release of adrenaline and other hormones that signal the brain that food is needed. Complex
carbohydrates (that also increase serotonin) and protein (that stabilizes blood sugar) make good
before bed snacks.
There are several natural options to prescription sleep aids. 5-HTP may be beneficial for patients
with low serotonin, as melatonin may benefit patients with low melatonin levels. Patients with RLS
may benefit from iron and/or magnesium supplementation. There are also several sedative herbs to
help calm an overactive nervous system and treat pain, including passionflower, valerian, lemon
balm, chamomile, kava, and tilia. Regular exercise has also been shown to increase sleep quality and
decrease anxiety. Homeopathic remedies, flower essences, cranio-sacral work, and counseling can
help release stuck emotional issues.
Patients who snore or have significant daytime fatigue may need to be evaluated for sleep apnea
and/or need oxygen at night.
© Kimberly Hindman, 2007