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Solutions for Sleep Issues Over 40

| June 29, 2018

Sleep Trouble

Years ago, I worked with an autism researcher who was both an MD and a PhD. I would sometimes get emails from him at 4 a.m., so of course my question to him was, “Don’t you ever sleep?” As a matter of fact, it turns out, he did not. At least, he did not sleep as much as I do. He told me that he has never needed much sleep, and generally gets about four hours a night. He was healthy and well rested. This same doctor had two adult daughters. One needed a normal amount of sleep, and averaged eight hours a night. The other was like him, and slept about four hours and was rested and healthy. He was quick to point out that getting only four hours a night consistently because of insomnia or stress or pain was very bad for both your mind and body, but that some people are wired a little differently and do quite well on less. He theorized that there was a genetic link to some of these differences.

Scientists have since confirmed his theory and found that a rare gene mutation called DEC2 allows less than one percent of the population to be perfectly healthy on four to six hours sleep a night. It was also found that these people are, on average, more energetic in the daytime, and tend to be positive, optimistic people. Does anyone wish we could all get an infusion of DEC2?

For most of us, the average is eight hours, and 125 years ago, that average was nine or more hours. We are losing sleep, personally, and as a nation.

Sleep Dysfunction

Today, the majority of adults are consistently getting less than seven hours of sleep a night. This results in increasing levels of physical and mental dysfunction. And as we age, our risk for disturbed sleep increases.

According to the Centers for Disease Control and Prevention (CDC), 39 percent of people aged 45 to 54 receive insufficient sleep, which is defined as less than seven hours per night. Since the 1980s, sleep duration has been steadily decreasing in U.S. adults. For example, in 1985, 39 million adults reported sleeping less than or equal to six hours in a 24-hour period. Just 30 years later, more than 70 million adults reported that same sleep deprivation in one day. Many sleep experts agree that for the standard adult, seven to nine hours of sleep per evening is optimal. So if your body needs nine hours, and you only get six, you have lost a third of the sleep you need to be healthy.

Research has indicated that women are slightly more affected by issues that result in loss of sleep. One possible explanation is the relationship between hormones and the sleep cycle. Many studies have demonstrated that sleep disturbances are significantly higher in women going through perimenopause, menopause, or surgically induced menopause compared to pre-menopausal women. Researchers have found that women in menopausal stages had lower oxygen saturation during sleep and also a higher apnea-hypopnea index (AHI). Also, many women are all too familiar with the abrupt awakening of a hot flash in the middle of the night.

There are several health conditions that can affect sleep quantity and quality. Some of these include chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD), chronic pain conditions (osteoarthritis), urinary issues (prostate enlargement, overactive bladder, cystitis), neurodegenerative disorders (Alzheimer’s and Parkinson’s diseases), and diabetes. Additionally, mood issues, such as depression and anxiety, play a tremendous role in sleep. Substances can interfere with proper sleep patterns as well, including certain prescription medications, caffeine and alcohol.

One study found that the risk of sleep apnea also more than triples in people aged 45 to 64 years old versus the 20- to 44-year-old age group.

Address the Underlying Cause

Therefore, the first step in addressing sleep problems is to understand the underlying cause and try to correct it. Are hot flashes waking you up? Try a quality black cohosh extract, 13 mg a day, or a combination of black cohosh with rhodiola—excellent interventions for hot flashes and night sweats. Tight chest, coughing, poor breathing from chronic lung inflammation? Try elevating the head of the bed a bit and consider a purified and standardized boswellia extract, with higher levels of AKBA, but reduced BBA for optimal effectiveness in alleviating lung inflammation.

And whether you are a man or woman, if your sleep is interrupted by frequent trips to the bathroom to urinate (called “nocturia”), you might want to consider a specialized extract of Icelandic Anjelica archangelica, which has been shown to settle down these issues and significantly reduce early and frequent waking for bathroom visits.

After you have determined the cause of your sleep issues, there are a variety of excellent natural interventions to improve sleep. Here are two that are quite popular and proven effective.

Melatonin

Melatonin is a hormone made by the body’s pineal gland. Melatonin is critically involved in circadian rhythm, which is the cycle of our daily life. It lets you know when it is time to be active, eat, and very importantly, sleep. It is called the “hormone of darkness” because much of it is made at night and natural melatonin production is reduced when light strikes the retina of the eye. So try to keep the bedroom in the dark!

Melatonin is a potent antioxidant, and may have cancer prevention properties as well.

Supplemental melatonin is probably best known for use as a clinically proven sleep aid that increases REM and stage 4 sleep (the stage of repair and rejuvenation). Some people find that they have vivid dreams when they use melatonin for the first time. This is a good sign that you are experiencing healthier sleep cycle, because it is expanding the time you spend in REM (or dreaming sleep).

Melatonin is a great choice to improve sleep. A good dosage is 2.5 to 5 mg a night. You generally don’t need a high dose to get results.

Hemp Oil

Many of you have heard about cannabidiol (CBD), especially as it relates to some of the controversies of marijuana and industrial hemp. The government’s definition of marijuana is any compound from the plant Cannabis sativa with 0.3 percent or more tetrahydrocannabinol (THC), which is the psychoactive compound in marijuana responsible for “getting high.” Industrial hemp is from a similar plant in the Cannabis sativa family, but contains less than 0.3 percent THC. In order for hemp oil to be legal for sale, it must be shown to contain less than 0.3 percent THC, so it is a good idea to work with manufacturers who have both high quality standards and expertise in this area to assure you are purchasing legitimate, legal hemp oil.

However, CBD and hemp oil are not the same thing. Hemp extract that is derived from the stalk (not seed) of industrial hemp is rich in a family of over 100 compounds called phytocannabinoids. These are plant nutrients that interact with the body’s own endocannabinoid system to elicit health benefits. CBD is only one of these nutrients, and it works much better within the full family of hemp phytocannabinoids than on its own. So while it is true that full spectrum hemp oil contains CBD, it also contains many other active nutrients that provide excellent benefits via their influence on the endocannabinoid receptors.

In a review article examining the use of cannabinoids for sleep, researchers reported that hemp compounds hold promise for REM sleep behavior disorder and excessive daytime drowsiness. Other compounds in hemp may reduce certain types of sleep apneas and nightmares associated with post-traumatic stress disorder (PTSD).

Since hemp oil has been shown to improve relaxation and mood, this indirectly influences sleep as well. In other research, hemp oil has been shown to reduce pain by a variety of physiological mechanisms, which indirectly influences sleep.

Dosages for full-spectrum hemp oil vary, but are generally in the 50 to 150 mg range. You might want to experiment with a few nights at 50 mg and if you are still tossing and turning, go up to 100 mg for a few more nights to judge how the product is working for you.

Conclusion

There are many natural interventions to facilitate healthy sleep, including taking a hot bath to light blocking window shades to nature sound white noise machines. And they all can make a difference! Do a little detective work to see if you can figure out underlying causes, see a doctor if needed, and consider clinically proven supplements that can improve sleep. You can get a better night’s sleep for a better tomorrow. VR

References:

Consensus Conference Panel, Watson NF, et al. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. J Clin Sleep Med. 2015 Aug 15;11(8):931-952.

Centers for Disease Control and Prevention. (2017). Short Sleep Duration Among U.S. Adults. Retrieved from www.cdc.gov/sleep/data_statistics.html on May 29th, 2018.

Ford ES, Cunningham TJ, Croft JB. Trends in Self-Reported Sleep Duration among US Adults from 1985 to 2012. Sleep. 2015 May 1;38(5):829-832.

Hachul H, et al. The effect of menopause on objective sleep parameters: data from an epidemiologic study in Sao Paulo, Brazil. Maturitas. 2015 Feb;80(2):170-178.

Pinkerton JV, Abraham L, Bushmakin AG, Cappelleri JC, Komm BS. Relationship between changes in vasomotor symptoms and changes in menopause-specific quality of life and sleep parameters. Menopause. 2016 Oct;23(1):1060-1066.

Punjabi NM. The Epidemiology of Adult Obstructive Sleep Apnea. Proc Am Thorac Soc. 2008 Feb 15;5(2):136-143.

Xu Q and Lang CP. Examining the relationship between subjective sleep disturbance and menopause: a systematic review and meta-analysis. Menopause. 2014 Dec;21(12):1301-1318.

Ammon HP. Boswellic Acids and Their Role in Chronic Inflammatory Diseases. Adv Exp Med Biol. 2016;928:291-327. Review.

Drewe J, Zimmermann C, Zahner C. The effect of a Cimicifuga racemosa extracts Ze 450 in the treatment of climacteric complaints--an observational study. Phytomedicine. 2013 Jun 15;20(8-9):659-66. doi: 10.1016/j.phymed.2013.02.012.

Sigurdsson S, Geirsson G, Gudmundsdottir H, Egilsdottir PB, Gudbjarnason S. A parallel, randomized, double-blind, placebo-controlled study to investigate the effect of SagaPro on nocturia in men. Scand J Urol. 2013 Feb;47(1):26-32.

Arendt J, Skene DJ. Melatonin as a chronobiotic. Sleep Medicine Reviews. February 2005. Volume 9, Issue 1, Pages 25–39. DOI: https://doi.org/10.1016/j.smrv.2004.05.002.

Babson KA, Sottile J, Morabito D. Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Curr Psychiatry Rep. 2017 Apr;19(4):23. doi:10.1007/s11920-017-0775-9. Review.

Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of Scientific Affairs and Education for EuroPharma, Inc.

Years ago, I worked with an autism researcher who was both an MD and a PhD. I would sometimes get emails from him at 4 a.m., so of course my question to him was, “Don’t you ever sleep?” As a matter of fact, it turns out, he did not. At least, he did not sleep as much as I do. He told me that he has never needed much sleep, and generally gets about four hours a night. He was healthy and well rested. This same doctor had two adult daughters. One needed a normal amount of sleep, and averaged eight hours a night. The other was like him, and slept about four hours and was rested and healthy. He was quick to point out that getting only four hours a night consistently because of insomnia or stress or pain was very bad for both your mind and body, but that some people are wired a little differently and do quite well on less. He theorized that there was a genetic link to some of these differences.

Scientists have since confirmed his theory and found that a rare gene mutation called DEC2 allows less than one percent of the population to be perfectly healthy on four to six hours sleep a night. It was also found that these people are, on average, more energetic in the daytime, and tend to be positive, optimistic people. Does anyone wish we could all get an infusion of DEC2?

For most of us, the average is eight hours, and 125 years ago, that average was nine or more hours. We are losing sleep, personally, and as a nation.

Sleep Dysfunction

Today, the majority of adults are consistently getting less than seven hours of sleep a night. This results in increasing levels of physical and mental dysfunction. And as we age, our risk for disturbed sleep increases.

According to the Centers for Disease Control and Prevention (CDC), 39 percent of people aged 45 to 54 receive insufficient sleep, which is defined as less than seven hours per night. Since the 1980s, sleep duration has been steadily decreasing in U.S. adults. For example, in 1985, 39 million adults reported sleeping less than or equal to six hours in a 24-hour period. Just 30 years later, more than 70 million adults reported that same sleep deprivation in one day. Many sleep experts agree that for the standard adult, seven to nine hours of sleep per evening is optimal. So if your body needs nine hours, and you only get six, you have lost a third of the sleep you need to be healthy.

Research has indicated that women are slightly more affected by issues that result in loss of sleep. One possible explanation is the relationship between hormones and the sleep cycle. Many studies have demonstrated that sleep disturbances are significantly higher in women going through perimenopause, menopause, or surgically induced menopause compared to pre-menopausal women. Researchers have found that women in menopausal stages had lower oxygen saturation during sleep and also a higher apnea-hypopnea index (AHI). Also, many women are all too familiar with the abrupt awakening of a hot flash in the middle of the night.

There are several health conditions that can affect sleep quantity and quality. Some of these include chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD), chronic pain conditions (osteoarthritis), urinary issues (prostate enlargement, overactive bladder, cystitis), neurodegenerative disorders (Alzheimer’s and Parkinson’s diseases), and diabetes. Additionally, mood issues, such as depression and anxiety, play a tremendous role in sleep. Substances can interfere with proper sleep patterns as well, including certain prescription medications, caffeine and alcohol.

One study found that the risk of sleep apnea also more than triples in people aged 45 to 64 years old versus the 20- to 44-year-old age group.

Address the Underlying Cause

Therefore, the first step in addressing sleep problems is to understand the underlying cause and try to correct it. Are hot flashes waking you up? Try a quality black cohosh extract, 13 mg a day, or a combination of black cohosh with rhodiola—excellent interventions for hot flashes and night sweats. Tight chest, coughing, poor breathing from chronic lung inflammation? Try elevating the head of the bed a bit and consider a purified and standardized boswellia extract, with higher levels of AKBA, but reduced BBA for optimal effectiveness in alleviating lung inflammation.

And whether you are a man or woman, if your sleep is interrupted by frequent trips to the bathroom to urinate (called “nocturia”), you might want to consider a specialized extract of Icelandic Anjelica archangelica, which has been shown to settle down these issues and significantly reduce early and frequent waking for bathroom visits.

After you have determined the cause of your sleep issues, there are a variety of excellent natural interventions to improve sleep. Here are two that are quite popular and proven effective.

Melatonin

Melatonin is a hormone made by the body’s pineal gland. Melatonin is critically involved in circadian rhythm, which is the cycle of our daily life. It lets you know when it is time to be active, eat, and very importantly, sleep. It is called the “hormone of darkness” because much of it is made at night and natural melatonin production is reduced when light strikes the retina of the eye. So try to keep the bedroom in the dark!

Melatonin is a potent antioxidant, and may have cancer prevention properties as well.

Supplemental melatonin is probably best known for use as a clinically proven sleep aid that increases REM and stage 4 sleep (the stage of repair and rejuvenation). Some people find that they have vivid dreams when they use melatonin for the first time. This is a good sign that you are experiencing healthier sleep cycle, because it is expanding the time you spend in REM (or dreaming sleep).

Melatonin is a great choice to improve sleep. A good dosage is 2.5 to 5 mg a night. You generally don’t need a high dose to get results.

Hemp Oil

Many of you have heard about cannabidiol (CBD), especially as it relates to some of the controversies of marijuana and industrial hemp. The government’s definition of marijuana is any compound from the plant Cannabis sativa with 0.3 percent or more tetrahydrocannabinol (THC), which is the psychoactive compound in marijuana responsible for “getting high.” Industrial hemp is from a similar plant in the Cannabis sativa family, but contains less than 0.3 percent THC. In order for hemp oil to be legal for sale, it must be shown to contain less than 0.3 percent THC, so it is a good idea to work with manufacturers who have both high quality standards and expertise in this area to assure you are purchasing legitimate, legal hemp oil.

However, CBD and hemp oil are not the same thing. Hemp extract that is derived from the stalk (not seed) of industrial hemp is rich in a family of over 100 compounds called phytocannabinoids. These are plant nutrients that interact with the body’s own endocannabinoid system to elicit health benefits. CBD is only one of these nutrients, and it works much better within the full family of hemp phytocannabinoids than on its own. So while it is true that full spectrum hemp oil contains CBD, it also contains many other active nutrients that provide excellent benefits via their influence on the endocannabinoid receptors.

In a review article examining the use of cannabinoids for sleep, researchers reported that hemp compounds hold promise for REM sleep behavior disorder and excessive daytime drowsiness. Other compounds in hemp may reduce certain types of sleep apneas and nightmares associated with post-traumatic stress disorder (PTSD).

Since hemp oil has been shown to improve relaxation and mood, this indirectly influences sleep as well. In other research, hemp oil has been shown to reduce pain by a variety of physiological mechanisms, which indirectly influences sleep.

Dosages for full-spectrum hemp oil vary, but are generally in the 50 to 150 mg range. You might want to experiment with a few nights at 50 mg and if you are still tossing and turning, go up to 100 mg for a few more nights to judge how the product is working for you.

Conclusion

There are many natural interventions to facilitate healthy sleep, including taking a hot bath to light blocking window shades to nature sound white noise machines. And they all can make a difference! Do a little detective work to see if you can figure out underlying causes, see a doctor if needed, and consider clinically proven supplements that can improve sleep. You can get a better night’s sleep for a better tomorrow. VR

References:

Consensus Conference Panel, Watson NF, et al. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. J Clin Sleep Med. 2015 Aug 15;11(8):931-952.

Centers for Disease Control and Prevention. (2017). Short Sleep Duration Among U.S. Adults. Retrieved from www.cdc.gov/sleep/data_statistics.html on May 29th, 2018.

Ford ES, Cunningham TJ, Croft JB. Trends in Self-Reported Sleep Duration among US Adults from 1985 to 2012. Sleep. 2015 May 1;38(5):829-832.

Hachul H, et al. The effect of menopause on objective sleep parameters: data from an epidemiologic study in Sao Paulo, Brazil. Maturitas. 2015 Feb;80(2):170-178.

Pinkerton JV, Abraham L, Bushmakin AG, Cappelleri JC, Komm BS. Relationship between changes in vasomotor symptoms and changes in menopause-specific quality of life and sleep parameters. Menopause. 2016 Oct;23(1):1060-1066.

Punjabi NM. The Epidemiology of Adult Obstructive Sleep Apnea. Proc Am Thorac Soc. 2008 Feb 15;5(2):136-143.

Xu Q and Lang CP. Examining the relationship between subjective sleep disturbance and menopause: a systematic review and meta-analysis. Menopause. 2014 Dec;21(12):1301-1318.

Ammon HP. Boswellic Acids and Their Role in Chronic Inflammatory Diseases. Adv Exp Med Biol. 2016;928:291-327. Review.

Drewe J, Zimmermann C, Zahner C. The effect of a Cimicifuga racemosa extracts Ze 450 in the treatment of climacteric complaints--an observational study. Phytomedicine. 2013 Jun 15;20(8-9):659-66. doi: 10.1016/j.phymed.2013.02.012.

Sigurdsson S, Geirsson G, Gudmundsdottir H, Egilsdottir PB, Gudbjarnason S. A parallel, randomized, double-blind, placebo-controlled study to investigate the effect of SagaPro on nocturia in men. Scand J Urol. 2013 Feb;47(1):26-32.

Arendt J, Skene DJ. Melatonin as a chronobiotic. Sleep Medicine Reviews. February 2005. Volume 9, Issue 1, Pages 25–39. DOI: https://doi.org/10.1016/j.smrv.2004.05.002.

Babson KA, Sottile J, Morabito D. Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Curr Psychiatry Rep. 2017 Apr;19(4):23. doi:10.1007/s11920-017-0775-9. Review.

Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of Scientific Affairs and Education for EuroPharma, Inc.

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