Insomnia Part 1 | Ketamine Treatment Center | 703-844-0184 | Dr. Sendi

INSOMNIA

Approximately 30% of the general population suffers from insomnia.  According to the National Sleep Foundation (NSF), almost six out of ten Americans report having insomnia and sleep problems at least a few nights a week (R).

I used to have terrible insomnia.  I realize now that it was caused by HPA activation as a result of inflammation.   This would derange my circadian rhythm and I’d make it worse by staying up late often.  I also had general anxiety about life and this would keep me up as well.

I’ve been sleep-hacking for years and this list has been the product of years of experimentation.

I don’t utilize all of these tools simply because I don’t need to anymore. But I have them if need be.  I try to always do the minimum that is effective.

I have not seen anyone implement these tips and still not be able to fall asleep.

 

Slow Wave Sleep

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There are two main types of sleep that are responsible for the vast majority of cognitive and health benefits of sleep.  These are slow wave and REM sleep.  Combined they make up 40-45% of sleep.

Slow Wave Sleep is the part of your sleep that is known as deep sleep.  It’s also called Delta wave sleep or stage 3 sleep because it’s the third stage of non-REM sleep. It makes up about 20% of total sleep time (R).

Slow-wave sleep is considered important to consolidate new memories.  Slow-wave sleep improves episodic, memory (R).

The primary function of slow-wave sleep may be to allow the brain to recover from its daily activities. Another function slow-wave sleep affects are the secretion of growth hormone, which is always greatest during this stage (R).

It is also thought to be responsible for a decrease in sympathetic (anxious) and increase in parasympathetic (relaxed) neural activity (R).

Lack of slow wave sleep can play a role in Depression, OCD, Anxiety, Narcolepsy, ADHD, Diabetes, Schizophrenia, Fibromyalgia, Juvenile Chronic Arthritis, Parkinson’s(R) and Autism (R).

Slow wave sleep declines drastically as we get older.  It goes from an average of 19% of total sleep during early adulthood (age 16-25 years) to 3.4%  during midlife (age 36-50 years).  It is replaced by lighter sleep (stages 1 and 2) (R).

Reduced slow wave sleep may predict high blood pressure in older men (R).

Overall, compared to REM sleep, slow wave sleep seems to be significantly more important at keeping us healthy.

REM Sleep

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REM sleep typically occupies 20–25% of total sleep.

REM sleep seems to have fewer health benefits compared to slow wave sleep, but it might be more important cognitively.  However, it still is critical, as prolonged REM sleep deprivation leads to death in experimental animals (R).

Most of your dreams occur during REM sleep (R).

During REM, our breathing becomes more rapid, irregular, and shallow, our eyes jerk rapidly in various directions, and our limb muscles become temporarily paralyzed. Our heart rate increases, our blood pressure rises, and males develop erections.

The release of certain neurotransmitters such as norepinephrine, serotonin, and histamine, is completely shut down during REM.  This is how our muscles are paralyzed (R). This paralysis protects you from acting out your dreams (R).

According to one theory, certain memories are consolidated during REM sleep. Numerous studies have suggested that REM sleep is important for consolidation of procedural memory and spatial memory (R).

REM sleep aids the process of creativity by forming associative elements into new combinations (R).

REM is particularly important to the developing brain, possibly because it provides the neural stimulation that newborns need to form mature neural connections and for proper nervous system development. It may also increase neurogenesis in adults (R).

Some say REM sleep is important because by shutting down neurotransmitter release, we regain sensitivity to them (R).

A reduction of REM is associated with Autism (R).

Sleep Problems and Inflammation

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It’s important to make sure that you’re not having inflammation in general because that can cause sleep issues.

Cytokines like IL-1, IL-6 and TNF can activate your stress response (HPA axis) and also disturb your circadian rhythm (R), both of which will keep you up at night.

Inflammation in the day will be bad for your sleep by disturbing your circadian rhythm, but slightly elevated cytokines at night and while you’re sleeping is normal and even beneficial.

It might be worth reading through some of my inflammation series.

  • TNF increases slow wave and REM sleep (RR2).  We want to decrease it in the day but have normal levels at night.
  • IL-1 increases slow wave sleep (R), but it decreases REM sleep. (R)
  • IL-6 decreases slow wave sleep, but it increases REM sleep.  Night time elevations are associated with fatigue the next day. (R)
  • High levels of IL-8 increases non-REM sleep, which could include slow wave sleep.(R)
  • IL-2 (Th1 cytokine) increases slow wave sleep but decreases REM sleep (RR2). IFNgamma (Th1 cytokine) increases slow wave sleep, but it can decrease REM sleep in the day (nap?).  It has no effect at night. (R)
  • IL-4, IL-10, IL-13 and TGF-beta all decrease slow wave sleep (RR2).  These are all Th2cytokines.
  • Th17 is hypothesized by some to cause sleep apnea. (R)

1) Be Outside As Much as Possible in the Day in Order to Obtain Enough Bright Light

Bright light is the single most effective way to readjust your circadian rhythm.  I notice a very significant effect with this intervention.

The more you’re outside in the day, the better your sleep will be.

I set my life up so that I live in an area where I can be outside for the most hours in the day (moderate temperature all year round, clear skies, rains very little, no mosquitos).

In people 60 years or older, bright light therapy helped their insomnia.  45 min was more effective than 20 minutes (R).

Another study didn’t find significant changes in older adults with primary insomnia (R).  However, it did find that it was able to shift the circadian rhythm.  I would still recommend you try it.

In any case, it’s important for neurogenesis/neural development (R).

Bright light therapy was found beneficial in a couple of studies to help shift workers change their circadian rhythm and in other conditions. (RR2R3).

I make sure to be outside as much as possible, which is very helpful.

If you live in a cold state, you can try some band-aids that aren’t as successful as the sun.

You can use the Bright light device in the morning about 1 feet away from my eyes. Or you can use the portable Bright Light Device. If you work in an office and can’t get the big one then I’d recommend this instead. When I can’t be around my computer or bright light device, I use a Bright Light Device that you can put on a cap.

You want to use the bright light first thing in the morning to reset your circadian rhythm. I recommend 15 minutes of usage if you’re sensitive to bright light and 30 minutes if you aren’t.

2) Get AM Sun

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AM sun will reset your circadian rhythm and you will become more tired at night.

This means right when you get up, you go outside and have the sun hit your retina.

I wake up and go outside with my computer for an hour while I guzzle 1 gallon of water.

3) Get Adequate Full Body Sun in the Day

In addition to exposing your eyes to light, getting adequate full body sun will also help your sleep.

Sun increases nitric oxide potently.

Nitric oxide accumulation in the brain’s basal forebrain is both necessary and sufficient to produce sleep.  Nitric oxide makes us tired by increasing adenosine (R).

Nitric oxide can also make us thinner by increasing metabolism (RR2).

I recommend 45 minutes a day on average.

4) Block Out Blue and Green Light At Night

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Red Glasses block blue and green light from entering your eyes.  I’ve tried 7 pairs over the years and I found these to be the best one for me.  You want to start wearing red glasses4 hours before you go to bed.

DEWALT DW0714 Laser Enhancement Glasses

UVEX orange or amber glasses will only block out blue, which is the worst spectrum for going to sleep.

I happen to usually wear the UVEX ones simply because I get tired with those….but if I were having sleep issues, I’d go with the red ones.

The Protocol is to keep wearing them for more hours if you still can’t fall asleep.

I also use the popular f.lux program to reduce blue light (it doesn’t completely block it out).

In addition to the glasses, I also have Blue blocking light bulbs so that I don’t get it from on top of my glasses.

Another good idea is to have Blackout Curtains to block light bombs from outside.

When the blue spectrum enters your eyes it shuts down melatonin production, a hormone essential for sleep.  Even dim light can interfere with a person’s circadian rhythm and melatonin secretion. A mere eight lux can inhibit melatonin.   8 lux is double the brightness of a night light.

These glasses actually work better than melatonin itself, which suggests that there’s more that light is doing than just shutting melatonin down.

Blue light is more damaging than just inhibiting melatonin, so melatonin supplements won’t suffice.

Warning: You will look like a dork (refer to the above picture).

“And those who were seen dancing were thought to be insane by those who could not hear the music.”

5) Reduce ALL Lighting At Night

In addition to blocking out certain spectrums of light (such as Blue), any wavelength or color of light is capable of keeping you awake if it’s bright enough.

For this reason, it’s important to not only block out light but make your light as dim as possible after the sun goes down.  So shut off your TV and dim your computer, phone, Ipad and any other electronics.

I also use the popular f.lux program to reduce the intensity of light.

In addition, the Blue blocking light bulbs are low wattage, so they’re also good.

Another good idea is to have Blackout Curtains to block light bombs from outside.

Black tape is also useful to block out stray light from electronics.

6) Don’t Eat At Least Three or Four Hours Before Bed

Eating before bed can destroy your sleep.  When I eat too closely before bedtime, my sleep takes a dive.  Other people notice this as well.  Food is an important circadian time-setter.

You shouldn’t go to sleep hungry either.  If you’re hungry before bed, then you’re either not eating enough in the daytime or you’re eating too far from the time you go to sleep.  I’ve found starting to eat dinner at about 6-6:30 PM is ideal.  My dinner takes about 30 minutes to eat and I go to sleep between 10-11PM.

If you find yourself hungry because you forgot to eat, then eat a small amount.  Consume foods that are easier to digest such as honey.

7) Keep to a Circadian Rhythm

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Your body has a rhythm by which it releases hormones such as cortisol and other proteins – including inflammatory cytokines.    Cytokines like TNF and IL-1b  are instrumental in causing fatigue.

When this rhythm is ruined, we won’t be able to fall asleep as easily.  So going to sleep and waking up at a similar time is pretty important.

I’m terrible at keeping to this, so that’s why I have to resort to other means.  But if you do keep to this, this could be all you need to do.

I consider circadian disruption as one of the fundamental causes of disease in modern civilization.

Frequent travel, especially across time zones, is one of the most common causes of circadian disturbance.

Animals that are forced to eat during their resting period show increased body mass and altered expression of clock and metabolic genes.  In humans, shift-work that favors irregular eating times is associated with altered insulin sensitivity and higher body mass. Shift-work and chronic circadian disruption also leads to increased risks for heart disease, diabetes, cancer, mental health issues and inflammation (RR2,R3).

Inadequacies of some nutrients like Vitamin D3 (R), Vitamin B-12 (R) and Vitamin A/Retinol can disrupt our circadian rhythm.  While all nutrients are important for the circadian rhythm, the above 3 are the most important based on my knowledge.  Even if we consume the RDA we can be deficient for various reasons.  Zinc is capable of delaying the circadian rhythm (R).

 

Sometimes even if we do everything right, we can still have a circadian disruption.

8) Temperature Regulation: Keep It Cold

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The ideal temperature for falling asleep is around 65° F or 18° C for most people.

60-67 degrees is the range that you should keep to, depending on the thickness of your sheets, how much clothes you have and how intolerant you are too cold.  For 67 degrees, you want a very thin sheet layer and fewer clothes.  For 60 degrees you want standard covers (not too thick). A bedroom that is too hot or too cold can interfere with quality sleep.

Temperature is only second to light as the most significant zeitgeber or circadian timer setter.  Make sure this is taken care of.

You should keep lowering the temperature or decreasing the thickness of your sheets until you wake up in the middle of the night because it’s too cold.  Then adjust to make yourself a bit warmer.

You also want to sleep in a room with adequate ventilation because a packed room will also interfere with your sleep.

9) Reduce Your Nervous System Activity

The activity of your nervous system is one of the biggest factors in causing sleep problems.

One of the most common reasons we have trouble falling asleep is because our mind is wandering and we are usually thinking about stressful things like work.  When this part of our brain is activated (prefrontal cortex, amygdala) it’s hard for us to fall asleep.

Stress causes a release of CRH, which destroys your sleep by decreasing slow wave sleep and increasing REM (R).  Therefore, you should chill out the rest of the day as well.

One mechanism by which CRH decreases slow wave sleep is by inhibiting GHRH, which stimulates growth hormone release.  CRH causes shallow sleep, blunted Growth Hormone and elevated cortisol (R).

The first step to stopping mind wandering is adopting certain attitudes.  These attitudes are letting go and acceptance. Letting go and acceptance are the hardest things in the world.  This is all simple, but not easy.

Letting go and acceptance doesn’t need explaining, but I’ve found exploring exactly what these mean to be beneficial.

That’s why I recommend these programs to get you on the way  to a better life:

  • Mindfulness for beginners – I fall asleep when I listen to this
  • Wherever you go there you are – I fall asleep when I listen to this

I literally listened to the first 2 programs about 200 times.  It’s been a godsend.

Ironically, stressing about going to sleep can keep you up.  Your goal should be to relax, not go to sleep.

10) Exercise – Especially At The Right Times

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In the National Sleep Foundation’s 2013 Sleep In America survey, regular, vigorous exercisers reported getting the best sleep (R).

A bout of moderate-intensity aerobic exercise (e.g., walking) reduced the time it took to fall asleep and increased the length of sleep of people with chronic insomnia.   However, in the same study, vigorous aerobic exercise (e.g., running) or lifting weights did not improve sleep (R).

The best time to exercise for sleep benefits is either right upon awakening or at 5 PM.

With long-term exercise, adults with insomnia fell asleep more quickly, slept slightly longer, and had better sleep quality than before they began exercising (R).

Exercise triggers an increase in body temperature, and the post-exercise drop in temperature may promote falling asleep.  Exercise also reduces arousal, anxiety and depressive symptoms.  Exercise can also help reset your circadian rhythm (R).

Exercise also lowers the body’s pH, which triggers an increase in adenosine (R).  Adenosine is a master regulator of sleep and it increases slow wave and REM sleep (R).  Exercise can increase slow wave sleep (R).

11) Stay Away From Lectins or Inflammatory Foods

Lectins are a big underlying cause of sleep issues by increasing inflammation and causing hypothalamic dysregulation.

The effects of lectins result in being tired in the day, and tired but wired at night.

 

12) Stop Working An Hour Before Bed

For most people, engaging in work or anything that is cognitively demanding before bed activates their prefrontal cortex and keeps you up.

You should put your laptop away and just chill out before bed.

 

If you’ve been awake for more than 15 minutes, try getting out of bed and doing a quiet, non-stimulating activity, such as reading a book. Keep the lights dim.

13) Make Sure You’re Eating Enough in the Day Time

If you aren’t eating enough calories, your metabolism will slow and you will build up less adenosine, which will make it harder to fall asleep.

In particular, it’s important to get enough protein, but adequate carbs and fat can also help sleep.

14) Make Sure Your Thyroid Hormones Are Optimal

If your thyroid hormones are low, your metabolism will slow and you will build up less adenosine, which will make it harder to fall asleep.

15) Do These Yoga Poses

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I do a basic yoga program at night that knocks me out.   Yoga in general decreases the HPA axis and sympathetic nervous system (R).   This makes any ‘nervous energy’ or jittery feelings disappear.   This is a large reason many people can’t fall asleep: we have too much nervous energy.

I’ve done many other yoga programs and this one works the best for putting me to sleep. 

 

 

16) Meditate and/or Breath

One of the most common reasons for insomnia is that our mind wanders and this will cause a type of excitement.  When we meditate this puts us in a much more relaxed state, which is conducive to going to sleep.

I recommend “Guided Mindfulness Meditation” by Kabat-Zinn.  These days, I don’t use a program, but it was important for me in the beginning.   My mind is still more likely to wander without the program. That’s why listening to the program is better.

The audio version of the “Open Focus” program is also good.  It’s a bit weird, but it works.  It has an added benefit of improving my heart rate variability.

If meditation isn’t your style, some simple breathing exercises may do the trick. Breathing deeply mimics how your body feels when it’s already relaxed, so after inhaling and exhaling for a few rounds, you just might find yourself feeling calmer. That’s because deep breathing stimulates the vagus nerve.

Dr. Weil gives good breathing exercises.

17) Go to Sleep and Wake Up At The Same Time

Sticking to a consistent sleep-wake schedule helps set your body’s internal clock and optimize the quality of your sleep. Start by setting a realistic bedtime that will work with your lifestyle. Choose a time when you normally feel tired, so that you don’t toss and turn. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime.

Avoid sleeping in—even on weekends or nights you’ve stayed up late. It can be tempting to sleep in on weekends, but even a couple hour difference in wake time disrupts your internal clock. The more your weekend/weekday sleep schedules differ, the worse the jetlag-like symptoms you’ll experience. If you need to make up for a late night, opt for a daytime nap rather than sleeping in. This strategy allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm, which often backfires in insomnia and throws you off for days.

Be smart about napping. As mentioned above, napping is a good way to recharge and make up for lost sleep hours. But if you tend to have trouble falling asleep or staying asleep throughout the night, napping can make things worse. If insomnia is a problem for you, consider eliminating naps altogether or limiting them to 15 to 20 minutes in the early afternoon.

 

18) EMFs

The only effect I’ve noticed from wearing EMF blocking clothes is a deeper sleep.

19) Use A Good Mattress

Make sure your bed is comfortable.

Everyone has different preferences for their bed.  Some people like more firm, while others like more soft.  If you’re a side sleep and you’re thin, you’ll want a relatively soft mattress.

You should have enough room to stretch and turn comfortably. If you often wake up with a sore back or an aching neck, you may need to invest in a new mattress or a try a different pillow. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more or less support.

  • Tuft and Needle Mattress (have not used)
  • Zinus Sleep Memory Foam Mattress, 6 inches for a cheaper option (Have Used)

In addition to these beds being comfortable, you shouldn’t be sleeping on coil mattresses because they attract EMFs (R).

If you’re using a magnetico, you’ll get more of a magnetic field with the 6-inch mattress

20) Reserve Your Bed For Sleeping and Sex

If you associate your bed with events like work or errands, it will be harder to wind down at night. Use your bed only for sleep and sex. That way, when you go to bed, your body gets a powerful cue: it’s time to either nod off or be romantic.

21) Visualization and Progressive Muscle Relaxation

First developed in 1915, this technique will never get old. “Progressive muscle relaxation is a relaxation exercise in which you systematically tense and then relax all the muscle groups of your body,” according to clinical director of UPenn Medicine’s Behavioral Sleep Medicine Program Phil Gehrman, Ph.D. (R).

It was shown to reduce fatigue and improve sleep quality in a study of women undergoing breast cancer treatment (R).

It might feel a little silly the first time you try it, but go ahead and imagine yourself somewhere calm, relaxing and sleep-inducing. This deep relaxation method can slow brain wave activity, coaxing you toward sleep.

22) Marijuana/Pot

When all else fails, there’s always pot.

Marijuana is the best substance to shut your mind down and relax your whole body.

There are different strains and they don’t all work the same.  Also, people differ in their response to it.  I would suggest to try it and see if it helps you fall asleep.

In a small study published in 1973, THC reduced the time it took for 9 subjects with insomnia to fall asleep by over an hour on average.  It also leads to an increase in time spent sleeping (R).

THC causes an increase in stage 4 sleep (i.e. deep or slow wave sleep) but decreases REM sleep (R).

One mechanism is by THC being an agonist of the CB1 receptor, which increases adenosine.  By the same token, anandamide also increases adenosine (R). CBD also increases adenosine (R).

In a small trial of 17 people, THC was found to significantly reduce sleep apnea (R).

“THC stabilizes autonomic output during sleep, reduces spontaneous sleep-disordered breathing, and blocks serotonin-induced exacerbation of sleep apnea.”  (R)

CBD, the other major active ingredient,  increases total sleep time.  There was a non-significant increase in slow wave sleep at higher dosages.  The time it takes to get into REM differed based on the dose (High dose took longer to get into REM, while lower dose took shorter) (R).

CBD also increases REM sleep in anxiety-related conditions like PTSD through its anti-anxiety properties (anxiety reduces REM) (R).

Interestingly, CBD is known to be very calming, but it’s also wakeful promoting (R).

THC is known to have some anxiety-producing effects, but it’s better at increasing slow wave sleep.

For sleep, you want to get strains that have a good amount of THC and CBD (a 1:1 ratio).  THC actually helps your sleep and CBD balances the anxiety-producing effects of THC, so both are important.

23) Anti-histamines/Benadryl

I don’t recommend ANY drugs or supplements for sleep, but not everyone can live optimally, so people need bandaids.

Diphenhydramine or Benadryl is a first generation antihistamine.   It’s FDA-approved as a non-prescription sleep aid.

Not every antihistamine will do.  You want to take the antihistamines that cross the brain barrier.  The newer ones don’t.

Benadryl has an anxiety-reducing effect.  It has also proven to have mild anti-obsessive effects in one study researching OCD medication. Originally intended to act as a control medication, it, in fact, produced a significant decrease in OCD symptoms (R).  The mechanism is probably as a result of increasing serotonin (R).

It works by blocking histamine, which promotes wakefulness. It doesn’t alter slow wave or REM sleep (R).

24) Honey

I’ve used honey for 5 years before sleep, but I’ve cut it out since going on a lectin avoidance diet.

One reason for bad sleep is energy depletion while sleeping.  Honey restores glycogen levels and keeps our brain fueled and calmer. This prevents bouts of low sugar (hypoglycemia).

Hypoglycemia during sleep can disrupt slow wave sleep (R).  High carbohydrate consumption increases slow wave sleep (R).

This will mostly be of benefit to you if you don’t eat past a certain time (good move) and you are generally watching your caloric intake.

Prescription: 1 tablespoon of raw Honey  before bed.

If you’re eating enough in the daytime and you’re doing the other tips right, you shouldn’t be getting hypoglycemic at night.

So I see this as a temporary measure for people.

25) Melatonin

You can’t talk about sleep-hacking without mentioning melatonin.  Melatonin is a powerful antioxidant and in most ways an anti-inflammatory.

Melatonin has shown benefits in humans or animals  regarding obesityIBSGERDcancerAlzheimer’s, immune disorders, cardiovascular diseases,depression, seasonal affective disorder (SAD), delirium, circadian rhythm sleep disorders,migraines and headaches, ALStinnitus, menopausal depression, gallbladder stones, sexual dysfunction and insomnia in the elderly.  Most of the studies have shown benefit (R).

A meta-analysis done in 2013 found that melatonin decreases the time it takes to fall asleep, increases total sleep time and improves overall sleep quality (R).  Melatonin increased slow wave sleep in elderly insomniacs (R).  Melatonin was able to increase REM sleep as well in people who had reduced REM (R).

A large dose of melatonin before bed (5mg) increases REM sleep (R).

I recommend 1mg of Melatonin to everyone who doesn’t follow the listed tips above.

26) Magnesium Calm

Magnesium Calm is one of the most effective forms of magnesium when it comes to making me tired.  It’s quite effective.  I’ve tried them all and this is the best magnesium for going to sleep.

Magnesium has been shown to be effective in clinical trials in improving sleep efficiency, increasing sleep time, decreasing the time it takes to go to sleep and reducing early morning wakings (R). Magnesium is also involved in thermoregulation (R).

The cited study gave the shittiest version of magnesium – magnesium oxide.  500mg of Magnesium via magnesium oxide is like a third or half of the effect as magnesium calm if you asked me.

I’m assuming the mechanism is by blocking  NMDA receptors (like ketamine) and increasing GABA (R). Magnesium also resulted in increased melatonin levels (R).  In another study, magnesium was able to increase slow wave sleep (R).

It’s irrelevant how much magnesium you have in your diet.  This isn’t to prevent a deficiency.  The purpose is to overload your body with magnesium so that it passes your brain barrier in larger quantities and blocks your NMDA receptors and increases GABA.

Magnesium is calming but also has a stimulating property for me.  I recommend it to people who have issues with sleep onset even after trying my other recommendations.

27) Glycine

In humans, approximately 45g of glycine is synthesized in our body, and 3–5 g of glycine is ingested from the daily diet.

Ingestion of 3g of glycine in sleep-restricted people resulted in less fatigue in the daytime (R).

In healthy people, 3g of glycine improved subjective sleep quality.  People went to sleep more quickly and got into deep or slow wave sleep more quickly as well.  There was no change in REM sleep. Glycine also lessened daytime sleepiness and improved performance of memory recognition tasks (R).

You need to take 3 grams because it won’t diffuse across the brain barrier if the concentration isn’t high enough.

Glycine acts as an inhibitory neurotransmitter via glycine receptors.  Furthermore, glycine improves sleep in rats by decreasing core body temperature and increasing vasodilation.  The suprachiasmatic nucleus (SCN) is necessary for glycine-induced hypothermia and vasodilatation because ingested glycine primarily acts on the NMDA receptors in the SCN (R).

I recommend Glycine at night for people who have sleep problems.

28) Arginine

Nitric oxide accumulation in the brain’s basal forebrain is both necessary and sufficient to produce sleep.  Nitric oxide makes us tired by increasing adenosine (R).

Nitric oxide can also make us thinner by increasing metabolism (RR2).

Arginine is the cheapest and one of the most effective supplements to increase nitric oxide.

It has the potential to make people sleepy and I recommend it when all else fails.

29) Valerian

You want to be very careful with taking herbs at night because they decrease cytokines TNF and IL-1b, which are important for inducing sleep.

Valerian is one exception.  Drinking this in a hot tea will have a better effect.

In a small clinical trial, Valerian increased slow wave sleep and the time it took to get into slow wave sleep.  There was an increase in REM sleep, but the placebo group also increased REM sleep (R).

It works by increasing adenosine (R) and  GABA (A) (R).

 

30) Uridine

Uridine has its own receptors by which it induces sleep (R).

In rats, it increases slow wave and REM sleep (R), both of which are extremely important.

31) Sarcosine

Whenever I ruin my circadian rhythm or stay up really late, I usually only sleep 5 hours or less.  The next night is annoying because I’m over-tired and usually don’t sleep well.

A nice dose of sarcosine prolongs my sleep and makes me feel very well rested when I awake.

Sarcosine’s main mechanism involves inhibiting a transporter, called GlyT1, which takes up glycine and D-serine into cells. This increases the levels of glycine and D-serine in the body and increases their effects.

I recommend sarcosine when lifestyle factors don’t cut it.

32) Theanine

Theanine is great at inducing sleep, sometimes making people sleep longer and feel more restful.

A clinical study in kids with ADHD, they found some improved measures such as sleep efficiency (R).

Theanine counteracts the reduction of slow wave sleep by caffeine consumption (R).

It works by increasing GABA and serotonin (It also increases dopamine) (R).

33) Vitamins and Minerals

A study of veterans suffering from both chronic pain and Vitamin D deficiency found that Vitamin D3  supplements led to both reductions in pain, and improvement to sleep and to the veterans’ sense of well-being  (R).

Calcium goes well with magnesium and can also help us sleep.  Calcium is directly related to our cycles of sleep. Calcium helps the brain use the amino acid tryptophan to manufacture melatonin.  I put some Calcium in my night stack and also in my water.

In one study,  researchers found that calcium levels in the body are higher during REM sleep (the dreaming phase). The study concluded that calcium deficiency can cause disturbances in sleep.   Supplementation of calcium reversed this (R).

It’s thought that milk helps us sleep in part because of calcium.  If you’re not eating dairy, then it’s very difficult to get enough calcium. 

Potassium is an important mineral in the body that helps to relax muscles and nerves, as well as to promote healthy circulation and digestion.  Research has shown a possible genetic link between potassium and slow-wave sleep (or delta sleep), which is the deepest phase of our sleep cycle .  This is the time when we get our most restorative sleep (R).

I’m often deficient in potassium and I know this when I get muscle twitches.  Supplementation makes this disappear in an hour.  I recommend Potassium gluconate.  I take 2 grams of the powder with meals in the morning and afternoon.  Be careful not to go overboard.

Zinc, when part of a formula of magnesium and melatonin, was effective in various sleep outcomes.  (R)  .  Zinc increases acetylcholine by being an acetylcholinesterase inhibitor.  I recommend 15mg daily.

Vitamin B1 (Thiamine) deficiency can cause less slow wave and REM sleep (R).  Vitamin B3 (also known as Niacin) has been shown to promote REM sleep. A deficiency in Vitamin B5 (pantothenic acid) can cause sleep disturbances (R).  Vitamin B6 helps the body to produce serotonin, which is a relaxing neurotransmitter.

I recommend taking 1 cap of a B-Complex a day to make sure you’re not deficient in any b vitamins.

34) Oxytocin

Oxytocin is our natural ‘love’ hormone.

 

In healthy people, long-term administration of oxytocin reduces the time it takes to fall asleep and it increases sleep efficiency by increasing the percent of REM sleep episodes (R).

Falling in love, having sex, nursing, and positive social encounters all of these lead to increased oxytocin (R).

Low levels of oxytocin promote sleep but be careful because high levels promote wakefulness (R).

I use L Reuteri to increase oxytocin (R).

 

 

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