Why sleep is the ‘magic pill’ we’re all searching for.
Consistent, good quality sleep is hard to come by, yet this is the number one thing that will have the greatest impact on our physical, mental and emotional health day to day and in the long term. The popular mentality of ‘we all have the same 24 hours in a day, if you want to achieve more, just sleep less’ needs to go! With sleep issues becoming more common, let’s explore the reasons why, and what you can do to improve your sleep quality.
Why good quality sleep is vital
While we may perceive sleep as a passive state there is actually a complex interplay of chemical, electrical, and biological processes unfolding within the body. Chemically, the brain experiences fluctuations in neurotransmitters, such as serotonin and dopamine, which regulate mood and cognitive function. Electrical activity in the brain, characterised by distinct patterns during different stages of sleep, facilitates memory consolidation, learning, and emotional processing. Biologically, sleep is a time for cellular repair, growth hormone release, and immune system strengthening. Disruptions to these processes due to inadequate QUALITY sleep have profound consequences for our health. Chronic sleep deprivation is associated with alterations in hormone levels, increased inflammation, impaired immune function, and changes in metabolism. Over time, these disruptions contribute to a higher risk of developing disease, including obesity, diabetes, cardiovascular disorders, and mental health conditions such as depression and anxiety.
Sleep stages
Light Sleep (NREM Stages 1 and 2):
Transitional stages between wakefulness and deeper sleep.
Characterised by theta waves (Stage 1) and sleep spindles/K-complexes (Stage 2).
Important for relaxation and preparing the body for deeper sleep stages.
Contributes to memory consolidation, particularly for declarative memories.
Supports emotional regulation and stress reduction.
Facilitates temperature regulation and sensory processing.
Deep Sleep (NREM Stage 3):
Characterised by slow delta brain waves.
Physically restorative stage of sleep.
Important for cellular repair, growth hormone release, and immune function.
Plays a role in memory consolidation, learning, and cognitive function.
Essential for physical health and recovery from daily activities.
Associated with increased blood flow to muscles and tissue repair.
REM Sleep (Rapid Eye Movement):
Characterised by rapid eye movements and desynchronised brain waves.
Mentally restorative stage of sleep.
Crucial for memory consolidation, emotional processing, and creativity.
Supports learning and memory retention.
Facilitates neural connections and brain plasticity.
Essential for mental health and emotional well-being.
Overall, each stage of sleep plays a unique and essential role in promoting overall health and well-being. Prioritising a balanced sleep cycle that includes sufficient amounts of each sleep stage is essential for optimising biological, mental, and physical health.
How to track your sleep
Using wearables during sleep is the only way to properly track your sleep stages and quality, at home. Your phone may have a sleep tracking app, yet this is the most inaccurate way to track your sleep and you need to have your phone in the bed with you which is NOT a good idea. I will cover why we need to keep our phones outside of the bedroom while we sleep in a future blog post. The most accurate way to track your sleep quality and stages is with an Oura Ring. Oura Rings are specifically designed to be a non-invasive wearable for tracking sleep and many other health metrics. The next best are Apple watches, Garmin watches, Whoop wearables and Fitbit devices.
Classification of insomnia
Insomnia is a sleep disorder characterised by difficulty falling asleep, staying asleep, or experiencing non-restorative sleep, leading to daytime impairment.
Acute Insomnia: Short-term insomnia lasting anywhere from a few weeks to a couple of months. Acute insomnia may be caused by stress, illness, or life events and can resolve with lifestyle changes or short-term treatment.
Chronic Insomnia: Persistent difficulty sleeping that lasts for at least three nights a week for three months or longer. Chronic insomnia may be primary (not related to other conditions) or secondary (resulting from underlying medical or psychiatric conditions).
Onset Insomnia: Difficulty falling asleep at the beginning of the night, often due to stress, anxiety, or racing thoughts.
Maintenance Insomnia: Difficulty staying asleep throughout the night, characterised by frequent awakenings or waking up too early and being unable to fall back asleep.
Comorbid Insomnia: Insomnia that occurs alongside other medical or psychiatric conditions, such as depression, anxiety, chronic pain, or sleep disorders like sleep apnoea or restless legs syndrome.
Idiopathic Insomnia: Persistent, lifelong difficulty sleeping that begins in childhood or adolescence with no apparent cause, often leading to lifelong sleep disturbances.
Chronic poor sleep leads to disease
Poor sleep and insomnia can have significant implications for health, as chronic sleep disturbances disrupt physiological processes and contribute to the development and exacerbation of various diseases. Inadequate sleep dysregulates hormone levels, including cortisol, insulin, and ghrelin, leading to metabolic dysfunction, weight gain, and an increased risk of obesity, type 2 diabetes, and cardiovascular disease. Sleep deprivation impairs immune function, compromising the body's ability to fight off infections and increasing susceptibility to illnesses. Poor sleep also wreaks havoc on our mental health with chronic sleep disturbances creating alterations in neurotransmitter activity, inflammation, and oxidative stress, contributing to mood disorders, cognitive impairment, and neurodegenerative diseases such as depression, anxiety, and dementia. Additionally, insufficient sleep disrupts the balance of pro-inflammatory and anti-inflammatory cytokines, promoting chronic inflammation and raising the risk of inflammatory conditions like arthritis and autoimmune diseases.
Why is our sleep quality declining?
Light- Have you ever noticed that when you go camping and only have a fire for light at night, you start to get sleepy shortly after sunset? Or when there’s a power outage, we may feel ‘bored’ without all our devices and decide to retire early? Have you also noticed that your pets seek out the early morning sun in any way possible?
If the answer is yes, this is a clue to how dysfunctional our relationship to light has become.
Exposure to artificial light, particularly in the evening and at night, is disrupting our circadian rythm. The circadian rhythm is the body's internal clock that regulates the sleep-wake cycle, hormone production, body temperature, and other physiological processes over a 24-hour period. Artificial light, especially blue light emitted by electronic devices such as phones, tablets, and computers, inhibits the production of melatonin, the hormone that regulates the sleep-wake cycle. When exposed to artificial light, in the hours leading up to bedtime, the suppression of melatonin secretion can delay the onset of sleepiness and make it harder to fall asleep. Prolonged exposure to artificial light at night can shift the timing of the body's internal clock, leading to irregular sleep patterns and decreased overall sleep quality.
Just as artificial light exposure at night affects our circadian rhythm and sleep quality, so too does a lack of natural light exposure during the day. Natural light exposure, particularly at sunrise, helps regulate the circadian rhythm, by signalling to the brain that it's time to wake up and be alert. Exposure to natural light suppresses the production of the hormone melatonin, which promotes sleepiness and helps synchronise the body's internal clock with the external environment. Without sufficient exposure to natural light during the day, our circadian rhythm may become desynchronised, leading to difficulty falling asleep at night, irregular sleep patterns, and reduced sleep quality.
Stress- When we experience stress, our bodies produce higher levels of cortisol, often referred to as the "stress hormone." Elevated cortisol levels can lead to increased alertness, making it difficult to fall asleep and stay asleep. Additionally, stress can trigger racing thoughts, worries, and anxiety, further hindering the ability to relax and unwind at bedtime.
Chronic stress can also interfere with the production of melatonin, as mentioned above, the hormone that promotes sleepiness and regulates the sleep-wake cycle. Over time, chronic stress and poor sleep quality can create a vicious cycle, exacerbating stress levels and contributing to long-term health consequences such as fatigue, mood disorders, and compromised immune function. Managing stress through relaxation techniques, mindfulness practices, and stress-reduction strategies such as acupuncture is essential for improving sleep quality and overall well-being.
Exercise- Regular physical activity is closely linked to better sleep patterns, as it helps to regulate the circadian rhythm and promotes the release of melatonin. Exercise also helps reduce stress and anxiety levels, which can interfere with the ability to fall asleep and stay asleep. Engaging in physical activity during the day helps expend energy and promotes feelings of tiredness, making it easier to achieve restful sleep at night.
How Chinese Medicine Views Sleep & treatment strategies
In Chinese medicine, sleep is considered a vital component of overall health and well-being, essential for restoring balance and promoting harmony within the body. Sleep is seen as a time for the body to rest, repair, and recharge, allowing for the replenishment of qi and the nourishment of yin, the cooling, nourishing aspect of energy.
Disruptions in sleep patterns indicate imbalances of the body's Qi, Blood, Yin, or Yang. Common issues people experience with sleep, such as difficulty falling asleep, waking frequently during the night, or feeling unrested upon waking, are often attributed to disharmonies in the body's internal organs or imbalances in the flow of Qi and Blood. These imbalances can be caused by factors such as stress, emotional disturbances, poor diet, overwork, or external environmental influences. In TCM, treatment for sleep disorders focuses on identifying and addressing the root cause of the imbalance, using acupuncture, herbal medicine, dietary adjustments, lifestyle modifications, and stress management techniques to restore harmony and promote restful sleep. By addressing the underlying imbalances, Chinese medicine aims to not only alleviate sleep issues but also improve overall health and vitality.
Supplements and herbs that can help
Supplementation for insomnia should only be explored only after you have addressed sleep hygiene, your light exposure and working on stress reduction or adaptation.
Melatonin: A hormone naturally produced by the body, melatonin helps regulate the sleep-wake cycle. Supplementing with melatonin can be particularly helpful for individuals with circadian rhythm disorders or difficulty falling asleep. However, I don’t recommend prolonged use of exogenous melatonin as it reduces our ability to produce our own melatonin.
Valerian Root: Valerian root is a herb traditionally used to promote relaxation and improve sleep quality. It may help reduce the time it takes to fall asleep and improve overall sleep duration.
Chamomile: Chamomile is a gentle herb known for its calming properties. It can help reduce anxiety and promote relaxation, making it useful for easing into sleep.
Lavender: Lavender is often used in aromatherapy and herbal remedies for its soothing scent and calming effects. It can help to reduce stress and anxiety, promoting better sleep quality.
Passionflower: Passionflower is another herb with sedative properties that can help promote relaxation and improve sleep quality. It may be particularly beneficial for individuals experiencing restlessness or racing thoughts at night.
Magnesium: Magnesium is an essential mineral that plays a role in muscle relaxation and stress reduction. Supplementing with magnesium glycinate/bi-glycinate may help improve sleep quality, especially for individuals with magnesium deficiency.
L-theanine: L-theanine is an amino acid found in green tea that has calming effects on the nervous system. It may help reduce anxiety and promote relaxation, leading to better sleep quality.
5-HTP (5-Hydroxytryptophan): 5-HTP is a precursor to serotonin, a neurotransmitter involved in regulating mood and sleep. Supplementing with 5-HTP may help improve sleep quality and mood in some individuals.
GABA (Gamma-Aminobutyric Acid): GABA is a neurotransmitter that helps promote relaxation and reduce anxiety. Supplementing with GABA may help calm the nervous system and improve sleep quality.
Ashwagandha: Ashwagandha is an adaptogenic herb that helps the body adapt to stress and promote relaxation. It may help reduce stress and anxiety levels, leading to better sleep quality.
If you are seeking a way to achieve deeper, more restorative sleep consider a combination of acupuncture and lifestyle changes as a holistic way to improve your overall health. In a meta-analysis of 24 RCTs exploring the treatment of insomnia with acupuncture compared to pharmaceutical therapy, a significant improvement in insomnia symptoms was achieved within 3 weeks of acupuncture treatment (Kim et al., 2021). When we are working with complex systems such as the circadian rhythm and hormones, creating balance can take time, yet it is much better than masking the issue and creating bigger problems in the future. Our body is sending us a message through unwanted symptoms, we have to listen and aim to restore harmony within these cycles.
References
Kim, S. A., Lee, S. H., Kim, J. H., van den Noort, M., Bosch, P., Won, T., Yeo, S., & Lim, S. (2021). Efficacy of Acupuncture for Insomnia: A Systematic Review and Meta-Analysis. The American journal of Chinese medicine, 49(5), 1135–1150. https://doi.org/10.1142/S0192415X21500543
Walker, M., & West, S. (2017). Why we sleep: Unlocking the power of sleep and dreams. Unabridged. New York, Simon & Schuster Audio.