Sleep is a wonderful thing, yet for quite a few of us it’s an elusive pleasure. The problem usually begins before bedtime. You may feel unable to switch off from feelings of stress, tension and anxiety – the buzz words for the 21st century. Sixty-three per cent of people say they suffer from stress and more than half of all doctor visits are for stress-related conditions, including anxiety and insomnia. And that is a clue to the best way of treating it.
According to a review from 2004, published in The Lancet, the various forms of counselling and psychological help are not only more effective than pills at tackling chronic insomnia – they are also, inevitably, far safer. But in the UK, for instance, good therapeutic help can be hard to find on the National Health Service. As a consequence, over 16 million prescriptions for what are called hypnotic (sleeping) and anxiolytic (anxiety-reducing) drugs were written out in 2004, at a cost of £37 million.
Taking drugs for sleeping problems and anxiety is very dangerous. While this route has place in a short-term crisis when you’re completely stressed out and need to sleep, most drugs on offer end up creating dependency if you take them for anything longer than a week. Combinations of nutrients, herbs and lifestyle changes are likely to be as effective, but without the downsides. These should be the first resort, not the last, if you are feeling stressed or anxious, or can’t sleep.
There are a number of routes you can take to vanquish anxiety and sleeplessness. Although it’s safe to combine behavioural techniques such as sleep hygiene with, say, taking GABA, it’s best to avoid taking all of the substances below in combination. For example, take either melatonin or 5-HTP or tryptophan, possibly with some GABA or Valerian, but not all of them together.
What Works
Find the right kind of psychotherapy, especially cognitive behavioural therapy.
Take 500mg of GABA an hour before bed. (Be aware that GABA is not available in the UK.) Don’t combine with drugs that target GABA, such as most sleeping pills, unless under the guidance of a health professional.
Take 3 to 6mg melatonin before bed; it’s available on prescription. OR take 100 to 200mg 5-HTP, or 2 to 4g of L-tryptophan, both one hour before bed with a light carbohydrate snack. Don’t combine 5-HTP with anti-depressants unless under the guidance of a health professional.
Practise sleep ‘hygiene’ (See Food is Better Medicine Than Drugs) and exercise regularly.
Listen to alpha-wave-inducing music while in bed.
Eat more green leafy vegetables, nuts and seeds to ensure you’re getting enough magnesium, and consider supplementing 300mg of magnesium in the evening with or without calcium (500mg).
Consider taking valerian, hops, passion flower, St John’s wort or a ‘sleep formula’ combining several of them. Choose a standardised extract or tincture and follow the dosage instructions.
Avoid sugar and caffeine and minimise your intake of alcohol. Don’t combine alcohol with sleeping pills or anti-anxiety medication.
Dig deeper by reading Food is Better Medicine Than Drugs for all the evidence to support this approach, and its comparitive effectiveness and safety compared to the conventional treatment of anxiety and insomnia. Also read Beat Stress and Fatigue by Patrick Holford.
Working with Your Doctor
Many of the recommendations we have made above are easy for you to put into action. You may wish to work with a nutritional therapist who can devise a more personalised plan of action and support you through the process.
If you are currently taking sleeping pills, and have some level of dependence, it is extremely important to enrol your doctor’s support to help you come off gradually. Most sleeping pills create ‘down-regulation’ to GABA, which means you become less responsive to the body’s own natural relaxant GABA, the net consequence being rebound anxiety when you reduce the dose. The body can ‘up-regulate’, making you more sensitive to your own relaxing GABA, but this takes time: hence the need to reduce the dose gradually.
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