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The‌ ‌6‌ ‌Best‌ ‌Natural‌ ‌Supplements‌ ‌for‌ ‌Sleep‌

By Dr. Michael Murray, ND

Sleep is perhaps one of the least understood body processes, but its value to our mood, energy levels, and proper brain function is appreciated by all of us. Without question, sleep is absolutely essential to both the body and mind. 

A chronic lack of sleep, or altered sleep patterns, or sleep deprivation all dramatically impair mental and physical function. As a result, many health conditions, particularly depression, chronic fatigue syndrome, and fibromyalgia, are either entirely or partially related to disturbed sleep. 

Although all of the benefits of sleep are still a mystery, sleep undoubtedly recharges the energy within our cells and is also necessary for the proper removal of harmful chemicals from the body (particularly the brain). Sufficient deep sleep is also absolutely critical to optimal immune function.

Before recommending the best supplements for sleep, it is important to learn about normal sleep and the importance of deep sleep and dreaming.

The Stages of Sleep

Based on eye movement and brain wave tracings (electroencephalographic [EEG] recordings), sleep is divided into two distinct types, REM (rapid eye movement) sleep and non-REM sleep. 

During REM sleep the eyes move rapidly and dreaming takes place. Having dreams and experiencing adequate time in REM sleep is an important part of sleep quality. Another factor determining sleep quality is the time spent in the deepest stages of non-REM sleep. This type of sleep is associated with reduced brain wave activity and is divided into four stages, numbered 1 through 4 according to the level of brain wave activity and ease of arousal. 

Stage 1 occurs as sleep initiates. It is a light sleep. As non-REM sleep progresses to deeper levels of sleep though it is characterized by lower brain wave activity, it is also linked to increased activity of cellular repair mechanisms, detoxification, and immune function. The deepest level of non-REM sleep is stage 4. It is during this deepest level of sleep when the immune system, repair mechanisms, and cellular energy production are functioning at their highest efficiency. Quality sleep increases the production of ATP, the fuel produced by the energy-producing compartments of our cells, the mitochondria. Sleep makes cells rich in ATP – the energy currency that drives life.

Sleep is a Dynamic State

Sleep is not a static process, there is a lot of activity taking place in successive approximately 90-minute cycles. The sleep cycle begins with stage 1 non-REM sleep, should progress through stages 2 and 3 to stage 4 non-REM sleep, and then, for some reason, the brain suddenly becomes much more active and triggers REM sleep. In adults, the first REM sleep cycle lasts about 5 to 10 minutes. We rarely remember these dreams, because, after the flurry of REM activity, brain wave patterns return to those of non-REM sleep for another 90-minute sleep cycle. With each subsequent cycle, the time spent in REM sleep increases. Each night most adults experience five or more sleep cycles (or a total sleep time of 7.5 to 9 hours). The last sleep cycle (either the fifth or sixth depending on the person), may produce a REM sleep period that can last about an hour. 

Sleep Quality vs. Sleep Duration

Often people equate sleep duration as the key indicator of sleep quality. On its own, it is not. Total sleep time is not as crucial to avoiding the harmful effects of sleep deprivation as time spent on sleep quality. The standard criteria of sleep quality cited by many are based on these indicators:

  • Falling asleep in 30 minutes or less. 
  • Waking up no more than once per night. 
  • Being awake for 20 minutes or more after initially falling asleep.

However, while these indicators are important, what is a bigger indicator of sleep quality is the time spent in the deeper stages of non-REM sleep coupled with sufficient REM sleep. As people hit their mid-40s to age fifty, in addition to a number of health issues that can lead to increased nighttime awakenings (e.g., sleep apnea, diabetes, menopausal hot flashes in women, prostate enlargement in men, etc.), there is a decline in REM, and they tend to awaken at the transition from non-REM to REM sleep. As a result, there is also a reduced time spent in deep sleep stages 3 and 4. These changes can lead to many people over 45 years of age dealing with poor sleep quality and lower energy levels.

The Problem with Sleeping Pills

While sleeping pills (sedative-hypnotic drugs) increase total sleep time and may reduce nighttime awakenings, they disrupt normal sleep architecture. Specifically, many significantly impair the ability to reach the deeper stages (3 and 4) of non-REM sleep as well as REM sleep. This effect has been known for a long time and is the main reason these drugs often produce the feeling of a morning "hangover." In contrast, several natural sleep enhancers (e.g., melatonin5-HTPGABAL-theanine, etc.) appear to actually increase the time spent in the deeper levels of non-REM sleep allowing for the brain and body to get fully recharged. 

Both prescription and over-the-counter drugs are associated with significant risks. The prescription drugs are highly addictive and produce side effects such as dizziness, drowsiness, and impaired coordination. That is why you should not drive while on these drugs. And alcohol adds fuel to the fire with these side effects.

The most serious side effects of both prescription and over-the-counter sedative drugs relate to their effects on memory and behavior in the short term and an increased risk for depression, cognitive decline, and early death in the long term.1 The link with an increased risk for early death is particularly concerning. As of December 2020, over 24 population-based studies have shown this link. It may mean that the use of sleeping pills is just an indicator of stress, anxiety, insomnia, and depression. All of these factors are also associated with an increased risk for early death. 

Sleep and the Immune System

With so much focus these days on immune function, it is important to recognize the critical role sleep plays in enhancing immune function. Sleep improves all aspects of immune activity.2 Much of this benefit is the result of improvements in white blood cell functions as a result of increased energy production. Keep in mind that during sleep (and meditation), diaphragmatic breathing improves, and this literally is what pumps the lymphatic system. As a result, white blood cells are mobilized and the filtering and clearance of viruses, yeast, and toxins are improved. 

How to Improve Sleep Quality Naturally 

Eliminate Caffeine

Like other health conditions, the most effective ways to improve sleep quality is based upon identifying and addressing factors that impair sleep. One of the first steps to improve sleep quality in many people is eliminating caffeine. The average person in most countries consumes 150 to 225 mg of caffeine daily, or roughly the amount of caffeine in one to two cups of coffee. Although most people can handle this amount of caffeine, there is a huge—15-fold—variation in the rate at which people break down caffeine. Genetic variations in enzymes that break down caffeine explain why some people can eliminate it quickly, while others take much as 12 to 24 hours to fully eliminate the caffeine from a single cup of coffee. Anyone who has trouble sleeping should simply try caffeine avoidance for seven to ten days. This avoidance has to be strict, so all sources, not just coffee, but tea, chocolate, drugs with caffeine, energy drinks, etc., must be avoided. 

Minimize Alcohol Intake

Alcohol must also be eliminated in people who struggle with sleep quality. Alcohol causes the release of adrenaline and disrupts the production of serotonin (an important brain chemical that initiates sleep). Although not considered a stimulant, sugar and refined carbohydrates can interfere with sleep. Eating a diet high in sugar and refined carbohydrates and eating irregularly, can cause a reaction in the body that triggers the fight or flight response, causing wakefulness. 

Reduce Sugar Consumption

Reducing sugar consumption is also important, especially in sleep maintenance insomnia where a person is able to get to sleep, but awakens 3, 4, or 5 hours later and has a really tough time getting back to sleep. In most cases, sleep maintenance insomnia is the result of faulty blood sugar control. Basically, these people are on a “blood sugar rollercoaster” day and night. Eating a diet low in carbohydrates, especially sugar and foods that quickly raise blood sugar levels, can really help. Taking PGX, a revolutionary dietary fiber matrix is also a very important consideration. PGX reduces after-meal blood sugar levels and helps eliminate the blood sugar roller coaster.3 New techniques in blood sugar monitoring indicate nighttime fluctuations in blood sugar levels are the major cause of sleep maintenance insomnia. Take 2.5 to 5 g of PGX before meals.

Manage Stress Levels

Other common causes of insomnia are stress, depression, anxiety, and certain medications. In fact, there are well over 300 drugs that can interfere with normal sleep. In addition, as mentioned above, certain health challenges are linked to disturbing sleep, such as menopausal hot flashes in women and an enlarged prostate in men. Fortunately, there are safe and effective natural approaches to supporting these challenges, and doing so can definitely improve sleep quality. Remember, elimination of the cause of poor sleep quality is by far the best treatment.

The Best Dietary Supplements for Sleep

There are many effective natural sleep aids, but these are the supplements that really stand out:

Melatonin

Melatonin is by far the most popular natural sleep aid. Melatonin has been shown to be very effective in helping induce and maintain sleep in both children and adults. It is most apparent in improving sleep when melatonin levels are low. Melatonin supplementation appears to be most useful in improving sleep quality in people 40 years of age and older as it is more common to find low melatonin levels in this age group.4,5

A dose of 3 to 5 mg at bedtime is more than enough for adults. Children 6 years of age and above should take a dosage range of 1 to 3 mg. Although melatonin appears to have no serious side effects at recommended doses, melatonin supplementation could conceivably disrupt the normal circadian rhythm in hormone secretion if taken in excess of recommended amounts. Hence, unless there is a specific need to take higher dosages, stick to the recommended dosage.

Methylcobalamin (Vitamin B12)

The active form of vitamin B12, methylcobalamin, can make melatonin more effective, especially in people over 40 and in shift workers. Methylcobalamin has been shown to help some people suffering from what is referred to as sleep-wake disorder. This disorder is characterized by excessive daytime sleepiness, restless nights, and frequent nighttime awakenings. It is very common in shift workers and the elderly. In people with sleep-wake disorders, taking methylcobalamin has often led to improved sleep quality, increased daytime alertness and concentration, and improved mood.6,7 Much of the benefit appears to be a result of methylcobalamin reducing daytime melatonin secretion and helping to set the stage for nighttime melatonin secretion. The recommended dosage is 3 to 5 mg of methylcobalamin upon arising.

Magnesium

Magnesium produces a calming effect, relieves stress, and promotes overall relaxation and restful sleep. Magnesium supplementation is especially important in improving sleep in the elderly and reversing age-related alterations in brain wave tracings and brain chemistry.8,9 The recommended dosage is 250 to 300 mg at bedtime. Magnesium citrate, malate, or bisglycinate in powdered drink mixes is a great choice at this dosage level vs. tablets or capsules. 

5-HTP (5-Hydroxytryptophan)

5-HTP is converted in the brain to serotonin, an important initiator of sleep. It is one step closer to serotonin than l-tryptophan and has shown more consistent results in promoting and maintaining sleep.10,11 One of the key benefits of 5-HTP is its ability to increase REM sleep (typically by about 25%) while increasing deep sleep stages 3 and 4 without lengthening total sleep time. The sleep stages that are reduced to compensate for the increases are non-REM stages 1 and 2—the least important stages. The dosage recommendation to take advantage of the sleep-promoting effects of 5-HTP is 50 to 150 mg 30 to 45 minutes before retiring but is also useful to take 5-HTP at a dosage of 50 to 100 mg three times a day before meals is an important consideration if its mood-elevating or weight-loss promoting effects are desired. Start with the lower dose for at least 3 days before increasing it. 

L-Theanine

L-theanine is a unique amino acid found almost exclusively in tea (Camellia sinensis). Clinical studies have demonstrated that L-theanine reduces stress, improves the quality of sleep, diminishes the symptoms of premenstrual syndrome, heightens mental acuity, and reduces negative side effects of caffeine.12 L-theanine is a great consideration for children at a dosage of 200 mg at bedtime. In adults, the typical dosages of 200 mg, L-theanine does not act as a sedative, but it does significantly improve sleep quality. It can be used at that dosage as a gentle way to improve sleep. For a sedative effect in adults, a higher single dosage of 600 mg L-theanine is required. 

Valerian

In terms of herbal medicine, there is no question that valerian (Valeriana officinalis) is the most popular and well-studied sleep aid. Detailed clinical studies have shown valerian to improve sleep quality, reduce the time required to get to sleep, and promote restful sleep throughout the night.13 All without producing "hangover feeling" in the morning.

As a mild sedative, take valerian extract (0.8% valeric acid) at a dosage of 150 to 300 mg thirty to forty-five minutes before retiring. If morning sleepiness does occur, reduce the dosage. If the dosage was not effective, be sure to eliminate those factors that disrupt sleep such as caffeine and alcohol before increasing dosage.

References:

  1. Kripke DF. Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit. F1000Res. 2016 May 19;5:918
  2. Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch. 2012 Jan;463(1):121-37. doi: 10.1007/s00424-011-1044-0. Epub 2011 Nov 10. PMID: 22071480; PMCID: PMC3256323.
  3. Brand-Miller JC, Atkinson FS, Gahler RJ, et al. Effects of PGX, a novel functional fibre, on acute and delayed postprandial glycaemia. Eur J Clin Nutr 2010 Dec;64(12):1488-93.
  4. Auld F, Maschauer EL, Morrison I, Skene DJ, Riha RL. Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders. Sleep Med Rev. 2017;34:10-22.
  5. Li T, Jiang S, Han M, et al. Exogenous melatonin as a treatment for secondary sleep disorders: A systematic review and meta-analysis. Front Neuroendocrinol. 2019;52:22-28.
  6. Honma K, Kohsaka M, Fukuda N, et al. Effects of vitamn B12 on plasma melatonin rhythm in humans. Increased light sensitivity phase-advances the circadian clock? Experentia 1992;48:716–20.
  7. Okawa M, Mishima K, Hishikawa Y, et al. Vitamin B12 treatment for sleep-wake rhythm disorders. Sleep 1990;13:1–23.
  8. Abbasi B, Kimiagar M, Sadeghniiat K, et al. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012 Dec;17(12):1161-9.
  9. Held K, Antonijevic IA, Künzel H, Uhr M, Wetter TC, Golly IC, Steiger A, Murck H. Oral Mg(2+) supplementation reverses age-related neuroendocrine and sleep EEG changes in humans. Pharmacopsychiatry. 2002 Jul;35(4):135-43. doi: 10.1055/s-2002-33195. PMID: 12163983.
  10. Wyatt RJ, Zarcone V, Engelman K. Effects of 5-hydroxytryptophan on the sleep of normal human subjects. Electroencephalogr Clin Neurophysiol 1971;30:505-509.
  11. Soulairac A, Lambinet H. Effect of 5-hydroxytryptophan, a serotonin precursor, on sleep disorders. Ann Med Psychol (Paris) 1977;1:792-798.
  12. Eschenauer G, Sweet BV. Pharmacology and therapeutic uses of theanine. Am J Health Syst Pharm. 2006;63(1):26, 28-30.
  13. Stevinson C, Ernst E. Valerian for insomnia: a systematic review of randomized clinical trials. Sleep Med 2000;1:91-99.

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