Natural Sleep: Solutions for Insomnia

Introduction

Despite our scientific progress, despite billions of dollars of government-sponsored sleep research, and despite numerous pharmacological medications, insomnia rates appear to be increasing.

Associated diseases of fibromyalgia, mania, anxiety, depression, brain fog, dementia and chronic inflammatory diseases are increasing along with it. Modern adults find themselves fighting sleep off during the day when we need alertness the most.

For some, getting to sleep has become desperate. This is evidenced by the shocking death of Michael Jackson, who needed sleep so desperately that he resorted to dangerous pharmaceutical strategies. Unfortunately, this desperation is not unique to the famous or the wealthy.

The more we research sleep and dreaming, the more we find that our bodies work best when finely tuned to nature’s cycles. Once we stray off the course from our body’s natural rhythms and cycles, we find ourselves in the strange and sometimes desperate zone of insomnia and dream deprivation.

Currently, conventional medicine is focused on a combination of pharmaceutical and cognitive behavioral solutions. These may provide some temporary benefit, but they also come with side effects and the risk of dependency.

While pharmaceuticals have their plethora of physical side effects, cognitive approaches can cause harm to our self-esteem and mental stability. Consider for example, being told that we need to change or even stop our thinking in order to get to sleep. This can create an endless loop of self-doubt and overthinking. You are thinking wrong and that’s why you can’t sleep, is the sage advice. This leads to: I’m thinking wrong. How should I think?

What happens if we don’t fall asleep once the thinking adjustments are made: Why am I not sleeping? I must still be thinking wrong. How do I think differently? This is commonly termed overthinking.

Then there is the grand solution given among cognitive solutions: You must not try to fall asleep. What does this mean? Does this mean we shouldn’t go to bed? Does this mean we don’t turn off the lights or lay down? Some advise: Don’t go to bed unless you are tired. Should we just wait until we fall asleep at the dinner table or worse, behind the wheel before we go to bed?

What have gotten far too little attention are nature’s solutions. Many have been used for thousands of years. Others have been developed through sleep hygiene research. These solutions have little risk of side effects, other than some much needed sleep.

Nature’s solutions remove both the necessity for pharmaceutical side effects, and the mind games of cognitive adjustment.

Nature’s tools and resources work in a full spectrum manner. They work to modulate moods and physiology at the same time. How this occurs is a huge subject—outside the confines of this book.

Leave it with the understanding that both the human body and mind can work synergistically only when they are tuned to the forces of nature.

We might compare this to flying a kite. We may have a great string and a great kite design, but unless we position the kite precisely up in the air with the right position to the wind, the kite will not fly for long.

The science of dreaming also lies within the context of nature. We sleep and dream for a reason, and a body and mind tuned to nature will result in productive and informative dreams.

Exploring the dreamscape with respect to what dreaming accomplishes is the first critical discussion of this topic. Why do we dream and what do our dreams mean? These have been questions that scientists have asked for many centuries.

Many different dream theories have been proposed by philosophers, psychologists and medical doctors alike. But now there is enough concrete research available to finally arrive at a clear understanding of what dreaming is and why we need it.

There’s a lot of science in this book. Feel free to skip around to the topics that most interest you.

1. The Need for Sleep

Every night we slip into another world. Each night we lay our body down under our conscious control, only to hand over the reins to our autonomous nervous system.

Our body becomes paralyzed as we drift into a realm unlike our waking world. Soon we find our mind wandering through distant lands while our body cruises on autopilot, breathing deeply and fully—as we lay oblivious to our external environment.

During this state, our body cycles through periodic states of metabolism. Our immune systems kick into high gear, as we cleanse and rejuvenate the cells.

Our memories are prioritized and consolidated. As we delve deeper, our eyes begin to dart around as though we were watching something moving under our eyelids. Just what is going on here? Just what is sleep anyway?

According to a poll done by the National Sleep Foundation in 2000, almost two-thirds of American adults experience a sleep problem a few nights per week or more, and 43% say that they are so sleepy during the day that it interferes with their daily activities.

Reports have shown that up to half of all Americans report having insomnia at some point. One out of ten adults will change their jobs in order to sleep more.

Drowsy driving causes over 100,000 car crashes each year, and more than 50% of adults report that they have continued driving while sleepy during the past year. From a financial perspective, sleep loss is costly. Some 40% of adults have reported that lack of sleep forces a decrease in work quality, with over two-thirds saying lack of sleep interferes with concentration and the ability to handle stress.

Our technology-driven, accelerated society has shifted into high gear. The distinction between day and night has become blurred with the advent of the internet, 24-hour shopping, and the unending pressure to do it all now.

As a result, sleep has fallen victim to the technical phantasmagoria of smart phones, laptop computers, MP3 players and televisions—all with remote high-speed access and satellite communications. The prospect of slumbering down to a relaxing night of deep dreams and soothing silence seems to have escaped into the shrieking lights of digital-land.

While there is some debate whether these have significantly decreased sleep among our population, it is certain that these at the very least present a strong deterrent to good quality sleep, as these media devices favor our waking attention.

The real debate has regarded why we sleep and why we need consistent good quality sleep. Most researchers agree that sleep represents a systemic recharging and resetting of the body.

This consists of metabolic renewal among cells and tissue systems around the body combined with the consolidation and sorting of the memories stored within brain cells.

It is quite easy to observe the importance of this resetting and recharging feature of sleep, and most of us know this all too intimately.

This still brings up many questions: Why do we need sleep every night? Do we all need sleep? If so, how much do we need? And what happens if we don't get enough?

These are a few of the mysteries that have plagued scientists and physicians for centuries. While research has progressed significantly over the past few decades, some of these questions are still being debated.

Sleep by its very nature is rhythmic. Sleep is circadian: We need it daily, and we feel better if we get it at the same time and length each day. Most people sleep between five hours and nine hours per night.

We find reports of people sleeping only one to three hours every night, while some seem to need ten to twelve hours per night to feel rested. Sleep researchers have concluded that most of us sleep an average of seven to seven-and-a-half hours every day.

It also seems that we need to fall asleep and wake up at about the same times each day for some reason.

Considerable research has concluded that many of us do not get enough good quality sleep. Ron Kramer, M.D. of the Colorado Neurology Institute’s Sleep Disorders Center has said that, "There is growing medical literature showing that many of us in today’s 24/7 society are not getting the basic sleep we need every day. At the same time, there is increasing evidence from human sleep research that chronic lack of even a few hours of sleep a night can result in significant health consequences.

These consequences include an increased risk of accidents; fatigue that makes you prone to depressive symptoms or not enough energy to exercise; and even chemical changes that stimulate your brain to eat more and to eat more salty and sugary food."

How do we know if we are not getting enough sleep? There are several signs, according to sleep research. These include:

-increasingly forgetting things

-drowsiness while behind the wheel, at work or class

-losing concentration

-making simple mistakes that could easily be avoided

-feeling depressed

-becoming easily frustrated

-being anxious about non-critical things

-becoming angry for little reason

-frequent illnesses

-feeling extremely drowsy as we wake up

Regarding the last item, most of us awaken slightly drowsy and would rather sleep some more. However, if we cannot readily rise and become alert within a few minutes (without coffee or other stimulation) then we likely didn't sleep enough, slept too much, or didn't get enough good quality sleep.

Sleep research has unveiled a lot about the mechanics of sleep over the past five decades. Recently, sleep research has gained increased funding. Governments, universities and private research foundations are all conducting sleep research now. And there is good reason for this increased focus.

Why Do We Sleep?

Though it may sound simple, this is not a simple question. Why? Because sleep itself is complicated. Sleep has a number of facets, and each of those facets has a purpose. We know from research that without the right amount of sleep we will die of heart diseases and other ailments a lot sooner.

We also know from research that a lack of sleep can cause a variety of psychological issues. These include cognitive dysfunction, memory loss and increased anxiety.

Without enough sleep, we will become more stressed and less productive. Without enough sleep, our immune systems will become weakened.

These together render at least five reasons for sleep. The first is to conserve and rest cellular metabolism, allowing the immune system to accelerate.

This enhanced state of immunity is supported by studies that have shown increased levels of interleukin-1, tumor necrosis factor (TNF) and other immune cells during sleep. Studies on intestinal microflora confirm that probiotic activity also increases during sleep. Probiotics provide upwards of 70% of the body’s immune response system.

Why does the immune system go into high gear when we sleep? When the body enters the paralysis of sleep, the immune system can more easily clear out pathogens and toxins. We can see this by the fact that bacteria loads increase within the lymph nodes of those who have been sleep-deprived. This is also the reason we are more prone to illness when we are not sleeping enough.

A second reason we sleep is cellular regeneration. This is the process of cell repair and cellular division. These processes are stimulated while we sleep. Just as road crews can get more highway paved with asphalt at night when they can block lanes, the body can heal damaged tissues and grow new healthy ones when the body’s metabolic activity slows down.

Cellular division is stimulated by growth hormone. Growth hormone release into the bloodstream is stimulated by GMRH, or growth hormone-releasing hormone. Research has illustrated that both GHRH and growth hormone levels increase as we sleep. Actually, it is more complicated than that. GHRH actually helps stimulate sleepiness along with the release of GH.

The third reason we sleep is memory consolidation. While we are in non-rapid eye movement sleep, our neurons begin to sort through the various images and stimuli that have been taken into the sensory organs and brain cells.

This information is stored as short-term memory at first. When we sleep, through a process involving the hippocampus, our brains sort through the information and store away for later retrieval those memories we consider important.

Memories we’d rather not keep, on the other hand, are tossed away and left to our sub-conscious self. These are typically events that we’d rather not face in the future, or events that we simply haven’t come to terms with.

The fourth reason for sleeping has to do with problem resolution for those events we haven’t come to terms with yet. During certain NREM sleep stages, our mind reflects upon the various events of the day (and previous days) and works through the confusing or uncomfortable issues or images. We ask the mind to reconcile problematic areas.

Why did this happen? Why did I see this? What can I do to fix this? How can I avoid a bad thing from happening?

These are questions the mind is asked by the self to fix. When we go to sleep, our sensory systems all shut down. This gives our minds the time to sort through the events of the day and help find resolution within them. It is for this reason that people who don’t sleep enough end up becoming confused and depressed. They aren’t regularly coming to terms with the things that are going on around them.

The fifth and last reason we sleep is for escape. As we’ll focus on later, every night, for some reason, we slip into a fantasy dimension. This is the dimension of our wildest dreams. This is a place where we can rearrange people, places and things in such a way as to live out our fantasies. This dream-state typically occurs at a particular stage (REM, discussed later) of our sleep.

During this stage, we subconsciously play out any and every variance of the physical world we can imagine. Why we do this is debated, but researchers know that we need this type of sleep so badly that if we don’t get enough REM-stage sleep, we’ll somehow rearrange all of our other sleep stages to specifically allow us to catch up on our REM- stage dreaming.

This brings up the notion of lucid dreaming, which is somewhat misunderstood. Lucid dreaming is often confused with the vivid and imaginative dreaming of the REM stage.

Actually, lucid dreaming describes a type of dream where we become conscious that we are dreaming. This means that we first become conscious of our dream as we are waking up—or remain conscious as we continue to watch or even steer the activities of the dream. Should we see a wall in our dream, we may decide to leap it. Or we decide to break it down.

Either way, we utilize conscious choice to move within the dream. This is often regarded as a hybrid state of consciousness, which is both physiologically and mentally different from REM-stage dreaming.

Furthermore, some researchers, namely Stephen LeBerge, Ph.D., have determined methods by which one can be trained to increase their ability to dream lucidly. We’ll discuss this further in our chapter on dreaming.

How Much Sleep Do We Really Need?

Our sleep requirements are unique to each of us. Some of us need more or less sleep than others. To force a different sleep pattern upon someone can have disastrous effects. Lowered immunity and difficulty concentrating are just a few of the results from dramatically changing our sleep length or sleep parameters too quickly or without the proper guidance.

Nonetheless, several large studies have found that optimal sleep duration for staying healthy is substantially less than the eight hours traditionally recommended by so many health experts, parents and others over the years.

In a study by researchers from the University of California-San Diego and the American Cancer Society, 1.1 million adults were followed between 1982 and 1988.

Survival rates (from death for any cause) were highest among those who slept an average of 7 hours per night. Those who slept more than 8.5 hours per night had a 15% increased chance of death.

Those that slept less than 6 hours also had an increased risk of dying.

Those who took prescription sleeping pills also had increased mortality rates.

In another study, 98,634 adults between the age of 40 and 79 years old were tracked for about 14 years. Mortality rates were compared to those who slept an average of seven hours per night.

Those who slept under four hours per night had more than double the likelihood of dying from heart disease and other non-cancer deaths.

Those who slept an average of more than ten hours per night had nearly double the risk of dying from heart disease and other non-cancer deaths—again compared with those who slept an average of seven hours per night.

Interestingly, there was no correlation between sleep duration and cancer incidence. When the total deaths were graphed against sleep duration in this study, the result was a U-shaped curve, with seven hours at the apex—meaning that seven-hour sleepers had the lowest risk of mortality.

Other studies over the past few decades have confirmed that lower mortality rates occur amongst those who have good quality sleep in the range of seven hours per night.

In a review of twenty-three sleep-mortality studies from the Weinburg Center for Women's Health and Medicine, both long sleepers (over 8.5 hours per night) and short sleepers (under 6 hours per night) had increased mortality rates from heart disease or cancer. Again, about seven hours was optimal.

Sleep research has also identified that long sleepers and short sleepers tend to have higher rates of obesity, stress, mental diseases and cognitive issues.

Furthermore, those with sleep disorders such as restless leg syndrome (RLS) or periodic limb movement (PLM) have an increased risk of cardiovascular diseases and kidney disorders.

Sleep among the elderly has other considerations. In a study from Okayama University's Graduate School of Medicine, 11,395 elderly adults between 65 and 85 years old were followed for seven years and analyzed for mortality risk.

In this study, short sleep was not associated with a higher risk of cardiovascular mortality. Longer sleep duration was, however. Those sleeping longer hours, when compared to those who averaged about seven hours per night, had a greater risk of dying of heart disease.

Most of these studies were based on self-reports. In other words, the test subject answers a questionnaire about his/her sleep habits. A revealing study regarding self-reporting versus actual sleep duration is worth considering with sleep research statistics.

The Department of Health Studies at the University of Chicago studied 669 adults for two years and measured their self-reported sleep averages against their actual sleep duration—obtained through sleep observation. They found that the average self-reported sleep duration was 6.8 hours, while the actual sleep duration averaged 6 hours.

This means that most of us calculate that we are sleeping more hours than we actually are. It also indicates that since most of the epidemiological studies on optimal sleep have measured sleep duration using self-reported sleep, there is a strong possibility that the real optimal sleep duration is closer to 6.25-6.5 hours of quality sleep per night.

This is measuring the time between when we actually fall asleep and the time we actually wake up—which may be difficult for us to determine ourselves.

Even with this variance, seven hours is still a good number to remember. Since most of the above-mentioned studies utilized self-reported surveys from sleepers, our perception of sleep duration is likely to be equivalent to their self-reporting.

Therefore, seven hours of sleep is still a good target, measured from our perception: when we think we fall asleep and wake up. After all, sleep includes quite a bit of relativity all the way around.

These studies of course apply to adults. Children should sleep far more hours than adults, depending upon their age. A healthy infant can sleep anywhere from 10-20 hours per day.

This decreases with age, to 10-15 hours after one-years old, 9-12 hours until the age of twelve, and 8-10 hours during the teenage years. Less sleep during these formative years can have drastic consequences upon development, both physically and psychologically—for reasons we'll discuss in more detail later.

Nevertheless, we each have unique biological clocks, and thus have slightly different sleep requirements.

This fact is supported by research from Harvard Medical School that showed that short sleepers had different biological clocks than did long sleepers. They studied 24 young adult volunteers, ten of which were long sleepers and 14 of which were short sleepers.

They found that the short sleepers and the long sleepers had similar relationships between their physiological conditions (such as body temperature and hormone levels) and their sleep particular duration.

In other words, the length of their biological nights was relative to their sleep duration regardless of how long they normally slept.

At the end of the day, as a rough rule of thumb, the best duration of sleep is the minimal level before daytime sleepiness takes hold. If we are falling asleep during the day, especially when trying to stay awake, we are not getting enough sleep. Let’s look at this angle a bit deeper.

The Sleep Study

The sleep study is a more scientific approach to sleep and sleep research. It is also used to diagnose sleep disorders in individuals. During a sleep study, the researcher attaches a variety of wire electrodes to the head and parts of the torso.

These are connected to a router that connects the electrodes to different physiological measuring devices. With these attached, the subject lays down for a hopefully restful night of sleep, while the equipment monitors the body's metabolic and electrical physiology throughout the night.

This is called polysomnography, or PSG, better known as a sleep study. The test result is called a polysomnogram—also abbreviated as PSG. The name is derived from Greek and Latin roots: the Greek poly for ‘multi-channel’ or ‘many,’ the Latin somnus for ‘sleep,’ and the Greek graphein meaning ‘to write.’

A polysomnographic recording combines readings from an electrooculograph (EOG), an electrocardiograph (ECG), an electroencephalograph (EEG), an elctromyograph, (EMG), a pulse monitor and a respiratory monitor.

These together collect data measuring eye movement, heart activity, brain wave and electrical activity, muscle activity, pulse activity and lung function, respectively.

Because each part of the body is active during different stages of sleep, the combination of data readings from this equipment allow the researcher to correlate sleep depth and staging.

This allows the researcher to determine the quality and functionality of the sleep, and diagnose eccentricities from the normal patterns of most sleepers. These are often called sleep disorders.

Thus, polysomnographic recordings offer researchers a comprehensive recording of the bio-physiological changes that occur during sleep. It is usually performed at a sleep center, where the subject cuddles up in a sterile bed inside a laboratory environment.

While sleep research can be very reliable, sleeping in a strange bed with wires attached to the head and torso does not exactly create a replication of a typical night’s sleep for most of us. This in itself prevents many people from undergoing a sleep study.

This of course, keeps most of us in the dark (no pun intended) about the quality of our sleep—and whether we have any sleep disorders.

New devices have been invented to screen sleep without as many electrodes and head attachments. Some have also been designed for the sleeper to use at home. One of the more popular of these is called the Watch-Pat 100®, developed by sleep researcher David White, M.D.

This small device takes readings from the hand and fingers and stores them on a removable disk, which can be put onto a computer. This allows a person to do a home sleep study in the comfort of his or her own bedroom.

Sleep Stages and Cycles

There are three relative sleep parameters that quantify and define sleep. These are the sleep stages, the sleep cycles, and the sleep brainwaves. While each of these is interrelated, they are measured through separate readings. These can be a bit confusing, so let’s review each of these individually.

The sleep stages are the depth of sleep that a person experiences during a night's sleep. The convention most sleep researchers agree upon now is that there are three stages of non-REM sleep, and two stages (or types) of REM stage. REM means rapid eye movement, which we will discuss in further detail later.

Then there are the sleep cycles. Sleep cycles are periods of deeper sleep separated by short periods of reduced sleep.

Then we have the brainwaves that occur when we sleep. These help us classify and categorize the type of brain activity occurring at any particular time, which helps us measure sleep cycles and stages. The sleep stages are often referenced to by their dominant brainwaves. We’ll discuss these more specifically later.

There are two general categories of sleep: Non-rapid-eye-movement (or NREM) sleep, which covers about three-quarters of total sleep; and REM sleep, which covers the remainder in healthy adults. Healthy adults thus get about two hours of REM-stage sleep per might. Adolescents get more REM-stage sleep. Children and especially infants have significantly more REM sleep.

Sleep researchers used to classify sleep into five stages, including REM-stage sleep. However, there were some grey areas within the third and fourth stages.

As a result, the American Academy of Sleep Medicine decided to combine the third and fourth stages of NREM sleep (the theta and the deep-theta) into a single third stage. The first two sleep stages are now called N1 and N2, and this third consolidated sleep stage is called the N3 stage. N3 is also sometimes referred to as slow-wave sleep.

A healthy night’s sleep consists of between four and six cycles. Each cycle often approximates about 90 minutes in length, but this can be different from person to person and can change periodically. In general, the first cycle proceeds from a light, stage one sleep to a stage two sleep. During this first sleep cycle, our breathing increases, our body cools, and our mind begins to drift into slumberland.

During this phase, the mind is still somewhat aware of the surroundings, but not completely aware. Sometimes, this phase will be characterized by some twitching, as the muscles progressively begin to lose their tone.

Most good sleepers will drop into a stage two sleep during the first cycle. Others might stay in the light stage one sleep during the whole first cycle. This, however, sets up the possibility of sleep stage latency, or a delay of the deeper sleep stages.

After about ninety or so minutes, the first cycle ends, and our sleep depth gets shallower for a few minutes. During