Who doesn’t like to get a good night’s sleep? There’s no feeling like waking up rested and refreshed. But getting enough good quality sleep might be more important for your health than you realise. And the research proves it! Good sleep quality leads too:
- Good immunity: “Research models show a strong interrelationship between sleep quality and immune function”.1
- Healthy body weight: “An inverse relationship between obesity and sleep duration has been demonstrated”.2
- Good memory: “Over more than a century of research has established the fact that sleep benefits the retention of memory”.3
- Lower risk of type 2 diabetes: “Sleep is increasingly being recognised as an important factor in the homeostasis of multiple body functions, including blood glucose metabolism”.4
Skipping out on sleep could cause you to put on extra pounds for a number of reasons. Obviously, since you’re awake longer you have more opportunity to eat and a disruption of your appetite hormones could add to the problem causing you to indulge even more. In addition, since you’re likely to feel sluggish chances are you’ll be less active than normal and less activity, of course, means less energy burned and a lower resting metabolic rate. Partial sleep deprivation also affects how we burn up carbohydrates, which may influence body composition changes, including a proportionately greater loss of lean body mass and preservation of body fat mass during weight loss.2
Beware dangerous and deadly sleeping pills!
Of course, many people don’t have any choice in how much sleep they get, because they suffer from insomnia. A sleeping pill from the doctor is often a desperate last resort. But there are problems here as well for good health, perhaps even potentially lethal problems. In a widely publicised 2012 article, a group of US scientists found a strong association between the use of modern hypnotic drugs (sleeping pills) and increased risk of death.5
The study’s principal author, Dr. Daniel Kripke, has been interested in this association for more than a decade, after he and colleagues found an increased mortality hazard with prescription hypnotics in a 1998 analysis that used earlier data from the American Cancer Society (ACS) Cancer Prevention Study II.6 In fact, as Kripke points out in the 2012 article, Study I of the ACS also found that both hypnotic use and cigarette smoking were associated with excessive deaths, but the hypnotic findings were discounted as the study was not designed to investigate these drugs. Since then, at least 24 published studies have examined mortality linked to hypnotic consumption, with 18 reporting significant positive associations.5
However, these studies generally failed to report the specific drugs used, and often confused hypnotics with tranquillizers (that are not marketed for the treatment of insomnia). Given the modern use of short-acting benzodiazepine agonist drugs such as zolpidem, zaleplon and eszopiclone that now dominate current prescribing, Kripke and team decided to conduct a matched cohort study to compare the mortality and cancer risk of these drugs.
Sleep drugs linked to cancer and elevated death risk
Their results were surprising and alarming. Participants (average age 54 years) were 10,529 patients who received hypnotic prescriptions and 23, 676 matched controls with no hypnotic prescriptions, followed for an average of 2.5 years between January 2002 and January 2007. Data were adjusted for age, gender, smoking, body mass index, ethnicity, marital status, alcohol use and prior cancer. Hazard ratios (HRs) for death were computed so that any confounding effect of a preexisting health condition was controlled. Patients prescribed any hypnotic drug had a substantially elevated hazard of dying compared to no hypnotics. For groups taking 0.4 to 18, 18 to 132, and greater than 132 doses/ year, HRs were 3.60, 4.43 and 5.32 respectively, demonstrating a dose-response association. HRs were elevated in separate analyses for several common hypnotics, including zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates and sedative antihistamines. Hypnotic use in the upper third was also associated with a significant risk of cancer; HR=1.35. The death and cancer hazards associated with hypnotic drugs were not attributable to pre-existing disease. Particularly disturbing was the finding that receiving hypnotic prescriptions was associated with a greater than threefold increased hazard of death, even when used at less than 18 pills a year. This held in separate analyses for several commonly used hypnotics and for the newer shorter-acting drugs.
Natural sleep aids can help you get your zzzz’s
In last month’s column, I reviewed the research supporting the use of kava for insomnia. It’s certainly a herb that is actually better than its research suggests (mainly because not enough clinical studies have been done), and is my number one herb for better sleep.
Valerian is also a good option. Leathwood and Chauffard back in the 1980s demonstrated that Valerian extract improved sleep latency (time taken to fall asleep) and quality, in poor or irregular sleepers.7 Results from subsequent trials have been mixed, but overall do indicate a clear effect on subjective sleep quality.8 Recently, the Committee on Herbal Medicine Products of the European Medicines Agency concluded “…that aqueous ethanolic extracts of valerian root have a clinical effect in sleep disturbances as assessed by subjective ratings as well as by means of validated psychometric scales and EEG-recordings… There is quite strong evidence from both clinical experience and sleep-EEG studies that the treatment effect increases during treatment over several weeks.”9 In other words, the effect of valerian on sleep improves with continuous use, something not commonly understood. (EEG stands for electroencephalograph, and is one of the tests used to evaluate objectively sleep quality. Subjective sleep quality is related to how well the person assessed they slept, and whether they felt good the next day etc.)
The key Chinese herb for insomnia is Zizyphus seed (Suan Zao Ren), the Spiny Jujube. In a recent systematic review of randomized controlled trials of Chinese herbal medicine for insomnia, Zizyphus seed was evaluated as the most used (in 190 of the 217 identified clinical trials).10 Another systematic review of Zizyphus decoction on its own for primary insomnia found 12 clinical trials that overall indicated Zizyphus was more effective than benzodiazepines, but trial quality was noted to be poor.11
Naturally stimulate more melatonin
Many people suffer from difficulty staying asleep. They may wake up at say 2 or 3 am, and toss and turn for hours before they can get back to sleep. This is known as sleep maintenance insomnia and a lack of the hormone melatonin from the pineal gland is thought to play a key role here. As well as supplementing with melatonin (available on prescription only in the UK), there are herbs which appear to be able to boost natural levels.
In an uncontrolled trial with 13 healthy volunteers, a significant increase in nocturnal melatonin plasma concentration was observed after 3 weeks of dosing with St John’s Wort.12 Chaste tree can also boost melatonin. The circadian rhythm of melatonin secretion was measured in 20 healthy men aged 20 to 32 years after the intake of placebo or various doses of an extract of Chaste Tree for 14 days. Using an open, placebo-controlled study, the doses investigated were 120 to 480 mg per day of this extract (corresponding to approximately 0.6 to 2.4 g of dried berries). Total melatonin output was approximately 60% higher in the group receiving the Chaste Tree.13
For best results, I usually recommend having a dose of these herbs in the morning to prevent a buildup of tension or mental excitability during the day that might lead to insomnia. Then one hour before bed double the morning dose is taken to ensure a good night’s sleep. All the herbs mentioned here are safe to take throughout the day and do not impair performance (some even might enhance it).
To your better health,
Nutrition & Healing
Volume 7, Issue 12 – December 2013
Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.