Our last look at sleep and its relation to brain health offered several tips for optimizing the quality of sleep. See Good Sleep = Good Brain (1). Here you will get tips on how to replace problematic over the counter (OTC) & prescribed sleep aids and why you would want to do so.
Researchers tell us that sleep quantity and quality is at an all-time low and the number of people who suffer from poor sleep is increasing. No wonder so many turn to medications for help. Unfortunately, the efficacy of these medications is in serious question and the demonstrations of detrimental, even dangerous side effects are mounting.
Benzodiazepines, including Valium, Xanax, Ativan, etc., the most commonly prescribed class of anti-anxiety sleep aids, have been shown to give a slightly quicker drop-off to sleep (10 minutes) and slightly longer sleep (15-20 minutes), but the downside far outweighs the minimal gains. The reality of the quality of sleep when measured objectively in scientific settings was that the drugs caused “fragmented sleep” – meaning frequent wake-ups, disrupting the healthy sleep cycle and, in turn, thwarting the much needed deep dive into the restorative sleep stage, where the “clean-up” takes place.(1) There is also an “amnesic effect,” wherein the subjects could not recall their sleep experience to report the quality of it.
More worrying from a brain-health perspective was a raft of studies that showed use of these hypnotics for longer than three months caused a 51% increase in the incidence of Alzheimer’s Disease. Dizziness, unsteady gait, and falling were all associated as well. (2) But most alarming was the significant increase of premature death (360%-500% greater risk, the greater number of pills per year, the higher the risk) and likelihood of developing a new cancer (35% more likely than non-pill takers), as reported in The Dark Side of Sleeping Pills, an e-book by Daniel Kripke, MD. (2)
There are a number of other OTC and prescribed medications that address pain and/or induce drowsiness that are used by many as sleep aids. These include anticholinergics such as Benadryl, Dramamine, Excedrin PM, Nytol, Sominex, Tylenol PM, and Unisom. More detail can be found in the articles referenced below, but without overwhelming you with statistics, suffice to say that these also have short term downsides such as dizziness, daytime drowsiness leading to an increase in auto accidents, ineffectiveness after two weeks and most notably, severe cognitive decline when used over a long time. (3)(4)
All of these ominous side effects have made many physicians reluctant to recommend or prescribe them, but desperate patients beg and insist. If you are taking them, work with your doctor to get off of them safely. Below are some alternatives backed by scientific studies.
Most important to quality Z’s are the daily habits of sleep hygiene, internal & external, listed in Good Sleep = Good Brain.(1) In addition to the powerful brain benefits, improved mood, lower stress, and a lowered risk of heart disease, diabetes, stroke and obesity are associated with sufficient & good quality sleep.
Healthline put together a list of natural sleep aids which are widely considered to be safe, with scientific references for each. Listed here are their top four. Check out the whole article online for the scientific research references and the longer list.(5)
Melatonin is a hormone produced in the brain by the pineal gland and it signals the brain that it’s time to sleep. Its natural cycle is to rise in the evening and fall in the morning, with the waning and waxing of sunlight. Its production is acutely responsive to all light stimulus, which is why we are encouraged to keep our sleeping chambers completely dark and avoid “blue light” in the evening. Melatonin production is too easily turned off by light that is perceived as daylight by the brain.
A melatonin supplement is the most frequently recommended natural sleep aid. The “brain doc’s”, the MD’s who specialize in brain health, especially dementias, have endorsed it fairly universally, making it a good first choice.
The generally suggested dosage is 3–10 mg of melatonin before bedtime. Start low and see how you do. It is considered safe to increase to 10 mg per night. Some people have noticed more vivid dreams.
2. Valerian Root
Valerian is one of the most commonly used sleep-promoting herbal supplements in the US and Europe. It is often found in capsule form in combination with others slumber inducers such as melatonin and magnesium.
Recent reviews “reported that 300–900 mg of valerian taken right before bedtime may improve self-rated sleep quality.” (5)
Magnesium, a very important mineral, is involved in multiple processes in the human body, many critical for healthy brain and heart functions. Magnesium is believed to help quiet the mind and body, relaxing both for better repose.
“Studies show that magnesium’s relaxing effect may be partly due to its ability to regulate the production of melatonin, a hormone that guides your body’s sleep-wake cycle. Magnesium also appears to increase brain levels of gamma-aminobutyric acid (GABA), a brain messenger with calming effects. Studies report that insufficient levels of magnesium in your body may be linked to troubled sleep and insomnia.”(5)
Magnesium can be found in capsule, tablet, and powder forms. Be sure to choose one that is recommended for sleep, as it can be used as a laxative as well, and different formulations of magnesium will have different effects.
Lavender oil has a soothing fragrance that is believed to encourage relaxation and sleep. Some studies have shown that smelling lavender oil for 30 minutes before sleep may be enough to improve the quality of sleep.
Lavender aromatherapy may help decrease anxiety and thereby promote sleep. It can be found in sprays that can be used in the bedroom, bath salts for a before-bed soak, or essential oil, which is quite concentrated and should be used very sparingly. Use genuine lavender, not a synthetic. It is very available and reasonable in price.
In summary, the most important delivery system of genuinely restorative rest is good sleep practices. Sleep at least 6 hours per night – know your body and its needs! Avoid caffeine after 2PM. Turn off “blue light” screens, TV & computers, for a least an hour before bed. Sleep in a totally dark and cool room, keep the electronic devices at least three feet from your sleeping space. Alcohol and heavy meals in the evening are “sleep disruptors,” and therefore to be avoided close to bedtime!
Simple solutions aren’t always easy when it seems like a lot of changes need to be made. But good sleep is a priceless ingredient in our overall health & well-being! Wishing you deep sleep & sweet dreams!
2. The Dark Side of Sleeping Pills, an e-book by Daniel Kripke, MD.