Millions of people suffer from sleep difficulties such as insomnia, jet lag and other circadian disorders. In fact, sleep problems have increased in recent years, which is not least due to the emergence of the corona virus. It is reported that the consumption of herbal sleep aids has increased by 40 to 50 percent and sleep laboratories are overflowing. Unfortunately medicine provides few answers to these debilitating problems. Sleep disorders can have devastating effects on health. If the body doesn’t get enough sleep, the cells cannot repair themselves, a process that normally occurs during this period. It is believed to be a contributing factor to depression, heart disease, cancer and a wide range of health problems. Tissue growth and repair, hormone production and release, metabolic processes including balancing glucose levels, and boosting the immune system are just a few of the bodily processes that occur during sleep. While you are sleeping, the brain does its chores, which includes removing toxins from the day and consolidating memories.
Corona Pandemic and Sleep Disorders
Exceptional situations such as the corona pandemic can trigger different feelings such as fear, stress and insecurity, which affects our sleep. It has also been shown that sleep disorders can occur as a result of COVID-19 diseases. Many patients report difficulty falling asleep, waking up too early or poor sleep. Hypersomnias (excessive sleepiness during the day) and increased nightmares are also linked to the coronavirus. Studies have shown that some patients have abnormalities in REM sleep. These people showed increased muscular activity during this sleep phase. This could indicate that corona disease also affects the central nervous system. In addition, the consequences of the pandemic, both professional and economic, have contributed to the development of sleep disorders for many people. The negative effects of the pandemic were particularly evident in certain occupational groups (in the hospital and nursing sector), as these people experienced increased sleep disorders and depression.
Why Good Quality Sleep is Important
Physical health, cognitive performance, and mental well-being are closely related to sleep quality. Unfortunately, many people of all ages routinely fail to get the sleep they need. This can increase the risk of numerous diseases such as obesity, diabetes and heart disease, decrease cognitive performance and increase the risk of mood disorders. Conversely, restful sleep not only ensures a better quality of life, it also reduces the risk of developing diseases. Optimal sleep is associated with a 74 percent lower risk of cardiovascular disease. Other research has found that the duration and quality of sleep affects how the immune system works. This is because the immune system releases proteins, also known as cytokines, during sleep. This allows the body to better fight diseases and infections. If you don’t get enough sleep, the hormonal balance can also get out of control and metabolic diseases such as diabetes can be promoted. When we don’t get enough sleep, our bodies secrete more cortisol, a stress hormone that helps us stay awake and alert. Unfortunately, cortisol changes the way we process insulin and blood sugar. Chronically high cortisol levels can ultimately increase the risk of diabetes. Recent research has also found that a misalignment between the body’s internal clock and overall sleep patterns can make people more vulnerable to mental health problems, further demonstrating the link between sleep and emotions.
Sleep Disorders and Possible Causes
As we sleep, we go through four stages of sleep, with adults completing about four to five cycles a night. These stages include three progressively deeper sleep stages, followed by a fourth sleep stage that features REM (rapid eye movement) sleep, unlike the first three stages. Each sleep cycle lasts between 90 and 120 minutes. According to experts, sleep disorders can be defined as: “difficulty falling asleep or waking up frequently during the night when the person should be able to fall asleep and stay asleep”. Insomnia can be either acute or chronic. According to estimates, every tenth person suffers from the chronic form. Women are affected by sleep disorders more frequently than men, and older people experience these problemes often than young people. People who have suffered from insomnia can attest that it quickly becomes a vicious cycle: having trouble sleeping can lead to anxiety and stress, which can make those affected more difficult to fall asleep.
There are many causes of insomnia. In addition to severe stress, frequent travel, which is known to cause jet lag, too much rumination, and the consumption of stimulants such as coffee and alcohol can also interfere with sleep. In addition, the use of electronic devices is also counterproductive to our sleep. Genetic factors can also play a role. Thus, scientists have found that people with a certain mutation of the seventh chromosome are much more likely to suffer from insomnia. Known as RFX3, this gene seems to affect our sleep in several ways. A mutation causes affected individuals to have trouble getting enough sleep. Although genetics can play a role, sleep problems are usually due to a poor lifestyle or certain medical conditions. In fact, there are around 80 different types of sleep disorders that negatively affect our sleep.
Delayed Sleep Phase Disorder (DSPD)
In DSPD, the sleep-wake cycle begins at least two hours later than what is considered typical. This usually occurs in adolescents and younger adults (affecting up to 7 – 16 percent) and is associated with “night owls” who typically stay awake until the early morning hours and may sleep into the afternoon. People who suffer from this report chronic insomnia. They may also have trouble falling asleep. There may be a high incidence of DSPD in their family history. Although those with DSPD often get inadequate sleep when trying to adhere to a “normal” sleep-wake schedule, when allowed to adhere to their preferred sleeping schedule, they experience very stable sleep patterns.
Advanced Sleep Phase Disorder (ASPD)
Typically experienced by older adults, this disorder is essentially the opposite of DSP and is associated with “morning people” who wake two or more hours earlier than is considered normal — between 3 a.m. and 5 a.m. — and prefer to go to bed between 6 p.m. and 9 p.m. Many who experience this disorder are middle-aged, and the incidence of ASPD has been seen to increase with age. If they are allowed to adhere to their preferred sleep schedule, their sleep patterns are extremely stable.
Irregular Sleep-Wake Rhythm Disorder
Irregular Sleep-Wake Rhythm Disorder involves inconsistent sleep patterns with no correlation to day-night cycles. Those who suffer from this disorder typically have trouble falling asleep and staying asleep in addition to daytime sleepiness. This sleep disorder is most commonly seen in people with neurodegenerative health conditions such as Alzheimer’s disease, Huntington’s disease or Parkinson’s Disease.
Obstructive Sleep Apnea Syndrome
This syndrome has become relatively well known since it was first defined in 1972 by Christian Guilleminault. The term “apnea” comes from the Greek “apnoe,” meaning non-breathing. This syndrome is characterized by short periods of respiratory arrest during the entire night that repeat themselves. The upper airways of affected people are contracted during sleep, which often leads to snoring. Breathing is not possible, or only possible with great effort. Characteristics of an obstructive sleep apnea syndrome are at least five apneas or hypopneas every hour that last at least 10 seconds each. Many subsequent illnesses are linked to this syndrome such as cardio-vascular illnesses, high blood pressure, anxiety disorders, diabetes and depression. Those affected are primarily men between the ages of 30 and 60, but women are also affected. Obstructive sleep apnea syndrome is often discovered fairly late and occurs often. Possible treatment options include surgical intervention, intraoral protrusion splints or CPAP therapy.
Non-24-Hour Sleep-Wake Rhythm Disorder
With Non-24-Hour Sleep-Wake Rhythm Disorder, the body’s internal clock fails to reset, resulting in a consistently shifting sleep-wake cycle. Insomnia and daytime sleepiness are often symptoms of this disorder, which primarily affects those who are totally blind. In fact, nearly 50 percent of this group experiences Non-24-Hour Sleep-Wake Rhythm Disorder.
Shift Work Disorder
This is commonly experienced by those who work late night or early morning shift jobs. It is associated with feelings of sleepiness at work and an inability to sleep during the day and early evening when most others are awake. People who prefer diurnal (daytime) activity may be especially vulnerable since their natural inclination is to be awake during the day and sleep at night.
Jet Lag
Flights that pass over multiple time zones can cause a condition commonly known as jet lag, wherein a person’s internal clock must reset itself in relation to the local time. Symptoms of jet lag include trouble falling asleep and staying asleep and daytime sleepiness. Jet lag sufferers can experience symptoms for up to a week or two after travel.
Restless Leg Syndrome
This is a very common neurological disorder. This syndrome is characterized by a disturbance in the central nervous system. At the forefront of this problem are faulty feelings of pain in the legs, which is present in most affected people at bedtime. The pain is experienced differently from person to person (i.e. tingling, stabbing, pulling or tearing). Only movement brings relief from the pain. Women are affected twice as often as men and the syndrome is especially common among pregnant women in the last few weeks before birth. The cause is not yet fully explainable, but a genetic predisposition is assumed. Therapy utilizes dopamine-like substances, i.e. L-Dopa, or so-called dopamine agonists. If a disturbance in melatonin release is also partly to blame, that is still being intensively researched.
Hypersomnia – Narcolepsy
A special form of sleep disturbance is the need for more than seven hours of sleep. Due to factors that have not yet been completely explained, affected people must have more than seven hours of sleep in order to feel rested and rejuvenated. In the case of narcolepsy, patients are suddenly overcome by an intense need for sleep so strong that they immediately fall asleep. The causes for these sleep disturbances have not been fully researched to this day, but genetic factors and changes in certain messenger substances have been documented. A causal therapy is not yet available.
What is a Circadian Sleep-Wake Cycle Disorder?
A circadian sleep-wake cycle disorder can be defined as any disruption in the body’s internal clock, an inability of the internal clock to keep track of each 24-hour period, or a discrepancy between a person’s internal clock and the environment around them. People with such a disorder may experience any of the following problems:
- Sleep is neither refreshing nor restful
- Insomnia, difficulty falling asleep or daytime sleepiness
- Chronic sleep disorders such as waking up frequently or waking up too early and being unable to get back to sleep
- Significant impairment in mental, emotional, physical, social, occupational, or academic functioning
Sleep and the Aging Process
According to research, poor sleep quality is one of the significant factors that can contribute to accelerated aging. In fact, many important things happen in deep sleep; factors that can impact both aging processes and overall health. During deep sleep, toxins are flushed from the brain, including amyloid beta and abnormal types of tau, both of which are linked to Alzheimer’s disease and other types of dementia. Getting enough deep sleep helps to protect cognitive functions, including memory and learning. Deep sleep also promotes physical health and helps protect against disease in a variety of ways, including boosting the immune system. It is that time when tissue repair and growth takes place. Good sleep helps to reduce stress, promotes healthy hormone production — such as melatonin and human growth hormone — and helps to reduce the risk of obesity. All of these factors are critical to slowing down the aging process and maintaining youthful vigor.
As people get older, they notice a slow decrease in sleep, both in terms of amount and quality of sleep. For some, this can mean experiencing persistent sleep deprivation. A study in the field of chronobiology may have identified the reason for this. As people age, a group of neurons associated with sleep gradually dies. These neurons are located in the ventrolateral preoptic nucleus of the hypothalamus in the brain. Scientists think they may be guiding the circadian rhythm, one explanation for why older people often don’t get as much sleep as they really need. By identifying the neurons behind the lack of sleep in older people, doctors may be able to develop new treatments to help these people to get better sleep.
Natural Measures to Improve Sleep Quality
Positive sleep hygiene is essential to ensure a restful night’s sleep. For many people, prior to bedtime, focusing on relaxing activities like yoga, meditation, autogenic training, or progressive muscle relaxation helps to calm the mind. In order to promote a healthy circadian rhythm, it is also important to stick to regular waking and bed times. Circadian rhythms influence countless bodily processes, down to the daily activities of a single cell. Our circadian rhythm helps to regulate sleep and wake times and is influenced by external cues.
Sleep experts also recommend avoiding strenuous physical activity in the hours before bed and moving exercise to the earlier hours of the day to avoid arousal. The use of electronic devices of all kinds should also be avoided before going to bed, as this can suppress the body’s natural release of melatonin. Stimulants such as alcohol and caffeine disrupt sleep, as do heavy meals, and should therefore not be consumed in the evening hours. Instead, it is advisable to drink herbal teas or warm milk with honey. Homeopathic remedies which contain hops, valerian, chamomile and lemon balm also have a sleep-inducing effect.
Getting some bright morning light daily is also important for better sleep. Increase your natural light exposure throughout the day, even if it’s just through a window. This can be a bit difficult, especially in the dark months of the year. Light therapy is an uncomplicated, effective method with no side effects in the treatment of sleep disorders. Luminous intensities of 2,500 to 10,000 lux are used. As a natural timer, high levels of light influence the body’s hormone balance and thus the circadian rhythm. This rhythm is deliberately set before and/or after. The circadian rhythm is shifted backwards when falling asleep and waking up early, and forwards when falling asleep and waking up late. With this method, improvements in sleep quality and general well-being can be achieved within a week. Unfortunately, this form of therapy only works for those people who still produce enough melatonin.
Research has also shown that the right diet can improve your sleep patterns, leaving you feeling rested and ready for the day ahead. For example, a study published in the Annual Review of Nutrition found that a diet rich in fruits and vegetables, coupled with legumes and whole grains, was associated with good quality sleep. A 2020 review of 19 studies found that diets higher in protein and lower in carbohydrates and fats were associated with better sleep quality. It has also been found that people who ensure adequate fiber intake spend more time in deep sleep than those who do not. Tryptophan also has a positive effect. This sleep-promoting hormone puts the body into a deeper state of sleep after increasing sleepiness. Good sources of tryptophan include turkey, chicken, pumpkin seeds, cherries, kiwi, eggs, seeds, and nuts. Vitamin B12 is a component of melatonin production, the hormone that naturally induces sleep. Vitamin B6 is also significantly involved in serotonin production. Finally, research has shown that eating too much sugar can lead to more frequent nighttime arousals. Scientists believe this is due to unstable blood sugar levels disrupting the body’s natural sleep cycles. Saturated fat is also associated with less frequent amounts of deep sleep, the type of sleep that restores the body.
The Role of Melatonin in Sleep Disorders
Sleep problems should not be ignored at any age, especially for older individuals who wish to maintain their health and well-being. Regardless of age, natural methods often don’t work to ensure a good quality sleep. Therefore, many people resort to sleeping pills. However, over-the-counter and prescription sleeping pills are usually not a good alternative, as they are associated with a number of side effects. This is where melatonin supplementation comes into play.
The pineal gland naturally produces melatonin in response to low light levels. Production of this hormone begins when the brain senses that the surrounding area has gotten darker and continues through the evening and night hours. As the sun rises and it gets lighter, the amount of melatonin that the pineal gland produces decreases and eventually stops altogether.
For decades, researchers have studied how melatonin production helps the brain to regulate sleep patterns. This early research led to melatonin supplements thought to promote sleep, which particularly helps people who have trouble sleeping due to shift work or jet lag. Likewise, people who suffer from insomnia may also benefit from taking a melatonin supplement, as extra melatonin increases hormone levels in the brain. Many health disorders could be due to an imbalance in melatonin levels. For example, seasonal depression is usually related to melatonin being made earlier or later in the day as light is often obscured during the cold months. In addition, many older people suffer from a slow decline in melatonin levels, leading to insomnia and problems staying asleep.
Pulsatile Controlled Release
Current research suggests that a unique formula, also known as pulsatile melatonin release, may be the answer to many people’s sleep problems. Melatonin has a very short half-life, as half of the hormones released are gone from the bloodstream after just 20 minutes. As a result, it’s not just released once a night, but rather in multiple spurts. In order to fall asleep and stay asleep, a large amount of the hormone must first be released, followed by smaller amounts throughout the night. Supplements that release melatonin in bursts immediately release large amounts of the hormone, followed by smaller amounts over the next seven to eight hours. This is enough melatonin at the beginning to fall asleep, and the permanent supply of melatonin also ensures sleeping through the night. The goal of this type of melatonin release is to keep melatonin levels at a certain level throughout the night to mimic the body’s natural (healthy) release pattern as closely as possible.