You’d think that something as natural as sleep would come easily, but millions of people around the world, of all ages, creeds and races, battle with the ability to get some shut-eye: from trouble falling asleep, to frequent awakenings, to waking up in the middle of the night and not being able to get back to sleep. Luckily for some, herbal treatments, supplementation with melatonin or learning to reschedule your body clock, normally do the trick. Taking a prescription sleeping tablet should be your last resort.
For years, insomnia has been conceptualised mainly as a psychological disorder caused by psychosocial stress and then maintained by maladaptive (out of the norm) behaviour and conditional arousal. However, several studies have reported that sleeping is intricately linked to neuropeptides, which are small protein-like molecules used by neurons to communicate with each other, influencing the activity of the brain in specific ways. Various hormones (peptides and steroids) play an important role in sleep regulation, regulated in part by GABA, one of the main brain neurotransmitters that calms the nervous system. As such, it’s now known that insomnia could be a genetic vulnerability to an imbalance between arousing and sleep-inducing brain centres that go on to promote maladaptive behaviour and learned sleep- preventing associations.
The hypothesis that sleep is regulated by humoral mechanisms (bodily fluids) was first loosely proposed by Aristotle who stated that vapours emanating from the stomach during food digestion were transported throughout the body to cause sleepiness. It was later confirmed that our circadian rhythms – our wake/sleep cycles – result from the interaction of humoral and neural mechanisms regulated by our central nervous and endocrine systems.
Until fairly recently, most studies on sleep have been performed selectively in men. This is because females are more heavily influenced by cyclic sex hormones that may affect sleep-wake structures. Indeed, women often develop sleep disturbances in association with ‘womanly’ events, such as during ovulation, pregnancy and menopause, because their hormone levels go out of kilter.
Insomnia is one of the most frequent complaints of women in their menopausal years due to the sharply declining output of progesterone and estrogen by the ovaries.
Now, numerous studies have examined the effects of progesterone on the quality of sleep in women reaching, within or past their menopausal years. Using EEG (an electroencephalogram to study the electric current within the brain), the researchers found that progesterone enhances the activity of GABA, producing a sleep brainwave pattern similar to that of tranquilisers.
Commonly prescribed sleep medications contain a benzodiazepine or a benzodiazepine derivative, which increases sleep duration but may inhibit deep sleep and thus deteriorate sleep quality. In addition, these medications may have side effects such as dizziness and mental confusion, and, when used on an ongoing basis, can result in addiction. Benzodiazepines are central nervous system depressants that work by enhancing the actions of GABA at its receptor, inducing muscle relaxation and promoting sleep. Scientists have found that progesterone promotes a benzodiazepine-like effect on sleep in women. Consult your doctor as oral progesterone is available on prescription only. It’s recommended to take oral dosages of micronised progesterone at night of no more than 50-100mg.
- Fix a regular bedtime
- Avoid napping during the day, if possible
- Avoid alcohol, caffeine and heavy, spicy or sugary food 4-6 hours before bedtime
- Exercise regularly, but stop at least two hours before bedtime
- Use comfortable bedding
- Find a comfortable temperature setting for sleeping and keep the room well ventilated
- Block out all distracting noise, and eliminate as much light as possible
- Reserve the bed for sleep and sex
- Try a light snack before bed, like warm milk and bananas
- Practise relaxation techniques, such as yoga or deep breathing, before bedtime
- Don't take your worries to bed
- Establish a pre-sleep ritual, such as a warm bath or a few minutes of reading
- Avoid working with electrical equipment close to bedtime.
Also see Sleep Support
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