Supplements for Sleep
46% of women report sleep disturbance every night
Insomnia affects more than one in 25 women in the US- over 25%. One of the first studies done regarding women and insomnia actually found a rate of 46% of women reporting sleep disturbance nightly [1]. And the lifetime risk of insomnia, meaning experiencing sleep disturbance consistently at some time in your life, is over 40% if you are female.
What qualifies as insomnia?
Chronic insomnia- lasts a month or longer
Acute insomnia- lasts a day or days, or weeks
Comorbid insomnia- associated with another disorder
Type 1 or onset insomnia- difficulty falling asleep
Type 2 or maintenance insomnia- inability to stay asleep
So why do women have a bigger issue with insomnia than men? Turns out a lot of it is biological- female hormone changes can lead to sleep disruption, particularly at times of major change like pregnancy, postpartum, and menopause. One example of this is sleep apnea- men and women can both have it, but it’s more commonly diagnosed in men because women experience symptoms differently.
One study showed that women with OSA complain of symptoms such as insomnia, restless legs, depression, nightmares, palpitations, and hallucinations whereas men are more likely to report snoring and apnea episodes [2] This may be the reason for under-diagnosis in women, but the same study showed a difference in the physical obstructions that cause apnea in women vs men as well.
Another common cause of insomnia is RLS, which is commonly caused by nutrient deficiencies and much more commonly reported in women than in men.
Aside from the obvious reasons about why sleep is important- being able to function cognitively the next day and have energy and be alert- insomnia over the long term has been shown to affect multiple health factors. It makes you more likely to develop:
stroke
asthma attacks
seizures
a weakened immune system
obesity
diabetes mellitus
high blood pressure
heart disease
hormone imbalance
depression and anxiety
low libido
So how do you figure out what the cause of your insomnia is? The best way to address persistent sleep issues is to look at the same underlying causes you would for any sort of chronic, low-grade inflammation. This means addressing diet, stress management, and other lifestyle factors.
Lifestyle Impacts Sleep to a Large Degree
As a society we now spend the vast majority of our time indoors, and the human body was developed to be outside more, which means our natural rhythms are synced with the sun.
We have specific receptors in our eyes that gauge the brightness, hue, and angle of the sun, and these receptors tell our body if it’s time to be waking up or heading to bed, cuing the brain to produce the appropriate hormones. If you are waking up before the sun rises, and want to be awake, it’s ideal to turn on bright artificial light, especially at eye level rather than overhead. Table lamps or a ring light at your work station or desk are a good way to implement this recommendation. Once the sun does rise, getting outside and viewing sunlight directly for about 10 minutes is ideal.
Doing this again in the late afternoon or evening- viewing sunlight- is the other half of the equation. It’s important that during this time you aren’t in the shade, or wearing sunglasses or a hat. Of course you also shouldn’t look directly at the sun, you just need to be facing it. Remember to turn indoor lights off once the sun sets, and try using low light lamps in the evening rather than bright overhead lights leading up to bedtime.
Keeping a sleep wake schedule that’s more or less the same each day is also important. Often times we stay up much later and sleep in much later on weekends than we do during the work week, and this is confusing to our circadian rhythm. Going to bed at night when you first feel sleepy is important and pushing through that can cause early waking.
To mention the obvious, avoiding caffeine within 8-12 hours of bedtime, avoiding alcohol before bed (yes it can help with falling asleep initially but will cause poor quality sleep the rest of the night), and limiting daytime naps are also things to consider.
You can’t out-supplement poor lifestyle choices
Sunlight exposure is essential to good sleep
Supplementing with building blocks for sleep hormone is ideal
Herbs can help initially but will not fix underlying causes of insomnia
The Best Supplements for Sleep
You can take supplements that will help turn on the relaxing neurotransmitters in your brain which will lead to sleep, or you can take supplements that lead to more of an induction of sleep the way a sleep medication would. Depending on your insomnia and the reason behind it, one may be a better choice than the other.
Amino Acids for Sleep
5HTP- 5HTP is an amino acid needed to make serotonin, and serotonin is required for melatonin production. Sometimes it’s just a matter of not having the building blocks we need, and if this is the case then 5HTP can help. Doses vary for 5HTP- start at 50 to 100mg and increasing every 4 to 5 nights until you find a dose that’s beneficial. I don’t typically recommend melatonin- it can disrupt other sex hormones, there is the potential of becoming dependent on any exogenous hormone taken regularly, and it doesn’t help uncover any underlying nutrient deficiencies.
L-Theanine- This is an amino acid that’s also responsible for boosting levels of GABA, but it also lowers levels of excitatory brain chemicals, and is known for enhancing alpha brain waves- these are the brainwaves experienced right as we drift off to sleep. Doses of 100-400mg can help with sleep. If you are prone to very vivid or lucid dreaming, sleepwalking, or night terrors, it may be best to avoid L-theanine before bed.
Glycine- Glycine been shown to improve slow wave sleep, or deep sleep, which is the stage of sleep right before REM. Slow wave sleep is when we produce growth hormone and repair damage done to our bodies during the day. Glycine also helps to slightly lower body temperature, which is an important factor in falling and staying asleep. Doses of 1-2g 1 to 3 nights a week are recommended.
Minerals for sleep
Mageneisum- L threonate or bisglycinate are best for sleep at 200-400mg about a half hour before bed. This can help with relaxing the brain so anxiety issues, but also muscles and nerves. Magnesium increases GABA, your brains main relaxing neurotransmitter, and also helps regulate the stress response system- low magnesium is related to high anxiety. If you get “monkey mind” or feel wired but tired at night, magnesium can often help. Frequent waking in the night has also been shown to be alleviated by magnesium.
Calcium- Levels of this mineral are higher during REM sleep, which is when we dream- this is the stage of sleep that, if too short or missed entirely, often leads to brain fog and slow mental state as it’s when the brain sort of washes itself clean for the next day. Disturbances in REM sleep have been linked to calcium deficiencies. Calcium also works with hydroxytryptophan - 5HTP- to produce melatonin.
Lithium orotate- This is a relaxing mineral that helps to regulate the circadian rhythm and sleep wake cycle. It’s also extremely helpful with depression (NOT to be confused with lithium carbonate, which is the prescription used for bipolar disorder and has horrible side effects). Doses of 15-150mg a day can be helpful. Starting low and slowly increasing is the best way to find your best dose.
Herbs for Sleep
Valerian root- Sometimes referred to as “nature’s valium”, valerian root has been shown to reduce activity in the brain’s motor cortex as well as increasing binding for GABA, serotonin, and adenosine receptors. Doses between 300-600mg about a half hour before bed seem to be effective for many. Valerian also often comes in a tincture.
Passionflower-Another herb often used for relaxation and sleep, passionflower can enhance levels of GABA in the brain. It’s usually found in tea or tincture form.
Holy basil- Also known as Tulsi tea, this is an adaptogenic herb that is also known to help with anxiety and depression. 300 to 2000mg about a half hour before bed is what’s recommended.
Kava- a stronger herb and not appropriate for everyone, you should avoid alcohol and any sort of benzodiazepine prescription with kava. Kava helps promote deep sleep without negatively impacting REM sleep.
Sometimes herbs work better synergistically than solo.
Deep sleep- A blend by Herbs, etc. combines California poppy, passionflower, valerian, chamomile, lemon balm, milky oat, and orange. One of my favorites, but you have to make sure you have at least 8 hours to devote to sleep or it can leave you hungover and groggy.
Wish Garden Sleepy Nights & Fresh Mornings- This blend contains passionflower, skullcap, hops. They leave out valerian and kava on purpose so this one you can take even later in the evening or if you were to wake in the middle of the night and not go back to sleep.
Wish Garden Serious Relaxer and Muscle Tension- this one does contain valerian, as well as passionflower, hops, and some others. A great blend after a rough day physically or mentally.
Wish garden makes these in versions safe for pregnancy and children as well!
Most of these herbs come as teas and are safe in those smaller doses! Yogi tea makes a bedtime tea that combines Passionflower and chamomile. It’s probably my favorite bedtime drink.
Keep in mind that herbal effects generally build over time and the best results are typically realized after about 3-7 days of consistent use.
What about Melatonin and GABA?
You can certainly take melatonin and GABA directly, but don’t do it too often. It’s better to allow your body to build neurotransmitters and hormones on its own. Taking GABA once or twice a week at about 100mg is safe for most people. Melatonin, on the other hand, has been shown lately to possibly affect sex hormones and is not recommended for people under 40 and for women in general.