Sleep that knits up the ravell鈥檇 sleave of care,
The death of each day鈥檚 life, sore labour鈥檚 bath,
Balm of hurt minds, great nature鈥檚 second course,
Chief nourisher in life鈥檚 feast.
If you recall your Shakespeare, those lines were spoken by Macbeth. It seems the Bard recognized the importance of sleep and current science does corroborate that it is indeed a 鈥渘ourisher in life鈥檚 feast.鈥� Sleep deprivation affects memory, ability to concentrate as well as emotions. Lack of sleep can cause fits of anger and increase reaction time when driving. But there is more. Risk of heart disease, type 2 diabetes, hypertension, mood disorders and impaired immunity have all been linked with poor sleep. The scientific consensus is that adults need 7-8 hours of sleep a night, but surveys show that about one third do not get enough sleep and are keen to try various approaches that may help.
There is no lack of studies that have explored sleep aids but unfortunately there are no universal solutions. There is reasonable evidence that blue light emitted from television, computer and cell phone screens affects the secretion by the pineal gland of melatonin, the hormone that signals the body to fall asleep. The recommendation is to turn off screens two hours before bedtime, advice that most people these days find difficult to follow. The wealth of television programs available, and the thirst for information and entertainment provided by computers are just too seductive. Something else that is seductive is taking a melatonin supplement. The research here is not conclusive, but points toward 1-3 mgs taken 3-4 hours before the intended sleep time possibly being beneficial. However, there is the usual caveat with supplements: labeling is unreliable since dietary supplements are not regulated as drugs. One study found that in the melatonin supplements assayed, the actual quantity of melatonin ranged from 74-347% of the labeled quantity and 88% of products were inaccurately labeled.
Over the years all sorts of simple remedies have been tried. Chamomile tea has some evidence although mostly anecdotal. It does contain apigenin, a compound that binds to benzodiazepine receptors in the brain, the same ones that drugs such as Valium (diazepam) and Ativan (lorazepam) bind to for the treatment of anxiety and insomnia. A glass of warm milk is said to help because it contains the amino acid tryptophan that the body converts into serotonin, which in turn is converted into melatonin. The amount of tryptophan in milk though is very little, so any benefit attributed to drinking warm milk is likely due to a placebo effect. Poultry, eggs, nuts and cheese are better sources of tryptophan although these are also unlikely to contain enough for a physiological effect. The Thanksgiving turkey dinner inducing sleep is a myth. The real reason for the post-meal sleepiness is more likely the alcohol and the large amount of food, especially carbohydrates consumed during the meal.
However, a recent study linked dairy products and lactose intolerance to disturbing dreams and nightmares that interfere with sleep. On the other hand, some studies have shown a beneficial effect by drinking tart cherry juice before bedtime. While it does contain some melatonin and tryptophan, the amounts are too low to be significant. The hypothesis is that procyanidins in the juice prevent the degradation of naturally circulating tryptophan and that would help with insomnia. Other supplements with some but certainly not conclusive evidence include cannabis, magnesium, L-theanine, glycine and valerian. No harm in a short-term trial. And if all that fails, count sheep. Good night!
