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Are you getting enough sleep?

The UK population are getting less shut-eye than ever before and it’s ruining our health! Over a decade ago the World Health Organisation (WHO) highlighted the problem of the 'sleep loss epidemic' on health. But things haven’t got better: The Mental Health Foundation published a UK-wide sleep report surveying over 6,700 adults which concluded that two thirds of adults were not good sleepers and not getting the recommended 8 hours of sleep a night and that 36% had chronic insomnia. In general, there has been a global rise in sleep disorders such as insomnia and sleep apnoea, but also, put simply, those who have the capacity to sleep well just aren't sleeping enough. Adults in the UK average just 6 hours and 49 minutes a night, meaning that since a study in 1942 found under 8% of the population was trying to survive on six or less hours, it's now rocketed to almost one in two of us.2

So how can you tell if you’re getting enough quality sleep? It isn’t just for how long we can sleep – if you’re one of the lucky ones who can sleep for 6-8 hours straight through you may still not be getting the full benefits. Everyone is different in terms of the sleep quantity they need but you can gauge your overall sleep quantity and quality by how you feel when you wake up.

If you can say, hand on heart, that within 10 minutes of waking you feel ready to take on the day ahead (without the use of a pick-me-up such as caffeine or nicotine) then you have had a good night of quality sleep. However, if your get-up-and-go doesn't surface for an hour or two (or doesn’t get started during the morning!), then you are not getting the restorative sleep quality that you, your mind and body needs to function at your peak during that day and also to maintain long-term health.

Yawn

So why is sleep important?

In recent years, quality sleep (i.e. the ability to achieve the deeper sleep cycles several times during a night) has been shown to underpin the mechanisms and pathways that keep our cells, organs, receptor and hormone systems in optimum health. In turn, sleep deprivation is now linked to nearly every chronic inflammatory disease, from obesity to Inflammatory Bowel Disease , ; cancer to diabetes , ; heart disease to Alzheimer’s disease. There’s no getting away from it – quality sleep is important no matter who you are!

So why aren’t we sleeping enough?

Modern lifestyles mean that we are digitally connected more than ever before. Use of technology is now a 24h activity and this hyperconnectivity means we are never truly away from the office or from pressure in our everyday lives and our brains can never truly “switch-off”.

Technology interferes with sleep in two ways:

1. Blue light emitted from smart phone, laptop, tablet and plasma television screens interferes with melatonin production, the hormone that should naturally rise during the evening as it gets dark to signal impending sleep. Using technology in the evenings means that the blue light essentially acts as a daylight trigger to the pineal gland deep inside the brain, suppressing melatonin levels and waking us up. This means we either can't get to sleep (Type 1 insomnia) or if we do sleep then melatonin can’t do its other jobs of cellular and DNA repair.

2. Being plugged into technology nearly 24/7 can leave us stressed; whether it’s social media, work or simply sitting around idly surfing the internet, we are stressing our brains and bodies by what we see, read and the sedentary behavior induced by most technology use.

From whatever source, stress raises cortisol levels in the body; this is another hormone that should work in sync with our 24 hour diurnal rhythms, otherwise known as circadian rhythms – the cycles of hormone release that help us fall asleep, wake up, stimulate appetite and all the important metabolic regulations that keep us healthy.

Simply put; high levels of cortisol in the evening, especially coupled with low melatonin, are a recipe for sleep disaster! Ideally we want low cortisol in the evening with levels rising through the night so that they peak around 6.30am, as part of our natural response to wake up which also includes daylight hitting our eyes to suppress melatonin levels.

Other reasons for sleep poverty include long commutes, sedentary behavior through the day with office-based jobs and fatigue through working long hours (shift work is the worst culprit for sleep poverty and health ); poor sleep is also likely to reduce our inclination to exercise. For many people, the continual overriding of the natural day-night cycle and their circadian rhythms through late nights, irregular bedtimes coupled with use of dietary stimulants like caffeine, medications and alcohol, all impact restorative sleep. All areas of our lifestyles are therefore impacting on our ability to sleep, sleep quality and our long-term health.

You could argue, however, that in the 21st century, technology and medical discoveries has made us more self-aware of our health and the need to get better sleep. Wellbeing and nighttime/sleep apps for smart phones are becoming increasingly popular and help us continually monitor our health. But are we trying to be too clever by overriding our body’s basic needs, such as a regular bedtime and wholefood diet, by using technology and the latest quick fixes to boost energy, such as coffee with added MCT coconut oil?

It’s important to remember that sleep is not like the bank where you can accumulate a “sleep debt” then catch up and pay it off another time. Every night’s sleep counts in the quest to maintain our health.

So what solutions can you implement to halt this ‘sleep loss epidemic’ and improve your long-term health?

Worryingly, NHS spending on sleeping pills is on the rise increasing by 17% in the last year , but these classes of addictive sedative hypnotic drugs (including benzodiazepines like temazepam and zolpidem) are most definitely not the answer, Yes, they may mean you can ‘black out’ but this is not the restorative, refreshing and quality sleep that your body needs for repair. Sleeping pills, as well as alcohol, block your ability to reach the deeper stages of sleep including REM (Rapid Eye Movement) sleep cycles; around 4-6 REM sleep cycles in the early hours of every morning are required for quality sleep.

There are plenty of lifestyle habits we can change to help us get better sleep. For example:

• Avoiding technology 1 hour before bed.
• Avoiding caffeine after 2pm and getting to bed similar time each night.
• Ideally switching lights out by 10.30pm.

All these actions can vastly helps to improve our sleep patterns.

And what about the proliferation of herbal and food supplement products? A frequent flyer favourite in the US is melatonin supplements; these are not legally sold in the UK so will not be discussed in this blog. However, there are other vitamins, minerals and nutrients that can work together synergistically, along with lifestyle changes, to help you achieve that successful slumber.

5-HTP and successful slumber

5-HTP (5-Hydroxytryptophan) is the amino acid your body makes from tryptophan, an essential amino acid found in the diet and also the precursor to the neurotransmitter serotonin and hormone melatonin (see image below).

Chart

We have already discussed the importance of melatonin for sleep; serotonin is a neurotransmitter also involved in regulating sleep, as well as mood and many other areas of health including heart and gut. Serotonin deficiency can lead to mood disorders, such as anxiety, emotional instability and depression, as well as gut and heart problems. So if you’re low in 5-HTP then your body is going to struggle to make serotonin and melatonin therefore affecting sleep and also your mood.

Tryptophan can be found in foods such as egg white, turkey, lamb, chicken, milk, nuts, oats, and cheese and superfoods such as seaweed and spirulina. In theory, eating these foods should help your body produce enough serotonin and melatonin, but tryptophan does not easily cross the blood brain barrier. In fact, most of the available serotonin in the body is found in the intestines and it cannot easily cross the blood-brain barrier to help in the production of brain-derived melatonin for sleep. This means that the brain requires its own supply of 5-HTP, which can cross the blood brain barrier with ease, to produce sufficient melatonin levels in the pineal gland.

Tryptophan is best derived from the diet; it’s not available as a single amino acid supplement. 5-HTP, however, whilst not present in food can be taken in a natural supplement form derived from the seeds of an African shrub know as Griffonia simplicifolia boost brain levels of melatonin and serotonin to support sleep, as well as boost mood and reduce anxiety. One human study showed that 5-HTP supplement significantly reduced the time it took to fall asleep, increased sleep duration and improved sleep quality. These results are corroborated in a recent study.

Magnesium and sleep

Magnesium is an essential mineral that is needed for many areas of health, including stress reduction and sleep. It helps cells produce ATP, activates enzymes required for production of hormones including melatonin, as well as aiding muscle relaxation.

But are you getting enough magnesium in your diet? Magnesium deficiency is more common that you think so supplementing your diet with an organic form such as magnesium citrate can help boost levels of this essential mineral. For more information about magnesium, sleep, health and bioavailable supplement forms, please enjoy the Nutrigold blogs on this subject:

Simply Magnesium Part 1

Simply Magnesium Part 2

Herbal extracts to support sleep

Tea

There are some well-known herbal remedies for promoting better sleep with one of the most popular being a cup of chamomile tea before bedtime. Chamomile is widely regarded as a sleep-inducer, in part due to the flavonoid, apigenin that binds to benzodiazepine (BZD) receptors in the brain in such a way as to promote health sleep cycles. This helps improve sleep quality but without the addictive side effects of prescription BZDs. Chamomile also has other therapeutic benefits in diverse health areas including hay fever, inflammation and gastrointestinal disorders.

Passionflower (Passiflora extract) may help treat anxiety and insomnia as supplement extracts appear to boost the level of gamma-aminobutyric acid (GABA) in your brain; a compound that calms brain hyperactivity so may help you relax and sleep better. One study has shown that passionflower extract in combination with chamomile had hypnotic-like activity when sleep was disturbed.

L-Theanine

L-theanine is the amino acid found in green and black tea leaves, as well as some other food sources including some types of mushrooms. In fact it’s the compound that is associated with the calming benefit that is often described when drinking a cup of tea. However, tea contains caffeine, which for many people can lead to overstimulation of the nervous system and may lead to difficulty getting to sleep. For this reason, supplementing with L-theanine, alongside other nutrients that help promote sleep, can be a better alternative to staying awake during the night with caffeine jitters!

Research shows that L-theanine calms the brain and nervous system in several ways: L-theanine boosts GABA levels and other calming neurotransmitters including serotonin and dopamine; it lowers the levels of excitatory neurotransmitters including-glutamate; enhances alpha brain waves that are associated with the state of relaxation such as you may experience when mediating, being creative, as well as during REM sleep. , Therefore, L-theanine is commonly associated with improving sleep and reducing stress and anxiety.

Vitamins for sleep

The conversion of 5-HTP into serotonin and melatonin (as outlined in the serotonin/melatonin conversion pathway) requires vitamins such as Vitamin B6 and Vitamin C. Vitamin B6 is best supplemented in the bioactive P5P form, alongside 5-HTP. Zinc and magnesium also help in the enzymatic conversion; organic citrate forms of these minerals improve their absorption and bioavailability in the body.

So are you getting the best night’s sleep for your health?

Here’s the Nutrigold summary to great sleep:
• Switch off from technology at least 1 hour before bed.
• Create a calming bedtime routine.
• Have soft lighting around the house before bedtime.
• Go to bed roughly the same time every night and ideally lights out by 10.30pm.
• Avoid caffeine after 2pm and avoid alcohol.
• Enjoy foods naturally high in tryptophan everyday.
• Take a natural plant based supplement containing 5-HTP, passionflower and chamomile extracts alongside organic minerals and vitamins to promote melatonin production.

Happy slumbers!

Sleep

References:

1 WHO Technical meeting on sleep and health (2004) Full paper
2 https://www.nhs.uk/news/lifestyle-and-exercise/sleep-problems-in-the-uk-highlighted/
3 Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of sleep disruption. Nature and Science of Sleep, 9, 151–161 Full paper
4 Marshall (2015) The sleep loss epidemic: hunting ninjas in the dark. J Sleep Res 24:1-2 Full paper
5 Shitri (2018) Sleep Disturbances Can Be Prospectively Observed in Patients with an Inactive Inflammatory Bowel Disease. Dig Dis Sci 1:6 View abstract
6 Ali et al (2013) Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients. Inflamm Bowel Dis 19:2440–244 View abstract
7 Kwekkeboom (2018) The Role of Inflammation in the Pain, Fatigue, and Sleep Disturbance Symptom Cluster in Advanced Cancer. J Pain Symp Man 55:1286–1295 View abstract
8 Jehan et al (2018) Obesity, obstructive sleep apnea and type 2 diabetes: Epidemiology and pathophysiological insights. Sleep Med Disor Int J 2:54 Full paper
9 Muraki et al (2018) Sleep apnea and type 2 diabetes. J Diab Inves Full paper
10 La et al (2018) Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults. J lLin Sleep med 14: 109 Full paper
11 Olsson (2018) Sleep deprivation and cerebrospinal fluid biomarkers for Alzheimer’s disease
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12 Torquati et al (2018) Shift work and the risk of cardiovascular disease: a systematic review and meta-analysis. Scan J Eork `environ health 44:229-238 Full paper
13 https://www.theguardian.com/society/2012/may/11/nhs-spending-sleeping-pills-50m
14 Shell et al (2010) A randomized, placebo-controlled trial of an amino acid preparation on timing and quality of sleep. Am J Ther 17:133-139 View abstract
15 Hong et al (2018) Two combined amino acids promote sleep activity in caffeine-induced sleepless model systems. Nutr Res Pract 2:208-214 Full paper
16 Avallone et al (1996) Benzodiazepine compounds and GABA in flower heads of matricaria chamomilla. Phytotherapy Res 10:177–179 View abstract
17 Srivastava et al (2010). Chamomile: A herbal medicine of the past with bright future. Mol Med Rep 3:895–901 Full paper
18 Shinomiya et al (2005) Hypnotic activities of chamomile and passiflora extracts in sleep-disturbed rats. Biol Pharm Bull 28:808–810 Full paper
19 Srimaharaj et al (2018) Classification of human brain attention focused on mediation affected by L-theanine acid in oolong tea. ICDAMT2018 Full paper
20 Dutta et al (2018) role of nutraceuticals on health promotion and disease prevention: A review. J Drun Del Ther 8:42 Full paper

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