Best Supplements and Habits for Better Sleep (16 min.)

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The Centers for Disease Control and Prevention (CDC) has deemed insufficient sleep a public health epidemic. Getting adequate sleep is not merely “nice to have.” It is an essential contributor to good health. When we’re consistently deprived of sleep, we feel tired, become forgetful, and have difficulty concentrating. Chronic sleep deprivation can be related to weight gain, high blood pressure, diabetes, and heart disease. Riva Rahl, MD, Cooper Clinic Platinum Physician, says, “A good night’s sleep can help us cope with stress, control our weight, solve problems and prevent serious illness and disease.” Individuals who consistently sleep fewer than six hours per night are 30 percent more likely to become obese. Decreasing sleep from seven hours to five hours a night increases the risk for cardiovascular death two-fold.

The Impact of Sleep Deprivation on Health

Sleep deprivation occurs when we don’t get enough sleep. There are strong associations between lack of sleep and diabetes, high blood pressure, stroke, anxiety, depression and obesity. While we sleep, our brain processes and sorts information, releases hormones, consolidates memories, fights inflammation and infection, and rids toxic waste.

Scientific reports identify several biological reasons linking sleep to weight gain. When we don’t get enough sleep, our body produces more ghrelin—the “appetite hormone”—which tells our brain it’s time to eat. Conversely, our body’s level of leptin—the” fullness hormone”—plummets, slowing the brain’s ability to recognize it’s time to stop eating.

A study by the National Institutes of Health shows that lack of sleep also changes how the body processes and stores carbohydrates, alters hormone levels, and reduces the body’s response to insulin, lowering energy levels and causing weight gain. The study also showed that subjects developed high blood pressure and higher cortisol levels—the “stress hormone”—both reversed when participants returned to adequate sleep.

There are consequences of too little sleep, yet nearly 30 percent of adults report sleeping six or fewer hours per night regularly. Routinely sleeping less than seven hours a night disrupts normal brain and body function, causing a decline in metabolic rate and endocrine functions, and can result in the following:

• Weight gain
• Memory issues
• Decreased metabolic rate
• Increased cancer risk through an impaired system
• Cognition issues – decreased attention, alertness, concentration, reasoning, problem solving
• Decreased pain threshold
• Impairs immune function
• Disrupts blood-sugar homeostasis
• Low leptin levels (satiety)
• Increases risk for chronic medical conditions such as diabetes, depression, autoimmune disorders and heart disease
• Collagen breakdown and aging skin
• Increased ghrelin (hunger)
• Mood changes
• Increased accident risk
• Low sex drive
• Decreased quality of life

How Much Sleep Is Enough?

Healthy People 2030 (an initiative of the U.S. Department of Health and Human Services) reported only 67.5 percent of adults get sufficient sleep. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society recommends the following:

• Adults should sleep at least 7 hours per night to promote optimal health
• Teens (ages 13-18) should sleep 8 to 10 hours per 24 hours
• Children ages 6-12 should sleep 9 to 12 hours per 24 hours
• Children ages 3-5 should sleep 10 to 13 hours (including naps) per 24 hours
• Children ages 1-2 should sleep 11 to 14 hours (including naps) per 24 hours
• Infants 4-12 months should sleep 12-16 hours (including naps) per 24 hours
• Sleeping more than 9 hours may be appropriate for young adults, those who are ill, or those recovering from a sleep debt

It’s uncertain whether health risks are associated with healthy adults sleeping more than 9 hours per night regularly.

Remember that these sleep recommendations do not account for the time it takes to fall asleep. While everyone is different, the average person typically falls asleep within 15 to 20 minutes.

Do Naps Help or Hurt the Ability to Get a Good Night’s Sleep?

Napping can be part of the equation for achieving a minimum of 7 hours of sleep every 24 hours, and research indicates napping doesn’t harm sleep quality as long as it is kept to 20-30 minutes and limited to the early afternoon, from 1 to 3 p.m. This is when most people’s natural circadian rhythm dips a bit, resulting in a natural energy drop.

Remember that if you snooze for longer than 30 minutes, you’ll transition from the light to the deep sleep stage, potentially waking up feeling more tired than before your nap.

Structured naps are recommended for shift workers to improve alertness. If you know you’ll be up later than usual, a brief nap (up to 30 minutes) can help.

Best Habits for Better Sleep

The two broad categories of sleep are rapid eye movement (REM) and non-REM sleep. Non-REM sleep is further subdivided into three different stages. We cycle through the four sleep stages four to five times each night, with deeper REM periods occurring as we move towards morning. Here’s a brief overview of each stage of sleep:

• Non-REM sleep Stage 1: The brain produces theta waves. This stage typically lasts 5-10 minutes, during which brainwave patterns, eye movements, heartbeat and breathing begin to slow. As the muscles relax, occasional twitching may occur.
• Non-REM sleep Stage 2: The brain produces alpha waves. This stage lasts approximately 20 minutes, during which body temperature drops and heart rate begins to slow as the body prepares to enter deep sleep.
• Non-REM sleep Stage 3: The brain produces delta waves, which are very slow brain waves. In this stage, muscles relax entirely, and heartbeat, blood pressure, and breathing slow to their lowest levels. The deepest sleep occurs during this stage.
• REM sleep Stage 4: This stage is marked by rapid eye movement and increased dreaming. The brain becomes more active, and the body becomes relaxed and immobilized. Intense or vivid dreams also characterize REM sleep.

The best way to improve the quality of your sleep—falling asleep quicker and staying asleep—is to adopt an approach that addresses both the external and internal factors contributing to poor sleep. Externally, establish habits that remove impediments and ensure your body gets the nutrients internally that make you sleep better and more naturally.

(Bonus: See Cooper Clinic Platinum Medical Director Riva Rahl, MD‘s list of 10 big consequences of too little sleep.)

1. Create a sleep-friendly environment

The key to a healthy, sleep-friendly environment revolves around comfort and light—specifically, the absence of light. Create a dark, cool, and quiet setting in your bedroom that is conducive to quality sleep. Exposure to sunlight can affect sleep because it impacts our circadian rhythm or inner body clock. Sunlight is detected by specialized cells in our eyes, which transmit those light signals to the brain. This causes chemical events to occur throughout the body, changing our physiology and behavior. For example, as the sun goes down in the evening, the sleep hormone melatonin increases, and our body temperature falls, making us more receptive to sleep. In turn, exposure to bright sunlight peeking through the window in the morning has the opposite effect, causing several chemical reactions that help us feel alert. The impact of light on subsequent sleep onset, sleep duration, and sleep quality is controlled by the duration of light exposure, intensity, and spectral composition.

At night, exposure to light can throw the body’s biological clock off track. This includes the blue light emitted by cell phones, computers, tablets, televisions, and some LED lights. Exposure of the specialized cells in the eyes to blue light delays the release of melatonin, making it take longer to fall asleep, robbing you of deep sleep. Many experts recommend avoiding looking at bright screens for at least an hour or two before bedtime to get your eyes—and body—conditioned for a night of healthy sleep. Consider taking a hot bath or shower as part of your nighttime routine, and make sure your bedroom is quiet, cool and dark.

Consider investing in a good pillow. The ideal pillow supports the spine and positions the neck in a neutral position. General pillow advice is:

• Side sleepers need a pillow that keeps the neck in a neutral position
• A cervical pillow may help if neck pain is an issue
• Use a feather pillow if that’s your preference, but keep in mind that they wear out after a year or two and need replacement
• Stiff pillows should be avoided
• Avoid sleeping on your stomach
• Invest in a neck-collar type pillow to use while traveling
• Side sleepers with a pillow between the legs and back sleepers with a pillow under the knees are less likely to experience low back pain. (Back sleeping without a pillow behind the knees hyperextends the back.)

2. Consume foods that help—and do not hurt—your ability to sleep

Caffeine, alcohol, heavy meals and tobacco often disrupt your sleep and prevent good sleep quality. Contrary to conventional thinking, alcohol may make you feel more relaxed and appear to help you fall asleep more quickly. But, it often reduces the quality of your sleep later in the night.

In the evening, before you go to bed, choose foods that promote sleep by increasing the serotonin levels in your body. Tryptophan is an amino acid found in protein and is thought to promote sleep by increasing melatonin and serotonin. Foods high in tryptophan include:

• Chicken
• Turkey
• Bananas
• Eggs
• Yogurt, cheese and milk
• Peanuts

Avoid foods high in sugar and saturated fats, such as cookies, candies, and chips, which can reduce your levels of serotonin. And don’t keep yourself up at night with heartburn associated with heavy meals. Keep evening meals light to sleep better.

3. Sleep better with regular exercise

The Physical Activity Guidelines Advisory Committee Scientific Report presented substantial evidence in 2018 that moderate to vigorous physical activity helps you fall asleep faster, get up easier in the morning, and stay more alert throughout the day.

A 16-week controlled study of adults 50-76 years of age who reported moderate sleep complaints was randomized, and the exercise group primarily had four 30- to 40-minute training sessions focusing on low-impact aerobics or brisk walking (60- to 75 percent of heart rate reserve). The results found the exercise group fell asleep 15 minutes earlier and slept 45 minutes longer, than the control group that did not exercise.

Regarding the best time of day for exercise, most find it better to work out in the morning or afternoon for a longer, deeper night’s sleep. While low-intensity exercise in the evening doesn’t interfere with sleep quality, a review published in Sports Medicine concluded that higher-intensity workouts can delay the onset of sleep and result in poorer sleep quality if completed less than an hour before bedtime.

A systematic review of fourteen studies found healthy older adults who engaged in moderate-intensity exercise three times a week showed the best improvement in sleep outcomes.

4. Manage Blue Light

Blue light is a compound of virtually all visible light, and during the day, these blue wavelengths help keep us awake, boost attention and positively impact mood. Natural sunlight contains blue light. Indoors, energy-efficient light bulbs, artificial lights, and digital devices (cell phones, tablets, laptops, and desktop computers) emit blue light. This continued exposure to blue light can significantly disrupt the circadian rhythm, which impacts hormone balance, body temperature, and digestion. Blue light exposure in the evening also dramatically impacts the sleep-wake cycle and regulation of sleep patterns as it reduces the natural production of melatonin. In addition, continued exposure to blue light can damage the eyes.

The more time spent on digital devices, the more eyes are exposed to blue light. It’s not uncommon to spend most of the day looking at a computer screen. After work, the computer screen might be replaced with a game or program on TV, checking online accounts, and connecting with family and friends via social media, email, and text. All of these screen time activities include exposure to blue light.

The Vision Council describes the discomfort our eyes feel after two or more hours of sitting close to a digital screen at a mid-range distance as digital eye strain.

The short-term effects of eye strain include:

•  Headaches
•  Blurred vision
•  Dry eyes
•  Eyestrain
•  Eye fatigue

Long-term blue light effects include:

•  Retinal damage
•  Poor glare recovery
•  Reduced visual performance

Age-related eye conditions
Lutein and zeaxanthin, common dietary carotenoids, are antioxidants located in the eye. Naturally found in kale, spinach and other dark, leafy greens, lutein and zeaxanthin concentrate in the eye’s macula and help filter harmful blue light. The body doesn’t make lutein or zeaxanthin, so these nutrients must be consumed through diet or supplementation.

While the typical diet provides 1-2 mg of lutein, studies suggest for optimal health, we need 10 mg of lutein and 2 mg of zeaxanthin each day. The following Cooper Complete nutritional supplements contain lutein and zeaxanthin:

• Eye Health Supplement – 10 mg lutein, 10 mg meso-zeaxanthin and 2 mg zeaxanthin
• Dermatologic Health Supplement – 10 mg lutein and 2 mg zeaxanthin
• Original Comprehensive Multivitamin – 6 mg lutein and 0.4 mg zeaxanthin

The level of lutein and zeaxanthin in Cooper Complete’s comprehensive eight-tablets-per-day multivitamin and mineral formulations is based on lutein and zeaxanthin consumption levels as found in Three-Day Food Records submitted by Cooper Clinic patients and analyzed by The Cooper Institute.

5. Best Supplements for Better Sleep

Stress, life change, travel, and sleep disorders are common contributors to tossing and turning. Vitamin deficiencies are often a little-known contributor to unhealthy sleep patterns and poor sleep quality. Supplementing your diet with vitamins and nutrients such as vitamin D, melatonin, magnesium, and iron can help fill in any gaps in your diet that may be associated with poor sleep.

Melatonin

Produced from the amino acid tryptophan by the brain’s pineal gland at a rate ten times higher at night versus daytime, melatonin is a natural hormone that helps regulate the sleep-wake cycle. Produced naturally in the body, melatonin helps initiate and maintain sleep by sending signals to the brain and the rest of the body.

Food sources of melatonin include meat, fish, poultry (including eggs), dairy, and some fruits, grains, and vegetables, but the amount is small. Some (but not all) studies have found that melatonin concentrations in our bodies decrease with age. Blue and green light (from smartphones and other electronic devices), high stress levels, too much caffeine, and exercising close to bedtime can also reduce melatonin production and impair our chances of better sleep.

Melatonin supplements may promote the shifting of circadian rhythms and the onset of sleep by helping the body mimic the natural effects of melatonin secretion. While the clinical trial evidence addressing the effectiveness of melatonin for the treatment of insomnia is of limited quality, the results suggest melatonin has modest, favorable effects on sleep:

• Jet Lag. Studies have shown that taking melatonin close to the target bedtime at the destination and continuing for several days can help reduce jet lag from flights that cross five or more time zones.
• Delayed Sleep Phase Syndrome is a sleep disorder caused by sleep patterns that vary two or more hours from normal sleep patterns. For example, someone may stay up late on Friday and Saturday nights compared to nights when they are working the following morning. In one study, participants who took melatonin on Sunday evening (before returning to work hours on Monday) experienced a 67 percent decrease in their time to fall asleep.
• Insomnia in the Elderly. A systematic review of six reports regarding melatonin supplementation in older adults with insomnia found that low doses of melatonin improved sleep quality, and morning alertness was not impaired.

To support better sleep, take melatonin supplements 20 to 30 minutes before bedtime as part of your winding down routine. Cooper Complete offers a 3 mg fast-acting melatonin for people who have difficulty falling asleep and a 5 mg biphasic controlled-release melatonin that releases melatonin quickly and then steadily over 6 hours.

(Bonus: Learn what Cooper Clinic Platinum Physician Steven Lilly, MD, MBA, says about melatonin supplements for sleep.)

Magnesium

Magnesium plays a vital role in the body’s sleep regulation, and the U.S. Department of Agriculture reports people with long-term lack of sleep often have low magnesium in their blood. While magnesium is found in whole grains, nuts, legumes, green leafy vegetables, and low-fat milk products, many people do not get enough magnesium through food sources to maintain optimal levels. In a small study of 100 adults, the subjects who took 320 mg of magnesium citrate each night as a sleep supplement reported a 37 percent improvement in sleep quality (based on self-reported feedback) compared to the placebo group. By increasing GABA—the neurotransmitter gamma-aminobutyric acid in the brain—magnesium induces calming effects by inhibiting specific brain signals to your nervous system that prevent healthy sleep.

Magnesium levels can also be increased by consuming foods such as:

• Whole grains
• Nuts – especially almonds
• Legumes
• Leafy vegetables

Magnesium helps your brain calm down and your muscles relax, which can help you sleep better, especially for those with anxiety, muscle soreness, or restless leg syndrome. Improve your magnesium levels naturally by taking a Cooper Complete magnesium supplement or multivitamin containing magnesium and other nutrients to encourage better sleep.

Magnesium L-threonate

A study published in Sleep Medicine, has shown a new form of magnesium, L-threonate, improves sleep quality. This highly bioavailable form of magnesium is the only magnesium that crosses the blood-brain barrier to directly nourish brain cells with magnesium. Researchers found that Magtein®, the magnesium L-threonate found in Cooper Complete Cognitive Health, could also increase the deep sleep known as REM. Participants reported experiencing better sleep, being more mentally aware, and having improved mood upon waking.

Iron

The English Longitudinal Study of Ageing assessed cross-sectional associations between various biomarkers and self-reported sleep of 6,465 adults (aged 50-99 years) and found an association between low hemoglobin and short or disturbed sleep. In China, a cohort study of 12,614 adults found an association between lower iron intake and fewer than 5 hours per night of sleep.

The physicians of Cooper Clinic emphasize a “food-first” approach to getting all the nutrients your body needs to function correctly. To help improve the quality of your sleep, add iron-rich food to your diet, such as:

• Liver
• Red meat, pork, and poultry
• Beans
• Dried fruit
• Dark leafy green vegetables such as spinach paired with citrus

To support a healthy level of iron in your blood, consider an iron supplement, such as Cooper Complete Bisglycinate Iron, or a multivitamin that contains 18 mg of iron. (A blood test can determine if you need supplemental iron.)

(Bonus: Learn how iron levels can impact fatigue levels.)

Ashwagandha

Ashwagandha supplements may modestly improve sleep in adults with insomnia or non-restorative sleep. A systematic review and meta-analysis of five randomized controlled trials containing 400 adults (age 18 and up) were analyzed. Sleep quantity and quality were the primary outcomes, while mental alertness upon rising, anxiety level, and quality of life were secondary outcomes. Ashwagandha had a small but significant impact on overall sleep, with effects more prominent in the adults diagnosed with insomnia and in studies where the treatment dose was 600 mg or more per day, and the study duration was eight weeks or longer. Ashwagandha positively impacted mental alertness on awakening and anxiety levels but did not significantly affect quality of life.

Cooper Complete Ashwagandha contains 300 mg per capsule.

Collagen

A tiny, randomized controlled trial recruited athletic men aged 20-28 with sleep complaints and had them take 15 grams per day of collagen peptides or a placebo one hour before bedtime for a week. In addition to subjective sleep dairies, polysomnographic sleep, and core temperature were recorded at the end of the study. No changes or differences were found in core temperature, endocrine function, subjective sleepiness, fatigue, and sleep quality, but surprisingly, the group who took the collagen supplement had reduced awakenings compared to the placebo group.

Consider Cooper Complete Collagen Complex supplement, which contains three clinically studied and patented Type I and Type II collagen peptides, along with vitamin C, magnesium and hyaluronic acid.

Probiotics

Beneficial bacteria help synthesize neurotransmitters and hormones such as melatonin and serotonin, which are essential for sleep/wake cycles. Even for only a few nights, lack of sleep seems to impact gut flora, so it may make sense to consider a probiotic if sleep issues are a concern.

Consider Cooper Complete Advanced Daily Probiotic, which contains a proprietary blend of 4 strains and 35 billion CFU probiotics to support gut microflora and health.

Vitamin D

Studies have shown poor sleep quality and short durations correlate with low vitamin D levels. Specifically, vitamin D receptors and enzymes that control its activation and degradation are located in the areas of the brain associated with sleep regulation. It’s not yet known what mechanisms vitamin D regulates; sleep, or its potential role in the pathways of production of melatonin, the naturally occurring enzyme needed for the regulation of circadian rhythms and sleep. A simple blood test is the only way to evaluate whether or not your vitamin D level is appropriate. If deficient, vitamin D may help with sleep if levels are brought up within normal range.

More clinical studies evaluating the effectiveness of vitamin D supplementation in improving sleep are needed.

Cooper Complete offers several nutritional supplements that may help improve the quality of your sleep. Before taking any new supplements, consult your healthcare provider or physician who is familiar with your health profile, including any pre-existing conditions.

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Cooper Complete March 27, 2024