Best Supplements and Habits for Better Sleep (12 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 not only tired but also become forgetful and have a hard time 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.”

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 how 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 subjects developed high blood pressure and higher levels of cortisol—the “stress hormone”—both reversed when participants returned to adequate levels of sleep.

There are consequences of too little sleep. Routinely sleeping less than 6 or 7 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
• Increased cancer risk through an impaired system
• Cognition issues
• Decreased pain threshold
• Impairs immune function
• Disrupts blood-sugar homeostasis
• Increases risk for chronic medical conditions such as diabetes, depression, autoimmune disorders and heart disease
• Collagen breakdown and aging skin
• 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 24-hour period to promote optimal health
• Sleeping more than 9 hours may be appropriate for young adults, those who are ill, or those recovering from a sleep debt (It is uncertain whether there are adverse health repercussions for others sleeping more than 9 hours per night)

However, it is important to note that these sleep levels 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 each 24 hours, and research indicates napping doesn’t harm sleep quality. In fact, 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 all 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 brain waves which are very slow brain waves. In this stage, muscles completely relax, and heartbeat, blood pressure and breathing slow to their lowest levels. The deepest sleep occurs during this stage of sleep.
• 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. REM sleep is also characterized by intense or vivid dreams.

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 is getting the nutrients internally that make you sleep better more naturally.

1. Create a sleep-friendly environment

The key to a healthy, sleep-friendly environment revolves around comfort and light—or, more specifically, the absence of light. Sunlight affects your circadian rhythm—your inner body clock. Exposure to light at night can throw off your body clock by sending specific messages to the brain that make it more difficult to fall asleep and others that make you feel more alert.

Your eyes feature specialized cells that, when stimulated by sunlight, cause chemical reactions in the body to make you feel physically alert, delaying the onset, duration and quality of sleep. Even the blue and red LED lights on electronic devices in the room delay the release of your natural melatonin, making it more difficult to fall asleep and sleep deeply. Avoid 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, an amino acid in many forms of protein, increases serotonin levels and is found in foods such as:

• Fish
• Chicken
• Turkey
• Bananas
• Eggs
• Yogurt, cheese and milk
• Nuts and seeds

Avoid foods high in sugar and saturated fats, such as cookies, candies, and chips, which can actually 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 2018 Physical Activity Guidelines Advisory Committee Scientific Report presents strong evidence that moderate to vigorous physical activity helps you fall asleep faster and get up in the morning easier. It also helps you stay more alert throughout the day.

In terms of the time of day best for exercise, most find it is 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 2019 review published in Sports Medicine concludes that higher-intensity workouts can delay the onset of sleep 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.

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

In terms of the time of day best for exercise, most find it is 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 2019 review published in Sports Medicine concludes that higher-intensity workouts can delay the onset of sleep if completed less than an hour before bedtime.

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Best Supplements for Better Sleep

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 create significant improvements in your ability to sleep better.

Vitamin D

Studies have shown that poor sleep quality and short duration are correlated with low levels of vitamin D in the body. Vitamin D receptors and enzymes that control its activation and degradation are located in the areas of the brain associated with sleep regulation. Vitamin D is also involved in the pathways of production of melatonin, the naturally-occurring enzyme needed for the regulation of circadian rhythms and sleep.

Melatonin

Produced from the amino acid tryptophan by the brain’s pineal gland at a rate 10 times higher at night versus daytime, the hormone melatonin is produced naturally in the body and helps initiate and maintain sleep by sending signals to the brain and the rest of the body.

Food sources of melatonin include meats, fish, poultry (including eggs), dairy, and some fruits, grains and vegetables, but the amount is small. Some (but not all) studies have found concentrations of melatonin 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. Even the limited clinical evidence suggests melatonin has modest, favorable effects on sleep and can be taken to address common sleep disorders, including:

• Jet Lag. Studies have shown that melatonin taken close to the target bedtime at the destination reduces jet lag from flights that cross five or more time zones.
• Delayed Sleep Phase Syndrome is a condition that causes delayed weekend sleep patterns from keeping a different wake- and sleep- schedule on the weekend compared to weekdays. Participants in one study who took melatonin on Sunday evening (before returning to work hours Monday) experienced a 67 percent decrease in the time it took to fall asleep.
• A systematic review of six reports regarding melatonin supplementation in the elderly with insomnia found low doses of melatonin improved sleep quality and did not impair morning alertness when taking melatonin.

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

Magnesium

People with persistent issues with sleep quality were found by the U.S. Department of Agriculture often to have low levels of magnesium in their blood. Found in foods such as whole grains, nuts, leafy vegetables and low-fat milk, magnesium helps calm the mind and body, making it easier to fall asleep. By increasing GABA—the neurotransmitter gamma-aminobutyric acid in the brain—magnesium induces calming effects by inhibiting certain brain signals to your nervous system that prevent healthy sleep.

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Improve your magnesium levels naturally by taking one of several Cooper Complete magnesium supplements or multivitamins containing magnesium and other nutrients to promote better sleep.

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. And in China, a cohort study of 12,614 adults found an association between lower iron intake and sleep of fewer than 5 hours per night.

The physicians of Cooper Clinic emphasize a “food-first” approach to getting all the nutrients your body needs to function properly. 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 Time-Release Iron, or a multivitamin that contains 18 mg of iron. (A blood test can determine if you need supplemental iron.)

Turmeric

Curcumin, the primary bioactive compound in turmeric, is known for its’ anti-inflammatory and joint health benefits, but it’s also potentially helpful in supporting restful sleep. Curcumin is a cytokine modulator. A small randomized, double-blind, placebo-controlled clinical trial of 58 adults (20-70 years of age) with cirrhosis of the liver was conducted to evaluate the effects of 1,000 mg/day of curcumin compared to a placebo on quality of life. Participants completed quality of life assessments (the chronic liver disease questionnaire (CLDQ)), which included assessments of fatigue and difficulty sleeping at baseline and after 12 weeks. The group taking turmeric had considerably improved quality of life scores after three months of supplementation.

Cooper Complete offers several nutritional supplements that may help improve the quality of your sleep. Be sure to consult your health care provider or physician familiar with your health profile, including any pre-existing conditions, before taking any new supplements.

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