As you probably know, insomnia is often a big issue if you have anxiety and/or depression. I like to address low serotonin, low GABA and low blood sugar for the sleep and mood issues but sleep issues can be caused by so many factors.
The Sleep Success summit addresses so many of these other factors: the adrenals, the thyroid, the gut, hormone health (all of which can impact sleep), plus topics on sleep apnea (and the inflammation connection), MTHFR, autoimmunity, using essential oils, sleep problems we see in kids and so much more.
Dr. Michael Breus is the host of the summit and is interviewed by Sean Croxton: “An Interview with The Sleep Doctor.” He shares:
We know that when people aren’t able to stay asleep or fall asleep there is always some type of a mental component, either anxiety or depression (60-70% of the time)
There are just not a lot of people out there treating insomnia other than just prescribing pills and I’m not a big fan of that. Now you have two problems – you have a sleep problem and you have a pill problem.
I learned something new listening to Dr. Breus’ interview. He uses an evidence-based technique called “sleep restriction” to help his patients with insomnia. He says it trains your brain to know when to sleep and it works for about 50% of his patients. When the “sleep restriction” technique isn’t enough he uses cognitive behavior therapy to help with the negative thoughts and worry around the lack of sleep and supplements. He does use medications short-term (a few weeks only) to break the insomnia cycle.
I’m so intrigued by this “sleep restriction” method that I went looking for the research and found this study published just last month: 70% of the women receiving cognitive behavioral therapy for insomnia (CBT-I) said they had no more insomnia after 8 weeks and 84% said they had no more insomnia after 24 weeks!
A randomized clinical trial was conducted among 106 perimenopausal or postmenopausal women aged 40 to 65 years with moderate insomnia symptoms and 2 or more daily hot flashes.
Telephone-based cognitive behavioral therapy for insomnia (CBT-I) – which included sleep restriction, stimulus control, sleep hygiene education, cognitive restructuring, and behavioral homework – was compared to menopause education MEC/ information about menopause and women’s health.
At 8 and 24 weeks, 33 of 47 women (70%) and 37 of 44 (84%) in the CBT-I group, had scores in the no-insomnia range, compared with 10 of 41 (24%) and 16 of 37 (43%) in the MEC group.
Dr. Breus’ expertise is CBT-I and he is new to the naturopathic and nutritional world so we do have some professional differences of opinion, like buying Cosco magnesium (I would suggest looking for a quality product just like I do with all supplments) and avoiding 5-HTP and melatonin (although I do agree we do need to be informed consumers when using them). The good news is that because he’s new to this he does ask great in-depth questions of the experts on the summit.
Other great interviews to check out:
- Ben Lynch, ND – Are Your Genes Affecting Your Ability to Sleep?
- Izabella Wentz, PharmD, FASCP – Getting to the Root Cause of Hypersomnia and Thyroid Fatigue
- Magdalena Wszelaki, HHC – Your Hormones Could Be Affecting Your Sleep
- Alan Christianson, NMD – Heal Your Adrenals and Get Better Sleep
- Daniel Kalish, DC – How Sleep Influences Functional Medicine
- Amy Myers, MD – Sleep, Functional Medicine and Autoimmune Function
- Eric L. Zielinski, DC, MPH(c), BA – Sleep and Essential Oils: What’s the Connection?
- Emily Fletcher – How Meditation Cured my Insomnia!
- David Wolfe – How Your Environment Could Be Affecting Sleep! (Earthing and grounding for better sleep + Analyzing your environment to sleep better)
You can REGISTER HERE
You can PURCHASE HERE (it’s summit special pricing until the summit ends)
I’d love to know if you’ve ever done cognitive behavioral therapy for insomnia (CBT-I) and if it helped you? Is yes did it include all of the following: sleep restriction, stimulus control, sleep hygiene education, cognitive restructuring, and behavioral homework? Please share in the comments.
I did CBT with a great therapist in Newport Beach. I spent a lot more time than her average insomnia patient. It did work….sleep restriction and weaning off unisom. Sleep diary etc. it really helped for a while with trouble falling asleep. Now I’m struggling with continual awakenings and being unable to return to sleep. I know I’m a difficult case. Have tried all supplements. Some work for a time, then don’t anymore. Rotation helps. I have a sleep induction mat and that helps sometimes but not regularly. I could probably write my own book but still not great sleep.
Kathi
Glad to hear CBT with sleep restriction has helped in the past. Sorry to hear you’re struggling again. Since it has worked in the past I’m curious why not apply the same techniques now or work with a therapist again?
I hope you’re listening to the summit and will hopefully get some additional insights? You say you’ve tried all supplements. Have you tried a GABA and tryptophan/5-HTP combo? https://www.everywomanover29.com/blog/sleep-gaba-5-htp/ and if yes which products? the actual product and dose can make a BIG difference
What about GABA and venetum? https://www.everywomanover29.com/blog/sleep-improvement-oral-intake-gaba-apocynum-venetum-leaf-extract/
I assume you’ve tried melatonin (sublingual and timed-release)? and looked at high cortisol? and parasites (very active at night)? hormone imbalance/hot flashes? sleep apnea? gluten? SIBO? and do not have a history of benzodiazepine use?
I’d love to hear what has worked for you? you say some for a time?
I’m not familiar with a sleep induction mat?
My Dr. Recommended the sleep induction mat, purchased from Amazon. It does help some nites, others not at all, so I do use it. It is acupressure and irritates at first but then relaxes you.
I tested too high for GABA which supposedly makes you nervous! I bought it before the neurotransmitter test, but do not take it. Can’t take 5 HTP but do use tryptophan occasionally. Sometimes melatonin in low dose will help.
Sometimes glycine helps. When all else fails I take 1/3 a unisom which does work. I know it can contribute to dementia and cancer and earlier death.
I try all nighttime relaxing strategies but sleep still is a struggle. Lucky to get 5 hrs and that us usually with several Some nites I can’t fall asleep at all.
Ashwaganda helped but it irritated my stomach. I have constant gastritis and sub clinical hypothyroid and I suspect low adrenals from continual stress. DHEA is extremely low. I bought some…5 mg but fearful to take it for side effects, especially hair loss which I already have.
Wish I could find a solution for sleep. Do not want to go back to sleep restriction. It is really miserable for 2 weeks or so.
Trudy I am listening to the sleep summit but much of the information is already familiar to me since I’ve suffered with insomnia for so long. I’ve spent a lot of time learning about it and possible solutions.
I forgot to mention that while taking a low dose of glutamine for my gastritis, my sleep became much worse. Could not sleep at all. Only took 500 mg in the morning. I did test high in glutamate on a specialized blood test. So frustrating when it helps on thing yet causes other problems. I tested sensitive to 33 foods on the immuno labs food blood print test. Need to cure my gastritis so fearful about glutamine because of making sleep worse!
Kathi and I have a lot in common. I could write a book about all the things I have tried, including CBT for sleep, dealing with chronic health issues, trauma, etc. RE: Sleep restriction. I did listen to Dr. Breus’ talk and knew there is no way I would do that, although I have tried skipping naps, which only makes me miserable. Since I have suffered with adrenal fatigue for at least 15 years, my practitioner now tells me that when I’m tired, I’m to LIE DOWN, rest, sleep, whatever my body needs. I am not to push through the extreme fatigue.
I have been menopausal for at least 15 years and have had this problem since before that happened.
I have no problem falling asleep, but have many awakenings during the night, sometimes for 2-3 hours. I have dealt with unresolved hypothyroidism for years. It’s possible the newest medication, compounded WP Thyroid, is helping after months of “low and slow” dosing, as I am a pixey, as Trudy describes us. I can never count on sleeping all night but am ecstatic on the rare occasion that I am able to return to sleep after each waking. I have to take supplements on an empty stomach and do that when I wake up.
I also agree with Trudy about the magnesium part of Dr. Breus’ talk – on many levels. There is a lot more to the magnesium story which requires a lot of study for this complicated and crucial substance. I recommend information provided by Dr. Carolyn Dean.
Lynne
I’m sorry to hear this. With adrenal fatigue I agree with the naps. I’d be curious to hear what Dr. Breus would say. As I said to Kathi I hope you’re listening to the summit and will hopefully get some additional insights?
I’d love to pose similar questions that I asked Kathi as it helps me learn too. Have you tried a GABA and tryptophan/5-HTP combo? https://www.everywomanover29.com/blog/sleep-gaba-5-htp/ and if yes which products? the actual product and dose can make a BIG difference
What about GABA and venetum? https://www.everywomanover29.com/blog/sleep-improvement-oral-intake-gaba-apocynum-venetum-leaf-extract/
I assume you’ve tried melatonin (timed-release to stay asleep)? and looked at high cortisol (in the middle of the night – it can be low in the day and high at night)? and parasites (very active at night)? hormone imbalance/hot flashes? sleep apnea? gluten? SIBO? and do not have a history of benzodiazepine use?
You mention hypothyroidism and assume you’ve been tested for Hashimoto’s? Izabella Wentz discusses this on the summit today – flares of too much thyroid affecting your sleep
And yes there is much more to magnesium and Dr Carolyn Dean is a great resource.
I’ve listened to all Anxiety Summits and have tried many aminos over many years without a positive response. I’ve tried the GABA, 5htp and tryptophan but never a combo. However, last summit your comment about hypothyroidism and other causes seemed true for me and I’m now taking a compounded WP Thyroid.
Yes, I am listening to the Sleep Summit. Niki Gratrix’s amazing and informative talk on childhood trauma on Day 2 is huge. I’ve known about ACES for awhile and know that you plan to address that in the next summit. Thank you so much for that. Now, after 20 years of looking for root cause, I am thinking ACES is it. Even a functional medicine doctor, and others, have told me for years that I cannot heal on the physical level until I heal the trauma. I have been working on that actively for years also including many of the techniques Niki mentioned as well as cognitive therapy and EMDR. I don’t remember a lot of the details from my childhood trauma but enough to know it is significant, happened when my brain was developing and beyond, and know that it is stored in my body. I HIGHLY recommend Niki’s talk! I have a lot more to explore.
Thanks so much for this forum, Trudy. I am unable to comment on the Sleep Summit because I would have to go through Disqus. I notice there aren’t many comments on the ones I’ve listened to.
Does the sleep restriction techniques work for restless leg syndrome?
Im up throughout the night. Im tempted to try but i know it will be difficult for me to only stay in bed for a few hours, when im so tired from waking up so many times. How effective is this with people who have RLS.
Thanks.
Michele
I don’t know enough about it to be able to comment but I would focus on addressing the restless legs as there are many underlying causes – like low ferritin and SIBO. Izabella Wentz and Dr Breus talk about this in her thyroid interview today. Dr. Ben Lynch talks about how too much methylfolate can be a factor in his interview. Dr. Woynarowski talks about GABA/theanine/5-HTP for restless legs in his telomere interview.
I hope you’re listening to the summit and will hopefully get some insights from these speakers
Thanks Trudy, yes im enjoying the summit. I been taking iron supplements for the RLS. My ferritin was low. It has improved but it’s still on a low side.
I did CBT many years ago but not for insomnia, it was depression and anxiety. It was moderately helpful in combination with talk therapy. I have had issues with insomnia for many years but in the last 3 years it has gotten increasingly worse to the point that even with medication and 10mg Melatonin I have trouble falling asleep and still wake up 1-2 times a night. The quality of sleep that I do get is very poor further aggravating the anxiety, depression and PTSD symptoms.
I noticed in the article you mentioned not taking Melatonin. Why is that? I have always understood it was a natural supplement that was already present in the human body. Is this information not correct?
I am curious about niacin as a sleep help. I hear so much about tryptophan and 5htp. What do we not hear more about niacin when discussing sleep issues. If this was mentioned in the summit, I must have missed it.
Laurie
I have not blogged about niacin or niacinamide yet but it’s on my list to do so. In the meantime here is a comprehensive article from the Linus Pauling Institite http://lpi.oregonstate.edu/mic/vitamins/niacin (fyi they mention nicotinamide which is the same as niacinamide)
Niacinamide also has benzodiazepine-like effects http://www.nature.com/nature/journal/v278/n5704/abs/278563a0.html
Can anyone explain the role of niacin more in the tryptophan path? It is opposite the serotonin path?
Thank you Trudy! I eagerly await your blog. A loved one is absolutely desperate for sleep and many of the remedies have thus far failed. I have a hunch about niacin, but need to know more before recommending,
Laurie
I’m sorry to hear this. Would you mind sharing what remedies and approaches you have tried? It sounds like you listened to the interviews on the summit? did nothing resonate with you?
He has tried dietary changes, eliminating sugars and caffeine of course, adding b vitamins, fish oil, magnesium, tryptophan complete from Litdke, melatonin, 5htp, and source naturals Gaba, all the recommended changes in sleep hygiene. I think the CBT msy be needed for some underlying anxiety that has developed simply from the struggle. He gets anxious about not sleeping becsuse it has been every night for over 20 years. I am also suspicious of thyroid or adrenal hormones. His tsh was .8 with a simarly low t4 yet t3 is ideal at 3.2. He complains of his heart having a dull ache from the extreme fatigue of never sleeping. A sleep study confirmed no apnea and that he woke 16 times during an 8 hour night struggling to go back to sleep each time. The sleep study documented less than an hour and half of REM. He was sent home from that with pharmecueticsls like trazadone and ambien which he took in desperation. They do work for several hours but even on those he awakens and struggles before a 7-8 hr sleep time. And he feels drugged upon waking and during the day. I feel the yrotophsn complete should have worked. It makes me wonder if he is not converting because of a niacin or other deficiency.