It’s obvious that the so-called “problem” with us night owls is not so much that we can’t get up early, but the fact that we have difficulty falling asleep at what society deems to be a reasonable hour.
I’ve personally struggled with this all my life, or at least until I started the business that set me free from society’s dictates; now that I have kids, I struggle with it once again because I like to see them—and my beautiful wife—before they head out the door in the mornings. And considering the fact that they leave at 7:40 a.m., that’s really, really early for me!
Having said that, on days when I do manage to get up around 7:30 a.m. and see them, I realize the full advantage of being a night owl. That’s because even though my rising time is earlier than my internal clock dictates, the beautiful truth is that night owls can go the distance while early risers cannot! So, while I may have gotten up two hours later than they did—still early by my standards!—I can keep on going and going long after they’ve crashed and called it quits for the day.
On those days I take my time waking up and getting ready, knowing that I have the house to myself for a while. Then I head out to my office, where I’m extremely productive since we night owls don’t crash and burn in the early- to mid-afternoon the way early birds do. In fact it’s not uncommon for me to have one of those days when I awaken early, or early for me anyway, only to really get in the zone as far as work goes and head home well past 7:00 p.m.
So, whether you have a reason to want to get up a bit earlier than your natural rhythm would like, which in my case is the desire to see my family before they all leave, or if you’re forced to get up early for work or school—which is most often the case—the million-dollar question is, how to get to sleep at a decent hour?
I struggle with this. Even today as I write this, I can think back to last night and how completely wired I was around ten or eleven o’clock. Thankfully I’ve come up with an evening/nighttime routine that allows me to get my shut-eye earlier than usual when the need arises.
A Look at Drug-Based Sleep Aids
I personally do not recommend pharmaceutical sleep aids for a variety of reasons. Here are some of the most common medications that are prescribed for insomnia.
The “Z-Drugs”
If you’re ever had a prescription for sleeping pills, you’ve taken one of the Z-Drugs. This class of drugs gets their nickname from the generic/chemical names of the drugs; for example, generic Ambien is called zolpidem, and so on.
Remember the discussion about the highly addictive class of drugs known as the benzodiazepines? They include tranquilizers such as Xanax, Valium, Ativan, and many others. These drugs work very similarly to alcohol in that they bind to the GABA—gamma-aminobutyric acid—receptors in the brain. GABA is the “calming” neurotransmitter. It is the chief inhibitory compound in the human body.
However, as seen, these drugs have a strong rebound effect. In fact, the reason Xanax is perhaps the most addictive prescription drug out there, known to cause addiction in as little as two days, is that it quashes panic and anxiety for 3–4 hours, but then it all comes back—even stronger! This causes the patient to take more and more and more, until either a stronger drug or a higher dose is needed. Over time these drugs can cause cognitive impairment. Stevie Nicks, of Fleetwood Mac fame, said that the benzodiazepine drug clonazepam, brand-name Klonopin, stole her life and years of memories from her. That is just how dramatic and far-reaching the negative effects of these drugs can be with long-term use.
Similarly, the Z-Drugs also bind to the brain’s GABA receptors at the same location as the benzodiazepines. They act slightly differently in that their intended purpose is to cause drowsiness and to induce sleep, while the benzodiazepines are intended to reduce anxiety; however, anyone who has taken any of the benzos will tell you how sedating they are, particularly the stronger ones such as Xanax (alprazolam).
The problem, then, should be obvious: Since these drugs work on the same brain receptors, at the same locations, as the benzodiazepines, they are equally as addictive and dangerous when used any longer than the month or so that experts agree on as the maximum length of time to depend upon these drugs for sleep.
Someone who I know personally had bouts of intermittent insomnia and finally went to see his physician to do something about it. He was prescribed Ambien, which he said, “Knocked me on my ass,” and he slept great. For two weeks.
Then he decided he was sleeping well again and that he didn’t need the Ambien.
Didn’t need it? He was hooked! He recounted the sheer hell of not sleeping at all for an entire week just to get off the pills. And he took them for only two weeks, and at less than the prescribed dosage, to boot.
Another big problem with these drugs is that they are Schedule IV controlled substances in the United States. As mentioned earlier in reference to the “opioid epidemic,” more and more physicians are refraining from prescribing controlled substances out of fear of being subjected to a DEA review, which for a doctor is roughly equivalent to being subjected to an IRS audit for me or you.
That means your doctor may simply decline to renew your prescription one day, and—BOOM! You’re going to be lying awake for a week straight or longer as my friend did. Finally, since these drugs work very similarly to both alcohol and the benzodiazepines, they also carry the same withdrawal symptoms: tremor, seizures, delirium tremens, and so on, are all potential risks with abrupt cessation of any of the Z-Drugs.
More “Z-Drug” Zingers
Another sticking point I have with the Z-Drugs, aside from the fact that they’re a chemical assistant and not a natural way to get to sleep, is the bizarre behavior they commonly induce, including amnesia, sleep-walking, sleep-eating, sleep-sex, and yes, even sleep-driving!
In one extreme case, a man who was taking Ambien for sleep got up at night, retrieved a firearm, and committed a mass shooting in his sleep. He went home and went back to bed with no memory of the event. Subsequent interrogations and polygraph examinations confirmed that the man truly did not remember the horrific things he did that night.
Sleep-induced shootings aside, just the thought of sleep-driving is terrifying to me, especially when I know that it could happen without my knowledge and that I could easily get myself, and others, killed by doing it.
For these and many more reasons, I consider the Z-Drugs like Ambien and Lunesta to be of questionable safety and efficacy.
Antidepressants
As newer and better antidepressants hit the market, older ones are relegated to taking up the slack in other departments. Most notable is the prescription antidepressant trazodone, which, believe it or not, is now the number one most prescribed drug to treat insomnia in the United States.
Similar drugs are sometimes prescribed, albeit off-label, for help with falling asleep. For example, the muscle relaxant cyclobenzaprine, brand-name Flexeril, is actually a slightly modified tricyclic antidepressant known for its drowsiness-inducing effects.
My concern here is, once again, that the drug is acting as a band-aid rather than naturally inducing restful sleep. Furthermore, the implications of prescribing antidepressants to people who are not clinically depressed and therefore don’t need them are still highly questionable. There are the usual side effects of antidepressants such as loss of libido, and in the case of tricyclics or muscle relaxants, severe dry mouth that leads to tooth erosion and cavities.
Antihistamines
Who hasn’t ever taken NyQuil and then sung the praises of how great they slept afterward?
NyQuil puts you to sleep through the use of an antihistamine, doxylamine, which is very similar to how Benadryl (generic name diphenhydramine) works. Seemingly everyone knows that Benadryl will cause drowsiness and works great as a sleep aid. I know I’ve used both doxylamine and diphenhydramine myself on and off over the years. (After surgery I used them to sleep, since opioid painkillers give me pretty severe insomnia.)
The main problem with these types of drugs,
other than the fact that they leave many people feeling groggy and like “zombies” the next morning, is that they block the all-important neurotransmitter acetylcholine in the brain. It is the neurotransmitter released by the nervous system in order to activate muscles. That means effects can range from the mild and unnoticeable to the severe, up to and including seizures and paralysis. It’s also a neurotransmitter in the sympathetic nervous system and as the final product released by the parasympathetic nervous system.
The brain contains several cholinergic areas that rely on acetylcholine, including influencing functions such as arousal, attention, memory, and motivation.
Most people take these drugs in the form of over-the-counter allergy meds such as Claritin and Zyrtec, which are low dose and pose little problem, although long-term consequences still exist.
At the University of Washington’s School of Pharmacy, a team led by pharmacist Shelley Gray tracked approximately 3,500 people aged 65 or older. Using the group’s pharmacy records to determine all drugs each participant had taken over the past 10 years up to the study, it was found that the approximately 800 people who had developed dementia within another 10 years were taking anticholinergic drugs. What’s more, the study found that taking an anticholinergic for three years or more was associated with a whopping 54% increase in dementia risk versus taking the same dose for three months or less.
For these reasons I do not stand by the use of antihistamines/anticholinergics like Benadryl and Unisom. When I happen to take Zyrtec or another allergy medication during the times of year when my allergies sometimes act up, I make a point to take a choline supplement with breakfast in order to counter the choline-reducing effects in order to hopefully prevent the long-term consequences of taking this class of drugs.
Natural and Herbal Sleep Aids
Nope, by herbal I do not mean marijuana, so don’t get your hopes up! Instead, here are some of the most common herbal sleep aids available as over-the-counter supplements, including ones I’ve used.
Valerian Root
If you’ve ever taken valerian root, you’ll remember it: The stuff stinks like days-old moldy gym socks and you’d better have water at the ready because hunting for it with that capsule in your mouth is no walk in the park!
Valerian root has been shown to reduce the amount of time to fall asleep by 15–20 minutes. It also helps to improve sleep quality. Recommended dosages are between 400 and 900 mg, taken two hours prior to bedtime, although I find that I sleep through the night better if I take it right at bedtime.
While valerian doesn’t work as quickly or effectively as sleeping pills such as the Z-Drugs, it’s a safe alternative, and what’s more, it can help with the insomnia and other withdrawal symptoms when coming off a Z-Drug.
Passionflower
Passionflower is commonly used for a variety of ailments, the most common of which are insomnia and anxiety.
On the anxiety front, passionflower has been shown in some clinical trials to be as effective as some of the benzodiazepines in reducing anxiety when taken twice daily. Unlike valerian, while it’s calming, it won’t knock you on your ass, although you should experiment on a weekend or other free day first to see how it affects you before getting behind the wheel.
It is also useful for preoperative anxiety when taken 30–90 minutes before rolling into the operating room.
As for sleep, there isn’t much research on this topic as there is anecdotal evidence, such as my personal experiences. Having said that, early research shows that passionflower tea taken an hour before bedtime for seven consecutive nights improves subjective ratings of sleep quality. Research also shows that taking a product containing passionflower, valerian, and hops (NSF-3 by M/s Tablets in India) for two weeks improves sleep similar to zolpidem (Ambien) in people with insomnia.
Kava
There is a lot of controversy over kava regarding liver health; in fact, it’s been banned in both Europe and Canada for this reason. However, research shows that it was a particular, single brand of kava that contained extracts from the entire plant, rather than just the root, that led to the hepatoxicity and cases of liver failure.
Having taken the herb for years and having gotten regular annual labs done by my doctor, I can tell you with certainty that my liver function values weren’t even slightly elevated, ever. However, my disclaimer still stands, and you should do your own research and/or consult with a healthcare professional prior to taking kava.
Kava has been proven effective in the treatment of anxiety, which is not surprising considering the fact that medications and supplements with antianxiety properties also cause some degree of drowsiness, which is why many un- or underinformed physicians will prescribe benzos such as Xanax off-label for sleep. (The practice of prescribing something off-label refers to prescribing a drug for a purpose outside the scope of its FDA approval, which is entirely legal; doctors have discretion here.)
Studies show that taking kava extracts that contain 70% kavalactones, something you should look for on labels before buying, reduce anxiety, sometimes to the same degree that prescription antianxiety medications do. However, this can take up to five weeks of daily use to take full effect and doesn’t provide immediate relief like the benzos do.
On that same note, it has been shown that slowly increasing the dose of kava over one week while simultaneously reducing the dose of a benzo over the course of two weeks can prevent most withdrawal symptoms and avoid severe rebound anxiety in patients coming off benzodiazepine drugs. Remember that they have some of the highest addiction potential as well as the most dangerous withdrawals of nearly any class of drugs. This is important to remember if you’ve struggled with quitting these drugs in the past but simply keep refilling your prescription because you’ve found it impossible to withdraw.
On the sleep front, which is why we’re here, some research shows that taking a kava extract daily for four weeks reduces sleeping problems, while other research contradicts this and states that it only reduces anxiety, not insomnia.
Knowing from personal experience that anxiety and anxiety alone can cause severe insomnia due to the endless thoughts in your head, the racing heartbeat, and so on, I see a strong connection between medications and supplements that control anxiety and the treatment of insomnia. Remember, the most common antianxiety drugs, the benzodiazepines, cause drowsiness, are commonly prescribed for sleep, and are nearly chemically identical to the Z-Drugs, which all support this hypothesis that antianxiety treatments work well for sleep.
Magnesium
Commonly known as a metal and an essential mineral in the human body, magnesium is a calming mineral that is known for its ability to reduce blood pressure, relieve stress, and improve sleep quality and prevent insomnia.
Magnesium works on helping you sleep by helping to regulate both melatonin, the sleep hormone, as well as several brain neurotransmitters. Research shows that there is a correlation between magnesium and melatonin levels in the body. Magnesium-deficient individuals commonly report insomnia and reduced sleep quality. Additional research shows that magnesium is tied to your circadian rhythm.
Magnesium promotes relaxation and assists with sleep by binding to GABA receptors, just like several prescription drugs previously discussed. This binding activity slows down nervous system activity, which calms you and your body overall and prepares you for slumber.
Sleep is just one small facet of magnesium’s myriad benefits; hence why it’s considered an essential mineral. It’s also known to be a muscle relaxant, and some studies show that magnesium glycinate, 400 mg taken twice daily, is just as effective as prescription muscle relaxants such as Skelaxin. I personally take the glycinate salt of magnesium over other varieties primarily because, unlike other varieties, it does not have any laxative properties, and is very well-absorbed by the body. (Magnesium oxide, the most commonly store-bought form of magnesium, is also the cheapest to manufacture and is very poorly absorbed; hence why it’s found in many lower-cost multivitam
ins. Magnesium citrate is used specifically as a laxative, hence why I avoid it.)
One thing to absolutely avoid are “cal-mag” supplements, those containing both calcium and magnesium. While both are essential minerals, the issue is that the two are antagonistic to each other, meaning that taking both at the same time means neither will have its intended effect. It is best, therefore, to take calcium, if you take it at all, in the morning, and to take magnesium with your evening meal and possibly at bedtime as well. Some nutritional experts even go so far as recommending that you take them on entirely separate days, alternating back and forth.
I do not take calcium supplements at all, first because it’s an excitatory mineral and my mind is very active as it is without the need for any additional stimulation, and second, and perhaps more important, because so much of what we consume, right down to bottled water, is overcalcified and has caused something of a magnesium deficiency epidemic in our society. In other words, calcium is everywhere in foods and beverages you consume, but not so much with magnesium.
Finally, if you consume alcohol regularly, it’s especially imperative that you supplement with magnesium. Alcohol consumption drastically depletes magnesium levels in the body, requiring replacement with a supplement. Those who have had gastric bypass or other GI surgery that affects absorption of nutrients should also be on the lookout for magnesium deficiency symptoms such as anxiety and insomnia.
Melatonin
The Morning Myth Page 16