Dr Jacob Teitelbaum MD
Getting 8 hours of deep sleep a night (yes-it is possible!)
Dear readers,
In the last 15 newsletters we’ve talked about how to recognize chronic fatigue syndrome and fibromyalgia and what causes these syndromes. We’ve discussed the concept that the hypothalamus acts as a circuit breaker inside of our body, shutting down to protect us in the face of what it perceives to be a dangerous and overwhelming stress. Like a circuit breaker in a house, this protects the system but at the same time results in the absence of function (or in our case markedly decreased function). We’ve also discussed how research has shown that there are four key things needed to “turn the circuit breaker back on”. These are nutritional support, sleep, treating the hormonal deficiencies, and treating underlying infections. In addition, it is important to make sure that the stresses that “blew your fuse” have been eliminated so that you don’t just blow the fuse again!
Having discussed nutritional support at length, I would like to take the next few newsletters to discuss how to get the eight to nine hours of deep sleep a night that is necessary to restore health and eliminate pain. To quickly review, the key points of nutritional support are: 1 — take the “Daily Energy Enfusion” vitamin powder and B-complex. This one drink and one capsule a day replaces 25 to 35 tablets daily. 2 — drink more water and avoid sugar. Also, increase salt if your blood pressure is low. 3 — use Eskimo 3 fish oil if you have dry eyes and dry mouth. 4– use plant based digestive enzymes (e.g. CompleteGest) if you have poor digestion.
Q: How can I get eight to nine hours sleep a night if I can barely stay asleep for three hours at a time?
A: Although sleep hygiene is important in insomnia, poor sleep hygiene is NOT the key problem here. We talked about the hypothalamic ‘circuit breaker’ being turned down in CFS/fibromyalgia. Unfortunately, the hypothalamus is the sleep center in the body, and when it is not functioning properly one cannot sleep without assistance. Unfortunately, most sleeping pills such as Dalmane, Valium, and Halcion actually can worsen the problem by keeping you in light sleep when what is needed is the deep restorative part of sleep. Fortunately, there are many treatments that can help pretty much everybody with these syndromes to get eight to nine hours of deep sleep each night.
Q: But isn’t nine hours of sleep too much?
A: Absolutely not! The average American 100 years ago was getting nine hours of sleep a night. This means it was as normal to get 10 hours a night as eight hours a night. What changed all this was electricity and development of light bulbs, television, radio, computers, etc. We are now averaging as little as 6 1/2 hours of sleep a night in this country, and this is simply not enough to maintain health for most people! In fact, if you ask the anthropologists they will note that the average night’s sleep back until 4 thousand years ago was twelve hours! When the sun went down, it was boring and dangerous to be out, so people want to sleep and then woke up at sunrise. The average time from sunset to sunrise is twelve hours. So you can see just how sleep deprived we are as a society.
Q: What you mean by “deep restorative sleep”?
A: Sleep is not just a matter of being unconscious. It takes a specific “switch” in the brain to put you into sleep and keep you there. Once you are asleep, there are 4 sleep stages plus dreaming. Stage one and two are the light stages of sleep. Stage 3 and 4 are the deep stages of sleep where you ‘recharge your battery’, improve immune function, and release growth hormone for tissue repair. These last two deep sleep stages seem to be diminished and are of poor quality in CFS and fibromyalgia. This is why it is important to pick sleep treatments that do not keep you out of deep sleep like most sleeping pills.
Q: So how to I get my eight to nine hours sleep a night?
A: The first thing, of course, is to make time for it. Many of us feel like we’re so rushed in our day-to-day lives that we don’t have time for sleep. Unfortunately, lack of sleep causes you to function so inefficiently that you’ll actually make more time in your life by getting eight to nine hours of deep sleep a night. Look at the things you’re doing to see which ones don’t feel good. I recommend you eliminate those and replace them with sleep.
The next thing to do would be to use treatments that have been shown to improve sleep quality and symptoms in CFS and fibromyalgia. Many of these are natural and others are prescription. The benefit of the natural ones is that they tend to have less side effects and that you can get them on your own. For those without prescription coverage they can also be cheaper. The benefit of prescription medications is that they are less expensive for those with insurance coverage and may require fewer tablets.
There are a few critical sleep therapy concepts to know before we start to discuss specific treatments in depth. These will be discussed next issue. For now, you can start with these if you’d like.
- Revitalizing Sleep Formula (by Enzymatic Therapies and PhytoPharmica) – Valerian 200mg, Passion Flower 90mg, L-Theanine 50mg, Hops 30mg, Piscidia 12mg and Wild Lettuce 28mg. Take 2-4 capsules each night 30 to 90 minutes before bedtime. This is available in most health food stores and on my website at http://www.EndFatigue.com
- Take calcium and magnesium at bedtime. You may choose to take half a scoop of the daily energy Enfusion powder at bedtime (take the other half scoop in the morning with the B-complex) to get the magnesium.
- Eat some turkey at bedtime. This can prevent hypoglycemia during the night and also supplies Tryptophan which helps sleep.
- Melatonin, one-half to 1 mg at bedtime (or 5 mg taken five hours before you want to go to sleep if you are wide awake at bedtime).
- Doxylamine 25 milligrams (Unisom for sleep) — make sure it is pure doxylamine with no other medications added. This is like Benadryl but more effective for sleep. It is not natural but it is over-the-counter.
- Taking 5-HTP 200-400 mg at bedtime (limit it to 200 mg if you are on antidepressants) can help sleep, pain, and induce weight loss. Where the other treatments will work the first night that you take them, it can take the5- HTP six to twelve weeks to see the full effect.
For those of you who would like to begin with prescriptions, the three best ones to use are Ambien 10 mg, Desyrel 25 to 75 milligrams, and or Klonopin 1/2 to 1 and 1/2 mg — often in combination.
In the upcoming newsletters we will review 20 natural and prescription sleep aids in more depth. The newsletter after the upcoming newsletter will list these with directions for use. Newsletters that follow will discuss each of the treatments in more length, discussing the strengths and weaknesses of each.
You can see this list now by going to http://www.EndFatigue.com , click on the left lowest link which says “treatment protocol” and scroll down to “sleeping AIDS for fibromyalgia”. The upcoming newsletters, however, will give you much more information!
Dr. Teitelbaum is a board certified internist and director of the Annapolis Research Center for Effective CFS/Fibromyalgia Therapies, where he sees CFS/Fibromyalgia/Chronic pain patients from all over the world (410-266-6958). Having suffered with and overcome these illnesses in 1975, he spent the next 28 years creating, researching, and teaching about effective therapies. He is the author of the best-selling From Fatigued to Fantastic!” and the newly released “Three Steps to Happiness! Healing through Joy”. His web site can be found at: http://www.vitality101.com
Dr. Judith Orloff MD