What is the safest sleep aid to take?

There are an overwhelming number of options when it comes to medications designed to force your body into sleep. Unfortunately, many sleep medicines promote “sleep”, but not healthy, natural sleep cycles, leaving you groggy and drowsy the next day. Even worse, most pharmaceuticals contain toxic additives and have multiple potential side effects. 

Perhaps, before turning to an over-the-counter sleep medicine full of difficult-to-pronounce chemicals, give some natural options a try. Certain nutrients are known to promote relaxation and restful sleep and can even work synergistically to help you fall and stay asleep through the night. 

The best part about our list of “sleep aids” is that you can choose one or two to try, or all of them together. Of course, the safest sleep aids of all are not ingested but practiced. Read on to find out about healthy habits that may cure your sleep difficulties. These tips are all backed by research, and so low-risk that they can be used in tandem. We really want to help you get some high-quality rest because sleep is so integral to feeling your best.

1. Have you tried taking Melatonin before bed?

Melatonin is a hormone that is produced naturally by the pineal gland during hours of darkness. Its job is to regulate the “body clock” that controls when you’re awake and when your body is ready for sleep. This clock typically follows a 24-hour cycle called the circadian rhythm. The rhythm affects how every cell, tissue, and organ works [1]. Natural melatonin production requires a diet rich in the amino acid tryptophan, which is used to make serotonin, the precursor for melatonin [2]. Supplementing with melatonin does not change circulating levels of serotonin, or affect mood, but low levels of serotonin could be a cause for poor melatonin production and consequential difficulty sleeping [3]. This is one probable link between sleep disorders and depression, drug addiction, and other serotonin-related pathologies [2].

Naturally, sufficient levels of circulating melatonin should spike at night to help us fall and stay asleep, but as we age, we tend to produce less and less melatonin [4]. This may be the reason new sleep difficulties often arise as we advance into our later years of life. It is also the reason that melatonin supplements should be taken in the evenings. The highest levels of circulating melatonin should occur when you are ready to sleep, mimicking the young, healthy body’s natural cycles. 

Melatonin is available as a stand-alone nutrient for supplementation and can be found in a range of dosing options. Metabolic Maintenance^® offers a 2 mg melatonin capsule designed to help you both fall and stay asleep. Melatonin is also a key ingredient in the R.E.M. Maintenance™ Natural Sleep Support supplement powder. 

2. How much magnesium is in your diet?

Magnesium promotes deep, restorative sleep. Deficiency in this essential nutrient can cause symptoms such as insomnia, leg cramping, and restless leg syndrome [5]. Magnesium-related insomnia is often associated with both restless sleep and frequent waking during the night. Luckily, for many people there is an easy fix to this problem: magnesium supplements lead to deeper, more restful sleep [6,7,8].

The mechanism of magnesium’s effects on sleep is related to its role as a regulator of the parasympathetic nervous system, which is the system responsible for promoting calm and relaxation [6]. It also helps to regulate melatonin [7] and GABA, the neurotransmitter responsible for quieting the nervous system [8]. 

Unfortunately, as we age, the digestive system becomes less efficient. We tend to absorb less magnesium from the diet in later years, even if the amount of magnesium in our food stays the same. This problem can be exacerbated by conditions such as diabetes, digestive issues, or high alcohol consumption [9]. 

Metabolic Maintenance^® offers supplemental magnesium in multiple forms. Magnesium citrate, magnesium bound to citric acid, is one of the most bioavailable options. “Bioavailable” means it is easily absorbed by the gut and enters circulation for use throughout the body. It does, however, have a natural, gentle laxative effect. If you already have bowel issues that make a gentle laxative sound uncomfortable, you could try magnesium glycinate (magnesium bound to glycine) instead. This option is less likely to affect your bowels and glycine may also add to the relaxation effect of magnesium. Magnesium can also be found in Metabolic Maintenance^®’s R.E.M. Maintenance™, in formulas with calcium, potassium, and/or zinc, as well as in most multivitamin formulas.

3. How about trading sugar for glycine?

Glycine is an amino acid that has a very sweet flavor and dissolves quickly and easily in water-based liquids. This characteristic makes glycine an excellent candidate for use as a sweetener in warm drinks, without adding empty calories or a burst of energy like sugar. Consider adding glycine to a calming cup of chamomile tea before bed for a sweet, warming, and relaxing treat that prepares your body for rest.

Glycine is a very versatile amino acid in terms of the roles it plays throughout the body. It easily crosses the blood-brain barrier, inducing a calming effect on the brain and helping you wind down to prepare for sleep. It does this by interacting with the suprachiasmatic nucleus (SCN; the 24-hour biological clock in the central nervous system that controls when we should be asleep and awake). In response to glycine, the SCN triggers a reduction in core body temperature through vasodilation, which is an important biological step in the onset of sleep [10]. 

Because glycine’s effect on sleep is considered to occur through thermoregulation, it will not contribute to any morning grogginess after a good sleep. And actually, it may do quite the opposite by regulating adrenal production of hormones for wakefulness during the day [11].

Glycine also works as a neurotransmitter with balancing effects on parts of the brain and central nervous system. It plays a positive role in cognition, mood, appetite and digestion, immune function, pain perception, as well as restful sleep [12]. Glycine is also involved in the production of other biochemicals that influence these body functions, including serotonin. Serotonin, as we mentioned above, is a necessary precursor for natural melatonin production and sleep [12]. 

4. Could a serotonin precursor, like 5-HTP help to put you at ease?

5-HTP supports the production and release of both serotonin and melatonin. You may notice a theme developing around the essential role serotonin plays in maintaining healthy melatonin levels. Both serotonin and melatonin are critical to sleep and a functional biological clock. 

We mentioned above that the body requires the amino acid tryptophan as a building block for serotonin production. Unfortunately, some people don’t get enough of this amino acid from the diet alone. Even if you do, the body must convert dietary tryptophan to 5-hydroxytryptophan, better known as 5-HTP, before it can be used to make serotonin. 5-HTP is the direct precursor for the production of serotonin and is therefore also an indirect precursor for melatonin. Supplementary 5-HTP bypasses the light-triggering system that regulates the natural release of melatonin, and provides the substrate for an increase in both serotonin and melatonin release, regardless of light or time of day. 

Because 5-HTP increases serotonin, it has a calming, relaxing effect on brain chemistry, and may help to ease any anxiety that occasionally arises at bedtime. Studies have shown that 5-HTP supplementation can help patients fall asleep faster and sleep more deeply than a placebo [13]. Serotonin also plays an important role in many other bodily functions, including digestion, appetite, and pain perception [13]. 

Metabolic Maintenance^® offers both L-tryptophan and 5-HTP as stand-alone supplements. 5-HTP is also an ingredient in R.E.M. Maintenance™. Please consult your doctor before taking these supplements if you are undergoing SSRI therapy, as both target serotonin activity. 

5. Does science support drinking chamomile tea for sleep?

Chamomile tea is widely known as a relaxation drink to be enjoyed before bed. But, there is in fact some science to support the calming power of chamomile. Chamomile tea is made from the dried flowers of the chamomile plant, a member of the daisy family [14]. These flowers are rich in terpenoids and flavonoids, including a specific antioxidant flavonoid called apigenin. Apigenin binds to benzodiazepine receptors in the brain; the same receptors bound by drugs like diazepam (Valium). Although its effects are much more subtle, the signal released by these receptors tends to decrease anxiety and bring on sleep [14]. There are also compounds in chamomile that bind GABA receptors, mimicking effects of the calming neurotransmitter, GABA [14]. Clinical studies have even shown chamomile extract to have mild anxiolytic effects in subjects suffering from mild to moderate generalized anxiety disorder (GAD) [14]. 

6. Can a morning light boost cause an evening relaxation effect?

Bright light may seem counterintuitive since a dark bedroom is best for sleep, but phototherapy in the morning may actually help you sleep soundly later. Photo- or light therapy is the act of having a bright light near your face for a period of time, simulating natural sunshine. Often, sleep difficulties arise from a disruption to the circadian rhythm. Melatonin at night can help get your body clock back on track, but so can bright light first thing in the morning. 

The light actually triggers photoreceptors that communicate with the SCN in the hypothalamus (the SCN is the ruler of the circadian clock we mentioned in the actions of glycine) [15]. Light stimulates a number of signaling cascades, telling your brain to wake up. If your mornings are often dark and gloomy, that could be contributing to your groggy feelings or daytime sleepiness. 

Not just any light will do, however. Phototherapy lamps or “lightboxes” are not the same as sun lamps or reading lamps. They filter harmful UV rays (so you won’t catch a tan) and emit a specific amount of sun-mimicking light, measured in “lux”. Your doctor can recommend the right strength of lux for your sleep-regulating needs, but lamps generally range from 2000 to 10,000 lux. The light must reach your eyes to trigger photoreceptors, so having the lamp near your face is a must. 

7. Is “meditation” the answer to EVERY question these days? 

Meditation may not feel like “your thing”, but before you roll your eyes, consider the science! The first evidence of an association between meditation and sleep was published in 1997 [16]. That study showed individuals who practiced Transcendental Meditation (TM)^® slept deeper, with more time in restorative slow-wave sleep than non-meditating subjects, as measured by electroencephalograph (EEG) [16]. It also showed that the longer people practiced, the more restful their sleep became. 

Since then, a lot of studies have been aimed at uncovering the mechanisms behind this phenomenon. It doesn’t just apply to TM either. Similar results are seen in mindfulness practice (vipassana meditation) [17]. In terms of the mechanism, meditation has been shown to reduce levels of stress hormones, cortisol, and catecholamines, through regulation of the hypothalamo pituitary adrenal (HPA) axis [17]. Meditation techniques can even raise melatonin levels by increasing production in the pineal gland and slowing breakdown in the liver [17]. Additionally, the natural deterioration of sleep as we age appears to be slowed by meditation. In other words, when older people meditate regularly, their sleep patterns tend to resemble the sleep patterns of younger people [17]. 

If you need help getting started with meditation, there are many meditation apps for your computer or smartphone (Headspace, Calm, etc.) and many free options on YouTube. You might consider searching “sleep meditation”, specifically. Some guided meditations are practiced during the day even though they are aimed at improving your nighttime sleep. Others are meant to be listened to in bed to send you off to sleep at night. Keep trying different guides and practices until you find one you connect with.

References

1. National Institutes of Health. Sleep Deprivation and Deficiency Website. Accessed Dec 10, 2018. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency
2. Erland, Lauren AE, and Praveen K. Saxena. “Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content.” Journal of Clinical Sleep Medicine 13.02 (2017): 275-281.
3. Hardeland, Rüdiger. “Neurobiology, pathophysiology, and treatment of melatonin deficiency and dysfunction.” The Scientific World Journal 2012 (2012).
4. Sack, Robert L., et al. “Human melatonin production decreases with age.” Journal of pineal research 3.4 (1986): 379-388.
5. Popoviciu, L., et al. “Clinical, EEG, electromyographic and polysomnographic studies in restless legs syndrome caused by magnesium deficiency.” Revue Roumaine de Neurologie et Psychiatrie (1993).
6. Wienecke, E., and C. Nolden. “Long-term HRV analysis shows stress reduction by magnesium intake.” MMW Fortschritte der Medizin 158.Suppl 6 (2016): 12-16.
7. Durlach, J., et al. “Biorhythms and possible central regulation of magnesium status, phototherapy, darkness therapy and chronopathological forms of magnesium depletion.” Magnesium research 15.1-2 (2002): 49-66.
8. Poleszak, Ewa. “Benzodiazepine/GABAA receptors are involved in magnesium-induced anxiolytic-like behavior in mice.” Pharmacological Reports 60.4 (2008): 483.
9. National Institutes of Health. Magnesium Fact Sheet for Professionals. Accessed Dec 10, 2018. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/.
10. Kawai, Nobuhiro, et al. “The sleep-promoting and hypothermic effects of glycine are mediated by NMDA receptors in the suprachiasmatic nucleus.” Neuropsychopharmacology 40.6 (2015): 1405.
11. Caldwell, Heather K., et al. “Social context, stress, neuropsychiatric disorders, and the vasopressin 1b receptor.” Frontiers in neuroscience 11 (2017): 567.
12. Breus, Micheal. “Understanding Glycine”. The Sleep Doctor. July 23, 2018. https://thesleepdoctor.com/2018/07/23/understanding-glycine/
13. Cauffield, Jacintha S., and Hiroko Jm Forbes. “Dietary supplements used in the treatment of depression, anxiety, and sleep disorders.” Lippincott’s primary care practice 3.3 (1999): 290-304.
14. Srivastava, Janmejai K., Eswar Shankar, and Sanjay Gupta. “Chamomile: a herbal medicine of the past with a bright future.” Molecular medicine reports 3.6 (2010): 895-901.
15. Van Maanen, Annette, et al. “The effects of light therapy on sleep problems: a systematic review and meta-analysis.” Sleep medicine reviews 29 (2016): 52-62.
16. Mason, Lynne I., et al. “Electrophysiological correlates of higher states of consciousness during sleep in long-term: Practitioners of the transcendental meditation program.” Sleep 20.2 (1997): 102-110.
17. Nagendra, Ravindra P., Nirmala Maruthai, and Bindu M. Kutty. “Meditation and its regulatory role on sleep.” Frontiers in Neurology 3 (2012): 54.