Insomnia – The Nutrition Connection
Editorial by Patrick Holford, CEO, Food for the Brain Foundation
There's a simple contributor to depression, anxiety, stress and other mental health issues and that is a lack of sleep. According to the National Sleep Foundation we sleep 20% less now than they did 100 years ago, one in three suffer from some kind of insomnia and, in the US, 10 million people take prescription drugs to help them sleep. Being too tired or needing sleep is also the most common reason given for not wanting sex, says a Consumer Reports survey [1].
The chemistry of sleep hinges on two key components. The first is melatonin and the second is adrenalin. Melatonin is the brain's sleep neurotransmitter that is released as it gets darker to give you a good night's sleep. Melatonin is an almost identical molecule to serotonin, from which it is made, and both are made from 5-HTP, itself derived from the amino acid tryptophan which is present in most protein foods.
One way to improve matters is to provide more of the building blocks that are used to make serotonin and that means
5-HTP (5-hydroxyytryptophan), which in turn is made from tryptophan, a conversion process that requires folic acid, B6, vitamin C and zinc. So you've got a biochemical chain stretching straight from foods that are particularly high in tryptophan, like chicken, cheese, tuna, tofu, eggs, nuts, seeds and milk, up to melatonin. Other foods associated with inducing sleep are cherries, lettuce and oats. To support your brain's ability to turn tryptophan into serotonin and melatonin, it's best to supplement a high-potency multivitamin that contains at least 200mcg of folic acid, 20mg of vitamin B6, 10mg of zinc, as well as 100mg of vitamin C and 100mg of magnesium, which promotes both mind and muscle relaxation.
Or you could supplement with these natural chemicals directly. Melatonin, which is a neurotransmitter, not a nutrient, is proven to help you get to sleep but needs to be used much more cautiously than a nutrient. In controlled trials it's about a third as effective as pharmaceutical sleeping pills, but has a fraction of the side effects [2]. If you have both difficulty getting to sleep, perhaps only going to sleep very late, and are prone to feeling low it's particularly effective both for helping you sleep and for improving mood [3].
Even so, supplementing too much can have undesirable effects such as diarrhoea, constipation, nausea, dizziness, reduced libido, headaches, depression and nightmares. However, if you do sleep badly, can't get to sleep until late and are prone to low moods, you may want to try between 3mg and 6mg before bedtime. Although melatonin is available over the counter and on the internet in countries such as the US and South Africa, in the UK, melatonin is classified as a medicine and is only available on prescription therefore, if you live in the UK, you will need to discuss this option with your doctor. I don't recommend melatonin on a long-term basis but it can be very useful to bring you back into balance.
Another option is to take the amino acid 5-HTP. Supplementing 100 to 200mg of 5-HTP half an hour before you go to bed helps you get a good night's sleep [4]. It's also been shown to reduce sleep terrors in children when given at an amount equivalent to 1mg per pound of bodyweight before bed [5]. 5-HTP is best taken on an empty stomach, or with a small amount of carbohydrate such as an oatcake or a piece of fruit, one hour before sleep.
The second factor is the process of relaxing and switching off adrenalin, the fight flight hormone. Many people find it hard to switch out of a state of general anxiety sufficiently to fall asleep without help. 
Many resort to alcohol, which temporarily promotes GABA, a neurotransitter that switches off adrenalin. But the effect doesn't last and too much alcohol leads to GABA depletion. Again, you can supplement directly with GABA. In the US and other countries you can buy GABA in 500mg capsules. Taking one to three an hour before bed helps promote a good night's sleep. The combination of GABA and 5-HTP is even better. In a placebo-controlled trial the combination of GABA and 5-HTP cut time taken to fall asleep from 32 minutes to 19 minutes and extended sleep from 5 to almost 7 hours [6]. Taking 1,000mg of GABA, plus 100mg of 5-HTP is a recipe for a good night's sleep. The herb Valerian also promotes GABA. A review of studies to date cites six studies that show a significant benefit [7]. My experience is that it works exceptionally well for many people. To use to help sleep, take 150 to 300mg about 45 minutes before bedtime.
It's also critical to avoid caffeine after noon because caffeine suppresses melatonin for up to ten hours [8]. Have a glass of cherry juice instead. Those who drank two glasses of Cherry Active versus placebo had increased melatonin levels, sleep duration and sleep quality, finds a recent study [9].
Learning how to switch off adrenalin in the evening is a key skill for insomniacs. Practising yoga, T'ai Chi or meditation are all good options. So too is listening to a CD called Silence of Peace by John Levine, which is music specifically designed to switched brain activity into alpha waves, which is the pre-requisite for a good night's sleep. Also, avoid stimulating exercise, movies or the ten o'clock news in the evening. It's also important to get to the root of deep-seated worries and fears and get some resolution. Psychotherapy can also be very helpful.
We treat many people at the Brain Bio Centre with insomnia and explore these and other potential reasons for having sleeping problems.
Article reproduced by kind consent of Patrick Holford CEO, Food for the Brain Foundation
GABA image courtesy of Vitamin Research Products
[1] Consumer Reports (2009) CR poll: Economy isn't hurting Americans' sex lives But insomnia and poor health could be taking a toll. Available from: www.consumerreports.org/health/conditions-and-treatments/sex-poll/overview/sex-poll-ov.htm
[2] A. Brzezinski et al., ‘Effects of exogenous melatonin on sleep: a meta-analysis’, Sleep Medicine Reviews, 2005;9(1):41-50S
[3] A. Rahman et al., ‘Antidepressant action of melatonin in the treatment of Delayed Sleep Phase Syndrome’, Sleep Medicine, 2010 Feb;11(2):131-136
[4] T. C. Birdsall, ‘5-Hydroxytryptophan: a clinically-effective serotonin precursor’, Alternative Medicine Review, 1998;3(4):271-80
[5] O. Bruni et al., ‘L-5-Hydroxytryptophan treatment of sleep terrors in children’, European Journal of Pediatric Neurology, 2004;163(7):402-7
[6] W. Shell et al., ‘A Randomized, Placebo-Controlled Trial of an Amino Acid Preparation on Timing and Quality of Sleep’, American Journal of Therapeutcis, 2009 May 15
[7] S. Bent et al., ‘Valerian for sleep: a systematic review and meta-analysis.’ American Journal Medicine. 2006 Dec;119(12):1005-12. Review.
[8] L. Shilo et al., ‘The effects of coffee consumption on sleep and melatonin secretion’ Sleep Medicine 2002;3(3):271-3
[9] Pigeon WR, Carr M, Gorman C and Perlis ML. Effects of a Tart Cherry Juice Beverage on the Sleep of Older Adults with Insomnia: A Pilot Study. Journal of Medicinal Food, 2010; 13: 579-583