Insomnia

Question 1

Insomnia:

Answer 1

Insomnia: A common complaint that is divided into: * Difficulty falling asleep (‘sleep onset insomnia’).

• Frequent or early waking (‘sleep maintenance insomnia’).

Question 2

Sleep physiology:

Answer 2

Sleep physiology:

• Melatonin (N-acetyl-5-methoxytryptamine) regulates sleep and the circadian rhythm. Serotonin-N-acetyltransferase (SAMe dependent) is released in prolonged periods of darkness, increasing the conversion of N-acetyl-serotonin (NAS) to melatonin. Levels can be tested with salivary testing.
• Cortisol / adrenaline — excessive sympathetic / stress response may result in high cortisol, resulting in difficulty ‘switching off’.

Question 3

Causes / risk factors

Answer 3

• Sleep onset: Anxiety, stimulants (e.g., caffeine), climate, fears, pain, stress.
• Sleep maintenance: Hypoglycaemia, sleep apnoea, medications, high stress, alcoholism, depression, restless leg syndrome.
• Identify if the person is waking at a repetitive time and look at the corresponding time on the TCM clock. E.g., 1–3am indicates liver disharmony

Question 4

Natural approach

• Sleep hygiene / advice

Answer 4

Sleep hygiene / advice — regular bedtime; blackout blinds / eye mask; avoid stimulants; avoid screen use 1–2 hours before bed; avoid naps; switch WiFi off at night; remove EMF sources; wear blue light glasses especially in evenings; Epsom salt baths (500 g–1 kg) in evenings; relaxation techniques, abdominal breathing, eat dinner earlier, optimise room temperature (e.g., ~18°C).

Question 5

Natural approach

Answer 5

• Exercise (especially earlier in the day, in daylight. Go for a walk until tired.
• Consider weight management where applicable
• CNM Naturopathic Diet with focus on low GL foods.
• Support serotonin-melatonin conversion and GABA (earlier), e.g., tryptophan, magnesium, B6, folate-rich foods; probiotics.
• Tart Montmorency cherry juice (200‒500 mls per day) — contains high levels of phytochemicals including melatonin.
• Avoid alcohol, caffeine and tyramine-containing foods — excitatory in those who are sensitive: cheese, chocolate, wine and also avoid MSG

Question 6

Natural approach — supplementation:

Answer 6