top of page

Is your sleep restorative?

One of the most fundamental health priorities and wellness indicators is sleep. Sleep quality, length and timing are all factors that will affect your quality of life. An appraisal of sleep usually involves the following:

  • Onset: Ability to fall asleep

  • Maintenance: sustaining sleep

  • Offset: waking early; and

  • Restorative sleep: feeling refreshed upon waking.

Are you experiencing restorative sleep?

How do you feel when you wake up? Are you drowsy or do you feel well rested?

This can definitely depend on what time you are getting up and what time you went to bed. A 12am bedtime or a 4am wake-up is likely to provide some intense sleepiness. If your sleep hours are approx. 8 hours between 9pm and 7am, it will be easier to assess because this is a typically restful routine.


Objectively, you can look at how many times you wake up during the night, wake times and how long you stayed awake, considering restorative hours are usually 2 - 4 am. Coupled with how you feel physically, an assessment can be made.


Poor sleep can be cyclic for some, but consistent for others and unfortunately physically getting used to sleep issues is not possible. The body needs restorative sleep for so many reasons including:

  • Immune health

  • Weight maintenance

  • Cognitive function

  • Memory creation

  • Mood balance

  • Emotional stability

  • Appetite

Just to name a few.


When is it considered “insomnia”

Sleep disorders such as insomnia are common and is usually applicable when there have been sleep complications for longer than 3 months and they occur up to 3 times a week. "Complications" being the factors used for appraisal as mentioned above.


The main symptom of insomnia is daytime sleepiness, while is common, often indicates that health improvements need to be made. This might be changes to sleep hygiene but often there will be other bodily systems to address.


Why can’t I sleep?

In this situation, occam’s razor is usually considered i.e. What is the most obvious answer? This cannot always be identified by an individual, which is why seeing a practitioner is helpful.


What a practitioner might assess:

Ingestive Disruptors – caffeine, alcohol, medication, recreational drugs. Note that your intake of these might be the same as usual, but a substance’s affect can change day to day. Adenosine is a sleep onset hormone which is antagonized by these substances.

Mental and emotional – stress, anxiety, fear, grief. Cortisol produced during this type of overstimulation interferes in the role of the “stay asleep” hormone Melatonin.

Environmental – Temperature changes, noise and light are huge interrupters. Melatonin is modulated by light, being more preferrable during the day.


Treatment

This will depend on the cause. It may mean 1. Reducing or eliminating substances, 2. improving the sleep environment and 3. adopting stress management practices.


Core Daily actions for better sleep:

  • Daily Exercise – for stress management, but also tires the body.

  • Nutrient dense diets – associated with better sleep onset. Sleep hormones also depend on Tryptophan, Magnesium and carotenoid rich foods for synthesis.

  • Sunlight – Sit outside for 30 minutes of bright light.

When to investigate further

Always seek help for causes such as pain, snoring or restless leg syndrome, which usually require further assessments, testing and a broader scope of treatment. Further investigation into reasons for fatigue that extend beyond poor sleep may also be required – these include thyroid hormones, Iron levels and infections.


If you would like to improve your sleep and relieve fatigue, please get in touch for a consultation.


Jo Knight – Naturopath @ Purple Tree Therapies

BHlthSc(ComplMed), Adv Dip Nat., Adv Dip Nut., Adv Dip. WestHerbMed

Located at Habitual Health Collective, New Farm, Qld.

enquiries@purpletreetherapies.com.au


References

Abdellah A, Berlin, A, Blondeau, C, Guinobert, I, Guilbot, A, Beck, M, Duforez, F, 2019, ‘A combination of Eschscholtzia californica Cham. and Valeriana officinalis L. extracts for adjustment insomnia: A prospective observational study, Journal of Traditional and Complementary Medicine, vol. 10, no. 2, pp. 116-123 1 – 5.


Aman, U, Subhan, F , Shahid, M, Akbar, S, Ahmad, N, Ali, G, Fawad, K & Sewell, R, 2016, ‘Passiflora incarnata attenuation of neuropathic allodynia and vulvodynia, apropos GABA-ergic and opioidergic antinociceptive and behavioural mechanisms’, BMC Complementary and Alternative Medicine, vol. 16, no. 77, pp. 1-17. Andersson H, Tullberg C, Ahrné S, Hamberg K, Lazou Ahrén I, Molin G, Sonesson M, Håkansson Å, 2016, ‘Oral Administration of Lactobacillus plantarum 299v Reduces Cortisol Levels in Human Saliva during Examination Induced Stress: A Randomized, Double-Blind Controlled Trial’, Int J Microbiol, vol. 2, pp. 1-7


Aoun, A, Maalouf, J, Fahed, M, El Jabbour, F, 2019, ‘When and How to Diagnose and Treat Vitamin D Deficiency in Adults: A Practical and Clinical Update’, J Diet Suppl, vol. 17, no. 3, pp. 336-354.


Assiss, GG & Gasanov, EV, 2019, ‘BDNF and Cortisol integrative system – Plasticity vs. degeneration Implications of the Val66Met polymorphism’, Frontiers in Neuroendocrinology, vol. 55, pp. 1-10.


Australian Bureau of Statistics 2018, Mental Health, Australian Government, viewed 19th January 2022, <https://www.abs.gov.au/statistics/health/mental-health/mental-health/latest-release>


Australian Institute of Family Studies (AIFS) 2022, Diagnosis in child mental health, Australian Government, viewed January 25th 2022, <https://aifs.gov.au/cfca/publications/diagnosis-child-mental-health/export>


Bayes, J, Schloss, J & Sibbritt, D, 2019, ‘Effects of Polyphenols in a Mediterranean Diet on Symptoms of Depression: A Systematic Literature Review’, Adv Nutr, vol. 11, pp. 602–615

Becker, A, Felgentreff, F, Schröder, H, Meier, B & Brattström, A, 2014, ‘The anxiolytic effects of a Valerian extract is based on Valerenic acid’, BMC Complementary and Alternative Medicine, vol. 14, no. 267


Bedrosian, TA & Nelson RJ, 2017, ‘Timing of light exposure affects mood and brain circuits’, Transl Psychiatry, vol. 7, no. 1, e1017- e1016


Boyle NB, Lawton C, Dye L, 2017, ‘The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review’, Nutrients, vol. 9, no. 5, pp. 429-450.


Cao, JX, Zhang, QY, Cui, SY, Cui, XY, Zhang, J, Zhang, YH, Bai, YJ & Zhao, YY, 2010, ‘Hypnotic effect of jujubosides from Semen Ziziphi Spinosae’, J Ethnopharmacol, vol. 130, no. 1, pp. 163-166.


Cao, Y, Taylor, AW, Wittert, G, Adams, R & Shi, Z, ‘Dietary patterns and sleep parameters in a cohort of community dwelling Australian men’, Asia Pac J Clin Nutr, vol. 26, no. 6, pp. 1158-1169.


Cao, Y, Zhen, S, Taylor, AW, Appleton, S, Atlantis, E & Shi, Z, 2018, ‘Magnesium Intake and Sleep Disorder Symptoms: Findings from the Jiangsu Nutrition Study of Chinese Adults at Five-Year Follow-Up’, Nutrients, vol. 10, no. 10, pp. 1354 – 1365


Carlessi, AS, Borba, LA, Zugno, AI, Quevedo, J, Réus, GZ, 2019 ‘Gut microbiota-brain axis in depression: The role of neuroinflammation’, Eur J Neurosci, vol.53, no.2, pp. 222-235


Cheah, KL, Norhayati, MN, Husniati, YL & Abdul RR, 2021, ‘Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis’, PLoS One, vol. 16, no. 9, pp. 1-22


Chen, N, Fong, DYT, Li, S & Wong, JYH, 2020, ‘Association between Non-Restorative Sleep and Quality of Life in Chinese Adolescents’, Int J Environ Res Public Health, vol. 17, no. 19, pp. 7249-7259.


Concerto, C, Boo, H & Hu, C, 2018, ‘ Hypericum perforatum extract modulates cortical plasticity in humans’ Psychopharmacology, vol. 23, pp. 145–153.


Culver, M, Bowman, J & Juturu, V, 2018, ‘Lutein and Zeaxanthin Isomers Effect on Sleep Quality: A Randomized Placebo-Controlled Trial’, Biomed J Sci & Tech Res, vol. 9, no. 2, pp. 7018-7024


Douglas, JA, Chai-Coetzer, CL, McEvoy, D, Naughton, MT, Neill, AM, Rochford, P, Wheatley, J & Worsnop, C, 2017, ‘Guidelines for sleep studies in adults - a position statement of the Australasian Sleep Association’, Sleep Med, vol. 36, no. 1, pp. S2-S22.


El-Sayes, J, Harasym, D, Turco, CV, Locke, MB & Nelson AJ 2019, ‘Exercise-Induced Neuroplasticity: A Mechanistic Model and Prospects for Promoting Plasticity’, Neuroscientist, vol. 25, no. 1, pp. 65-85.


Fan, J, Liu, W, Xia, J, Li, S, Gao, F, Zhu, J, Han, Y, Zhou, H, Liao, H, Yi, J, Tan, C, Zhu, X, 2021, ‘Childhood trauma is associated with elevated anhedonia and altered core reward circuitry in major depression patients and controls’, Hum Brain Mapp, vol. 42, no. 2, pp. 286-297.


Fedurco, M, Gregorova, J, Šebrlová, K, Kantorová, J, Peš, O, Baur, R, Sigel, E & Táborská, E, 2015, ‘Modulatory Effects of Eschscholzia californica Alkaloids on Recombinant GABAA Receptors’, Biochemistry Research International, vol. 2015, no. 617620.


Grosso, G, Galvano, F, Marventano, S, Malaguarnera, M, Bucolo, C, Drago, F, Caraci, F, 2014, ‘Omega-3 fatty acids and depression: scientific evidence and biological mechanisms’, Oxid Med Cell Longev, vol. 2014, no. 313570


Guadagna, S, Barattini, DF, Rosu, S & Ferini-Strambi, L, 2020, ‘Plant Extracts for Sleep Disturbances: A Systematic Review, Evidence-Based Complementary and Alternative Medicine’, vol. 2020, no. 3792390

Hausenblas, HA, Saha, D, Dubyak, PJ & Anton, SD, 2013, ‘Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials’, J Integr Med, vol. 11, no. 6, pp. 377-83.


He, X, Yang, L, Wang, M, Zhuang, X, Huang, R, Zhu, R & Wang, S, 2017, ‘Targeting the Endocannabinoid/CB1 Receptor System For Treating Major Depression Through Antidepressant Activities of Curcumin and Dexanabinol-Loaded Solid Lipid Nanoparticles’, Cell Physiol Biochem, vol. 42, no. 6, pp. 2281-2294.


Hechtman, L 2019, Clinical Naturopathic Medicine, 2nd edn, Elsevier, Chatswood.

Huang, Q, Liu, H, Suzuki, K, Ma, S, Lui, C, 2019, ‘Linking What We Eat to Our Mood: A Review of Diet, Dietary Antioxidants, and Depression’, Antioxidants, vol. 8, no. 9, pp. 376-393.

Gangadharb, BN, 2016, ‘Serum cortisol and BDNF in patients with major depression—effect of yoga’ International review of psychiatry, vol. 28, no. 3, pp. 273-278


Ghasemi, T, Abnous, K, Vahdati, F, Mehri, S, Razavi, BM & Hosseinzadeh, H, 2014, ‘Antidepressant Effect of Crocus sativus Aqueous Extract and its Effect on CREB, BDNF, and VGF Transcript and Protein Levels in Rat Hippocampus’, Drug Res vol. 65, no. 7, pp. 337-343.


Hofheinz, C, Reder, M & Michalak, J, 2020, ‘How specific is cognitive change? A randomized controlled trial comparing brief cognitive and mindfulness interventions for depression’, Psychotherapy Research, vol. 30, no. 5, pp. 675–691.


Holley, AL, Rabbitts, J, Zhou, C, Durkin, L & Palermo, TM, 2017, ‘Temporal daily associations among sleep and pain in treatment-seeking youth with acute musculoskeletal pain’, J Behav Med, vol. 40, no. 4, pp. 675-681.


Jorde, R, Sneve, M, Figenschau, Y, Svartberg, J & Waterloo, K, 2008, ‘Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial’, J Intern Med, vol. 264, no. 6, pp. 599-609


Kennedy DO, 2016, ‘B Vitamins and the Brain: Mechanisms, Dose and Efficacy--A Review’, Nutrients, vol. 8, no. 2, pp.68-96.


Khoraminya, N, Tehrani-Doost, M, Jazayeri, S, Hosseini, A & Djazayery, A, 2013, ‘Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder’, Aust N Z J Psychiatry, vol. 47, no. 3, pp. 271-275


Kim, KM, 2021, ‘What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide’, Eur Child Adolesc Psychiatry, vol. 30, no. 3, pp. 359-367.


Kim, S, Jo, K, Hong, KB, Han, SH & Suh, HJ, 2019, ‘GABA and l-theanine mixture decreases sleep latency and improves NREM sleep’, Pharm Biol. 2019, vol. 57, no. 1, pp. 65-73.


Leonard. BE, 2017, ‘Inflammation and depression: a causal or coincidental link to the pathophysiology?’, Acta Neuropsychiatrica, vol. 30 , Issue 1, pp. 1-16.


Liu YJ, Chen J, Li X, Zhou X, Hu YM, Chu SF, Peng Y, Chen NH. Research progress on adenosine in central nervous system diseases. CNS Neurosci Ther. 2019 Sep;25(9):899-910. doi: 10.1111/cns.13190. Epub 2019 Jul 23. PMID: 31334608; PMCID: PMC6698970.


Ma, Y, Han, H, Eun, JS, Kim, HC, Hong, JT and Oh, K, 2007, ‘Sanjoinine A Isolated from Zizyphi Spinosi Semen Augments Pentobarbital-Induced Sleeping Behaviors through the Modification of GABA-ergic Systems’, Biol. Pharm. Bull, vol. 30, no. 9, pp. 1748—1753.


Mah, J., & Pitre, T, 2021, ‘Oral magnesium supplementation for insomnia in older adults: a Systematic Review & Meta-Analysis’, BMC complementary medicine and therapies, vol. 21, no.1, pp. 125-136


Mitchell, BL, Thorp, JG, Wu, Y, 2021, ‘Polygenic Risk Scores Derived From Varying Definitions of Depression and Risk of Depression’, JAMA Psychiatry, vol. 78, no. 10, pp. 1152–1160.


Nadeem I, Rahman MZ, Ad-Dab'bagh Y, Akhtar M, 2019, ‘Effect of probiotic interventions on depressive symptoms: A narrative review evaluating systematic reviews’, 2019, Psychiatry Clin Neurosci, vol. 73, no. 4, pp. 154-162.


Nam, JN, Kim, J, Cho, KH, Choi, J, Shin, J & Park, E, 2017, ‘The impact of sitting time and physical activity on major depressive disorder in South Korean adults: a cross-sectional study’. BCM Psychiatry, vol. 17, no. 274, pp. 1-9


Naveen, GH, Varamballyb, S, Thirthallic, J, Raod, M, Christophere, M, & Pizzorno, J, Murray, M & Joiner-Bey, H 2015, The Clinician's Handbook of Natural Medicine, 3rd edn, Churchill Livingstone, London


Niyonsenga, T, Blunden, S, Meyer, B, Segal, L, Baune, BT & O'Dea. K, 2019, ‘A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial’. Nutr Neurosci, vol. 22, no. 7, pp. 474-487.


Oquendo, MA, Bernstein, CA, Mayer, LE, 2019, ‘A Key Differential Diagnosis for Physicians’, JAMA Psychiatry, vol. 76, no. 11, pp. 1111-1112.


Osiecki, 2010, The Nutrient Bible, 8th edn, Bioconcepts, Brisbane


Osser, DN, 2021, ‘Bipolar Depression: How Not to Miss the Diagnosis’, Psychiatric Times, vol. 38, no. 10, p.43


Oster, H, Challet, E, Ott, V, Arvat, E, de Kloet, ER, Dijk, DJ, Lightman, S, Vgontzas, A, Van Cauter, E, 2017, ‘The Functional and Clinical Significance of the 24-Hour Rhythm of Circulating Glucocorticoids’. Endocr Rev, vol.1, no.38, pp.3-45.


Panossian, A, 2017, ‘Understanding adaptogenic activity: specificity of the pharmacological action of adaptogens and other phytochemicals’, Acad Sci, vol. 1401, no. 1, pp. 49-64.


Park, CH, Song, JH & Kim SN, 2019, ‘Neuroprotective Effects of Tetrahydrocurcumin against Glutamate-Induced Oxidative Stress in Hippocampal HT22 Cells’, Molecules, vol. 25, no. 1, pp. 144-154


Peuhkuri, K, Sihvola, N, & Korpela, R, 2012, ‘Dietary factors and fluctuating levels of melatonin’, Food & nutrition research, vol. 56, pp. 17252-17261


Ramachandran, N, Smyth, N, Thorn, L, Eardley, A, Evans, P & Clow, A, ‘Relationship between post-awakening salivary cortisol and melatonin secretion in healthy participants’, Stress, vol. 19, no. 2, 260-263.


Quirk, SE, Williams, LJ, O'Neil, A, Pasco, JA, Jacka, FN, Housden, S, Berk. M & Brennan, SL, 2013, ‘The association between diet quality, dietary patterns and depression in adults: a systematic review’, BMC Psychiatry, vol.13, no.175


Roth, T, 2007, ‘Insomnia: definition, prevalence, etiology, and consequences’, Journal of clinical sleep medicine, vol. 3, no. 5, pp. S7-10.


Remenapp, A, Coyle, K, Orange, T, Lynch, T, Hooper, D, Hooper, S, Conway, K, & Hausenblas HA, 2022, ‘Efficacy of Withania somnifera supplementation on adult’s cognition and mood’, ‘Journal of Ayurveda and Integrative Medicine’, vol. 13, no. 2, pp. 1-6


Rotomskis, A, Margevičiūtė, R, Arūnas, G, Gintaras, K & Gintaras, B, 2015, ‘Differential diagnosis of depression and Alzheimer’s disease with the Addenbrooke's Cognitive Examination-Revised (ACE-R)’, BMC Neurology, vol. 15, no. 57, pp. 1-8


Sakurada, K, Konta T, Takahashi S, Murakami N, Sato H, Murakami R, Watanabe M, Ishizawa K, Ueno Y, Yamashita H, Kayama T. Circadian Clock Gene Polymorphisms and Sleep-Onset Problems in a Population-Based Cohort Study: The Yamagata Study. Tohoku J Exp Med. 2021 Dec;255(4):325-331.


Samadi, Z, Jannati, Y, Hamidia, A, Mohammadpour, RA, Hesamzadeh, A, 2021, ‘The effect of aromatherapy with lavender essential oil on sleep quality in patients with major depression’, Journal of Nursing and Midwifery Sciences, vol. 8, no. 2, pp. 67-73


Sarafino, EP & Smith, TW 2014, Health Psychology: Biopsychosocial interactions, 8th edn, Wiley, Hoboken.


Schmidt A, Costa MP, Vitorino PV, Corrêa KS, 2020, ‘Physical inactivity and symptoms of depression, anxiety and stress in adolescent students’, Acta Paul Enferm, vol. 34, pp. 1-9.


Solati, Z, Jazayeri, S, Tehrani-Doost, M, Mahmoodianfard S & Gohari MR, 2015, ‘Zinc monotherapy increases serum brain-derived neurotrophic factor (BDNF) levels and decreases depressive symptoms in overweight or obese subjects: a double-blind, randomized, placebo-controlled trial’, Nutr Neurosci, vol. 18, no. 4, pp. 162-168.


Seow, LSE, Verma, SK, Mok, YM, Kumar, S, Chang, S, Satghare, P, Hombali, A, Vaingankar, J, Chong, SA & Subramaniam, M, 2018, ‘Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population’, J Clin Sleep Med, vol. 14, no. 2, pp. 237-244.


Speers, AB, Cabey, KA, Soumyanath, A & Wright, KM, 2021, ‘Effects of Withania somnifera (Ashwagandha) on Stress and the Stress- Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia’, Curr Neuropharmacol, vol. 19, no. 9, pp. 1468-1495.


Stengler, M, 2021, ‘The Role of Folate and MTHFR Polymorphisms in the Treatment of Depression’, Alternative Therapies, vol. 27, no. 2, pp. 53-57.


Stringham, JM, Stringham, NT & O'Brien, KJ, 2017, ‘Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure’, vol. 6, no. 7, pp. 47-60


Thakkar, MM, Sharma, R & Sahota, P, 2014, ‘Alcohol disrupts sleep homeostasis’, Alcohol, vol. 49, no. 4, pp. 299-310.


Tang, AL, Thomas, SJ & Larkin, T, 2019. ‘Cortisol, oxytocin, and quality of life in major depressive disorder’, Quality of Life Research, vol. 28, pp. 2919–2928.


Veronese, N, Stubbs, B, Solmi, M, Ajnakina, O, Carvalho, AF, Maggi, S, 2018, 'Acetyl-L-Carnitine Supplementation and the Treatment of Depressive Symptoms: A Systematic Review and Meta-Analysis’, Psychosom Med, vol. 80, no. 2, pp. 154-159.


van der Burg KP, Cribb L, Firth J, Karmacoska D, Mischoulon D, Byrne GJ, Bousman C, Stough C, Murphy J, Oliver G, Berk M, Ng CH, Sarris J, 2020, ‘EPA and DHA as markers of nutraceutical treatment response in major depressive disorder’, Eur J Nutr. 2020 vol. 59, no. 6, pp. 2439-2447


Wu, PY, Lin, MY & Tsai, PS, 2020, ‘Alternate healthy eating index and risk of depression: A meta-analysis and systemematic review’, Nutr Neurosci, vol. 23, no. 2, pp. 101-109.

Yale Medicine 2021, How Depression Affects the Brain, Yale Medicine, viewed January 17th 2022, <https://www.youtube.com/watch?v=BZOLxSQwER8>


Zisapel N, 2018, ‘New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation’, Br J Pharmacol, vol. 175, no. 16, pp. 3190-3199.





Comments


Single Post: Blog_Single_Post_Widget
bottom of page