The issue of insomnia became a particular interest of mine during the past year or so, when a loved one disclosed that she only sleeps a few hours per night. My natural reaction, of course, was to dive into research and try to figure out how to help; however, I found that despite the outward perception, trouble sleeping stems from more than just an endless list of worries, an overactive mind or long-term stress. It may actually have a direct connection to one’s immune system.
Mary Bove, ND, recently gave a compelling presentation on “The Cytokine Connection to Insomnia" at the Southwest Conference on Botanical Medicine in Tempe, Arizona. Bove explained how cytokines, regulating glycoproteins acting as intercellular chemical messengers of the immune system, can be stimulated by chronic infection and inflammation. This causes the cytokines, which are responsible for regulating immunity and activating inflammation cells, to “wake up" the body at inopportune times in the night or early morning. A vicious cycle then begins: pro-inflammatory cytokines are released, causing sleep disruption; the same cytokines are released the next evening, causing another sleep disruption; and so on. Because cytokines tend to fall into patterns, the issue can seem never ending for many exhaustedly frustrated insomniacs.
Controlling chronic pain and inflammation can help improve one’s sleep, daytime alertness and performance, according to Bove. Along with inflammation, a variety of other factors can stimulate pro-inflammatory cytokines, varying from stress to nutrition to hormonal imbalances.
“Basically any system of the body that’s not functioning correctly can confuse the cytokines, causing them to work improperly," Bove said. “They will appear when they shouldn’t, and go away when they’re needed."
Bove suggested a multi-focused approach using botanical medicine to help people get their systems back on track. Regulating cytokines requires modulating neurotransmitters, quenching inflammation, regulating the immune system, eliminating triggers (stress, hormones, etc.), improving HPA axis function and using nervines and sedatives as needed.
Though insomniacs’ first instinct may be to turn to sleep medications, Bove stressed that these will not eliminate the triggers, and the medications often lead to addiction, daytime drowsiness and withdrawal symptoms. Some alternatives to taking sleep medications include improving sleep hygiene (which may involve adjusting one’s bedtime routine, eliminating lights and technology in the bedroom, etc.), improving diet, using botanicals treatments, and possibly implementing glycemic modulators (these modulators might be needed if the body wakes up from a shot of cortisol during the night).
Bove also listed several nutrients used for supporting sleep, which include:
- Melatonin—restores circadian rhythm and induces sleep cycle
- Magnesium—co-factor for serotonin
- Niacinamide—increases rapid eye movement (REM) sleep
- Cobalamin—improves sleep quality
- GABA (Gamma-aminobutyric acid)
- Omega-3s—reduce epinephrine and cortisol spikes
- Phosphatidylserine –blunts cortisol response to stress
“Believe it or not, it actually takes energy to fall asleep," Bove explained. “Factors such as a person’s BMI [body mass index], thyroid function, exercise habits and intake of B vitamins and coQ10 [coenzyme Q10] all affect sleep."
When regulating cytokines to improve sleep and eliminate disruption, herbal combinations can help significantly. Bove suggested using anti-inflammatories, immunomodulators, adaptogens and sedatives at certain times of the day for the best results. In the morning and midday, consumers with sleep difficulties should take adaptogens and immunomodulators (such as holy basil and ashwagandha, or milk thistle and Echinacea). At midday/early evenings, they should take adaptogens and immunomodulators once again, along with anti-inflammatories (turmeric and black pepper, for example). And finally, in the evenings, those hoping to improve sleep should consume anti-inflammatories and sedative plants (such as fresh milky oats or Jamaican dogwood).
There’s certainly no one-size-fits all treatment when it comes to insomnia and sleep disruption. Though solving sleep issues is far from simple, supplement and functional food manufacturers can help consumers catch the Z’s they need by formulating products using sleep-supporting, cytokine-modulating ingredients.