An Integrated Approach to Sleep Disturbances

By Dr. Britta Zimmer, Medical Director

Thirty percent of children and adolescents experience some sort of sleep disturbances. Sleep disorders include insufficient sleep, insomnia, sleep apnea, circadian rhythm disorder, bedwetting, sleepwalking, restless legs and narcolepsy. Insomnia is defined as the prolonged inability to get the amount of sleep you as an individual, need to wake feeling rested. We often use this term (insomnia) loosely when describing a poor night’s rest.

Teenagers need an average of 9.25 hours of sleep every night. The fact is, you can do everything right for your health in terms of eating well and exercising, but if your sleep is dysregulated then you cannot achieve optimal health. With proper sleep, our memory is well consolidated, our immune systems are strong and our neuroendocrine systems are balanced.

Sleep is one of the Pillars of Health at Pacific Quest. We evaluate sleep quality for all adolescents and young adults in our care as part of our integrated approach to wellness. Though sleep disturbances are common for incoming Pacific Quest students, many do not consider sleep when making a connection to their overall health and well-being.  At Pacific Quest, we help young people to gain a greater sense of awareness around the importance of quality sleep. This awareness, coupled with the structure of the program help to restore quality sleep for many of our students.

Poor sleep can cause a variety of symptoms including: Mood swings, irritability, fatigue, inattention, hyperactivity, depression, impulse control problems, low tolerance for frustration, learning problems, behavioral problems, cardiovascular issues, adverse metabolic effects, hormonal imbalance, headaches, hypoglycemia, and anxiety.  Many of these symptoms mimic or are a symptom of other disorders and can be addressed with sleep restoration.

Many people experience sleep disturbance related to “cognitive popcorn”.  This refers to when you wake up in the middle of the night and cannot go back to sleep because your mind is racing. This is a common complaint I hear from the Pacific Quest students.

How to address sleep issues:

1.   Practice proper sleep hygiene

  • Sleep in a dark environment. Even the light from your cell phone can disturb melatonin secretion. Melatonin is a hormone needed for adequate sleep and an important antioxidant. It gets secreted most efficiently in the complete dark.

  • Avoid stimulants such as caffeine, chocolate, nicotine and alcohol within 4 hours of bedtime. I have had some patients who need to give up coffee completely (to their dismay) in order to fully correct their sleep disturbances. It can take up to 2 weeks of strict caffeine avoidance to correct a sleep disturbance.

  • Designate your bed and bedroom for sleep only. Watching TV or working on your computer in bed will disrupt your sleep.

  • Avoid napping during the day.  This can disturb your circadian rhythm.

  • Exercise. Leave the vigorous exercise for the morning hours and more restorative types of exercise for the afternoon.

  • Establish a regular bedtime and “wind down” routine. Going to sleep and waking up at the same time every day (including the weekends) will restore your natural sleep rhythms.

  • Do not eat a big meal right before bed. Having said that, I have used a protein snack to help sleep disturbances as this can balance the blood sugar levels throughout the night.

  • Expose yourself to natural light daily. This helps maintain a healthy sleep-wake cycle

  • Establish a nighttime ritual that does not include electronics.  Sip tea, do some light stretching, or journaling.

2.   Ditch the sleeping pills

  • NIH produced a meta-analysis finding that most sleeping pills create amnesia for awakenings and poor sleep. So you think you are sleeping well but really you are not experiencing restorative rest.
  • Sleeping pills can disrupt your memory formation and cause daytime sedation.
  • Consult your doctor before discontinuing any medications.

  • There are natural alternatives that can be used in place of sleeping pills.

3.   Learn mind-body techniques to induce sleep

  • Progressive Muscle Relaxation

  • Breathing Exercises

  • Visualization Techniques

4.   Treat the underlying causes

  • Uncover underlying issues such as hormone imbalance, anemia, hypoglycemia or thyroid disorders.

  • Evaluate medication side effects. Medications for the following medical issues have insomnia as a common side effect: pain medications, thyroid, asthma, depression,  high blood pressure, and cold/allergy medications.

  • Treat your sleep disturbance with non-toxic substances like melatonin, magnesium, chamomile, L-theanine, passion flower, GABA, and 5-HTP.

If you dread the night time because you consider yourself a “bad sleeper” or have labeled your child as a bad sleeper, create a new story with the above plan. Too often people accept poor sleep habits as part of their normal routine.

The integrative team at Pacific Quest recognizes the essential importance of restful sleep for optimal health.  We take a proactive integrative approach to sleep issues and with knowledge and insight, you can too. Sweet Dreams…