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Once again I am asking on behalf of my girlfriend,

Her sleep sucks, and it is really starting to bother her.

She is 100% paleo,

She has crappy digestion (taking HLC to help improve) She is currently doing a variation of Starting Strength with Squatting and Deadlift well below maximal. (working on form)

We go to sleep either at 9-10pm every night and normally get up at 5:30 if we go to the gym in the morning or at 7:00am. Depends on what time we go to bed. More often that not we get up at 7:00am.

Her sleep sucks, she is a very light sleeper, wakes up to pee 3-4 times a night which is more habit than anything. She doesn't drink water with in 2-3 hours of bed time. Has trouble falling asleep and staying asleep. I don't think she has had a good night sleep in months. However her sleep has improved since she has removed caffeine from her diet. She does drink Tea but it is decaf, so very low amount of caffine in it.

We sleep in a 100% dark cool room, no nights, no noise, no fans.

I am wondering what things can be used to improve sleep quality?

I was looking at Melatonin but I've seen stuff that taking it will down regulate your natural production of it, but I have been unable to find any studies that show it? Anyone have any input on this?

Would increasing Tryptophan supplementation help improve your bodies natural production of Melatonin?

Would having background music like rain help her sleep (or just make her pee more?)

Blue Light Therapy?

Looking for any input, ideas, or things that people have tried and have helped. Stress is higher than normal because she started a new job a while ago but her sleep problems go back before he job, so while i am not saying they are not related it is not the underlying cause IMO.

Any input will be greatly appreciated.

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Unless I'm super stressed all these work for me: a small fan for white noise, and air flow, and two ZMA when I crawl into bed. No electronics at least an hour before sleep. No books only magazines so I can put them down easily. I'm lucky to live in a railroad apartment, no windows in the bedroom, so I don't have to worry about light peeping in. As you already have a cool dark room, maybe try magnesium and the fan? Any other white noise option was too distracting for me.. – jesuisjuba - paleorepublic.com Nov 5 2011 at 14:05
^What is the job that she's now doing? Paleo friendly jobs/hobbies are important as to get exercise and not be too stressed. – Henry S Nov 5 2011 at 15:45
She is an allocation analyst, The job is only stressful because it is new and she is learning it, they have fired a 3 people all ready for not picking up the material fast enough. – Ryan H Nov 5 2011 at 20:02
^Does she do crossfit or anything like that? – Henry S Nov 5 2011 at 22:22
You mentioned that she is taking B complex as well. It is possible that something in the B complex supplement is actually causing her insomnia. I have had exactly the same symptoms whenever I take B6: restless, fitful sleep, frequent nighttime urination; plus early morning awakening, sometimes with anxiety. It took me a long time to figure out that it was actually aggravating things. By contrast, I find that B1 helps. She might want to try stopping the B complex and trying just B1. Beyond that, laying off the sources of caffeine for a while would be prudent. Even chocolate throws me off! – Stephen Mar 19 2012 at 10:12

8 Answers

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Melatonin can be very helpful for many people, but not everyone. One reason is a little known fact is that much of the melatonin we produce, like serotonin, is in the gut. According to one study it produces 400 times more than the pineal gland http://visceralsynergy.com/Visceral_Synergy/About_Dr._Mariotti_files/Melatonin%20Gut.pdf. If you have digestive issues it can help you as some studies show, but in my case it made things worse, and I found out why when I learned that it delays gastric emptying, which is a problem for someone who already has dysfunctional peristalsis. It's better to do things that improve the body's ability to make its own melatonin and change your lifestyle to support that (sleeping in darkness, not getting up during the night, not eating before bed, tryptophan supplementation, etc). From all the research I've done and from my experience, digestion is the key to sleep. I see the brain and gut as one organ just spread out over a larger area. Just as the brain is active yet resting at night, the gut is active as well. The more food you eat and the more is undigested during the day, the harder your gut has to work while you sleep to digest and absorb this food. This is why many people who take hcl acid and digestive enzymes, including myself, notice improvement in sleep quality while requiring less time to sleep. Good adrenal health is also key since it disrupts melatonin production among other things as this article summarizes http://bodyecology.com/articles/eat-before-bed. Finally, optimal leptin levels are also crucial for sleep. In evolutionary terms it makes sense because optimal leptin levels means lower appetite throughout the day, and the less your gut has to digest during the day, the less it has to absorb and assimilate at night, freeing up energy for the repair processes that take place while you sleep. Your appetite is lower since you require less food due to your mitochondria being more efficient at burning calories for energy. So our ancestors who evolved with genes that allowed them to do this could spend less time looking for food and less time sleeping, making them less likely to be eaten by a hungry animal. The hypocretin neurons control wakefulness and are controlled, among other things, by leptin. This shows that energy metabolism and sleep are connected and why studies show that sleep deprivation lowers leptin levels and is associated with obesity. So we're dependent on leptin for efficient energy metabolism, and the brain depends on it for wakefulness. http://www.marksdailyapple.com/leptin/ There's not just one thing you can do, because all these things are interconnected and affect each other. That's why the conventional system doesn't understand that paleo works as a lifestyle, not just a diet.

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this is some of the best advice i have EVER seen on hacks... – Mallory Nov 6 2011 at 0:33
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Agreed. Answer of the year 2011. – Phoenix Nov 6 2011 at 2:26
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i second and third! This guy is brilliant and one of the few who actually knows what he's talking about. :) – godb4science Nov 6 2011 at 2:48
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Magnesium will for sure help her (400mg before bed is fine), but I sincerely doubt it will be enough. From the symptoms, I would bet good money she has adrenal fatigue. Try the Iris Contraction Test:

http://forum.lowcarber.org/showthread.php?t=117152

Also, have her answer this thorough online questionnaire:

http://www.adrenalfatigue.org/take-the-adrenal-fatigue-quiz

If the results are pointing to adrenal fatigue, check out Dr. James Wilson's book, Adrenal Fatigue: The 21st Century Stress Syndrome. The information it contains on treatment is invaluable.

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Here's a vid showing what to look for with the Iris Contraction test: youtube.com/watch?v=GJz4U3C-mIw – White Dolemite Nov 5 2011 at 14:40
I would suggest mag chelate versus mag citrate. Definitely worth a try. – Annie Nov 5 2011 at 18:29
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What about her carb intake? Increase carbs, especially before bedtime. A sweet potato with a little butter and honey drizzled on it may help

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Because of her digestion problems, eating large amount of carbs like a sweet potato) cause her stomach pain and she doesn't sleep at all. She can't eat butter as she is allergic to casein and Glee also seems to cause her stomach problems. – Ryan H Nov 5 2011 at 17:54
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Glee also causes me stomach, and head problems. I of course mean the TV, show, not Ghee :) – peter Nov 6 2011 at 0:34
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If she doesn't take a B Complex I would recommend trying that as well. Thiamine levels have been shown to have an effect on sleep. Melatonin may not be a bad route to try for a while, but I wouldn't make a lifelong habit. It might be worth a try to see if it helps, and if it does then you know where the issue is and can make some lifestyle changes to naturally increase melatonin levels.

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Dhea is the better choice. Bad sleep predicts very low dhea and very high IL6 simultaneously. Mg and melatonin are like putting spackle on a blown out wall. You must get to the core brain issue to solve it. Sleep is yoked to leptin. This girl has to change a lot to get to the core. Testing would show this. – The Quilt Nov 5 2011 at 16:11
What tests? She is taking a B Complex as well. Could you give me a list of tests that would be good, as well as what to look for with in those test? – Ryan H Nov 5 2011 at 17:58
dhea and IL 6 for starters. I bet her pregnenolone and D levels are also poor. – The Quilt Nov 6 2011 at 4:13
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One thing I have learned is: sleep is not some separate category of life, treatable effectively with magic potions, and eyeshades.

What are your waking hours like? Do you do go all-out in ways that usually produce mammals in need of sleep?

If not, why not? Go for it. Go to bed exhausted from your true passions.

If you find yourself awake, don't make it worse with worry. I sometimes can't sleep, and when that's the case, I make a point not to add mental agitation, which is a form of work, and quite demanding. I breathe. And at some point, I wake up. Having slipped into sleep at some point.

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Even though the answer chosen as the best answer covered most of the requirements for treating insomnia using the paleo paradigm, I have a few recommendations to add based on my extensive research on insomnia as a result of suffering from it myself for many years.

Whenever anyone has insomnia for unknown reasons when they are living a generally healthy lifestyle like your gf is, I suspect cortisol dysregulation (or adrenal fatigue if cortisol dysregulation has lasted a long time) before anything else. Adrenal fatigue is a much more common problem than both the allopathic medical community and the paleo community recognize (although some in the paleo community give it due attention). Although I don't see any obvious behaviors in your description of your gf's lifestyle that would contribute to adrenal fatigue, you mentioned that her sleep improved after she removed caffeine from her diet, so if she was consuming large amounts of caffeine every day, or even moderate amounts later in the day, that alone could have caused elevated nighttime cortisol that could take several weeks to undo, even after removing caffeine from the diet.

Fortunately, it is actually easier to diagnose adrenal fatigue using tests one can do at home for free or salivary tests that one can order online and do at home then send to a lab than it is for an allopathic doctor to make the diagnosis. This article is the most comprehensive and useful I have found on how to diagnose this condition: http://www.stopthethyroidmadness.com/adrenal-info/#

If money isn't an issue for you, I would order the 24 hour salivary cortisol and DHEA tests, or at least the cortisol test from the lab listed on the above web page. If you want to save money, the 4 tests and questionnaire on the above page are often adequate for diagnosing adrenal fatigue. I have found the daily body temperature recordings to be especially helpful for myself (see my question here: http://paleohacks.com/questions/74722/is-body-temperature-an-accurate-indicator-of-metabolic-function-dysfunction). Adrenal fatigue is relatively simple to treat, and your gf doesn't seem to have symptoms of more advanced adrenal fatigue like inability to rise from bed in the morning or extreme fatigue, so if she does have an imbalance in cortisol it should not take very long to correct.

It is also worth playing around with macronutrient ratio and meal timing/frequency, as these factors can contribute to insomnia in various ways also. Eating too late can cause insomnia for some people, as the best answer described. On the leangains website I just read that carbs promote water retention, while protein promotes diuresis, so it might be worthwhile to increase her carb intake if she is low carb or especially if she is very low carb, at least on days including intense exercise, as explained in the leangains approach. Just one of many possible explanations for why she has to urinate multiple times per night.

Lastly, I would try supplementing with either 5-htp or tryptophan to increase serotonin and melatonin levels before going to bed, as my sleep quality improved drastically when I increased my dosage of 5-htp from 100 to 200 mg before bed time. Supplements that increase GABA levels like L-theanine and valerian root are also worth experimenting with, since GABA deficiency causes insomnia.

Of course there are many other potential causes of her insomnia which other people have already covered, but I felt obligated to add cortisol dysregulation to the list because it was barely mentioned so far (props to White Dolemite for mentioning it). In summary, I recommend getting as many lab tests done as you can afford or feel appropriate, as well as the free tests I mentioned above that you do at home, and just keep experimenting with behavior and/or supplement modifications until you find what works.

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Has she tried taking magnesium before bedtime?

A lot of people have good luck with Natural Calm which is powdered magnesium citrate. Others take high doses in other forms, as high as 1200 mg. In high doses magnesium citrate gives me diarrhea, but I can tolerate magnedium glycinate and magnesium malate. Magnesium oxide is the least absorbable of them all. (Dr. Kruse has stated that he doesn't like Natural Calm, but I don't know the reason.)

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Yes, she does take Natural Calm. I forget to mention that. Thought about it while we were shopping this morning. Was just coming back to add that in. We normally take a huge table spoon before bed, so maybe around 300-500mg. I will figure out how much we take with a little bit more of an exact science and then try upping the intake from there. – Ryan H Nov 5 2011 at 14:33
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Maybe she could try using blue blocker glasses/sunglasses in the evening? One can buy some quite cheap ones from Amazon or eBay.

Amber lenses to block blue light and improve sleep: a randomized trial.

Seth's Blog - Bipolar Disorder: Good Results With Blue-Blocker Glasses

I also think that bright light or blue light therapy would probably be quite a good idea, but the devices cost a lot. Outdoor light should be as useful.

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