As a psychiatrist with an integrative focus, Ellen believes mental well-being is powerfully influenced by sleep, exercise, thought patterns, relationships, nutrition, spirituality and creative outlets. She incorporates a variety of modalities into her psychiatry practice, including acupuncture, yoga philosophy, breathing, and relaxation techniques in conjunction with conventional treatments such as cognitive-behavioral therapy, psychotherapy, and psycho-pharmacology. Ellen believes mental health is fundamental to primary care and treats a range of health issues, from panic disorders to bipolar illness and ADHD to fibromyalgia. After graduating from Yale University, Ellen earned her MD at Columbia University and stayed on to complete an internship at Columbia University Medical Center. She began her postgraduate training at Saint Vincent's Catholic Medical Center and completed her residency in psychiatry at Mount Sinai Hospital. She is a member of the American Psychiatric Association and the American Academy of Medical Acupuncture, and is a board-certified psychiatrist, licensed medical acupuncturist, and certified yoga instructor.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Making it through each sleep stage is crucial to getting high-quality sleep, but exactly how many times do you need to go through the sleep cycle? Many people argue that they get by just fine on very little sleep. However, research shows that only a tiny fraction of people can function well on fewer than eight hours of sleep each night. Sleep expert David Dinges, PhD, estimates that, over the long haul, perhaps one person in a thousand can function effectively on six or fewer hours of sleep per night.
I haven’t seen a study that empirically shows that it’s helpful. There is certainly a false myth that we need eight hours of continuous sleep: I think it’s possible to have your sleep be a little bit broken up and be perfectly healthy—but getting that eight hours is crucially important. The thing is that the placebo effect in some of these polyphasic sleep methods runs really high.
If you always seem to get a poor night’s sleep, it may be because you’re not following a bedtime ritual. One of the easiest natural sleep remedies: Make it a priority to go to bed and wake up at the same time every day. Introducing nightly habits like reading in bed or listening to music will also help to quiet your brain for the day and prepare it for sleep. Try setting your phone or iPod on a timer and nod off to your favorite soothing melodies. In one Taiwanese study, music helped 60 problem-sleepers fall asleep faster and snooze more soundly. Here are some more relaxation techniques to help you wind down for sleep.

Are you physically uncomfortable? A too soft or too firm mattress, an uncomfortable pillow, or an older, worn-out bed can all impede a good night’s sleep. Check your mattress for signs of wear at least twice a year, and consider new pillows. You may also want to see an osteopathic physician who specializes in osteopathic manipulative therapy. A session or two of this safe and effective sleep aid treatment can be life-changing.
Aging also plays a role in sleep and sleep hygiene. After the age of 40 our sleep patterns change, and we have many more nocturnal awakenings than in our younger years. These awakenings not only directly affect the quality of our sleep, but they also interact with any other condition that may cause arousals or awakenings, like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. The more awakenings we have at night, the more likely we will awaken feeling unrefreshed and unrestored.
Experts say that during the teen years, the body's  rhythm (sort of like an internal biological clock) is temporarily reset, telling a person to fall asleep later and wake up later. This change might be due to the fact that the brain hormone   is produced later at night for teens than it is for kids and adults. This can make it harder for teens to fall asleep early.
If any of this resonates with you, you might be interested in a new book by Henry Nicholls called Sleepyhead: The Neuroscience of a Good Night’s Rest. Nicholls, a science journalist in England, chose the topic of sleep in part because of his personal experience with narcolepsy, a rare neurological disorder that impacts the brain’s ability to control sleep-wake cycles. So he decided to write a book about how to sleep better.
Journaling. You might think that writing stuff down would make you dwell on it. But when you focus on the things that you appreciate, you might actually sleep better. One recent study, published in Applied Psychology, found that students who wrote in a gratitude journal for just 15 minutes per night worried less at bedtime—and achieved better sleep.

Insomnia usually becomes a problem if it occurs on most nights and causes distress or daytime effects such as fatigue, poor concentration, and irritability. It predisposes to mental disorders such as depression, anxiety disorders, and psychotic disorders; to physical problems such as infections, high blood pressure, obesity, and diabetes; and to motoring and other accidents. The relationship between insomnia and psychological symptoms is far from simple, as insomnia can both cause, and be caused by, depression, anxiety, and stress, opening up a vicious circle.


 The brain stem, at the base of the brain, communicates with the hypothalamus to control the transitions between wake and sleep.  (The brain stem includes structures called the pons, medulla, and midbrain.)  Sleep-promoting cells within the hypothalamus and the brain stem produce a brain chemical called GABA, which acts to reduce the activity of arousal centers in the hypothalamus and the brain stem.  The brain stem (especially the pons and medulla) also plays a special role in REM sleep; it sends signals to relax muscles essential for body posture and limb movements, so that we don’t act out our dreams.
Stay out of your head. Hard as it may be, try not to stress over your inability to fall asleep again, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.
Each of us has different patterns of high and low states of energy throughout the day. Some people find that exercise in the morning can go a long way toward keeping their energy level consistent during the afternoon. A secret known to those who have become habitual exercisers is that effort creates energy. Don’t wait for energy to come when you are tired; as soon as you begin to feel that afternoon slump, shake it off by moving your body. Try taking a brisk walk after lunch. It may be what you need to keep you awake and alert the rest of the day.

You've followed the usual tips for getting enough sleep — sleeping on a regular schedule, avoiding caffeine and daytime naps, exercising regularly, avoiding lighted screens before bed, and managing stress. Still, it's been weeks and a good night's sleep remains elusive. Is it time for an over-the-counter sleep aid? Here's what you need to know if you're considering medication to help you sleep.
Whether you’re scrambling to meet the demands of a busy schedule or just finding it hard to sleep at night, getting by on less sleep may seem like the only answer. But even minimal sleep loss can take a substantial toll on your mood, energy, mental sharpness, and ability to handle stress. And over the long-term, chronic sleep loss can wreak havoc on your mental and physical health. By understanding your nightly sleep needs and how to bounce back from sleep loss, you can finally get on a healthy sleep schedule and improve the quality of your waking life.
Did you know that a lack of exposure to sunlight may be interfering with your sleep quality? Light exposure is crucial to our circadian rhythms (aka our internal clocks), which control vital biological processes including sleep. Scientific research reveals that that a lack of light in the workplace results in poorer overall sleep quality, as well as sleep disturbances, which can then have further negative effects on health.
An average adult needs between 7.5 and 8 hours of sleep per night. “But many people can function with 6 hours' sleep, and there also some who need 9 hours or more,” says Sudhansu Chokroverty, MD, professor and co-chair of neurology and program director for clinical neurophysiology and sleep medicine at the New Jersey Neuroscience Institute at JFK Medical Center in Edison, N.J.

Probably the most common wearable to measuring sleep right now is the Fitbit. I’ve studied these devices in depth in a well-controlled laboratory experiment where we’re monitoring brainwaves. I can say the Fitbit is pretty accurate in measuring when you’re asleep and when you’re wake, but when it comes to measuring sleep stages, basically any device that measures heart rate, like the Apple Watch, is totally inaccurate. That’s because they don’t sample at the frequency necessary to get a good read on your sleep stages.
Reading books on electronic devices before bedtime disrupts the body’s natural sleep rhythms, according to research published in the Proceedings of the National Academy of Sciences. In the study, 12 people read a book on an electronic device for 4 hours before bed, in a dimly lit room, for 5 consecutive nights. On another 5 nights, they read a real printed book on the same schedule. When using an electronic device, they were less drowsy, took longer to fall asleep, and were less alert in the morning. According to the researchers, use of electronic devices suppressed melatonin levels, making it more difficult to get a good night’s rest.
Sleep gives your body a rest and allows it to prepare for the next day. It's like giving your body a mini-vacation. Sleep also gives your brain a chance to sort things out. Scientists aren't exactly sure what kinds of organizing your brain does while you sleep, but they think that sleep might be the time when the brain sorts and stores information, replaces chemicals, and solves problems.
Studies have shown that higher magnesium levels can help induce a deeper sleep, and as I noted, this is especially true when taken together with calcium for better absorption. Research from the Biochemistry and Neurophysiology Unit at the University of Geneva’s Department of Psychiatry indicate that higher levels of magnesium actually helped provide better, more consistent sleep since magnesium is a calming nutrient. In addition to the goat’s milk kefir, foods like spinach, pumpkin seeds and even dark chocolate can help since they’re loaded with magnesium. (5)
Finally, you may find yourself turning to over-the-counter medications to help your sleep. One of the most common is a naturally occurring hormone called melatonin. It is sold in many pharmacies and herbal supplement stores. It can be highly effective if you have insomnia related to a poorly timed circadian rhythm. As it has a low risk of major side effects (the most frequent is sleepiness), it might be an option to consider. Other herbal supplements (such as valerian root) do not have a lot of research supporting their efficacy.
Probably the most common wearable to measuring sleep right now is the Fitbit. I’ve studied these devices in depth in a well-controlled laboratory experiment where we’re monitoring brainwaves. I can say the Fitbit is pretty accurate in measuring when you’re asleep and when you’re wake, but when it comes to measuring sleep stages, basically any device that measures heart rate, like the Apple Watch, is totally inaccurate. That’s because they don’t sample at the frequency necessary to get a good read on your sleep stages.
They’re placed under a category called sedative hypnotics and include benzodiazepines and barbiturates. You’ve probably heard of the benzodiazepines, or psychotropic drugs, called Xanax, Valium, Ativan and Librium, which are also known as common anti-anxiety medications. Because they can induce drowsiness, they can help people sleep, but these drugs can be addictive too — and that’s not a good thing.
So I can confidently say this decades-old technique worked for me. Mind you, it didn’t work every night. Some nights during that second week I didn’t get that “release” after my visualization. But as the weeks went on, the trick seemed to work more often than not. And it seemed to work more effectively when I visualized myself in a velvety hammock instead of in a canoe, so it helps to switch up visualizations to see what works best.
Of all the sleep tips you could ever read or hear about, the most important one is to stick to one sleep schedule—every day. This means going to bed and waking up at the same time each day. When sleep has a regular rhythm, your biological clock will be in sync and all of your other bodily functions will go smoother, including your sleep. You are probably squirming as you read this tip, thinking about your own sleep issues and how you have anything but a regular sleep routine.
Beyond food and plants, regular exercise and turning off electronics can make a huge difference in getting some rest. Exercise wears out the body and is one of the best natural remedies. As for electronics, the blue light emitted can trigger the brain to stay awake. Try developing a nightly bedtime routine that promotes relaxation and allows you to wind down. The brain will begin to associate the routine with sleep and help you get the rest you need.
The basal forebrain, near the front and bottom of the brain, also promotes sleep and wakefulness, while part of the midbrain acts as an arousal system.  Release of adenosine (a chemical by-product of cellular energy consumption) from cells in the basal forebrain and probably other regions supports your sleep drive.  Caffeine counteracts sleepiness by blocking the actions of adenosine.
A professor I collaborate with at Penn State named Orfeu Buxton says that 8.5 hours of sleep is the new eight hours. In order to get a healthy eight hours of sleep, which is the amount that many people need, you need to be in bed for 8.5 hours. The standard in the literature is that healthy sleepers spend more than 90% of the time in bed asleep, so if you’re in bed for eight hours, a healthy sleeper might actually sleep for only about 7.2 hours.
Regular exercise will go a long way toward improving your sleep, Cralle says. Finding the perfect time in your day where a workout won’t hinder your sleep is crucial—some people have no problem falling asleep after an evening workout, but others may need to hit the gym first thing in the morning. The key is working out at least several times a week, whether it’s a 10-minute walk, a yoga class, or a sweaty weight-lifting session.
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Try to go to sleep and get up at the same time every day. This helps set your body’s internal clock and optimize the quality of your sleep. Choose a bed time when you normally feel tired, so that you don’t toss and turn. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock, you may need an earlier bedtime.
For those that are looking to get a good night's rest or ease their insomnia the natural way without the use of sleep medications, there are certain plants and foods that can help out. As someone who has tried pretty much anything and everything other than taking sleeping pills, I can tell you that these natural sleep remedies do make a difference.
Use
Helps to reduce difficulty in falling asleep

Drug Facts
Active ingredient (in each tablet) - Purpose
Doxylamine succinate 25 mg - Nighttime sleep-aid

Give your body and mind the good night's sleep they deserve with Equate Sleep Aid Doxylamine Succinate Tablets, 25 mg. Sleep is incredibly vital to good health and well-being in your life. Making sure you get enough sleep can be beneficial to mental health, quality of life, and safety. Sleep helps your brain work properly by preparing for the day, increasing learning efficiency and memory. Not only is sleep vital to mental health but it is also critical to positive physical health. This bottle includes 32 tablets, each containing 25 mg of Doxylamine Succinate in tamper-evident packaging. With just one tablet before bed you can rest assured that your mind and body will get the sleep they need without all the tossing, turning, and late night wakefulness. Start every morning feeling wide awake and refreshed with Equate Sleep Aid Doxylamine Succinate Tablets, 25 mg.

Certain protein-rich foods like milk, eggs, peanuts, and soy contain an amino acid called tryptophan that causes sleepiness, says Alissa Rumsey, MS, RD, founder of Alissa Rumsey Nutrition and Wellness. For best results, combine these foods with a source of carbohydrates, which help more tryptophan enter the brain. Some recommendations: roasted soybeans, peanuts, sunflower seeds, cheddar cheese, canned tuna, and pistachios. You don't need much: "Even smaller snacks can provide a tryptophan dose that studies have shown to be significant in helping with sleep," Rumsey says.
Melatonin. Melatonin is a naturally occurring hormone that increases at night. It is triggered by darkness and its levels remain elevated throughout the night until suppressed by the light of morning. Although melatonin does not appear to be particularly effective for treating most sleep disorders, it can help sleep problems caused by jet lag and shift work. Simple exposure to light at the right time, however, might be just as effective. If you take melatonin, be aware that it can interfere with certain blood pressure and diabetes medications. It’s best to stick with low doses—1 to 3 milligrams for most people—to minimize side effects and next-day drowsiness.
If pretending you’re tired sounds like too much work for you, you might want to look into hypnosis. Get that image of a creepy guy swinging his pocket watch back and forth until you bark like a dog out of your head. We’re talking about watching a five-minute hypnosis video while tucked in your bed. (YouTube is full of them; search “hypnosis for sleep.”) It might sound like a bit of hogwash, but researchers from the universities of Zurich and Fribourg beg to differ. Their 2014 study on the subject concluded that hypnosis can actually increase the quality of sleep. Huzzah.
A smart tip for jetsetters: Pack melatonin supplements, such as Natrol Melatonin Fast Dissolve Tablets. The supplement helps your body better adjust to the new time zone, allowing you to fall asleep come bedtime and avoid jet lag. But the sleep aid isn’t just for jet lag. You can also pop the tablets when you have occasional sleepiness or when your sleep schedule shifts and you need to get your body into sleep mode. It’s recommended that you start with a small 1 mg dose (take it 20 minutes before bedtime). You can slowly increase your dosage, but don’t exceed 10 mg.

If you experience frequent insomnia, you’ve probably already tried the basics, like cutting back on caffeine and alcohol. Maybe you’ve also turned to the medications, luxury mattresses and pillows, white-noise machines, and other remedies that make up the $41 billion Americans spent on sleep aids and remedies in 2015, according to a report from BCC Research. But you might be wary, understandably, of relying on drugs.
What to do: I drink a tablespoon of tart cherry juice at night to help with sleep quality, especially on days with intense workouts since it also seems to help with muscle recovery and stiffness. Cherry juice can even be added to chamomile tea or other relaxing herbal teas (with the honey salt remedy above) to help improve the taste. I definitely recommend organic cherry juice if you can find it since it is concentrated and cherries are typically on the Dirty Dozen list.
Visualization: Involves actively imagining a relaxing scene. You can try it in bed for 20 minutes before falling asleep. Involve all your senses. If you're imagining yourself on a tropical island, think of the way the warm breeze feels against your skin. Imagine the sweet scent of the flowers, look at the water and listen to the waves. The more vivid the visualization and the more senses you involve, the more effective it will be.
Of course logging your troubles is all well and good, but it's a habit you build in the light of day, during the hours when you're supposed to be studious and bright. It's not particularly helpful when you're wide awake at 4 a.m. At that point, Walia suggests, "jotting down all your worries on a piece of paper so it's out of your head." And try the breathing, muscle relaxation and visualization techniques above.
If you're a smartphone user, you'll have seen countless devices and apps that promise to measure sleep cycles. But Anna is dubious. 'Equipment like Fitbits aim to record levels of activity, measuring each time you move the device. The way they measure 'sleep' is by noting a period of motionless – predicting that's when we're sleeping. But there are issues with this – people often wake but don't move, for example. Just because we're still doesn't mean we're necessarily asleep.'

They’re placed under a category called sedative hypnotics and include benzodiazepines and barbiturates. You’ve probably heard of the benzodiazepines, or psychotropic drugs, called Xanax, Valium, Ativan and Librium, which are also known as common anti-anxiety medications. Because they can induce drowsiness, they can help people sleep, but these drugs can be addictive too — and that’s not a good thing.
Treatment issues related to sleep and depression. Thase ME. The Journal of clinical psychiatry, 2000, Aug.;61 Suppl 11():0160-6689. Most often, insomnia stems from a combination of factors, including medical and psychological issues, scheduling issues, relationships conflicts, and behavioral factors (poor bedtime routines, physical hyperactivity, watching TV right before bed, etc.).
Scientists continue to learn about the function and regulation of sleep.  A key focus of research is to understand the risks involved with being chronically sleep deprived and the relationship between sleep and disease.  People who are chronically sleep deprived are more likely to be overweight, have strokes and cardiovascular disease, infections, and certain types of cancer than those who get enough sleep.  Sleep disturbances are common among people with age-related neurological disorders such as Alzheimer’s disease and Parkinson’s disease.  Many mysteries remain about the association between sleep and these health problems.  Does the lack of sleep lead to certain disorders, or do certain diseases cause a lack of sleep?  These, and many other questions about sleep, represent the frontier of sleep research.
Cognitive Behavioral Therapy for Insomnia is a pretty common technique. Also called CBT-I, the therapy typically involves self-monitoring, mental strategies (like developing positive thoughts about sleep), and creating an environment that promotes sleep—and it’s been shown to improve sleep quality. Self-help treatment for insomnia symptoms associated with chronic conditions in older adults: a randomized controlled trial. Morgan K, Gregory P, Tomeny M. Journal of the American Geriatrics Society, 2012, Oct.;60(10):1532-5415. Learn these strategies with the help of a therapist or with online guidance or books—both are equally effective ways of implementing CBT-I. Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia—a randomized controlled trial. Jernelov, S., Lekander, M., Blom, K., et al. Department of Clinical Neuroscience, Karolinska Institutet, Sweden. BMC Psychiatry, 2012 Jan 22;12:5 Not into seeing a therapist? Check out Sleepio, a digital program that helps users learn about and implement CBT practices from the comfort of their own homes.
REM sleep first occurs about 90 minutes after falling asleep.  Your eyes move rapidly from side to side behind closed eyelids.  Mixed frequency brain wave activity becomes closer to that seen in wakefulness.  Your breathing becomes faster and irregular, and your heart rate and blood pressure increase to near waking levels.  Most of your dreaming occurs during REM sleep, although some can also occur in non-REM sleep.  Your arm and leg muscles become temporarily paralyzed, which prevents you from acting out your dreams.  As you age, you sleep less of your time in REM sleep.  Memory consolidation most likely requires both non-REM and REM sleep.
According to one study, exposure to electrical lights between dusk and bedtime might negatively affect our chances at quality sleep. Assuming you don’t want to sit in the dark for hours, find the happy medium by dimming the lights as bedtime draws near. Also consider changing all light bulbs to “soft/warm” varieties with a color temperature less than 3,000 kelvins, all of which can reduce lights’ effects on our nervous systems.
A regular meditation practice may help to promote sleep by slowing breathing and reducing stress hormone levels. Meditation is a technique that involves consciously directing one's attention to an object of focus (such as breathing or a sound or word) in order to increase awareness, relax the body, and calm the mind. Some types of meditation include guided meditation, vipassana meditation, yoga nidra, or body scan. Also try:
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures, widened pupils. In children, mental/mood changes (such as restlessness, irritability, hallucinations) may occur before drowsiness.

One reviewer says that the Stress-Relax Tranquil Sleep Chewable Tablets have helped calm him down and stopped his mind from spinning when lying in bed. Someone else says that the tablets even help him get better sleep when having panic attacks. Try the Stress-Relax chewables for your own anxiety, but remember to see a professional if you feel that your stress is too much to manage. 


Probably the most commonly known characteristic that can help through food is tryptophan — yes, that sleepiness from the Thanksgiving turkey is no joke. Tryptophan is an amino acid that can help the brain get into a relaxed state, similar to serotonin and melatonin. You can obtain tryptophan and serotonin from carbohydrates, particularly 100 percent whole grain oats, brown rice, corn or quinoa.

There are many reasons why people have a difficult time staying asleep. The good news is that common problems with sleep are often easily addressed without the use of medication or pharmaceutical sleep aids. There are no guaranteed natural cures for insomnia, but there are effective steps you can take, including natural sleep aids. Ask yourself these questions (and try the simple sleep aid recommendations) if you find yourself waking frequently in the night:

Everyone needs sleep, but its biological purpose remains a mystery.  Sleep affects almost every type of tissue and system in the body – from the brain, heart, and lungs to metabolism, immune function, mood, and disease resistance.  Research shows that a chronic lack of sleep, or getting poor quality sleep, increases the risk of disorders including high blood pressure, cardiovascular disease, diabetes, depression, and obesity.
There are other non-medication options that might be helpful. Some people find benefit with the use of aromatherapy, although research studies may not support its use. Various relaxation techniques, including the use of biofeedback and breathing techniques, may also establish a connection between your mind and body. This can be incorporated into your bedtime rituals and make it easier to relax and transition into sleep.
Science shows that meditation significantly lowers stress and reduces anxiety.[4][5] Meditation makes you aware of your automatc thoughts and impulses, and with that awareness comes more control. You learn to differentiate between a helpful thought and a destructive one. Meditation also rewires your brain, strengthening neural pathways that calm your nervous system.[6]
Millions of people are using smartphone apps, bedside monitors, and wearable items (including bracelets, smart watches, and headbands) to informally collect and analyze data about their sleep.  Smart technology can record sounds and movement during sleep, journal hours slept, and monitor heart beat and respiration.  Using a companion app, data from some devices can be synced to a smartphone or tablet, or uploaded to a PC.  Other apps and devices make white noise, produce light that stimulates melatonin production, and use gentle vibrations to help us sleep and wake.

On the other hand, if you find you're waking up too early in the morning or have advanced sleep-phase syndrome, you may need more light late afternoon and could try taking a walk outdoors or light therapy for two to three hours in the evening. Home light therapy units are available and may be recommended by your doctor or sleep specialist to use in conjunction with your sleep therapy.
Well, I think the approach to sleep should be really simple stuff first. I’m not a physician, so I can’t give advice about which medications to take and when, but the consensus among the specialists I spoke to was that you should try to get your sleep stability right first, and make sure that you’re getting consolidated sleep and not waking up all the time.
Black, D. S., O'Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015, April). Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: A randomized clinical trial. JAMA Internal Medicine, 175(4), 494–501. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110998?hc_location=ufi
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