Tracy Gaudet: An Integrative Medicine Approach to Sleep Problems

I have chronic sleep problems, and nothing seems to help. I don't want to take prescription medications. Does integrative medicine address sleep problems? If so, what's the approach? Have any natural remedies been shown to be effective?

Tracy Gaudet: Sleep is such a crucial part of health and often not something medicine addresses until it is a significant problem. Medications can be helpful in breaking a sleepless cycle, but integrative approaches can be very helpful in the long run.

First, of course, you should be certain you are practicing what is called good "sleep hygiene." Be sure to use your bed only for sleep (and sex!), but don't use your bed as your office, for example. You want crawling into bed to signal to your body that it is time to sleep. Go to sleep and wake up at approximately the same times every day, and don't exercise too close to bedtime. Once you've gone to bed, if you can't sleep after 20 to 30 minutes, get up and do something boring. This is often better than staying in bed and getting increasingly agitated that you are not sleeping.

It is also important to pay attention to your food and beverage consumption. Your body will not want to sleep on a full stomach, and certainly caffeine can interrupt your natural sleep cycles. You should avoid all caffeine from the afternoon on, as well as high quantities of sugar. Remember—chocolate has both sugar and caffeine! And even one glass of wine taken just before you go to bed can be enough to disturb your sleep. It's easy to experiment to see what's the issue for you. Simply eliminate the substance in question for a few days and notice if your sleep improves. Understand your own body so that you can make the choices that work best for you.

Lastly, and most important, a major factor in why many of us do not sleep well is that we have not completely relaxed before going to bed. This may sound overly simple, but it is incredibly important. In our culture today, in which we are "plugged in" virtually all of the time, our bodies and our minds are constantly in "go mode." Our sympathetic nervous system is turned on, ready for action, not for sleep. Very often, we reach the point where we are so totally exhausted that we have no problem falling asleep, but then as soon as the body has just enough rest to go again, we awake—in "go mode" again—after only a few hours of sleep.

The best strategy here is to practice a relaxation technique every night before going to sleep. This can take many forms—meditation, visualization, prayer, music, or paced breathing, to name a few. If you have had a stressful day, journal about it—offload it completely so you don't continue to process it during the night. You can also purchase some great relaxation or visualization CDs to play before bed. Perhaps my favorite approach is hypnosis. Most hypnotherapists will record their session with you and will focus completely on deep relaxation and sleep. Listen to it every night before bed, and then keep it by your bedside. If you awake in the night, start it again. You will be asleep in no time!

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