By Helen Malik, published in the March 2013 issue.
Often patients in clinic, as well as friends and family, mention that they have problems sleeping. Although this may not be altogether surprising given the stresses of modern day living, the health of the economy etc, often it is not the case that they are lying awake worrying about such things, in fact they often find it quite easy to get to sleep. The problem comes in the early hours when they find themselves wide awake and unable to get back to sleep.
If this sounds familiar and you have ruled out the most common reasons for night time waking (eg. needing the toilet or the light coming through the curtains) and you are not worrying about any specific issues, then it may be worth looking at your diet and blood sugar control. However, it is also worth mentioning that stress during the day (even if it’s not on your mind at night) can affect the levels of hormones involved in the sleep-wake cycle, so finding some stress reducing techniques is important. If you are struggling to get off to sleep then ensure your bedroom is very dark, turn off all electronic equipment and don’t be tempted to watch TV or use a backlit device such as an iPad before bed. Instead try a relaxation CD or Medical Resonance Therapy Music, which has found success in hospitals and homes at improving sleep patterns. This is not ‘normal’ music; it is specially prepared sounds that have then been placed under clinical trials to determine the most effective combination.
Turning to diet - caffeine, chocolate, nicotine and alcohol, if consumed too close to bedtime, can all disrupt sleep. Although you may feel that alcohol helps you get off to sleep, it has a stimulating effect later on as the body starts to metabolise it.
There is not a one size fits all approach to diet as other underlying health conditions can play a part, but ideally cutting out or at least significantly reducing sugar intake should help. Avoiding snacks and sticking to three nutritious meals consisting of good quality lean protein, low GL (glycaemic load) carbohydrates and plenty of fresh non-starchy vegetables. Ensuring you are getting sufficient nutrients from your diet is important. Functions such as mood, appetite and stress can be modulated by dietary components - including vitamins and minerals which are involved in the conversion of chemical products within the body. A protein based snack before bedtime may help, and recent research has shown that the concentrated juice of Montmorency cherries (which are high in melatonin) may help improve the quantity and quality of sleep.
It’s certainly somewhat of a “vicious circle” - lack of sleep has been shown in studies to increase the risk of diabetes due to its effect on blood sugar control, whilst poor blood sugar control can result in lack of sleep. So ensuring you are getting good sleep now may be vital for your long term health.