Sleep Basics- 101 Questions About Sleep and Dreams

Chapter 5 - Sleep and Things You Put in Your Body

37. Does diet make a difference in your sleep? For example, is warm milk at bedtime a good idea?
38. Will a 'night cap' aid in sleeping?
39. Is it bad to eat just before going to bed?
40. Does melatonin really help in getting to sleep?
41. I have just stopped drinking coffee. Now I can't stay awake and I get terrible headaches. Am I hooked on coffee?
42. I have just stopped smoking. Now I can't stay awake and I get terrible headaches. What should I do?
43. What does marijuana do to your sleep?
44. What does cocaine do to your sleep?
45. What does amphetamine do to your sleep?
46. What does heroin do to your sleep?
47. My husband has been put on a medication to reduce pain and swelling. Since he started taking the drug, he has complained of insomnia. Could there be a connection?

37. Q: Does diet make a difference in your sleep? For example, is warm milk at bedtime a good idea?

The effect of diet on sleep has not been researched with good laboratory techniques. All of us certainly hear many personal observations and testimonials concerning the sleep benefits of various diets and health foods. However, there is no systematic research on, for example, whether people eating a high protein diet sleep differently night after night than people eating a high carbohydrate diet.

There is some information on several dietary substances, though. We know of one published study on a malted-milk product that may have sleep-promoting effects. Conversely, there are studies showing that caffeine-containing substances really do disturb sleep.

Americans spend billions of dollars each year or health foods and dietary supplements. It is wise to remember that the research supporting the use of non-prescription compounds and dietary supplements is of poor quality or non-existent. By contrast, the laws governing the safety and efficacy of prescription drugs are rigorous. When a prescription drug reaches the market, the consumer can be confident that the safety of the drug and the claims of effectiveness have been scientifically demonstrated. This situation is no better illustrated than in the case of melatonin versus prescription sleeping pills. Melatonin, because its manufacture and distribution are not subject to the laws and policies of the U.S. Food and Drug Administration, continues to be sold in health food stores as a sleep aid. This situation continues despite scientific studies showing that melatonin is not effective as a sleep promoter or as a treatment for jet lag. Further more melatonin's long-term safety is still in question, particularly with respect to its effects on hormonal and reproductive systems. Yet, many people seem to believe that, because melatonin is sold as a dietary supplement in health food stores, it is a safe and effective sleep aid, and that prescription sleeping pills are dangerous drugs. The reality is just the reverse.

38. Q: Will a 'night cap' aid in sleeping?

If it is an alcoholic drink, absolutely not. Alcohol is actually an organic solvent and depressant of the central nervous system that disrupts normal sleep. A drink may make you drowsy, but it also distorts the normal pattern of NREM and REM sleep. And, when the alcohol wears off (in 2 - 4 hours) you may wake up and have difficulty getting back to sleep. People who drink significant amounts of alcohol between dinner and bedtime are among the worst of sleepers.

An additional concern is that alcohol causes relaxation of the muscles in the throat and upper airway and also interferes with breathing. As a result, people who rarely snore when they do not drink may snore quite loudly after nighttime drinking. Furthermore, people with mild sleep-related breathing problems, such as sleep apnea, may get much worse even after small amounts of alcohol. In fact, many sleep clinics use bedtime alcohol as a test to determine how bad a person's breathing difficulties can get.

39. Q: Is it bad to eat just before going to bed?

There is no single answer to this question. Obviously, if the eating leads to intestinal discomfort and indigestion, sleep will be disrupted. Small amounts of light food may help some people feel comfortable and, thereby, assist sleep. Furthermore there are a few studies showing that malted milk and foods rich in tryptophan may promote sleep.

40. Q: Does melatonin really help in getting to sleep?

Probably not. Melatonin is a hormone produced by the pineal gland located in the center of the brain. Using input from the eyes, the brain links melatonin production to the light-dark cycle of the environment. Melatonin levels in the body are highest during the hours of darkness. Synthetic forms of melatonin are available as dietary supplements in health food stores. However, studies have failed to show that melatonin affects sleep in any way. Furthermore, there is no definitive research indicating that melatonin treats the symptoms of jet-lag.

Some studies do indicate that taking melatonin at bedtime is helpful for the insomnia blind people experience because they cannot receive light-dark signals from the environment. And, the sleep of people who have diseases causing a deficiency in natural melatonin is improved by bedtime melatonin. However, there is reason for caution. Melatonin's effects on other hormone systems are fully not known. In animals, melatonin rises are associated with the seasonal shrinking of testes and ovaries. The effects of melatonin on the human reproductive systems have not been thoroughly studied.

Melatonin is chemically related to another brain chemical, serotonin. Research has also linked serotonin to sleep. Since the brain chemically changes tryptophan into serotonin and melatonin, pure tryptophan has also been studied as a natural sleep inducer. Early studies showed that 3 - 5 grams of tryptophan, manufactured in tablet form, helped some people who take a long time to fall asleep and wake up frequently. However, it is not likely that the amount of tryptophan in a normal meal, even of a tryptophan-rich food, will affect subsequent sleep. Some years ago many people used tryptophan tablets to help with relaxation and sleep. However, in the late 1980's, more than 1500 cases of a painful and sometimes fatal disease called eosinophilia-myalgia was linked to an impurity in the tryptophan produced by the Japanese company, Showa Denko. During the search for the cause of the disease, all tryptophan tablets were recalled. Costs of product liability and impurity-free production have blocked the return of tryptophan tablets to the market.

41. Q: I have just stopped drinking coffee. Now I can't stay awake and I get terrible headaches. Am I hooked on coffee?

It may very well be that you are having withdrawal symptoms. Somnolence and headaches are two common symptoms of caffeine withdrawal. However, if these symptoms are due to getting off coffee, do not worry -- the symptoms will pass quickly. Unlike more powerful and addictive stimulants such as amphetamine, the symptoms of caffeine withdrawal seem to disappear in a few days without serious complications.

42. Q: I have just stopped smoking. Now I can't stay awake and I get terrible headaches. What should I do?

The effects of nicotine withdrawal that come from stopping a tobacco habit can include both nervousness and somnolence as well as the more well-known symptoms of increased appetite and weight gain. Nicotine can act as a mild stimulant which explains the sleep problems associated with withdrawal.

43. Q: What does marijuana do to your sleep?

The most active compound in marijuana is delta-9 tetrahydrocannabinol or 'THC'. This compound alters brain chemicals involved in sleep and produces changes in brain wave patterns. Sleep changes with long term use include increased time in getting to sleep and reduced REM sleep. It is not considered to be a good sleep aid.

44. Q: What does cocaine do to your sleep?

Cocaine is a stimulant that produces a sense of euphoria followed in several hours by a sense of depression. Cocaine potentiates certain brain chemicals. Cocaine's arousing and addictive influences stem from its effects on the brain chemical, dopamine, which is involved in wakefulness and body movement. Sleep changes include reduced stage 3 and stage 4 NREM sleep and reduced REM sleep. When cocaine is discontinued, the individual becomes very sleepy and may feel that more cocaine is necessary just to function. Cocaine is addictive particularly when used in the very short-acting form known as 'crack'.

45. Q: What does amphetamine do to your sleep?

Amphetamine and amphetamine-like drugs are also known as 'speed' or 'crank'. They are powerful stimulants that are not unlike cocaine in many respects. Amphetamines also potentiate brain chemicals involved in wakefulness and produce changes in brain wave patterns. Sleep changes include reduced stage 3 and stage 4 NREM sleep and reduced REM sleep as well as decreased tendency to fall asleep and stay asleep. When amphetamine is discontinued, the individual becomes very sleepy and may feel that more amphetamine is necessary just to function. Also, discontinuation of amphetamine leads to greatly increased REM sleep known as 'REM rebound' which may be accompanied by nightmares. However, amphetamine and related drugs are medically useful in controlling the disabling sleepiness of sleep disorders such as narcolepsy.

46. Q: What does heroin do to your sleep?

Heroin is a depressant that retards intellectual and motor functioning as well as reaction to pain. The drug also interferes with breathing because it is a powerful respiratory suppressant. Heroin decreases stage 3 and stage 4 NREM sleep and reduces REM sleep. Heroin also disturbs sleep by causing frequent shifts to stage 1 NREM sleep and wakefulness. When discontinued, there can be withdrawal symptoms such as intense pain, runny nose and craving for more heroin. During withdrawal from heroin, there may be 'REM rebound' that is often accompanied by terrible nightmares.

47. Q: My husband has been put on a medication to reduce pain and swelling. Since he started taking the drug, he has complained of insomnia. Could there be a connection?

Yes. Many drugs, even when properly used, can have disruptive effects on sleep. Steroids (for example, prednisone which is used to treat inflammation) and respiratory stimulants (for example, theophylline which is used to treat breathing disorders) often cause insomnia as a side effect. The best approach to insomnia caused by the use of a needed medication is to adjust the time of the day that the drug is taken and the dose of the medication in hopes of keeping the desired effect and reducing the side effect of sleep disruption. Another possibility is to have the doctor prescribe a different drug in the same class of medications. It is always unwise to make any changes in the way prescribed medication is taken without the doctor's supervision.

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