Insomnia

[EllenL]

I couldn't find a thread on this that was newer than about 2004-5, so I thought I would see if anyone has any new suggestions or thoughts---or even just some reassurance that it's possible to survive without very much sleep.

I've never been a good sleeper, even as a kid. But when I was working, I was so stressed and exhausted that I could fall asleep readily, at about 10 p.m. Wake-up time was 5:30 a.m., sometimes earlier. Usually I was awake even before the alarm went off, with some waking during the night.

I retired a year ago. At first things were going well in terms of sleep. I readjusted my schedule to stay up till about midnight, stayed in bed until 7 a.m., with some waking during the night and falling asleep in half an hour. But lately I'm unable to fall asleep until 2 or 3 a.m., still with some waking during the night (small bladder!) and not sleeping past 7. While I don't need eight hours of deep, uninterrupted sleep, four hours doesn't seem like enough sleep for me.

Stuff that's changed recently: officially in menopause a few months ago and stopped taking a low-dose birth control pill (but I question whether I am fully in menopause since I'm getting a monthly period). And I've had no stress or hard work (a couple of months after retiring, we moved and had to adjust to a new place and new life). Things are very stable and mellow. It's almost like I need to work and be stressed to feel tired at night!

I tried melatonin and antihistamines. Hasn't worked. Even tried Lunesta and it didn't work. I feel relaxed when I try to go to bed at 12...just not sleepy. I've tried not watching TV and not being on the computer close to bedtime. Eat really well, no caffeine, exercise early in the day.

Does anyone have any suggestions? I could go back to the doctor and try more sleep meds, but I'm not sure they would work or that I want to take them long term. And I usually don't feel terrible per se nor do I have any commitments this is interfering with, but I feel somewhat tired and often groggy (can't tell if it's from lack of sleep or the antihistamines) with not as much energy as I would like. And I worry about the long-term damage of living on four hours or less of sleep. It's definitely stressing me out. As much as I love to read, I don't enjoy it at 1:30 a.m. knowing that DH and everyone else is sleeping!

[Laura]

I think hormones (or lack of them?) might play a big part. I get insomnia the week before I get my period.

[cangoss]

I have gone through a few periods where I wasn't sleeping well because of anxiety issues. Twice during those periods, a therapist has told me that a key to sleeping is physical exhaustion. It may be that in retirement you're not getting as much activity as you used to. Go out and use up your energy and you will probably sleep better. Whenever I start to have sleep issues now, I make sure I'm exercising and walking around a lot during the day and it really seems to make a difference.

[armel]

If Lunesta didn't work for you, I would try other sleep aids. I tried all the suggestions that were non-meds and they just didn't reliably work for me. Once I found a sleep aid that worked, it was a life saver. And I don't even need to take it every night. It has really helped with my insomnia and is the only thing that ever has.

Lunesta worked for me. You might need a different dose of that or a different medication altogether.

[aggie94]

My DH suffers from insomnia like you've described. It typically takes him a long time to fall asleep, he wakes often during sleep, and what sleep he does get is usually fitful and restless. I can't remember the last time he got a full night's sleep. He has learned to cope on very little sleep, but I can't say it's great for his health.

He had to try a number of prescription sleep aids before he found one that works for him (Lunesta). Sonata, Ambien, and at least one other did nothing for him or left him feeling really bad the next day. So if Lunesta is the only prescription sleep aid you've tried, I would suggest asking your doc for samples of some of the others (I've heard good things about Rozerem) to see if there is one that works better for you. It sounds like you are doing everything else right (avoiding caffeine, not reading/watching TV/playing on the computer in bed, not exercising late, etc.), so you might just need a little help.

Sorry, and hope you are able to get some relief. I suffer from a night of insomnia maybe a couple of times a year, and I can't imagine it being a regular thing. It's so hard for me to function when I don't feel rested.

[MNGirlTX]

I had insomnia for most of August. I guess at 43, while I'm not menopausal, I'm "peri-menopausal". Up until last month, sleep wasn't a problem.

I take Zyrtec-D and neurontin at bedtime, so adding an over the counter sleep aid such as Unisom was a no-go. Currently, I'm trying a combination of things...melatonin and a cup of Sleepytime Extra tea about an hour before bed, along with a Calcium/Magnesium/Zinc tablet at supper time.

Interestingly, my period in August was about 5 days early (and I've always been a 27-29 day cycle). This month, right on day 28 and I've been sleeping just fine. So, I'm guessing my hormones were out of whack.

[Gilgamesh37]

I've had slow-sleep insomnia (as opposed to premature-waking insomnia) my whole life, literally since I was 5 or 6 years old. So first, yes, it's possible to survive even when you're getting little/cr@ppy sleep most of the time. You may not need much sleep to start with--even when you were working you were only getting 7 hrs a night, while many people I know feel they really don't function well on less than 8 or 9. That said, I completely share your frustration with just lying there trying to wish yourself to sleep.

I second the recommend to talk to your doc and try some of the other sleep meds out there. Many people on this thread seem to do well with Lunesta, but it absolutely does nothing for me (except leave a nasty metallic taste in my mouth). It sounds like maybe an Ambien-CR (to address both teh falling asleep and the waking in the night) might be a good fit. Personally, I have found that, of all things, a very low dose valium does as well for me as anything---which just confirms my suspicion that what I have is a transition problem (once I'm asleep, I can generally sleep for hours, and I'm very slow to get moving and mentally "snap to" in the mornings). Good luck!

[Gumbeaux]

If your situation is severe, I would talk to your doctor. He might try a few things first then order a sleep study if those things don't work.

[Terri_A]

I think I would talk to your doctor. Perhaps having a sleep study done would reveal something as well. I also agree with trying other sleep meds, but see if your doc can figure it out - there may be something else at work here.

Good luck - I know that without Lunesta I would be a very cranky and mean person!:D

[Jazzmatazz49]

I take dramamine, not the non-drowsy formula, but a walmart generic brand, and it makes me sleep through the night without that icky feeling I get from benadryl. It might not help a case of true insomnia, but it helps with that wide-awake at 3 a.m. problem I was having. I do know that hormones have a lot to do with sleep, and the dr. might need to get involved.

[Laurielee]

I feel your pain, I have sleep problems for years. I am in the same boat right now, I have had no sleep for the last 3 days. I am perimenopausal and started a low dose bc pill Sunday, Its like I have had 3 cups of coffee before going to bed each night!

Have you tried Valerian? it used to help me pretty good. And a friend of mine is going thru menopause now and for sleep her Dr prescribed Lexipro. Its an antidpressant but it was prescribed for sleep


Laurie

[blazedog]

If you are retired, it seems as though you have no commitments, so why worry about it.

Menopause (or perimenopause) typically brings sleep problems -- and as people age, they just don't sleep as long or as well. Early morning waking -- or periodic waking is a very typical sleep pattern.

I don't sleep well but I have basically adjusted to it -- If I don't get enough sleep on several consecutive nights, I find that my body makes up for it. Cat naps are wonderful in the middle of the afternoon to restore energy -- if you sleep too long or too late, it adds to sleep problems.

Ambien is good if I wake up at 2 AM or so and really want to get back to sleep because I need to be fully on the next day.

Otherwise, I find that if I don't worry about it -- turn something not that interesting on (Food Network or Property shows like House Hunters) are perfect, I generally fall back to sleep.

There are sleep hygiene techniques that help -- but most people generally get enough sleep if they allow their bodies to take it. Most people are sleep deprived because they want to cram too much into 24 hours so they allow too little hours -- this isn't a value judgment but just a fact of life -- If you are working full time, have family commitments, hobbies etc., that's a lot of hours.

[Romandub]

I also started having sleep problems about a year or so ago and I attribute them to age (50) and hormones (still having periods, but have every other menopausal symptom known to man!) Anyway, I find Tylenol PM helps. I only take one and it doesn't leave me feeling drowsy in the morning. I tried Advil PM and it didn't help at all. For a while I had a prescription for Ambien, which worked great, but then I got scared of all the sleep-walking, eating, driving stories.

I do have a question for those of you who take sleep aids. I actually never have trouble going to sleep, but I wake up in the middle of the night (usually 3 or 4 a.m.) and can't get back to sleep. At that point, I am afraid to take a sleep aid because I don't have the 8 hours to sleep. Blazedog--you are ok the next day if you take an Ambien in the middle of the night? Anyone else?

[blazedog]

I also started having sleep problems about a year or so ago and I attribute them to age (50) and hormones (still having periods, but have every other menopausal symptom known to man!) Anyway, I find Tylenol PM helps. I only take one and it doesn't leave me feeling drowsy in the morning. I tried Advil PM and it didn't help at all. For a while I had a prescription for Ambien, which worked great, but then I got scared of all the sleep-walking, eating, driving stories.

I do have a question for those of you who take sleep aids. I actually never have trouble going to sleep, but I wake up in the middle of the night (usually 3 or 4 a.m.) and can't get back to sleep. At that point, I am afraid to take a sleep aid because I don't have the 8 hours to sleep. Blazedog--you are ok the next day if you take an Ambien in the middle of the night? Anyone else?

Well the catch with Ambien (or other sleeping aids) is that you need at least 4 hours -- I don't take the stuff if I wake up later than about 1:30 AM -- figure that it takes about 1/2 hour to put me under. If I awake at 4 AM, I generally either just lie there -- sometimes I can get back under -- or I will just get up and start my day.

I also try not to take it more than 2 days in a row because none of the sleep aids are supposed to be taken for prolonged periods. I have to think that at the least they are interfering with REM or other psychological benefits of sleep that scientists still haven't figured out. When I am going through a true rough patch (dealing with death or after my operation), I had no qualms about taking them every night for 2 or 3 weeks because I knew that the insomnia was acute and situational -- as opposed to the kind of insomnia that seems to be part of every aging person's life.

I never have trouble falling asleep -- but like Romandub, have problems with sleeping through the night.

I do think there is something about the aging process which makes people wake up earlier -- in the same way that adolescents find it difficult to fall asleep early and really need to sleep late. I used to smirk at my parents but now find that I have had to readjust my sleep/wake cycle to reality -- early bird specials are just around the corner no doubt.

But I just try not to worry about the insomnia because I find that over the course of several days the actual time spent sleeping averages out so that I am not sleep deprived.

[JulieM]

I have been having sleep problems as well, and am in menopause after having my ovaries removed a couple of years ago. I was taking hormones and stopped earlier this year. I did a LOT of reading on hormones though during the last couple of years and can say low progesterone can cause sleep issues. You could consider having your progesterone level tested and supplementing with natural progesterone in the form of prometrium. It is recommended to take it in the evening because it can make you sleepy. I was on the lowest dose and never felt drowsy from taking it but I did fall asleep and stay asleep much better when I was taking it.

[Libra20]

Avena Sativa is a homeopathic than helps relax the body and can help with sleep. I use it. There are also homeopathic combinations for sleep.

[mbrogier]

Does anyone has issues with taking Lunesta and not feeling sleeping within an hour or so?

The Ambien knocked me out, but the Lunesta doesn't. My doctor started me at 12mg Ambien CR, and I was saying odd things after waking up, which scared Rob and the doctor. I think I should have started with the lowest dose, which I'll bring up with my family doctor.

I have fibromyalgia, and if it wasn't for the sleep aids, I wouldn't sleep at all.

[armel]

Does anyone has issues with taking Lunesta and not feeling sleeping within an hour or so?

The only time that happens is if I take the Lunesta soon after eating a late dinner. I think it just doesn't get in my system quickly in that case.

Otherwise, I normally am ready to drop off in less than 15 minutes.

[vbak]

I started taking Excedrin PM in July, and it has changed my life. I have no trouble falling asleep but staying asleep was a different story. I would wake at 1 and roll around til 3 and get up. Some mornings I would click the coffee pot on at 2:30. I still wake during the night, but I fall right back to sleep. I know how miserable you feel and hope you can get your sleep issues worked out.

Vicky

[manetta]

I feel your pain. I know how frustrating and exhausting it is to get so little sleep. I was just in my doctor's office Tuesday to discuss my lifelong insomnia. He was hesitant to prescribe Lunesta or Ambien because of the dependency issues. Rozerem leaves me feeling like I have a massive hangover. He gave me a prescription for Trazodone starting at 50 miligrams, but I can take up to 150 mlgs if needed. I have taken 50 mlgs for the past 2 nights, so the verdict isn't in yet. I will say that at 50 mlgs that I still wake up 2 - 3 times a night, but I am able to go back to sleep and that is major for me. I am going to try 100 mlgs this weekend while DH is home and see if I am able to sleep for longer periods without waking.

My doctor also discussed a sleep study. He gave me a referral to a doctor within the sleep study group who specializes in insomnia. I have had a sleep study done before so I know that I don't have sleep apnea or anything else interfering with normal sleep.

If nothing else, we are all in good company. Maybe we can start a nightly "It's 3 AM and I can't sleep klatch". ;)

[JulieM]

If nothing else, we are all in good company. Maybe we can start a nightly "It's 3 AM and I can't sleep klatch". ;)

LOL! I got up last night in the middle of the night, turned on the TV, took 2 aspirin and drank some orange juice for about a half hour. I get hip pain in the night too which I think is hormonal related as well.

[Laurielee]

I forgot a friend told me she takes liquid magnesium before she goes to bed. I may try that, here is some info I found on magnesium helping for sleep


http://www.holisticonline.com/Remedies/Sleep/sleep_ins_nutrition.htm

Laurie

[Libra20]

Laurielee - I do a calcium/magnesium combo at night.

I'll also suggest homeopathics, again, because it has greatly helped me with insomnia and staying asleep. However, they don't work like a sleeping pill that you take and it makes you sleepy. You take them regularly (it doesn't kick in the first night always) and they gradually relax your system down and you can sleep better. I notice a big difference if I stop taking them daily. And, unlike sleeping pills, there are no side effects and they don't make you groggy.

[nanco]

I am sitting here waiting for my Dr. to call me back on the same issue! I am 46, in June I stopped the low dose BCP after 15 years of being on it (goodbye migraines!) and I have not had my period for 45 days now. I fall asleep at 10 and wide awake at 1 AM, restless. I am not having full blown hot flashes but, having surging of warm blood run thru me. My best way to describe it! I have that about 20 times a day. I stand on my feet all day for 10-11 hours ,three days a week. I am physically tired when I get home My husband gets the runt of all this. He looks at me wrong and I growl ! He looks at me and goes "wow". How many more years of this? I gave up Caffiene for my migraines 3 months ago. I could go for a Diet Coke!

I took 500 MG of magneisum last night (friend suggested) It did help me dose off and have less restlessness. On the downside, I felt like I sucked on tin foil! I had the worse case of cotton mouth!

[DmOrtega]

This comes from Vegetarian Times Oct 2007.

Foods that Heal - The problem: insomnia, stress

Food Rx: Just before bed, dissolve 2 tsp honey in a cup of warm water, and drink. Honey relaxes the nervous system and mucles, making it easy to drift off to sleep.

.... and this from http://whfoods.org


How do foods affect our sleep?

There's no doubt that there are many of us in the United States that have trouble getting a good night's sleep. The statistics here are striking. 42% of all healthy, middle-aged women report some kind of sleep trouble, including difficulty falling asleep, awaking during the night, or not feeling refreshed in the morning. For women 65 years and older, this percentage drops slightly to 30%, but the impact on other health problems may in fact increase. Even in younger age brackets, sleep problems are significant. Almost 17% of all 21-30 year olds report insomnia in research studies.

Sleep is a "Mind-Body" Experience

There's also no doubt that from a physiological standpoint, sleep is a complicated event and one that's related to many factors that cut across the "mind-body" spectrum. When we can't get to sleep because we're worried and feeling anxious, or depressed and feeling down, or confused and can't figure something out, we obviously aren't going to get to the root of our sleep trouble until we're able to work through the parts of our lives that we're feeling anxious or depressed about. At the same time, however, our nutritional status and the food we eat always influence our sleep. While we can't afford to overlook the psychological aspects, we also need to pay attention to the way we eat.

Patterns and Timing Make a Difference

We've all heard the advice, "don't eat a big meal too close to bedtime." Although this advice sounds simple, it's actually very important and not that easy to follow. On our World's Healthiest Foods website, we've tried to emphasize the sheer joy of eating healthy food. Getting to savor the aroma, and taste, and visual beauty of food is a part of what it means to be healthy. Many of us eat a meal late at night - within 2 hours of bedtime - precisely because we haven't made time during the day to enjoy food. In fact, we let ourselves get so hungry that we don't really care any more about the joy of eating. We just want something in our stomach! Research shows that the timing and size of our evening meal is closely related to the timing and size of our other meals throughout the day. When we have a cup of coffee in the car on the way to work, grab a sandwich for lunch or take care of all the household chores before getting around to dinner, we are setting ourselves up for a bad night's sleep.

Sometimes we rationalize and think that a big meal will actually help us get to sleep by exhausting our body and having it slow down from exhaustion as it tries to digest the large meal. It's tempting logic, but research evidence points in the opposite direction. A large meal does the opposite of slowing our body down. It asks our circulatory system to move more blood to our digestive tract. It asks our stomach to secrete more gastric acid. It asks our pancreas to become more active and produce digestive enzymes. It asks the smooth muscles around our intestines to become active. In short, a large meal does anything but relax us. In addition, our digestive tracts are set up to work best when we are standing; lying down results in gravity pulling the
"wrong way" to help food digest. Even though the practice of napping after a meal is common, it isn't ideal from the standpoint of digestion. Sitting and resting are fine. For example, enjoying each other's company around the table after a delicious meal is a good idea. But lying down to sleep just doesn't help digestion.

It's also worth thinking about the physiological purpose of eating in regard to late-night meals. Nutrients and energy get released from food after we eat, not before. These nutrients and energy help increase our vitality hours after the meal. They cannot go back and compensate for a prior day's worth of activity that received no nutritional support. The time to have our largest meal is always before we need the most nutritional support, i.e., before we have the most physically demanding part of our day. Sleep is the least physically demanding part of the day, and the least logical target for release of food energy and nutrients. We tell ourselves we've had a hard day, and we're starved, but at this point, it's too late to repair the nutritional damage. We need the nourishment before the hard day, and hopefully it will make the day less difficult!

We should also mention the problem of going to bed actually hungry; this other extreme also interferes with sleep, usually by failing to keep the brain supplied with enough glucose (sugar). A small snack in the hour before bed is usually not problematic if you are truly hungry, but the ideal solution is to time your last meal so that you don' feel hungry during the 1-2 hours before bed.

Food Stimulants

Some components of food, such as caffeine, artificially wake us up, so it makes no sense to have stimulant-containing foods before bed. Unfortunately, this applies not only to caffeinated coffee, but to all caffeine-containing foods, and to theophylline-containing foods (like black tea) as well. Chocolate and many soft drinks (including diet soft drinks) have substantial amounts of caffeine. An ounce of chocolate can contain from 10-60 milligrams of caffeine, and a soft drink will usually fall into this same range. Brewed coffee can have over 100 milligrams per cup, depending on the grind and brewing time. Eliminating these foods from your evening meal routine is recommended for improved sleep.

Although alcohol acts in the opposite way - as a depressant that slows down our nervous system activity - it has also been shown to interfere with the quality of sleep.

Serotonin, Food and Sleep

The hormone serotonin is an important factor in triggering sleep. Since our nerve cells use the amino acid tryptophan to make serotonin, much attention has been given to the role of tryptophan (and tryptophan-containing foods) in promoting sleep. First, we don't recommend increased intake of high-tryptophan foods as a way of improving your sleep. Second, studies of tryptophan's impact on sleep have found that it is only one phase of sleep - the falling asleep part - that is enhanced by tryptophan. Other aspects of sleep, such as the amount of deep-sleep reached during the night, are actually harmed by supplemental tryptophan.

Researchers typically divide sleep into two basic types, REM and non-REM. REM stands for rapid eye movement, and it's the phase of sleep that corresponds to dream sleep. Non-REM sleep has four stages, and we typically move through these four stages into REM in about 90 minutes. This 90-minute period is called the sleep cycle. In healthy sleep, we experience 5 or more sleep cycles per night, and the length of the REM phase increases as we move from one cycle to the next. Supplemental tryptophan gets us into the non-REM stages of sleep more quickly, and in this respect can be helpful with insomnia. At the same time, however, tryptophan has been shown to increase non-REM sleep and decrease REM sleep - a non-desirable outcome in most situations.

Many animal foods are relatively high in tryptophan and might sound like logical candidates for improving sleep because their tryptophan could be used to produce serotonin. However, these same animal foods are also fairly high in other amino acids (like tyrosine) that could be used to produce other regulatory substances (like adrenalin) that would usually decrease with the onset of sleep. In summary, we don't recommend trying to up your serotonin by increasing your evening intake of high-tryptophan foods as a way to improve your sleep.

Our serotonin levels respond to other aspects of our diet, however, and one of those aspects is carbohydrate intake. Eating foods higher in carbohydrates raises our blood insulin level. This is because carbohydrates are digested relatively quickly and raise our blood sugar level more quickly than proteins or fats. Along with this increased insulin level there is an increased transport of amino acids into our brain, including tryptophan. More brain tryptophan leads to more brain production of serotonin and increased likelihood of sleep onset.

This line of thinking has been explored by researchers Richard and Judy Wurtman at the Massachusetts Institute of Technology, particularly with respect to carbohydrate-craving during depression. With respect to sleep, our conclusion would be: if you're going to eat a snack 1-2 hours before bed, a small carbohydrate-based snack that includes some protein and some fat would make the most sense. This snack could be a slice of whole grain bread with a little almond butter, or a 1/2-serving of our website Perfect Oatmeal.

Food, Sleep and Exercise

In many studies, and in our own practical experience, being physically tired from a healthy day's activity - including morning, mid-day, or early evening exercise - is one of the best promoters of a good night's sleep. We can be mentally exhausted from the day, but if our body is not physically tired as well, it may not feel ready for a night's rest. Exercise helps regulate our appetite just as much as it helps regulate our sleep. When we're active, moving and placing physical demands on our body, it gives our body a healthy context for deciding when food is needed and when it is not. Even if it's simply a twenty-minute walk, coordinating our meal plan with an exercise plan is a huge plus when it comes to sleep. Food, sleep and exercise are three components of our life that are meant to work together. Replacing your lunch hour with an exercise hour does not make sense, any more than skipping a walk to provide a more leisurely dinner. For healthy sleep, we need to plan our day so that both components get included.

Overall Nutrient Supplies and Sleep

The complex nature of sleep means that all nutrients - including amino acids, fatty acids, vitamins, and minerals - are needed in optimal amounts to support the sleep process. Some of our most important immune system functions occur only during sleep, as well as some of our most important "antioxidant balancing" activities. On this website, we list literally dozens of food components that act as antioxidants, and we explain how specific vitamins and minerals support immune function. Sleep requires many nutrients to support a very complex process so the World's Healthiest Foods strategy of enjoying nutrient-dense foods will also help you get a better night's sleep. It will also allow you to relax and enjoy the pleasure of real food.

Note: (For additional information on sleep, you may want to visit the following websites: www.sleepnet.com, www.sleepohio.com)

Practical Tip:
What should I eat to help me sleep?

Not too much! It is important that your body be able to focus on rest and repair while you sleep, rather than on digestion. It is more important to gear your evening meal towards relaxation and good digestion than to consume any particular food or drink before bed. Try some of our delicious, easy to prepare recipes, for a healthy promoting evening meal. Your evening meal should: emphasize low-to-medium glycemic index carbohydrates, such as whole-grain breads, rice, or pasta, yams, a mixed green salad, or lightly sautéed vegetables include a small portion of a healthy fat-containing food, such as olive oil, avocado, or nuts or seeds or their oils or butters include herb tea (especially chamomile or peppermint) or other non-stimulating water-based beverage include only fresh, dried, or cooked fruit for dessert, if dessert is desired.

Your evening meal should be eaten about 4 hours before bedtime so that the main digestive effort is finished, but the energy from these foods can be released gradually throughout the night. If it is necessary for you to eat a snack at bedtime, choose one or two of the following:

small cup of herb tea or warm milk (soy, nut, or dairy)-not so much that you must wake up to use the restroom in the middle of the night small serving of fresh or dried fruit small handful of raw nuts or seeds

References

Breslau N, Roth T, Rosenthal L, Andreski P. Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry 1996;39:411-8.

Hayes MJ, Parker KG, Sallinen B, Davare AA. Bedsharing, temperament, and sleep disturbance in early childhood. Sleep 2001;24:657-62.

Moldofsky H. (1995). Sleep and the immune system. Int J Immunopharmacol 17(8):649-654.

Newman AB, Enright PL, Manolio TA, Haponik EF, Wahl PW. Sleep disturbance, psychosocial correlates, and cardiovascular disease in 5201 older adults: the Cardiovascular Health Study. J Am Geriatr Soc 1997;45:1-7.

Owens JF, Matthews KA. Sleep disturbance in healthy middle-aged women. Maturitas 1998;30:41-50.

Reynolds CF 3rd. The implications of sleep disturbance epidemiology. JAMA 1989;262:1514.

Wetter DW, Young TB. The relation between cigarette smoking and sleep disturbance. Prev Med 1994;23:328-34.

Wurtman RJ, Wurtman JJ. Brain Serotonin, Carbohydrate-craving, obesity and depression. Adv Exp Med Biol 1996;398:35-41.

© 2001-2007 The George Mateljan Foundation

[armel]

Your evening meal should be eaten about 4 hours before bedtime so that the main digestive effort is finished, but the energy from these foods can be released gradually throughout the night.

And I always wonder what the folks who give this advice do for a living. So I guess I plan on not going to bed before midnight (even though I get up at 5:30am - so that probably wouldn't help with the whole sleep issue) or somehow find a way to eat my evening meal while I am either still at work or in the middle of my hour long commute home.

ETA: I don't mean you DmOrtega, but the authors of the article.