The “Z-Drugs”

If you’re ever had a prescription for sleeping pills, you’ve taken one of the Z-Drugs. This class of drugs gets their nickname from the generic/chemical names of the drugs; for example, generic Ambien is called zolpidem, and so on.

Remember the discussion about the highly addictive class of drugs known as the benzodiazepines? They include tranquilizers such as Xanax, Valium, Ativan, and many others. These drugs work very similarly to alcohol in that they bind to the GABA—gamma-aminobutyric acid—receptors in the brain. GABA is the “calming” neurotransmitter. It is the chief inhibitory compound in the human body.

However, as seen, these drugs have a strong rebound effect. In fact, the reason Xanax is perhaps the most addictive prescription drug out there, known to cause addiction in as little as two days, is that it quashes panic and anxiety for 3–4 hours, but then it all comes back—even stronger! This causes the patient to take more and more and more, until either a stronger drug or a higher dose is needed. Over time these drugs can cause cognitive impairment. Stevie Nicks, of Fleetwood Mac fame, said that the benzodiazepine drug clonazepam, brand-name Klonopin, stole her life and years of memories from her. That is just how dramatic and far-reaching the negative effects of these drugs can be with long-term use.

Similarly, the Z-Drugs also bind to the brain’s GABA receptors at the same location as the benzodiazepines. They act slightly differently in that their intended purpose is to cause drowsiness and to induce sleep, while the benzodiazepines are intended to reduce anxiety; however, anyone who has taken any of the benzos will tell you how sedating they are, particularly the stronger ones such as Xanax (alprazolam).

The problem, then, should be obvious: Since these drugs work on the same brain receptors, at the same locations, as the benzodiazepines, they are equally as addictive and dangerous when used any longer than the month or so that experts agree on as the maximum length of time to depend upon these drugs for sleep.

Someone who I know personally had bouts of intermittent insomnia and finally went to see his physician to do something about it. He was prescribed Ambien, which he said, “Knocked me on my ass,” and he slept great. For two weeks.

Then he decided he was sleeping well again and that he didn’t need the Ambien.

Didn’t need it? He was hooked! He recounted the sheer hell of not sleeping at all for an entire week just to get off the pills. And he took them for only two weeks, and at less than the prescribed dosage, to boot.

Another big problem with these drugs is that they are Schedule IV controlled substances in the United States. As mentioned earlier in reference to the “opioid epidemic,” more and more physicians are refraining from prescribing controlled substances out of fear of being subjected to a DEA review, which for a doctor is roughly equivalent to being subjected to an IRS audit for me or you.

That means your doctor may simply decline to renew your prescription one day, and—BOOM! You’re going to be lying awake for a week straight or longer as my friend did. Finally, since these drugs work very similarly to both alcohol and the benzodiazepines, they also carry the same withdrawal symptoms: tremor, seizures, delirium tremens, and so on, are all potential risks with abrupt cessation of any of the Z-Drugs.

More “Z-Drug” Zingers

Another sticking point I have with the Z-Drugs, aside from the fact that they’re a chemical assistant and not a natural way to get to sleep, is the bizarre behavior they commonly induce, including amnesia, sleep-walking, sleep-eating, sleep-sex, and yes, even sleep-driving!

In one extreme case, a man who was taking Ambien for sleep got up at night, retrieved a firearm, and committed a mass shooting in his sleep. He went home and went back to bed with no memory of the event. Subsequent interrogations and polygraph examinations confirmed that the man truly did not remember the horrific things he did that night.

Sleep-induced shootings aside, just the thought of sleep-driving is terrifying to me, especially when I know that it could happen without my knowledge and that I could easily get myself, and others, killed by doing it.

For these and many more reasons, I consider the Z-Drugs like Ambien and Lunesta to be of questionable safety and efficacy.

Antidepressants

As newer and better antidepressants hit the market, older ones are relegated to taking up the slack in other departments. Most notable is the prescription antidepressant trazodone, which, believe it or not, is now the number one most prescribed drug to treat insomnia in the United States.

Similar drugs are sometimes prescribed, albeit off-label, for help with falling asleep. For example, the muscle relaxant cyclobenzaprine, brand-name Flexeril, is actually a slightly modified tricyclic antidepressant known for its drowsiness-inducing effects.

My concern here is, once again, that the drug is acting as a band-aid rather than naturally inducing restful sleep. Furthermore, the implications of prescribing antidepressants to people who are not clinically depressed and therefore don’t need them are still highly questionable. There are the usual side effects of antidepressants such as loss of libido, and in the case of tricyclics or muscle relaxants, severe dry mouth that leads to tooth erosion and cavities.

Antihistamines

Who hasn’t ever taken NyQuil and then sung the praises of how great they slept afterward?

NyQuil puts you to sleep through the use of an antihistamine, doxylamine, which is very similar to how Benadryl (generic name diphenhydramine) works. Seemingly everyone knows that Benadryl will cause drowsiness and works great as a sleep aid. I know I’ve used both doxylamine and diphenhydramine myself on and off over the years. (After surgery I used them to sleep, since opioid painkillers give me pretty severe insomnia.)

The main problem with these types of drugs, other than the fact that they leave many people feeling groggy and like “zombies” the next morning, is that they block the all-important neurotransmitter acetylcholine in the brain. It is the neurotransmitter released by the nervous system in order to activate muscles. That means effects can range from the mild and unnoticeable to the severe, up to and including seizures and paralysis. It’s also a neurotransmitter in the sympathetic nervous system and as the final product released by the parasympathetic nervous system.

The brain contains several cholinergic areas that rely on acetylcholine, including influencing functions such as arousal, attention, memory, and motivation.

Most people take these drugs in the form of over-the-counter allergy meds such as Claritin and Zyrtec, which are low dose and pose little problem, although long-term consequences still exist.

At the University of Washington’s School of Pharmacy, a team led by pharmacist Shelley Gray tracked approximately 3,500 people aged 65 or older. Using the group’s pharmacy records to determine all drugs each participant had taken over the past 10 years up to the study, it was found that the approximately 800 people who had developed dementia within another 10 years were taking anticholinergic drugs. What’s more, the study found that taking an anticholinergic for three years or more was associated with a whopping 54% increase in dementia risk versus taking the same dose for three months or less.

For these reasons I do not stand by the use of antihistamines/anticholinergics like Benadryl and Unisom. When I happen to take Zyrtec or another allergy medication during the times of year when my allergies sometimes act up, I make a point to take a choline supplement with breakfast in order to counter the choline-reducing effects in order to hopefully prevent the long-term consequences of taking this class of drugs.

Valerian Root

If you’ve ever taken valerian root, you’ll remember it: The stuff stinks like days-old moldy gym socks and you’d better have water at the ready because hunting for it with that capsule in your mouth is no walk in the park!

Valerian root has been shown to reduce the amount of time to fall asleep by 15–20 minutes. It also helps to improve sleep quality. Recommended dosages are between 400 and 900 mg, taken two hours prior to bedtime, although I find that I sleep through the night better if I take it right at bedtime.

While valerian doesn’t work as quickly or effectively as sleeping pills such as the Z-Drugs, it’s a safe alternative, and what’s more, it can help with the insomnia and other withdrawal symptoms when coming off a Z-Drug.

Passionflower

Passionflower is commonly used for a variety of ailments, the most common of which are insomnia and anxiety.

On the anxiety front, passionflower has been shown in some clinical trials to be as effective as some of the benzodiazepines in reducing anxiety when taken twice daily. Unlike valerian, while it’s calming, it won’t knock you on your ass, although you should experiment on a weekend or other free day first to see how it affects you before getting behind the wheel.

It is also useful for preoperative anxiety when taken 30–90 minutes before rolling into the operating room.

As for sleep, there isn’t much research on this topic as there is anecdotal evidence, such as my personal experiences. Having said that, early research shows that passionflower tea taken an hour before bedtime for seven consecutive nights improves subjective ratings of sleep quality. Research also shows that taking a product containing passionflower, valerian, and hops (NSF-3 by M/s Tablets in India) for two weeks improves sleep similar to zolpidem (Ambien) in people with insomnia.

Kava

There is a lot of controversy over kava regarding liver health; in fact, it’s been banned in both Europe and Canada for this reason. However, research shows that it was a particular, single brand of kava that contained extracts from the entire plant, rather than just the root, that led to the hepatoxicity and cases of liver failure.

Having taken the herb for years and having gotten regular annual labs done by my doctor, I can tell you with certainty that my liver function values weren’t even slightly elevated, ever. However, my disclaimer still stands, and you should do your own research and/or consult with a healthcare professional prior to taking kava.

Kava has been proven effective in the treatment of anxiety, which is not surprising considering the fact that medications and supplements with antianxiety properties also cause some degree of drowsiness, which is why many un- or underinformed physicians will prescribe benzos such as Xanax off-label for sleep. (The practice of prescribing something off-label refers to prescribing a drug for a purpose outside the scope of its FDA approval, which is entirely legal; doctors have discretion here.)

Studies show that taking kava extracts that contain 70% kavalactones, something you should look for on labels before buying, reduce anxiety, sometimes to the same degree that prescription antianxiety medications do. However, this can take up to five weeks of daily use to take full effect and doesn’t provide immediate relief like the benzos do.

On that same note, it has been shown that slowly increasing the dose of kava over one week while simultaneously reducing the dose of a benzo over the course of two weeks can prevent most withdrawal symptoms and avoid severe rebound anxiety in patients coming off benzodiazepine drugs. Remember that they have some of the highest addiction potential as well as the most dangerous withdrawals of nearly any class of drugs. This is important to remember if you’ve struggled with quitting these drugs in the past but simply keep refilling your prescription because you’ve found it impossible to withdraw.

On the sleep front, which is why we’re here, some research shows that taking a kava extract daily for four weeks reduces sleeping problems, while other research contradicts this and states that it only reduces anxiety, not insomnia.

Knowing from personal experience that anxiety and anxiety alone can cause severe insomnia due to the endless thoughts in your head, the racing heartbeat, and so on, I see a strong connection between medications and supplements that control anxiety and the treatment of insomnia. Remember, the most common antianxiety drugs, the benzodiazepines, cause drowsiness, are commonly prescribed for sleep, and are nearly chemically identical to the Z-Drugs, which all support this hypothesis that antianxiety treatments work well for sleep.

Magnesium

Commonly known as a metal and an essential mineral in the human body, magnesium is a calming mineral that is known for its ability to reduce blood pressure, relieve stress, and improve sleep quality and prevent insomnia.

Magnesium works on helping you sleep by helping to regulate both melatonin, the sleep hormone, as well as several brain neurotransmitters. Research shows that there is a correlation between magnesium and melatonin levels in the body. Magnesium-deficient individuals commonly report insomnia and reduced sleep quality. Additional research shows that magnesium is tied to your circadian rhythm.

Magnesium promotes relaxation and assists with sleep by binding to GABA receptors, just like several prescription drugs previously discussed. This binding activity slows down nervous system activity, which calms you and your body overall and prepares you for slumber.

Sleep is just one small facet of magnesium’s myriad benefits; hence why it’s considered an essential mineral. It’s also known to be a muscle relaxant, and some studies show that magnesium glycinate, 400 mg taken twice daily, is just as effective as prescription muscle relaxants such as Skelaxin. I personally take the glycinate salt of magnesium over other varieties primarily because, unlike other varieties, it does not have any laxative properties, and is very well-absorbed by the body. (Magnesium oxide, the most commonly store-bought form of magnesium, is also the cheapest to manufacture and is very poorly absorbed; hence why it’s found in many lower-cost multivitamins. Magnesium citrate is used specifically as a laxative, hence why I avoid it.)

One thing to absolutely avoid are “cal-mag” supplements, those containing both calcium and magnesium. While both are essential minerals, the issue is that the two are antagonistic to each other, meaning that taking both at the same time means neither will have its intended effect. It is best, therefore, to take calcium, if you take it at all, in the morning, and to take magnesium with your evening meal and possibly at bedtime as well. Some nutritional experts even go so far as recommending that you take them on entirely separate days, alternating back and forth.

I do not take calcium supplements at all, first because it’s an excitatory mineral and my mind is very active as it is without the need for any additional stimulation, and second, and perhaps more important, because so much of what we consume, right down to bottled water, is overcalcified and has caused something of a magnesium deficiency epidemic in our society. In other words, calcium is everywhere in foods and beverages you consume, but not so much with magnesium.

Finally, if you consume alcohol regularly, it’s especially imperative that you supplement with magnesium. Alcohol consumption drastically depletes magnesium levels in the body, requiring replacement with a supplement. Those who have had gastric bypass or other GI surgery that affects absorption of nutrients should also be on the lookout for magnesium deficiency symptoms such as anxiety and insomnia.

Melatonin

Melatonin, contrary to popular belief, is neither an herb nor a supplement; it is a hormone that’s naturally produced in the human body via serotonin, magnesium, and other chemicals in the body. (That’s why many SSRI antidepressants, that act solely by increasing serotonin levels in the brain, also cause drowsiness as a side effect.)

Melatonin is also perhaps the most misused of sleep aids due to the fact that it’s sold in tablet form at supraphysiological dosages, or in plain English, much, much more than is necessary or even desirable to take.

On a recent trip to my local pharmacy I was looking for 0.3 mg melatonin tablets, or 300 mcg. No luck! The lowest dose I could find was 3 mg, or 10 times the dose I was seeking. They even had 10 mg tablets in the store! And yet, nothing remotely near safe and recommended doses.

Your body’s melatonin production is regulated entirely by light. It’s a big reason that night owls are night owls; due to our innate circadian rhythms, our bodies begin to produce melatonin later and also stop producing it later. That’s why we fall asleep late and get up late. During winter when the days are short, or during dreary days in general, much of the sluggishness experienced by people comes from the lack of adequate sunlight needed to shut off melatonin production. This is why sleep therapy lights are so effective for waking up, and to some degree, even shifting your rhythm and wake time, although we’ve seen that it’s not possible to make any drastic changes there. You have what you were born with, and only small changes are possible, say, getting up one hour earlier. Maximum.

Likewise, melatonin is the reason why light can keep so many of us awake, particularly night owls. I use blackout curtains in my bedroom and make sure any light sources, for example, the power light on my air purifier, are covered up with black tape. I don’t recommend the wake-up strategy of leaving your curtains and blinds open so the sunlight can come in and wake you in the morning, due to the fact that even trace amounts of light coming in can mess with your sleep. This is particularly true when there’s a full moon, or when it’s overcast out and urban light is reflecting back down.

Start with taking 0.3 mg, or 300 mcg, about two hours before bedtime. A common mistake people make is to take it at bedtime; however, the body naturally begins to produce it after dark or once you’re home for the night under artificial lighting.

If you have the problem of waking frequently through the night, sublingual melatonin supplements are available that are absorbed instantly into the bloodstream when allowed to melt under your tongue, getting you back to sleep very quickly. Another option is time-release melatonin, commonly available in stores, if you’re someone who wakes frequently throughout the night.

Check with your doctor or pharmacist, or use an online drug interaction checker, to make sure melatonin won’t interfere with anything else you’re taking. In particular, anticlotting drugs such as Warfarin, immunosuppressants such as corticosteroids (prednisone), diabetes drugs, and birth control pills can cause interactions with melatonin.

Finally, despite cautioning you on using too much melatonin, it is a very powerful antioxidant and is very good for your overall health. However, that doesn’t necessarily mean that more is better, unless you want to feel like a zombie in the morning!

Proper Lighting

As mentioned, even low amounts of stray light can keep a night owl awake for hours. That’s why it’s so important to make sure you do what needs to be done to control nighttime light in your bedroom.

I use blackout curtains and also close the blinds behind them, while blacking out any power buttons or other extraneous electronic light sources. My clock has very dim red lighting, which I keep so dim I can barely read the clock when I wake up and am still in that blurry and groggy state of having just awakened.

Sleep masks are recommended and you should try it out and see what works best for you. I used them for a long time and then stopped, because of two reasons. One, having something on my head all night was enough to give me sleep problems and frequently wake me up, despite spending a small fortune on a super soft and comfortable sleep mask. Second, I frequently found myself waking up way, way too late with a sleep mask on. Even with the blackout curtains, I can still tell when it’s daylight out, and will check the clock; as long as it’s not six or some other crazy hour, I get up. With the sleep mask I would routinely wake up as much as two hours past my usual rising time, and on top of that, the unnecessary extra sleep would leave me feeling so groggy and brain-fogged that I would’ve been better off just fighting through a toss-and-turn night! Hence why I suggest that you try it out and see if it works for you or not.

Finally, if you must keep a smartphone on your nightstand, make sure it’s on airplane mode and do-not-disturb, unless you’re on call for work. Also use a feature such as Night Shift on iPhone or one of the apps that can dim your backlight and remove the blue light element from it (more on that later), and keep the phone’s brightness at the minimum level.

Proper Sound

You’re probably guessing that I’m going to recommend total and complete silence; however, that’s the polar opposite of how I sleep, and once again, you’ll have to try it both ways and find out what works best for you.

Personally I have trouble sleeping in a quiet room because I have exceptional hearing—I don’t understand why, after playing in rock bands and sitting in the front row at dozens of concerts—but I do. I hear everything in the house, and my wife even marveled about this one time long ago when we were still dating. She was on the opposite side of the house, with the air conditioner running loudly (it was an older house in Phoenix), my noise generator was on in my room, the door was closed, and she was on the phone at a distance that should have been way out of earshot for me.

When I got up, I said, “So, Frank will do …,” which was a comment on her phone call. And she was taken aback! So, yes, my seemingly supernatural hearing ability makes it tough for me to sleep in total silence.

What I do is twofold. First, I have an air purifier, as mentioned previously. It’s big and it’s loud, and that’s how I like it—it blocks out any other sound I might possibly hear other than my Great Dane’s very loud bark. Second, I’ve used a noise generator on and off. In the past you had to buy one, but now there are endless free noise generator apps you can get on your smartphone. Just remember to follow my advice about smartphones on your nightstand if you go this route.

If silence works for you, then perhaps heavier drapes and even acoustic foam in the right spots will really deaden it for you. You may also want to try earplugs, something I use particularly on weekends when the kids will have been up for a couple of hours by the time I get up, and of course the big dog usually manages to bark at something! I haven’t found any one particular brand or variety of earplugs to be any more comfortable than others—or very much comfortable at all for that matter—so I simply use the inexpensive ones that I keep in my range bag, that I carry to the shooting range and competitions.

Foam earplugs are disposable, so dispose of them after one or two uses, otherwise you run the risk of ear infections due to mold, fungus, and bacteria. On the same note, if you are prone to ear infections at all, your ears need to breathe, so avoid them entirely.

Proper Temperature

This is one of the biggest mistakes people make: keeping their houses and/or bedrooms entirely too warm for deep, restful sleep.

It happens to me all the time when I travel, so much so that I’ve gotten to the point of drop-shipping a cheap tabletop fan from Amazon to the hotel ahead of time; that way I don’t have to go hunting around for one, and I know which cheapie ones work well. Considering that they’re under $20 and most hotels charge a daily, bogus “resort fee” of at least $25, apparently for the “free” wifi, I see it as a cheap investment in good sleep, whether the trip is for business or for pleasure. And heck, I’m sure at least a few members of hotel housekeeping staff have appreciated the free fan to take home!

The best temperature for falling asleep is in the low- to mid-60s. Most people consider this “cold” but this is the body’s natural sleep temperature. Maintaining proper temperature helps ensure that your body will properly thermoregulate during sleep.

I’ve found about 65 degrees Fahrenheit to be ideal. Any lower than that and getting up in the middle of the night can be uncomfortably cold, and any warmer than that and I find myself hot, sweating, and tossing and turning all night. Remember, if it’s too chilly, you can fix that with blankets, but too hot is too hot and there’s nothing you can do about it other than lowering the thermostat.

I also like air moving around me. That means a ceiling fan, and, in summer months, a small table fan, like the one I use in hotels, aimed indirectly at the bed. Few things will keep you up all night like a fan blasting air directly at your face, so keep it indirect. Even when it’s cool enough, if the air is stagnant, that can be enough to keep me needlessly awake. And remember, while some of these recommendations go well above and beyond the usual sleep hygiene recommendations, I’m one of your fellow night owls who struggles with getting and staying asleep and these extra measures will be necessary for us more often than not.

On a side note, if you’re worried about the cost of things, such as natural sleep aids, blackout curtains, sleep masks, fans, and all that—not to mention a slightly higher electric bill thanks to the air conditioner—think of the cost that lost productivity does to you when you don’t sleep well. It’s not only financially damaging in terms of job or business performance; it also takes a toll on your well-being and overall happiness. So just make the investments needed to get a good night’s sleep!

Avoid “Blue” Light at Night

By blue light, I’m referring to the light emitted by LCD and LED screens, found on everything from smartphones to tablets to computers to Apple Watches to your television to you-name-it. LED lightbulbs that emit a daytime light frequency, which most do, also fall under this category.

If you doubt the validity of this, open your smartphone, put it on the floor, walk to the other side of the room, and turn off the lights. Obviously this is best done at night. What you’ll see is a big blast of blue light emanating from that screen!

The reason why electronics light can keep you awake is because it’s the same light frequency as, well, daylight. Regular daylight on a sunny day, thanks to our blue sky, is not white light but actually a bluish hue, right around a light temperature of 5600 Kelvin. That’s why photographers, when wanting to augment outdoor lighting, or do an indoor scene that simulates the outdoors, will set their lights to 5600 K. On the other end of the scale, for softer and/or “late” lighting, they’ll drop way down to 2600 K to get that soft, yellowish hue.

The most common advice you’ll hear is to avoid all screens for one to two hours prior to bedtime. However, this is more easily said than done in today’s world.

I do agree with stopping work about an hour before bed, since it’s the work itself, and not the light from the computer screen, that will keep my mind overflowing with thoughts and therefore keep me awake. When I do use a laptop at night, I use both the Night Shift feature along with the free f.lux app to remove the element of blue light. Using both together produces a very noticeable yellow light, which looks unnatural, but I value my sleep more than how good my computer screen looks! I also have a thin, blue-blocking screen protector film on the laptop. Unlike the apps, it doesn’t look too far off from the natural screen light.

The same goes on tablets and phones—use blue-light reducing features such as Night Shift, apps that can do the same, and screen protector films that are hued to block some degree of blue light.

Since my wife and I have our handful of television shows we watch together, and there’s no Night Shift on the TV (yet), I use a pair of cheap blue-blocking glasses I got on Amazon for under $20. If you’re in your mid-forties like me and starting to use reading glasses, you can get over-the-counter reading glasses with the same blue-blocking tint. They do add some amount of yellowish tint to what you see, but once again, sleep quality is first and foremost with me and thus is far more important than any inconvenience it adds; having said that, I had to switch my Kindle highlights from yellow to blue because the yellow tint of the glasses combined with the yellowish light with the device turned to night mode was blocking them out completely to the point where I couldn’t see the highlights!

Also, do not look at screens if you happen to wake up at night. This is especially important nowadays with seemingly everyone using his or her phones as nighttime clocks. Don’t look at it. In fact, hide the clock altogether. Nothing is going to give you sleep anxiety and keep you awake more than seeing that you have to get up in two hours but feel like you need at least that much more sleep. It will merely cause you to lie awake thinking and worrying about it, guaranteeing that you indeed will not fall back asleep.

Avoid Daytime Naps

Unless you literally didn’t sleep the previous night and absolutely require a nap to make it through the day, avoid napping. Even though it’s so common, and many people swear by it, the fact is that napping is considered to be a symptom of a sleep disorder by medical science.

I for one cannot take the 20-minute “catnaps” people rave about and instead will fall into a regular, full 90-minute sleep cycle. This leaves me groggy for the rest of the day and feeling far more tired and sluggish than simply dealing with insomnia would have, so for me they’re not worth it.

The more insidious part, however, is that daytime napping will interfere with your falling asleep and simply lead to more insomnia. It’s like how Xanax rebounds and, after it wears off, the original anxiety is back—and it’s worse!—and the user must take more frequent doses, and eventually higher doses, in order to get the same effect. Likewise, daytime napping can turn into rebound insomnia when you do try to get to bed on time, which leads to more insomnia, which leads to more napping, and you end up in the same vicious cycle as a Xanax addict.

So, in summary, no napping. Fight through the fatigue and save it for a great night’s sleep!

Get Daytime Exercise

Many years ago I was experiencing insomnia and asked my then-doctor for sleeping pills. He said he will not prescribe them, and explains to patients that insomnia is more often than not due to lack of exercise and a sedentary lifestyle.

Think about it: If your body doesn’t get enough exercise, it’s never tired out and of course falling asleep will be a challenge! I got my ass back in gear, got back to pumping iron at the gym, and, amazingly, I almost immediately began sleeping much better!

One caveat, though, is to avoid exercise close to bedtime. Some light stretching as part of a nighttime routine is fine, but don’t lift weights or do cardio or anything else that’s going to elevate your heart rate and your body temperature with it. Remember the importance of keeping yourself cool in order to sleep well? If you do any kind of exercise that warms you up within three to four hours prior to bedtime, your body simply won’t want to shut down for the night. The same goes for any kind of heavy lifting or any other strenuous activity. If the furniture needs rearranging, save it for the next day.

Get Daytime Sunshine!

This one sounds counterintuitive, so bear with me here.

You now know that your circadian rhythm, and the production and subsequent cessation of production of melatonin, are strongly tied to light. One of the issues night owls experience is that society demands we get up at a time when our rhythm is still stuck in the sleep phase and our bodies are producing melatonin. Hence why gloomy days and seasonal affective disorder can be especially problematic for night owls.

While I say “sunshine,” what I really mean is any kind of daylight. Even many overcast, gloomy mornings will produce more natural outdoor light intensity than any therapy light can. It’s important to get this light as soon as possible upon rising. It serves to terminate melatonin production, which gives you a boost in energy. It also stimulates vitamin D and serotonin production, both of which are feel-good neurotransmitters (well, vitamin D is a hormone, specifically a secosteroid and not a neurotransmitter, but it works to make you feel good and happy, simulate growth hormone production, and in men, stimulate testosterone production).

One myth about vitamin D is that you can get it from a supplement, and while true in theory, it is not the same substance that your body photosynthesizes during exposure to daylight. The vitamin D3 in pill bottles is called cholecalciferol, while the substance produced by your body is cholecalciferol sulfate. It’s the naturally produced, sulfated version that has far-reaching and superior effects to the bottled version.

Just like the lipid hypothesis has been disproven and it’s now known to medical science that cholesterol is not responsible for clogged and hardened arteries, it’s also known that sun exposure in moderation, along with UVB-only¹ tanning beds in moderation, increases natural production of vitamin D3 which in turn prevents a myriad of health problems. Most interestingly, it’s now known to prevent melanoma, the deadly form of skin cancer, which was previously blamed on sun exposure despite it most commonly appearing on areas such as the inner thighs and buttocks, which ordinarily get zero sun exposure.

While the FDA’s daily recommended intake of vitamin D3 is well below what’s now known to be beneficial, and irrelevant anyway if you’re getting the natural form, it’s important to know that you can accumulate too much D3 in your body, which can lead to toxicity. Also, because it assists with calcium absorption, you may be well-advised to avoid calcium supplements along with calcium-based antacids like Tums and Rolaids.

To really know where you’re at, request a D3 check from your doctor or from a walk-in lab. Knowing what your levels are is the right start for getting them ideal. Also, I strongly recommend the book The Vitamin D Cure by James Dowd, MD (Wiley, 2012), to educate yourself on the importance of sunshine, not only for good sleep but for overall health. It does a great job of destroying the myths about skin cancer and other needless mythology about sun exposure that has led to a D3-deficient nation and the long parade of health problems and illnesses that the deficiency causes.

Wake Up with a Therapy Light

I’ve mentioned therapy lights (or therapy lamps) earlier in the book and want to touch on them again here.

As with daylight, getting bright light as soon as you awaken, or are forced to wake up whatever the case may be, terminates your body’s melatonin production so you can fully wake up and become alert and ready for the day.

The reason I like using a therapy light is convenience: I wake up, turn on the light and set it to the 30-minute timer, and sit up and read in bed until the light turns off. Then I’m wide awake and get up. It’s more practical than getting up and trying to immediately get outside, particularly if the weather isn’t inviting, or if you live somewhere like Seattle where even normal outdoor light levels can fall below those of a good, bright therapy light.

By shutting off melatonin production as soon as you wake up, you sort of “program” your body to turn it off at that same time every day. In turn, your body will begin to produce it a bit earlier in the evening, allowing you get to bed on time and fall asleep much more easily.

If you need to get up and move immediately and can’t sit next to a therapy light for a half hour, another option is a light therapy visor. These will run you a lot more money—most go for over $100 or more—however, you can get your light exposure while “on the move” whether that’s making coffee, eating breakfast, or whatever your morning routine entails.

On rainy days, which happen in Dallas a lot more than I’d care for, I’ll bring my light out with me and plug it in on the kitchen counter while out there, and on the bathroom counter while getting ready. I know I can just get a visor, but until the light breaks, why bother?

TIP: Unplug your therapy light at night! I once dropped a tissue or something at night, and when I accidentally hit the power button on the light. bam—10,000 lux of 5600 K daylight right in my eyes! Thankfully I instantly clamped my eyes shut and took a sublingual melatonin and got back to sleep, but that was too close a call. Since the buttons are so light as to be practically touch-sensitive, I now unplug the light when not in use.

ANOTHER TIP: Sleep Cycle, the most popular sleep app out there, now integrates with Philips Hue lighting. I picked up four of their bulbs for my bedroom, synced them up with our wifi, and can now have the Sleep Cycle app gradually turn on the lights over a 30-minute period prior to my set waking time. This simulates the natural sunrise our bodies evolved to wake up to over millions of years. Better still, I can control the light temperature with the Hue app, ensuring a nice, bluish daylight hue to wake me up! Likewise, I can turn them way down or even change color, say to dark red, for nighttime use without interfering with melatonin and sleep.

Always Go to Bed at the Same Time (Optional)

This is a classic, time-tested piece of sleep hygiene advice, and it works—on most people.

During the week I go to bed when my body is naturally tired, with the help of some of the herbal sleep aids I mentioned. However, as a night owl, I love—and I mean love—staying up late. That is why I don’t go to bed at the same time every night, and seriously question whether any true night owl can pull that one off.

The thing is, if I know I have something lined up the next morning, or a busy day in general, I’ll pay attention to what time I go to bed and sometimes will go easy on any sleep aids to avoid next-day grogginess.

However, if I have nothing planned the next day, other than the self-employed daily routine of figuring out what needs to be done next, I let my inner night owl come out to party and enjoy it to the fullest! I might put on a movie I like, read a book, or if the weather is nice I’ll sit outside late at night and read or listen to an audiobook.

If I really don’t care how late I go to bed, say, if it’s a Friday or Saturday night, then I put the headphones on and bring on the Rush because I love few things more than good music but also know that listening to music gets me very worked up and that will delay my bedtime by at least one to two hours.

Having said all that, even if you’re a tried-and-true night owl like me, if getting enough sleep is posing a real problem for you, this one is worth trying. Choose your desired bedtime based on how many hours of sleep you do best on, and if you use any sleep aids like melatonin, valerian, or others, set out the ones you take right at bedtime, and take others such as melatonin at their recommended times; in the case of melatonin that would be about two hours prior to bedtime.

Have any morning supplements or medications out and ready to go for the morning (such as, in my case, thyroid medication), and do what you need to do to make that plan work. You now have a nice, long list of tips and suggestions to get to sleep and stay asleep, so what do you have to lose?

Alcohol

Alcohol, or more properly, ethanol, the kind found in alcoholic drinks, has long been used as a “nightcap” to help one get to sleep easier, and it will indeed do that—have you ever been passed out drunk or know someone who has? That isn’t sleep; it’s just being passed out drunk. This is largely where the misconception that alcohol can assist with getting a good night’s rest comes from.

Alcohol, once in the bloodstream, rapidly binds to the brain’s GABA receptors. Remember that GABA is the calming or relaxing neurotransmitter, the same one that the benzodiazepines bind to, as well as magnesium to a much smaller degree. It’s the activation of GABA by alcohol that provides the relaxation and drowsiness it’s known for.

However, there are two huge problems with this that prevent you from truly getting a solid night’s sleep after drinking alcohol. The first I’ve already touched on: The fact that it interferes with stage 4, or deep sleep.

During deep sleep, the brain produces slow-wave sleep patterns called delta waves. This does occur with alcohol in the body; however, alcohol simultaneously causes alpha activity to occur. Alpha activity is not normal during sleep, but rather occurs with conscious relaxation and resting.

The other problem with alcohol is that you won’t sleep through the night after an evening of drinking. First, as with drugs like Xanax, the GABA-binding activity wears off rather quickly, and the rebound effect wakes you up. The common misconception is that alcohol turns into sugar and the sugar rush wakes you up; however, alcohol is not converted into sugar, nor is it a sugar, nor can any alcohol be a sugar any more than a fat can be a carbohydrate.

What alcohol is actually converted to in the liver is acetaldehyde, the chemical responsible for hangovers. Again, sugar and what kind of alcohol you drank, in relation to how bad of a hangover to expect, is also total mythology. It is acetaldehyde, and only acetaldehyde, that causes the hangover effect, and of course the dehydrating effect of alcohol contributes to the morning headache and fatigue. Acetaldehyde is a very toxic substance and your liver works overtime to get rid of it.

Eventually, acetaldehyde is finally converted into water and carbon dioxide, at which time it is eliminated from the body.

The other reason alcohol can put you to sleep easily is that it increases the production of adenosine, which I’ll also touch on in the caffeine discussion, which is a sleep- or drowsiness-inducing chemical in the brain. Just like with the GABA rebound effect, adenosine doesn’t stick around through the night and also contributes to you finding yourself wide awake in bed four or so hours after crashing.

Other less technical, but equally problematic, effects of drinking alcohol include the fact that it’s a diuretic and causes water to be eliminated from your body. That’s why a night of drinking is followed by one or more nighttime bathroom trips, which ruin your sleep. It also causes breathing problems by causing muscles to become overly relaxed, hence why people who don’t normally snore can keep the entire house awake after a night of drinking!

In summary, alcohol is the last thing you want to consume, except maybe for caffeine, before going to bed if you expect to sleep well and wake up feeling rested and rejuvenated.

Caffeine

This one is more obvious in terms of understanding why it disrupts sleep: Caffeine is a stimulant.

Before getting too technical, let’s visit the biological half-life of caffeine. Half-life is defined as the time it takes for your body to get rid of half of the active drug in your body. So, for a simple example, say you drink a big mug of coffee on your way to work. Your body will take 5–6 hours to eliminate only 50% of your morning caffeine intake.

Using a half-life calculator, I did some math based on consuming 200 mg of caffeine in the morning, which is less than most coffee drinkers realize they consume, along with a 5.5-hour half-life. Based on that, I would have 50% or 100 mg in my body 6 hours later, 25% or 50 mg 11 hours later, and 13%, or 25 mg, 17 hours later.

Are you beginning to see the problem with caffeine?

At issue isn’t that you only drank it in the morning and should be good to go by bedtime. The hard reality is that you still have active caffeine in your body at bedtime. Let’s say you had that coffee at 8:00 a.m. and go to bed at 11:00 p.m. If you drank 200 mg of caffeine at eight, about the same amount in a large Starbucks drip coffee, you’re going to have about 35 mg or so of active caffeine still in your body at bedtime.

Double those numbers for the amount most coffee drinkers actually consume, combined with the astonishing amount of foods, beverages, and even medications that contain caffeine.

Every fall, my kids’ school has an event called Donuts with Dads. I take them to school and we hang out on the playground for thirty minutes enjoying coffee and donuts, and hot cocoa for the kids. It’s at 7:30 a.m., which never amuses me, and I can’t help but notice that while I’m holding my little Styrofoam cup of coffee, virtually all the other dads are walking around with huge plastic mugs in their hands!

In my research I learned that many people who use those big mugs and have two or more are actually consuming upwards of 900 mg or so every day! Based on caffeine’s half-life, these guys are going to bed with somewhere around 150 mg of caffeine still active—more than two espresso shots! It’s little wonder that so many people are chronically fatigued and just can’t seem to catch up on sleep. It’s because their morning “jolt” is still jolting them at midnight. What’s worse is that caffeine’s infamous “crash” keeps them drinking more and more throughout the day, compounding the negative effects.

Speaking of a caffeine crash, let’s revisit adenosine, the fatigue-inducing neurotransmitter.

Caffeine keeps you awake (actually stressed) in two ways. First, it releases the stress hormones cortisol and epinephrine (adrenaline) in order to activate the fight-or-flight response. It’s this caffeine-induced stress that masquerades as “energy.” In reality, caffeine doesn’t give you any energy at all. It merely puts you into the same situation as a caveman facing a lion. The same fight-or-flight response is activated, and if you’ve ever had an adrenaline dump, as I’ve experienced while doing advanced firearms combat training with law enforcement officers, you’ll know that it massively increases alertness, situational awareness, and also has other effects such as shaking hands, sweaty palms, and tunnel vision.

While research at Johns Hopkins University has shown that caffeine does increase alertness and cognitive ability on the “up” swing and during the “high,” it equally inhibits those same functions during the “down” phase, entirely negating any so-called benefits you believe you may be getting from it.

Speaking of the down phase and subsequent crash, that’s where adenosine comes into play. The other way caffeine causes heightened wakefulness is by binding and occupying the brain’s adenosine receptors, preventing them from being activated.

In response to caffeine, like any drug, the body builds a tolerance, causing the coffee drinker to gradually need more and more to get the same effect. That’s because, in response to caffeine clogging up the adenosine receptors, the brain simply creates more and more of them.

The end result? The added adenosine receptors have a compound effect, and when the caffeine starts to lose effect—boom! Adenosine takes over and you experience the so-called “crash” of caffeine. What is really happening is that the sleepiness-inducing neurotransmitter has expanded its capacity in the brain in response to caffeine consumption and it fights like hell to bring you back “down.”

Finally, caffeine has long-term implications on your endocrine system and HPA axis. The constant release of cortisol and epinephrine from your adrenal glands eventually wears them out over time. For a long time my office was near the best coffee shop I’ve ever experienced anywhere, Local Coffee in San Antonio, Texas.

For a few years I was having as many as six double espressos every day!

And then it happened: I found myself in the throes of what many might mistake as chronic fatigue syndrome, but in reality was adrenal exhaustion. Beating up my adrenal glands with daily, high caffeine intake gradually depleted their ability to keep up, and soon they weren’t producing enough cortisol for normal daily functioning.

I was completely wiped out. There was no “pushing through”—it was like trying to drive a car, not on fumes, but rather with the gas tank missing entirely. It’s impossible to do so, and it had negative effects on both my personal and professional lives.

My physician sent me to see a nutritionist, who set me up with certain adaptogens, which are herbs and supplements that help your body to adapt to circumstances. About six months later my cortisol levels were perfectly normal and I never went back to that crazy high caffeine consumption, although I’ll still have a small cup if I feel like I need it in the morning, or just want to enjoy a good cup of coffee. (I’ve become a big fan of Black Rifle Coffee Company! Erring on the side of caution though, I get only their low-caffeine light roasts delivered.)

Finally, caffeine, like alcohol, has a strong dehydrating effect on the body. For each cup of coffee you drink, you need to consume two cups of water to replace what your liver needed to use to get rid of the caffeine. Just being able to avoid the endless bathroom visits while I’m trying to work during the day, all thanks to caffeine’s diuretic effect, is enough to keep me away from becoming a regular caffeine consumer again!

Marijuana (Cannabis)

With marijuana legalization sweeping the country, I felt it necessary to include it here because the marijuana industry works hard to perpetuate the myth that it’s a “medical” sleep aid. (According to them, marijuana is a cure-all for everything and we can just shut down the pharmaceutical industry. Yeah, right.) In reality, it’s yet another substance that will wreck the restorative phases of your sleep just like alcohol does. Wait, let me correct myself—marijuana affects all five phases of sleep, some good, some bad.

Stage 1 sleep is the initial stage and lasts usually about 10 minutes. Cannabis actually helps with this by providing a relaxing sensation that assists with entering Stage 1 sleep, in part by increasing adenosine activity.

Stage 2 sleep is still light sleep, albeit for a longer duration, and here, cannabis has minimal negative impact.

Stage 3 and Stage 4 sleep, the more restful and restorative stages, particularly Stage 4, have a complex relationship with cannabis. Depending on what type of strain you’re consuming, these stages can be interrupted or they can be prolonged.

The problem is with its most popularly known constituent, 9-delta-tetrahydrocannabinol, or THC, which tends to produce an activating or excitatory response during sleep; however, in very low doses, this does not occur.

The other most commonly known of the over 100 chemicals found in cannabis, cannabidiol or CBD, is known for countering the effects of THC. That’s why so many medical marijuana strains are high in CBD; the idea is to get the benefits to the user without the “high” and its associated cognitive impairment.

Having said that, growers in the recreational marijuana industry, which is rapidly outgrowing the medical marijuana industry, have been working hard to completely breed CBD out of their products and get the THC level to insanely high amounts, guaranteeing that the user will get a very intense high, very quickly.

Even with consuming CBD only, research has produced conflicting results and it appears that the timing of administration and dosage of CBD is crucial as to whether it will help or hurt your sleep, and if you’re consuming the plant/flower and not a pill produced by a pharm company, there’s literally no way of knowing how many milligrams you have consumed, making such calculations impossible.

Finally, there’s REM sleep, sometimes referred to as Stage 5. REM sleep is when dreaming occurs, which many research scientists believe is the brain’s way of releasing old, useless, and random memories, freeing up space for new ones. Other aspects of dreaming are not understood, other than the fact that it’s a necessary and required phase of sleep for maintaining good health as well as sanity.

Cannabis absolutely interferes with REM sleep, and this is where it fails as a sleep aid. Cannabis use decreases REM sleep and dreaming, primarily due to its blunting of dopamine. Dopamine, the “feel good” neurotransmitter, is what floods your brain when you’re highly aroused and about to have sex with someone. It also floods your brain in response to drugs that produce a high, and as such it’s also known as the “addiction” neurotransmitter since it’s the dopamine response people get psychologically addicted to, and not the drug itself. (This of course is not the case with drugs that cause physical addiction, although psychological addiction frequently precedes it.)

The reason why recreational drug users have to take higher and higher doses over time to get the same effect is because the dopamine response becomes blunted. This is particularly true with drugs like cocaine, which so deplete dopamine that it’s common for recovering addicts to become severely depressed. That is, in part, why antidepressants that increase dopamine levels have been developed. One of these is bupropion, commonly prescribed for smoking cessation.

Finally, frequency and duration of cannabis use also determine its effects on sleep quality. A study published in the Journal of Addictive Diseases found that daily cannabis users had significantly higher rates of insomnia when compared with occasional users. If you enjoy cannabis, or take it medically, a periodic tolerance break will help with this.