Do Natural Sleep Aids Promote Better Sleep?

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About the Show
On this episode, Chuck Gaidica is joined by Dr. Angela Seabright, Care Management Physician for Blue Cross Blue Shield of Michigan. Together, they discuss whether or not sleep aids promote better sleep.
In this episode of A Healthier Michigan Podcast, we explore:
  • Common difficulties achieving restful sleep
  • Commonly recommended sleep aids
  • "Sleep cocktails" and if they're effective
  • How natural sleeps aids play within a broader approach to sleep

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Transcript
Chuck Gaidica:
Would it surprise you to know that one in three adults don't get regular quality sleep? Maybe it doesn't and that's not good because quality sleep has a direct correlation on our overall health. This is A Healthier Michigan Podcast, episode 154. And coming up we'll discuss natural sleep aids and whether they can help improve your sleep.
Welcome to A Healthier Michigan Podcast, a podcast dedicated to navigating how we can improve our health and wellbeing through small, healthy habits we can start implementing right now. I'm your host, Chuck Gaidica, and every other week we'll sit down with a certified expert and we discuss topics that cover nutrition, fitness. And in last episode, this episode we're focusing on sleep. But in particular, this time we're diving deep into natural sleep aids. We hear about them, they're advertised everywhere. Can they really help achieve a better night's sleep? With me today is care management physician of Blue Cross Blue Shield of Michigan, again, Dr. Angela Seabright, welcome back.

Dr. Angela Seabright:
Hi, Chuck. Thanks for having me.

Chuck Gaidica:
Sure thing. We're into episode two. Last episode, we were talking about power nap, something much shorter. But this time if we start to focus on all the stuff that maybe we get bombarded with of how to get better sleep, it leads us to studies and information. According to UC Davis Health, sleep is one of the three pillars of health. And you've talked about this in previous episodes. It promotes improved mental function, it helps maintain a healthy weight, it reduces stress, it improves mood just to name a few things. However, getting a good quality night's sleep is sometimes easier said than done for many of us. And in this survey from Gallup came out in 2022, it showed that one in three adults do not regularly get the recommended amount of uninterrupted sleep. For those that are having trouble sleeping, can these natural sleep aids, whether they're like a vitamin or anything else, can they really be a better way to improve our sleep quality?

Dr. Angela Seabright:
It's a great question, and I think many people turn to sleep aids out of desperation to be honest, because sleep is such an important component of our health and wellbeing. And when we don't get sleep, we feel terrible and it can have an effect on every function of our body. And for many sleep can be a struggle. And there are many factors that can influence our sleep. Turning to a supplement is one thing you can do, but there are also other important things that you can do, especially when you're trying to get to the root cause or the reason why you're having a hard time sleeping. There are things you can do there, and I would encourage people to look into that first before you turn to medication, whether that's a supplement or a prescription medication.

Chuck Gaidica:
This may seem obvious, but what are common challenges that contribute to these difficulties in achieving restful sleep?

Dr. Angela Seabright:
Sometimes it could just be due to poor sleep habits. Some people don't prioritize sleep, especially this day and age, we're so busy, we're working longer hours. There's so many distractions in the evening, whether it's television, social media. Our lifestyle definitely plays a role. Our work schedules, people who are shift workers, those who travel for work, those who are caregivers. If you're taking care of loved ones or infants, sometimes even pets who get up in the night can definitely interrupt our sleep.
Health conditions can also disrupt our sleep, medications, substances like alcohol, nicotine and caffeine can also impact our sleep, psychological stress and mental health conditions. Another big one, anxiety, depression, post-traumatic stress disorder, PTSD can all cause insomnia and frequent awakenings. And then of course, sleep conditions. Sleep apnea, restless leg syndrome can also prevent us from getting adequate sleep. And what's unique about some sleep conditions is that you think you're sleeping, you think, "I fell asleep, I woke up at this time." But really your sleep architecture is disrupted. You're not actually going through the typical phases of sleep properly. You may not be getting that deep sleep or that restorative sleep that's so important.

Chuck Gaidica:
That list you just gave us, it seems like a shotgun blast that covers most of America at some point in all of our lives, you have kids and then you grow up and your job is stressful, whatever it is. But this idea of going right to a sleep aid, something that brings you natural sleep, are you saying then that we should try to look at thyself and start to wonder and maybe attack those things that are in our life that we can somehow begin to correct or tap back into place a little bit before we start reaching for supplements, et cetera?

Dr. Angela Seabright:
Absolutely. That is the first thing you should do.

Chuck Gaidica:
When you think of these natural sleep aids that we see advertised or otherwise, what kind are you seeing? What are the typical ones? I keep thinking of supplements, but there are other things, I've seen little things people put on their nose, all kinds of stuff.

Dr. Angela Seabright:
There are all kinds of stuff. It's a huge industry because people want sleep, they desire sleep, and we've all had sleepless nights, some people more than others, but it is definitely an industry. And I just want to give a disclaimer that dietary supplements are marketed as sleep aids, but dietary supplements are not regulated by the Food and Drug Administration, the FDA. There's really no guarantee that what's in the bottle matches what the manufacturer says is in the bottle. And there can be significant variation in the concentration and the purity of the supplements. There have been some independent labs that go and look at supplements and see is what's in the bottle, what they say is in the bottle, and you'd be amazed at what they find. I just want to give that disclaimer when you are looking towards supplements. But with that said, one of the most popular sleep supplements and it's almost a household name is melatonin.
Melatonin is a hormone produced by the brain that stimulates sleepiness. It's taken on the nickname, the sleepy hormone. Melatonin levels naturally increase in response to the dark and then light suppresses our melatonin. Melatonin is usually considered safe in the short term, especially for those with jet lag or circadian rhythm disorders. It may be useful for sleep onset insomnia. For people who are having a hard time falling asleep, but it's really not going to help maintain sleep later in the night. Other popular supplements you may have heard of include chamomile, lavender, magnesium. These are all marketed for sleep, but again, you want to talk to your healthcare provider before you start taking any supplement. I think when people hear the word natural, they assume that it's safe and it may not always be the case.

Chuck Gaidica:
It's interesting when I think of lavender or chamomile tea, and I think we've actually got one of those versions here in the house, when I think about that, it's almost the ancillary stuff that's helping me get tired. I make a cup of tea and I'm not a big tea drinker, but if I need to get tired, I then to read not even on a device, and I'm relaxing and I'm getting tired because I'm sipping tea. I'm not sure it's what's in a teabag that came out into the hot water is really what's doing it. It's the other stuff that it's encouraging me to do, which is calm down, find a mindfulness place that's good for me. And if that works, I guess it works.

Dr. Angela Seabright:
It's the activity itself and it's that winding down. We always recommend, how do we get kids to sleep? We establish a routine, we wind them down, we give them a warm bath, we put lotion on, we read them a story, and that's how we get them to sleep. And for adults, we really should take note of that because we also need a bedtime routine, whether that's sipping tea, reading a book, putting lotion on, taking a hot shower. These are things that are going to trigger our mind that, "Hey, it's time to wind down, it's bedtime." And help us, calm us and get us ready for sleep.

Chuck Gaidica:
And I'm going to make notes on this because I'm going to tell my wife that you said it's a good idea to read to me, apply lotion to my back and neck massage.

Dr. Angela Seabright:
There you go. Rock you to sleep.

Chuck Gaidica:
There's a health podcast, it's rather popular, and the host was discussing a combination of things that will help you sleep faster, you will achieve better sleep. Those don't necessarily my mind completely go together, but that's what they're saying. And it consisted of this cocktail, literally magnesium threonate, theanine and apigenin. There were certain milligram doses associated with this. Have you heard of this cocktail?

Dr. Angela Seabright:
I have heard of that. I hate to use the word cocktail because it has that alcohol connotation. And alcohol before bed, a lot people say they use that for sleep and that's a whole other thing and maybe it helps you fall asleep, but it's really not good for your sleep overall. But this is a cocktail of supplements. If you look at those individually, they do have properties that can promote sleep, and this is usually by way of how they interact with our GABA receptors. GABA stands for gamma-aminobutyric acid, which is an inhibitory neurotransmitter in the brain, which essentially means it decreases activity of the neurons. You can guess that if your neurons are decreased, the activities decreased, you're going to fall asleep. We can start with magnesium that's been around for years and years. People have been using it for sleep.
And one way to think of that is it's in Epsom salt. Epsom salt is magnesium sulfate and people soak in there to help relax their muscles. Magnesium has been around for a while. It's a mineral in the body. It's responsible for hundreds of functions from anything from muscle and nerve contraction to blood glucose control. But there are multiple forms of magnesium. If you stand down the supplement aisle and you're looking for magnesium, you might feel a little overwhelmed. That particular recommendation that you mentioned, magnesium threonate. That's a form that's more easily absorbed. And animal research shows that it's more effective for increasing magnesium concentration in brain cells. So another form, magnesium glycinate is also easier absorbed, whereas something like if you picked up a bottle of magnesium citrate or magnesium oxide, that stays primarily in the gut and has more of a laxative effect.
That's commonly recommended to help someone with constipation. Again, not all magnesium supplements are equal and magnesium may not be safe for you to take if you have kidney disease or you take certain medications such as diuretics. Again, you always want to make sure you're talking with your doctor before you start taking any supplements. Theanine is an amino acid which is found in tea. Here's tea again, and it does also have an effect on the GABA receptors in the brain, which again is that inhibitory neurotransmitter. It also has effect on serotonin and dopamine as well. Apigenin is a compound derived from chamomile. Chamomile, as you mentioned before, that's a flour extract that's commonly consumed in tea and is used for relaxation and to decrease anxiety and to promote sleep. That compound apigenin binds to the receptor in the brain that helps sleep and reduces anxiety.
I do see that how each one of these individually can promote sleep. But I have questions on this cocktail recommendation because while the claim is that if you take these supplements together, they have this synergistic effect, which basically means they work in conjunction with each other. There's really no evidence to prove that taking all three of these is superior to maybe just taking one. You may save your pocketbook a few dollars by just picking one. And also keep in mind that a lot of the effectiveness is based on animal studies, very small human studies or purely anecdotal evidence. We don't have robust evidence to prove the effectiveness of these supplements when it comes to sleep.

Chuck Gaidica:
What's so interesting about supplements, and again using the word cocktail, I understand what you're saying, I'm not even sure you can buy a supplement that has all three of these in the milligram doses that were suggested by this other podcast. But let's just say you could, it's not FDA approved, by the time most of us get to that aisle, the giant aisle of supplements that are just there for your joint health or if now your sleep health, we may be desperate. I don't know of how many people actually go, "I'm going to call my doctor or send them a text to ask them if I should take magnesium." You're experimenting. And yet if you do come across the experiment that works, it's like a placebo if it works. I'm not quite sure what the downside is as long as you're not doing something toxic. But there again, how do we know?

Dr. Angela Seabright:
And if it's something that you think you're going to start taking on a regular basis, then you definitely should talk with your doctor about it because again, there could be interactions with certain prescription medications. You definitely want to get that green light and it's all individualized. If someone came to me and asked about a supplement, I hate to give a blanket recommendation. I'd really want to see someone review their health history, other medications that they're taking before giving them the go. Again, it's just that holistic approach because you may review their medications and find a medication and say, "Hey, this medication is actually quite stimulating and maybe that's why you're having a hard time falling asleep." Rather than adding medication, whether that's a supplement or a prescription, maybe we can take away something that's actually doing more harm than good.

Chuck Gaidica:
That's a great point. And I think of myself, I wonder too, when you're taking any kind of supplement for any reason, how much of it by the time you down it with your tea, and a lot of times people are just thinking, "I'm going to take the melatonin now and it's going to knock me out," not really. You have to start thinking in advance of how much time in advance are you trying to use something that's a sleep aid that's literally going to get you sleepy. There's a lot to this that's fuzzy.

Dr. Angela Seabright:
And then you may take something that helps you fall asleep, but then you're up again at three o'clock in the morning so you're not maintaining your sleep. And that's a whole other issue as well. It's one thing to fall asleep, but we really want to get a full night's rest.

Chuck Gaidica:
Is there any supplement or additional thing that you've come across that you would say, "This is something as a first line of defense to try," something that's natural that you would recommend to people or you really would say, "I need to check out all your drug history," et cetera?

Dr. Angela Seabright:
I think the most natural thing that you can do, and I know it's easier said than done, but I think it's really with changing and tweaking our behaviors a little bit. Is it, you can't fall asleep because you are scrolling through social media or is it because you're drinking caffeinated beverages all day long? I think we can really take a look at our behavior and make some changes there, and I think that's going to be our first line before we reach for supplements and medication.

Chuck Gaidica:
That's a good point. And I know for me, what I've wound up doing now, I look at my watch when it comes to getting a cup of coffee after dinner. I'm not a big after dinner coffee drinker, but I just realized that there's a chain who we would all know the name of, and if I get one of those after eight o'clock because it's like rocket fuel, there's no way I'm going to sleep on time. There's just no way. I now look at my watch even at home and I go, "I don't think so. I better go for decaf if I really have the hankering for a cup of coffee." There are those ways that you can start to figure out your body and holistically just deal with whatever it is that you need to deal with.

Dr. Angela Seabright:
It's part of that sleep hygiene that we've talked about before, sticking to a consistent sleep wake cycle or schedule. Making sure you're going to bed at the same time, you're waking up at the same time, light exposure, making sure that you're getting natural light exposure, preferably early in the morning, early in the day so that you can set your clock and that you know, "Okay, I'm awake." These little things that you do throughout the day are going to make a difference at night. It's just very important to make sure that you're mindful of that because I think we've all heard the phrase, "You can't out-train a bad diet," meaning you're not going to lose weight with exercise alone if you're eating poorly. I think in this case, you really can't supplement your way to sleep. I highly doubt that a magnesium deficiency or whatnot is the only reason you can't sleep. There's got to be something else. And so you really need to look at it from a holistic standpoint and make some changes.

Chuck Gaidica:
I think that's all good advice. Any other takeaways? Because you've given us so much great stuff here and at the top of the list for me is this idea of even though you're trying to do this holistically by yourself, talking to your doc is really toward the top of the list to make sure you don't have interactions or you're not doing something else that is going to interfere with your life.

Dr. Angela Seabright:
And I think people turn to supplements because they want to avoid taking prescription medicines for sleep and the risks that come with that. Probably one of the most risk averse things we can do to promote sleep is just tweak our behavior. And when it comes to sleep, small changes can make big impact. Whether it's skipping out on that afternoon cup of coffee or getting some natural sunlight or avoiding screens, these can make a big impact. And you can initiate them slowly so it's not such a shock to your lifestyle if you're changing too many things at once, you can slowly integrate them until they become healthy habits.

Chuck Gaidica:
All good stuff. Dr. Seabright, sure good to have you with us the past couple of episodes and we've learned a whole lot.

Dr. Angela Seabright:
Thanks so much for having me.

Chuck Gaidica:
You're very welcome. Dr. Angela Seabright is a care management physician of Blue Cross Blue Shield of Michigan. We're glad you've been with us. Thanks for listening to A Healthier Michigan Podcast, brought to you by Blue Cross Blue Shield of Michigan. If you like the show and you want to know more, you can check us out in multiple places. First of all, you can go online. It's a newly refreshed website. It's ahealthiermichigan.org/podcast. Or you can leave us a review or rating on Apple Podcast or Spotify. You can follow us on Facebook, Instagram, or Twitter. We've got a YouTube channel for you. And don't forget, you can get all of our new episodes. What are we? 154 now. You get all the old episodes as well. Be sure to subscribe to us. Hit the subscribe button on Apple Podcast or Spotify or your favorite podcast app. I hope you get a good night's rest tonight. I'm Chuck Gaidica, be well.

A Healthier Michigan is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association.
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