Healthy sleep is essential for all bodily systems, and crucial for mental and emotional wellbeing. There are a few stages of sleep which affect our quality of health in different ways.
Introduction
A combination of increasingly fast-paced living, advances in technology, and the onset of a ‘24-hour culture’ with the accompanying expectation to be continually ‘switched-on’ and available, make it no wonder that sleep deprivation (a lack of sufficient and good quality sleep) is becoming more common.
Insufficient sleep is prevalent across various age groups and can be considered a public health epidemic that is often unrecognized (1). An estimated 1 in 5 people in the UK are not getting enough sleep (2), which over a prolonged period of time impacts health.
Many factors contribute to the different types of sleep disturbances which range from getting off to sleep (sleep latency), staying asleep, or getting a sufficiently deep sleep. A frazzled nervous system plays a major role in many sleep issues. There are plenty of herbs which can help to reset the balance to ensure that sleep becomes more healthy, easeful, restorative, and nourishing, exactly as it is supposed to be.
This article will look at what sleep is, its importance for health as well as why so many people are not getting enough sleep. We will also share herbs which can support the different stages of sleep and other holistic solutions which can support better sleep.
The stages of sleep and sleep cycles
Sleep is an altered state of consciousness where changes in the brain’s activity take place (3), and it is essential for human life.
Although sleep is in part for resting, it is also actually quite a busy time for the body and it requires a certain amount of energy to maintain good quality sleep. Sleep is the time for cellular repair and is where maintenance mechanisms are actioned and healing for the body occurs.
Normal sleep consists of two parts: non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep. NREM is broken down into stages 1 -3, and stage 4 of sleep is where REM sleep takes place (4).
These four stages of sleep are thought to gradually merge (3, 5):
Stage 1
This is where the transition between wakefulness and sleep which is normally up to about 5 minutes in duration. During this stage the person may have fleeting thoughts and if they wake think they have not been sleeping. Many people struggle with this stage as it takes them a while to get to sleep.
Stage 2
Light sleep is the first stage of true sleep. There may be fragments of dreams and the duration is around 10 – 60 minutes.
Stage 3
Moderately deep sleep, referred to as slow-wave (SWS) sleep. During this stage the body temperature and blood pressure tend to decrease, this usually occurs around 20 minutes after falling asleep. This stage of sleep is thought to be critical to restorative sleep, allowing for growth and recovery of the body. Experts believe it also is vital for the immune system and other bodily processes (5).
Stage 4
The deepest level of sleep, REM sleep. Duration 10 – 60 minutes. The eyes may move rapidly (hence the name). Most vivid dreaming usually occurs during REM sleep.
Sleep ideally consists of a single block of three to five cycles of sleep stages, usually happening during the night (6). Typically a person goes from stage 1 – 4 of sleep in less than an hour and during a typical night’s sleep of 7 – 8 hours there will be approximately 3 – 5 episodes of REM sleep as a person passes between NREM sleep and REM sleep, with REM sleep occurring approximately every 90 minutes.
A baby’s sleep consists of around 50% of REM sleep, whereas in adults it usually makes up about 25% of sleep. Although it is not fully understood, this high level of REM sleep in infants suggests that it is important for the maturation of the brain. Neuronal activity is high in REM sleep, brain blood flow and oxygen use are equal to or higher in REM sleep than in intense mental or physical activity while awake (3), indicating that sufficient energy is required to actually be able to sleep well and access all the stages of sleep.
Sleep is in part a time when organising and housekeeping in the brain takes place and is thought to play a vital role in retention of new learning (7). This may be considered again in the context of new-born babies who need between 14 – 17 hours of sleep per day (2). This is because aside from supporting the growth which is taking place in their bodies, they are creating neural networks as they learn new information about the world. Sufficient sleep necessary to facilitate this.
Why is sleep important for health and how much sleep do we actually need?
Sufficient good quality sleep is necessary for physical and mental health, and for quality of life. Sleep is known to be important for regulation of the nervous system, helps with overall resilience, immune system function, ability to deal with stress, mental and emotional health. It is vital for the maintenance of overall health and wellbeing.
Sleep deprivation disturbs the circadian physiology, exerting a negative impact on the brain and behavioural functions, and can cause neuroinflammation and oxidative stress (8). Long term, this can lead to neurodegenerative issues. Mental health issues such as depression have also been linked to neuroinflammation now. Circadian rhythms are natural changes in physiology over a 24-hour day-night period, particularly hormone levels which typically influence sleep and wake cycles and our ability to fall asleep easily at night.
There is an ever-increasing body of evidence to suggest that insufficient sleep contributes to a host of adverse medical and mental dysfunctions, such as unbalanced body systems, increased incidence of cardiovascular morbidity, increased chances of diabetes mellitus, obesity, issues with cognitive function, increased accidents, and depressive symptoms (1).
It is suggested that sleep plays a key role in the optimization of energy as during sleep energy reserves are redirected to processes such as maintenance of cells, anabolism (‘rebuilding’ and repair), immune function, and neural plasticity (6). Neural plasticity refers to the capacity of the nervous system to modify itself both functionally and structurally in response to experience and injury. Ultimately it ensures the healthy development and function of the nervous system (9) which can also impact on memory.
A recent study has found that sleep also seems to play a role in facilitating the clearance of molecular waste products from the brain which accumulate during waking hours (10). The authors noted that sleep seems to increase the brain’s interstitial volume (meaning the space between the tissues), and that the impact of one night of complete sleep deprivation on the molecular clearance was not recouped in the following 2 -3 night’s sleep. This potential build-up of molecular waste in the brain which may occur as a result of consistent sleep deprivation is of particular relevance when considering the development of neurodegenerative health conditions such as Alzheimer’s disease (10).
For adults, 7 – 9 hours of sleep per night are usually recommended (2). Although there is a lot of focus on the number of hours of sleep, and whilst this is important, it is also necessary to consider sleep quality and whether the time spent sleeping is actually restorative.
The smooth progression through the stages of the sleep cycle is necessary multiple times during a sleep period to ensure that the rest taken whilst sleeping is high-quality and actually restorative (5). An example of this is the suggestion that whilst sleep stages each have their unique qualities, it is also thought that the change between SWS in NREM sleep stage 3 and REM sleep stage 4 is actually important for memory (7).
It is clear to see that although sleep is in some ways a time of rest from our usual waking activities, there is actually still a lot of activity going on during sleep which can be thought of as the ‘behind the scenes’ housework to keep everything functioning well. This is particularly true for the nervous system, and this requires a certain amount of energy to maintain.
Why is sleep deprivation so common?
Insufficient sleep is a prominent problem in today’s modern 24-h society, with the increased usage of smart phones and electronic devices worsening this epidemic (1).
Problems with sleep are often caused by (2):
- Environmental issues: Night-time noise, screen light from phones, TVs and tablets, and light from the outside can trick your body into delaying sleep. Air pollution can also disrupt your sleeping patterns.
- Life events: You may feel distracted, stressed or worried about something going on in your life while you’re trying to go to sleep, which can affect your ability to relax.
- Thinking cycle: Anxious thoughts about not getting enough sleep can cause distress, which can prevent you from relaxing and falling asleep. This can become a vicious cycle. Also an overactive mind when going to sleep delays sleep latency.
- Lifestyle: Developing poor habits around sleep, such as not having a regular routine, can cause problems.
– Not having a regular sleep-awake routine
– Eating late at night
– Consuming alcohol, nicotine or caffeine around bedtime
– Vigorous exercise late at night
– Using smart devices (phones, tablets etc.) before bed
– Checking and responding to work emails outside of working hours
It’s common for most people to experience periods of poor sleep at some point in life, but short bouts of sleep problems don’t usually result in health problems. However, consistently poor sleep can begin to contribute to health issues, including being a symptom and cause of mental health problems (2).
‘Tired but wired’ is a phrase coined to explain when the nervous system is in overload (in sympathetic or ‘fight and flight’ mode) and it can become difficult to switch off. Although one may feel tired or even exhausted, falling asleep (known as ‘sleep latency’) and/or maintaining sleep can become difficult. This is partly because of higher than normal levels of the hormone cortisol tend to circulate the bloodstream when we are over-stressed. When the body is functioning well, cortisol levels naturally dip at night as part of the circadian rhythm, easing us into a restful night’s sleep. Understanding this contextualises why and how living removed from the rhythms of nature can have an impact on our sleep.
In addition to this from a holistic perspective when the nervous system is depleted due to chronic stress, we are tired and really need sleep. There are often not actually enough energy resources available to achieve and maintain the good quality sleep we really need. This can become a vicious cycle where the over-tiredness prevents sufficient sleep, and the lack of sleep exacerbates stress on the body and further inhibits the capacity to sleep well.
This is where herbs can really help to reset this cycle. Herbs which are classed as nervous system tonics can be helpful in restoring the nervous system so that it becomes less frazzled, which can be considered energetically as providing ‘food’ to the nervous system so that it has the sufficient nourishment required to maintain sleep. Herbs which are classified as adaptogens can also be beneficial to help reset the stress response, allowing the nervous system to function well, and redress the natural balance of stress hormones throughout the sleep-waking cycle of the circadian rhythm.
In addition to this, herbs classified as sedatives and hypnotics can assist with getting off to sleep (sleep latency), and often have additional benefits of helping with anxiety or nervousness which often accompany sleep issues. However, the primary goal with herbal support is always to rebalance the body by addressing the root cause of issues. This means that the natural processes can be restored and systems can function in a healthy way. Therefore, herbs which act as hypnotics and sedatives are only recommended as short-term solutions while the body systems are further restored and regulated, and lifestyle factors are addressed so that a healthy sleep cycle can be re-established.
Which herbs can help support the stages of sleep?
It is best to note when considering herbal support for sleep is that if there are underlying factors at the root of sleep issues then these must be addressed alongside taking herbs. In the case of long-term issues then the guidance of a herbalist is recommended to tailor a personalised treatment plan. You can find clinical herbalists on our “Where to find a herbalist” page.
Valerian (Valeriana officinalis)
Valerian is traditionally considered a convalescent tonic to calm the nervous system and enhance its function. Its name comes from the Latin valere – meaning “to be strong, powerful, healthy”, which explains why, although it is typically considered to be a hypnotic and sedative herb, it can in some people also be stimulating due to providing an increase in vital energy. Despite this is it often helpful in restoring the nervous system. Therefore even in cases where it is stimulating as a bedtime remedy, it can sometimes be beneficial to continue taking the herb to help restore the nervous system so that deeper more relaxed sleep can be accessed eventually.
Valerian is often helpful when there is difficulty getting to sleep or staying asleep. It is particularly helpful when this is accompanied by emotional stress, excitability, or a sense of irritability. This is because it not only provides the tonic support to rebuild the nervous system allowing deeper more nourishing sleep to be possible, but it also has a sedative effect so can also be beneficial in assisting with getting off to sleep. Valerian is also a muscle relaxant so can be a great support where muscle tension is present along with sleep issues.
Ashwagandha (Withania somnifera)
This is a tonic for both the nervous system and for restoring sleep. It is best thought of as when the body is too exhausted or worn out to be able to sustain good quality sleep, because sleeping also requires a certain amount of energy. When one becomes “tired and wired” the depth of good quality sleep can become difficult to sustain. In these instances, ashwagandha helps on a deeper level than simply sedating or aiding falling asleep, it can be considered as laying a deep restorative foundation which provides a base from where better-quality sleep becomes possible, allowing the body to truly rest and restore.
Occasionally because of this restorative effect ashwagandha can sometimes be felt as stimulating, in which case it can be taken during the daytime rather than at night, where it will still have a restorative effect which will over time nurture better quality sleep. Ashwagandha is considered an adaptogenic herb, so it also improves the bodies resilience to stress, and helps to reset the balance of the stress response. This makes it particularly beneficial when frazzled nerves and being overly stressed is a factor in sleep issues.
St John’s wort (Hypericum perforatum)
This is a nervous system tonic which is traditionally used for insomnia, particularly when emotional stress, anxiety, or depression are also a factor. Because of its restorative effect on the nervous system, St John’s wort can benefit the onset of sleep and staying asleep (insomnia which involves waking in the night and difficulty getting back off to sleep is common feature of depression).
Passionflower (Passiflora incarnata)
This is helpful in cases where sleep issues are accompanied by anxiety, excitability or irritability. Traditionally it has been given as a tea by Native Americans for sedative and anxiolytic effects and continues today to be given for this and its hypnotic effect. Passionflower can aid getting off to sleep, as well as staying asleep. It is considered particularly beneficial where circular thinking is preventing sleep onset (for example, worrying and repetitive over thinking). Passionflower helps to switch off this thinking and so getting to sleep becomes easier. It is also a nervine so helps to relax the nervous system and assists the ability to stay asleep.
Vervain (Verbena officinalis)
This herb is not particularly sedative as such, but as more of a tonic for the nervous system it tends to relax the body, energetically bringing a sense of grounding. This can allow a better quality of sleep which will be overall deeper and more nourishing, especially when combined with other herbs which have sedative or hypnotic qualities such as valerian or passionflower. Herbalists may consider it for people who feel they sleep lightly, wake easily, or simply do not feel well rested after sleep. The grounding effect allows the sleep to become deeper.
Hops (Humulus lupulus)
Hops can be helpful when there is difficulty getting off to sleep or in staying asleep. It tends to be hypnotic and mildly sedative and is particularly helpful if sleep issues are accompanied by a sense of excitability or restlessness, and also for people who experience excessive libido. It is also beneficial for people experiencing sleep issues associated with the menopause. It is best avoided in depression due to its slightly depressive effect.
Chamomile (Matricaria recutita)
This is a well-known remedy for sleep and suitable for children due to its gentleness. However, it is traditionally said of chamomile that ‘gentleness should not be confused with weakness’. Although gentle in nature due to its calming effect Chamomile can be a simple but beneficial sleep remedy. It can be taken as an evening drink to aid getting off to sleep, particularly when sleep issues are accompanied by a feeling of restlessness or mild anxiety.
Limeflower (Tilia spp.)
Popular in France where it is a common home remedy taken as a relaxing evening drink to aid getting off to sleep. It is relaxing and helpful if anxiety accompanies sleeplessness.
Skullcap (Scutellaria laterflora)
This is a wonderful herb when sleep issues are due to emotional stress, or when excitability, irritability, or anxiety are present with sleep issues. It is a tonic for the nervous system, and as with other nervous system tonics it helps to restore the ability to achieve good quality deep sleep. It is also sedative so aids getting off to sleep. Herbalists consider it to have an affinity with the head (from the name skullcap), and is helpful to stop worrying about things that you cannot do anything about.
Lemon balm (Melissa officinalis)
Helpful for promoting better sleep quality, a calming herb that blends well with chamomile and lime flower for a pleasant tasting evening beverage. It is also considered energetically helpful for nightmares, and irritability in children and the elderly.
What else can support healthy sleep?
Key components to healthy sleep are ensuring healthy sleep routines and where possible eliminating or managing stressors which may be contributing to a lack of sleep.
The following guidelines have been recommended by Mental Health UK (2) as tips for getting a good night’s sleep:
- Create a regular sleeping pattern of sleeping and waking
- Create a restful sleeping environment (dark, peaceful and a comfortable temperature)
- Assess your stressors from work (for example workload, commute, work environment and boundaries at work)
- Regular exercise releases stress from the body, and tires us out in a healthy way so we can slip into a deep regenerative sleep. Avoid vigorous exercise too close to bedtime when possible as this can keep you awake.
- Be mindful of food and drink consumption. Caffeine takes at least 5 hours to leave the body and massively disrupts sleep for most people, as does alcohol. A herbal tea in the evening from the plants mentioned above could be a wonderfully soothing alternative.
- A sleep diary can be helpful for seeing how much sleep you are actually getting, allowing you to analyse your patterns and take informed action.
- A wind down routine will help you to relax before bed and nurtures a good night’s rest. This can include a warm bath, some gentle yoga or a relaxing and quiet podcast or music. Its important to support the transition between the day’s chores and activities and rest.
- Write down your thoughts, especially if you tend to lie and think about all you have to do the next day. Simply writing these down allows us to release them and have a clearer mind so we can get to sleep more quickly.
- Create and maintain good sleep hygiene by avoiding bright lights at bedtime and screens for at least 30 minutes to an hour before bed.
In addition, Yoga Nidra can be helpful for re-establishing healthy sleeping habits. It is also referred to as ‘Yogic sleep’, and is a guided relaxation practice which accesses the space between the conscious and subconscious mind, aiding the release of physical and mental tension, and promoting deep relaxation. It helps to re-establish balance in the body-mind complex, nourishing the nervous system, and can be a great aid for re-establishing the balance and energy resources necessary to access sufficient good quality sleep. Yoga Nidra can be practised during the daytime, or as part of a wind-down routine before going to bed at night.
References
- Chattu VK, Manzar MD, Kumary S, Burman D, Spence DW, Pandi-Perumal SR. The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare (Basel). 2018;7(1):1. doi:10.3390/healthcare7010001
- Sleep and mental health. Mental Health UK website. https://mentalhealth-uk.org/help-and-information/sleep/. Accessed December 3, 2022.
- Tortora, G, Derrickson, B. Principles of Anatomy and Physiology. Vol. 1. 13th ed. Asia: John Wiley & Sons; 2011.
- Patel AK, Reddy V, Shumway KR, et al. Physiology, Sleep Stages. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. https://www.ncbi.nlm.nih.gov/books/NBK526132/ Accessed December 8, 2022.
- Stages of Sleep. Sleep Foundation Website. https://www.sleepfoundation.org/stages-of-sleep. Accessed December 3, 2022.
- Nollet M, Wisden W, Franks NP.Sleep deprivation and stress: a reciprocal relationship. Interface Focus. 2020;10:20190092. http://dx.doi.org/10.1098/rsfs.2019.0092. (Accessed 02.12.22).
- Newbury, CR, Crowley R, Rastle K, & Tamminen J. Sleep deprivation and memory: Meta-analytic reviews of studies on sleep deprivation before and after learning. Psychological Bulletin. 2021;147(11):1215–1240. https://doi.org/10.1037/bul0000348.
- Bishir M, Bhat A, Essa MM, Ekpo O, Ihunwo AO, Veeraraghavan VP, et al. Sleep Deprivation and Neurological Disorders. BioMed Research International. 2020;5764017. https://doi.org/10.1155/2020/5764017.
- R, Bernhardi LE, Eugenín J. What Is Neural Plasticity?. Adv Exp Med Biol. 2017;1015:1-15. doi:10.1007/978-3-319-62817-2_1.
- Eide PK, Vinje V, Pripp AH, Mardal KA, Ringstad G. Sleep deprivation impairs molecular clearance from the human brain. Brain. 2021;144:3: 863–874. https://doi.org/10.1093/brain/awaa443.
