Dr John Briffa: Night nurse

In a world where time seems to be in ever-shorter supply, it can be tempting to skimp on our sleep. Yet while sleep is often viewed as a dispensable commodity, the reality is that not only do the brain and body need sleep to recoup energies expended during the day, but the physiological downtime it creates gives the body the opportunity to get on with essential maintenance including detoxification and repair.

The value of sleep has become particularly evident to me of late. I'm normally an eight-hour-a-night man, but my slumber time over the past few weeks has become squeezed at both ends by a frenetic schedule. As a result, I found myself snoozing my way through most of a play on Tuesday, and sometimes wake up feeling as if I have hardly slept at all.

My sleep-debt situation, though self-imposed, has given me cause to consider the plight of the millions of Britons who suffer from insomnia. There is some evidence that people who have difficulty getting to sleep tend to have high levels of stress hormones (such as cortisol) in their systems. As a rule, therefore, insomniacs would do well to avoid anything that increases stress-hormone secretion in the evening.

Strenuous exercise, cracking on with some paperwork after supper, and exposure to heart-quickening images on the news are unlikely to aid sleep. A relaxed meal, an hour buried in a novel or a good soak in the bath are much more likely to help ease our passage into the land of nod. However, we also need to be mindful of going off too soon; snoozing in the evening can reduce our chances of falling asleep once we are in bed.

In practice, I see caffeine as a common factor in insomnia. Studies have shown that coffee and tea drinkers are more likely to suffer from sleep disruption. The effects of caffeine can tend to linger in the body, so cutting out caffeine after breakfast (and sometimes complete elimination of it from the diet) can be important if we want to give ourselves the best chance of getting a decent night's sleep.

The herbal-medicine chest is full of sleep aids.

A mug of camomile tea after dinner or a few drops of lavender oil in the bath may be all it takes to tip the balance. Another useful natural remedy for insomnia is the herb valerian (Valeriana officinalis). This is widely used in folk medicine as a sedative and sleep aid, and unlike many of the conventional sleeping tablets is not addictive or prone to leaving us feeling hungover in the morning. 300-500mg of root extract or 1 tsp of tincture should be taken one hour before bedtime.

For some, it's not getting to sleep, but staying asleep that's the problem. In my experience, this is very often related to drops in the level of sugar in the bloodstream in the middle of the night. When blood-sugar levels fall, the body tends to secrete the stress hormone adrenaline to stimulate the release of sugar from the liver. Adrenaline's other major effects are to increase alertness, wakefulness and feelings of anxiety; it's hardly the best substance to have whooshing around our bloodstream in the middle of the night.

Those who wake in the night often find their quality of sleep improves if they eat an evening meal which releases sugar in a slow, sustained way into the bloodstream. Suppers based around a portion of meat, fish, eggs, tofu or beans, accompanied with some vegetables and a modest amount of rice, pasta or potato are ideal for this. Another useful tactic is to have a light snack of some fruit and/or nuts before bedtime. This can help keep blood-sugar levels from dropping into the red during the wee hours.

Nutrition news

Many soft drinks are stacked full of sugar, which is well known to increase the risk of dental decay in kids. However, the health consequences for children of consuming sugary drinks appear to go way beyond the erosion of their dental health. Recently, researchers from the Children's Hospital in Boston and the Harvard School of Public Health examined the link between soft drinks and body weight. The study found that for each additional glass or can of sugary soft drink consumed each day, the risk of obesity rose by a staggering 60 per cent. The findings of this study alone are a good argument for keeping the consumption of sugared soft drinks in children to a minimum.

Dear John...

I suffer from bad period pains. I've had tests but, apparently, there is nothing wrong. Painkillers hardly help at all. Can you recommend anything?
Brigitte Connor, Chichester

The body of the womb is made up of muscular tissue. During a period this muscle contracts to help expel the womb's bloody lining. Sometimes the contractions can be very strong, and this can lead to severe pain and possibly cramping.

Calcium and magnesium are essential to muscle function, and can be very effective in reducing cramps. Taking 1,000mg of calcium and 500mg of magnesium every day will almost certainly reduce the severity of your cramping, although it might take a while to have full effect.

Several medicinal herbs may help reduce the pain. Black cohosh (Cimicifuga racemosa) has traditionally been used to treat period pain and spasm in the uterus, and may therefore offer you some relief. The usual dose is 20-40mg of extract, twice a day.

Another natural substance which may help is the herb cramp bark (Viburnum opulus).

Take 1 tsp of tincture, three times a day, when you have symptoms.

You can obtain black cohosh and cramp bark preparations from Advanced Herbals (02920 219 853).

· If you have any issues you would like Dr John Briffa to address in this column, please contact him by email on john.briffa@observer.co.uk. Please note that Dr Briffa cannot enter into any personal correspondence

Thanks to guardian.co.uk who have provided this article. View the original here.


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