I’ve struggled with insomnia my whole life, I think. The battles my parents went through to get me to sleep at night as a child were epic. (I know: I heard about it years later. My parents were still shaking their heads, years later.) When adolescence and its lovely hormonal cocktail hit, things ramped up some; then motherhood was a whooooole new level!

I’ve tried medications and alternatives. Here are all the things I know to try. At the end, I’ll list what has and hasn’t worked for me.

Why am I talking about this on a food blog? Fatigue and food are intertwined: feeling more rested will help you make better food choices, and better food choices will give you more energy during the day. Most adults need seven to eight hours of uninterrupted sleep every night for optimal health.

Additionally, getting too little sleep may cause hormonal imbalances that make the fight to lose or maintain weight even more of an uphill battle. (Boo! Not fair!)

First let’s consider the source of your problem. Are you getting seven to eight hours a night, or not?

Getting enough sleep but still tired

If you are getting seven to eight hours of sleep every night but you’re still tired, it may be a side medical issue.

• Sleep apnea (you may not know you have it)
• Low iron (anemia)
• Low Vitamin D
• Thyroid issues
• Hormone imbalances (testosterone for men, especially)

…can all cause extreme fatigue. To rule these or other medical issues out, you should see a doctor for testing.

About vitamin D: Don’t try to self-medicate for low D without testing; it’s also possible to get too much, which can be harmful. And if you’re severely low, you may need a mega-dose not available over the counter. I’ve written in more detail about Vitamin D here.

Frequent fatigue can also be a sign that your body isn’t getting the energy it needs from food (you’re undereating), or, you’re eating too many carbs, sending your body’s energy-budgeting system into a constant roller coaster of spikes and crashes.

Not getting enough sleep / chronic insomnia

If your fatigue is about sleep — if you consistently struggle to fall asleep and/or stay asleep — there are many things you can try. You’ll need to experiment to try the mix that works for you.

Check the caffeine

First of all, I’m assuming you know not to drink any caffeine after 12-noon, right? And that “decaffeinated” doesn’t mean “zero caffeine”? And that there’s caffeine in tea? And cola? (And Mountain Dew?)

And chocolate?

A thing I’ve learned about caffeine that I think is very important: caffeine doesn’t just perk you up — it prevents your “getting sleepy” chemical — adenosine — from getting to the right receptors in the brain. But the adenosine doesn’t just go away or dissolve; it stays dammed up, building up with every caffeine hit, so that when you finally quit the caffeine, it comes slamming in at once, causing a flash flood of overwhelming fatigue.

About medications, supplements, and food

Side effects of current meds. I’m sure there are exceptions, but in my experience, many traditional medical doctors rarely consider the possibility whether your symptoms may be caused by one of the meds you’re already taking, and explore whether there are better alternatives. So you might start by looking up side effects of your current prescriptions to see if insomnia is one of the common ones listed. Don’t discontinue your med without talking to your doctor! (I’m not a medical professional. I’m just sharing what I know as one who’s been in the trenches. I’m not qualified to tell anyone what they should or shouldn’t take, so please don’t ask me that. 🙂 )

If you do find a possible culprit, maybe you need to switch meds. I only know about antidepressants, but I imagine other kinds of drugs may also have differences in whether their side effects help or hinder sleep. Some antidepressants do one; some, the other. You may be able to find a medication that you already need which also luckily has the side effect of causing sleepiness. Again: talk to your doctor about this.

“Sleeping pills.” Since I’m not a medical expert, I’m just going to quote a couple guys who are.

Matthew Walker, PhD is a professor of neuroscience and psychology at UC Berkeley, and the director of its Sleep and Neuroimaging Lab.  Author of Why We Sleep. (He also has more than 100 published medical studies to his name.) He says:

The older sleep medications… such as diazepam, were blunt instruments. They sedated you rather than assisting you into sleep. [Sleep and sedation are not the same thing, as he’ll explain next.]…

If you compare natural, deep-sleep brainwave activity to that [sedation] induced by modern-day sleeping pills, such as zolpidem (brand name Ambien) or exzopiclone (brand name Lunesta), the electrical signature, or quality, is deficient. The electrical type of “sleep” these drugs produce is lacking in the largest, deepest brainwaves. Added to this state of affairs are a number of unwanted side effects, including next-day grogginess, daytime forgetfulness, performing actions at night of which you are not conscious… and slowed reaction times during the day that can impact motor skills, such as driving.

…These symptoms instigate [kick off] a vicious cycle. The waking grogginess can lead people to reach for more cups of coffee or tea to rev themselves up…. That caffeine, in turn, makes it harder for the individual to fall asleep at night… perpetuating the downward spiral….

Another deeply unpleasant feature of sleeping pills is rebound insomnia…. When the drug is stopped, there is a withdrawal process, part of which involves an unpleasant spike in insomnia severity.

Sleep expert Robert S. Rosenberg, DO, FCCP — the medical director of the Sleep Disorders Center of Prescott Valley, Arizona — does believe that there are times when these medications are useful short-term, but only after carefully considering the problem and possible solutions. In his book Sleep Soundly Every Night, Feel Fantastic Every Day, he says,

If someone just writes a prescription for a sleep medication without taking the time to discuss your problem in depth, you are probably in the wrong place.

Herbs and supplements. There’s no silver bullet. What works for one person may or may not work for another.

Herbs. Chamomile helps some people, but it’s related to ragweed, so if you’re strongly allergic to ragweed (many people are), it may cause other unwanted effects. Some people are helped by tea containing valerian and/or passionflower. (Didn’t work for me.)

Lavender essential oil.  Lavender has been used for ages as a sleep aid, and some research suggests it may help. And as long as you use it within safe doses, it probably can’t hurt. You can put it in a diffuser, rub it on the soles of your feet (supposedly a great absorption site), or just rub a small amount into your wrists or neck so the scent will waft up as you lie in bed. (If you’re not familiar with diluting essential oils for use on skin, ask a knowledgeable friend or do a little googling. )

Melatonin. Melatonin is a chemical that occurs naturally inside your body. It doesn’t make you sleep, but it assists sleep. If you’ve tried it before and it didn’t work for you, it may have been the dose. While you’ll often see or hear recommendations to take 10 to 15 mg, some people actually have better results with a lower dose — in the 0.5 to 3 mg range. Also, if you’ve only tried it in pill form, it’s also available as a spray that you spray under your tongue and hold for 30 seconds before swallowing, purportedly getting it into your bloodstream quickly, without having to be processed by the digestive system.

Magnesium. For some unknown reason, it seems that a lot of us are short on magnesium. Functional medicine practioner Chris Kresser says,

 Magnesium has calming effects on the nervous system, and several studies have found magnesium to be effective in treating insomnia and improving sleep. Many people have success with 1 to 2 teaspoons of magnesium citrate powder before bed, while others do better with chelated forms like magnesium glycinate or magnesium taurate (400 to 600 mg). It’s important to note that magnesium may have a laxative effect, and the chelated forms are usually better tolerated by those with sensitive guts.

He also references other supplements that may help, here.

Food. This may surprise you, coming from a low-carber, but you may need more carbs in the evening.

Potato. Kathleen DeMaisons, author of The Sugar Addict’s Total Recovery Program, puts forth the idea that the protein you eat has the tryptophan that helps you sleep, but it can’t get into your brain without some assistance from the effects of carbs. She recommends having a dinner that includes protein, then three hours later, having a whole-food carb, such as potato or sweet potato, shortly before bed. I have seen another source say something similar; I’ve heard yet another refute it. But it’s so harmless: why not try it? (She does say that you can have fat, such as butter, with your carb, but no protein, because of the timing with which the protein hits the brain.)

Warm milk. It does work for some people. If you tolerate dairy milk, you might try it. Add a little cinnamon and/or vanilla if you can’t handle it straight up. (Other milks, such as soy, nut, or coconut would not have the same effect.)

Here are some other tips you may not know…

5 other ways to support your body’s natural sleep cycle:

Address sleep-related health issues. There are several health issues that may disrupt sleep. I mentioned this above, but I think a couple items deserve more detail.

• Restless leg syndrome is when you feel like you must move your legs, or they feel “antsy,” making it hard to sleep. Sometimes, this is a sign of anemia, and is often fixed simply by taking iron. (Another thing you should consult a doctor about.) Also…
• Many people suffer from sleep apnea without realizing it. If you wake up often during the night, snore a lot, or are always tired in the morning, talk to your doctor about doing a sleep study. If you’ve put this off because you didn’t want to go into a sleep lab, it’s now possible to do the sleep study in your own home. Sleep apnea has profound implications for your health beyond how groggy you feel during the day, so if you even think this might be an issue for you, I strongly exhort you to get this checked out!

Get sunlight in the morning; avoid blue light in the evening.  Your body sets its daily wake/sleep cycle by light entering the eye, so try to get outside every day. The earlier in the morning, the better, but by lunchtime at least, if possible. Also, the blue light emitted from your computer, TV, and phone screens tells your body it’s daytime, so put those away two hours before bedtime. Or get some blue-blocking glasses to wear.  (I’ll include a link to my favorite below.) I actually try to start dimming all the indoor lighting around sunset,

Use up your energy. Exercise during the day has also been shown to improve sleep quality at night — perhaps as effectively as sleeping pills. This doesn’t have to mean going to the gym or running miles! Another word for exercise? Movement! A brisk morning in the garden, walking the dog, playing tag with some young ‘uns, a dance party for one in your living room — all these count as movement. And if you enjoy it, you’ll be more likely to do it often.

Lay down your stress, before you lay down. If things on your mind is what keeps you up, you may need to find a process that helps you consciously set aside all the stressful thoughts of the day before you crawl in bed. You may want to explore prayer, journaling, listening to music, making lists, or renewing your mind, to find one or two of these that will work for you.

Keep your bedroom cool and dark. One thing that signals your body’s sleep trigger is a decrease in core body temperature, and a too-warm bedroom can work against this. Also, exposure to even small amounts of light during the night can disrupt the sleep cycle. Either remove all light sources, or use a sleep mask. (I’ll include a link to my favorite below.)

(For more detail and a few more items, read the article that these five tips are condensed and edited from: chriskresser.com/8-tips-for-beating-insomnia-and-improving-your-sleep/)

What I’ve tried; what works for me

Here it is! Remember: your mileage may vary. 🙂

+ means it helps me

– means it doesn’t help me

? means I dunno

+ Self-discipline before bedtime. I didn’t mention this above, but this is important. I had to be intentional about getting my body and brain ready for bed. People who can fall asleep as quickly as a helicopter lands don’t need to do this, but my sleep challenge is like a jumbo jet: I need lots of runway! Before, I usually spent the latter part of the evening wandering the web — and as we all know, that is an endless road. So I set a certain hour past which I do no internet and no computer work. I also started setting an alarm to remind myself to start winding down about an hour before I go to bed. “Winding down” includes turning out unnecessary lights and dimming the others, settling down with a calming book or game, and maybe a cup of herbal tea. Having a routine that signals to my brain and body that “we’re winding down now” helps trigger the end-of-day chemicals, I think.

+ Checking and fixing low iron and vitamin D levels. Having anemia made me have restless legs, which kept me from sleeping. When my iron levels returned to normal, this went away. My vitamin D tends to run low, so I get this checked regularly. The traditional “normal” range says that if your D is 20 or 30 ng/mL or higher, you’re good. But this number is really only taking into consideration bone health. Many functional medicine practitioners say (and my own personal, non-professional experience confirms) that for optimal health — including strong immunity and good energy — your level really should be 50 or higher.

+ Less carbs overall. Getting my fat, protein, and carbs into a healthier ratio helped even out my energy during the day. Also, even though I do enjoy the occasional sweet treat, having sweets too close to bedtime is not good for my sleep. It tends to send my heart racing, just like I’ve had a cup of coffee.

+ No caffeine after noon. A strict rule for me; absolutely essential. (Watch herbal teas for cocoa shells and other chocolate ingredients.)

+ Side effects of current meds. Yep. I’m currently in the process of trying to find a replacement that works.

– Sleeping pills. Nope. Nope. Nope. Knocked me out, yes. But the side effects were unlivable. When I read Dr. Walker’s explanation that these pills sedate you rather than letting you sleep, it made perfect sense. I was out for several hours, I woke up, but I felt like I hadn’t slept at all.

– Herbs. I’ve tried these three in tea: chamomile, valerian, and passionflower. Can’t do chamomile because of allergies; the other two made my eyes sleepy but my legs squirmy — a most uncomfortable combination! You may have better results. I have an Instagram friend who this works great for.

? Essential oil. I sometimes use lavender oil as described above; I have no idea if it helps or not, because I’ve never tested it alone. But I figure it can’t hurt. I do seem to have better results with apply them to my feet than the smelling methods. Again: If you’re not familiar with diluting essential oils for use on skin, ask a knowledgeable friend or do a little googling.

+/? Supplements. I use 3 mg of melatonin in a pill, and supplement with the spray if I’m having a difficult night. I also take magnesium for gut issues; I’m not sure what role it plays in my sleep.