The times I still don't sleep

Generally, the times I haven’t slept as well over the past 2 months have been the days that I’ve had a fair amount of sugar during the day – a chocolate bar, or a sweet drink. But I spent last week at my parents’ home – on what I saw as a relaxing holiday – and stopped sleeping. I was enjoying a break from study, pleased to be sleeping in my childhood bed, and happy to be spending the week with my parents and old friends. However the first night home I slept for 5 hours (not out of the ordinary), the second night for only 3 hours, and the third night I didn’t sleep at all. Because I wanted to enjoy my holiday, I took sleeping pills - Imovane - for the remaining 3 nights (a few hours into the night, after trying to fall asleep on my own).

I want to understand why my sleeping deteriorated last week. I crossed time zones (2hrs difference), but I don’t think this contributed, as I got a reasonable sleep on the first night home. What I think may have been made the difference is not eating as well as usual, and not taking the “women’s balance” supplement. (I forgot to bring it with me, and couldn’t find it there). I can’t come up with any other plausible contributing factors. That I stopped sleeping at my parents’ suggests that the “women’s balance” is making an important difference to my sleep, as usually when I don’t eat well I still get some sleep. Interestingly, the “women’s balance” supplement is one of the key supplements targeting the balance of female hormones.

As for all my posts, I'm keen to hear any comments/suggestions you may have.

Possible pathways linking PCOS and insomnia

These are two pathways by which PCOS may cause insomnia:

(1) via glucose intolerance / insulin resistance
(2) via an imbalance of the ratio of oestrogen to progesterone

From what I’ve read, insulin resistance / high blood glucose levels put pressure on the adrenal glands, resulting in the release of too much cortisol. This excess of cortisol promotes anxiety and makes it difficult to relax, and fall asleep.

The second pathway is about an excess of oestrogen and lack of progesterone – two female hormones. Many conventional doctors disagree, but according to Patient Advocates Ltd (the link is provided) and a naturopath I saw a few years ago, progesterone is the ‘feel good’ hormone. Here’s a list of some of the things it does:

* Reduces mood disorders (eg. anxiety, depression)
* Relieves endometriosis and PCOS
* Increases energy and libido
* Balances blood sugar levels and thyroid function
* Is necessary for fertility and maintaining pregnancy
* Relieves menopausal symptoms
* Reduces hair loss
* Improves sleep

Progesterone levels can be increased by using a progesterone cream. I’ve been prescribed this cream in the past, but haven’t used it (yet) for treating insomnia. However from what I’ve been told, the “women’s balance” supplement that I'm taking - and listed in the previous blog - also helps to improve the oestrogen/progesterone ratio.

The solution

In this post I’m going to describe the dietary changes I've made and supplements that I’ve been taking for the last 6 weeks. I’ll also mention a few extra things I do to maintain my health and sleep well.

The main reason for the dietary changes and supplements is to balance blood sugar levels (I will describe in another entry why this is important). Therefore, I have reduced my intake of refined carbohydrates (white bread, white rice, pasta etc) and sugar (including less fruit). I have also increased my intake of unrefined carbohydrates (wholemeal/grainy breads, brown rice, grains, nuts and pulses) and increased my intake of protein. If you know about the glycaemic index (GI), then it’s low GI foods I’m trying to include in my diet. (A low GI diet is actually recommended for all women with PCOS). Whereas before I would often have cereal for breakfast or honey on toast, these days I’m more likely to have eggs or scrambled tofu on wholemeal toast or a protein shake. I try to make sure that I’m getting some protein in every meal.

As for the supplements, some are for balancing blood sugar levels (like the glucolin tablets) but others are ones recommended for women with PCOS (like fish oil). At the moment, I’m not exactly sure which are the “key” ones – this is something I’ll work out in a few months, once I feel that my sleeping patterns have stabilised and its time to reduce the supplements.

Here is a list of supplements I take, and when:

On rising
2x women's balance

At breakfast
1x glucolin (take 1/2 hour before meal)
2x fish oil
1x evening primrose oil
1x stress & stamina formula
1x women's ultivite
1x calcium (best to take between meals)
1/2 teaspoon inositol
1/2 teaspoon acetyl-L-carnitine (expensive - so can take just 20mins before aerobic exercise)

At lunch
1x glucolin (take 1/2 hour before meal)
2x fish oil
1x calcium (best to take between meals)
1x evening primrose oil

At dinner
1x glucolin (take 1/2 hour before meal)
2x fish oil
1x evening primrose oil
1x calcium (best to take between meals)

~ Just a warning ~
I recommend speaking to a naturopath, or at least the person selling the supplements, before taking them. You want to be sure that what you're taking is appropriate for you.

I also do/have these things to stay healthy and relaxed:
· yoga (15 mins every morning, and weekly yoga classes)
· meditation and relaxation exercises
· deep breathing (or pranayama, to use the yoga term)
· regular aerobic exercise (but not too much! - and I try to finish with some yoga)
· acupuncture
· massages (unfortunately might have to cut back on these!)

A brief (?) history of my insomnia

I've set up this blog to share with you how I overcame chronic insomnia. I had insomnia for 2 years, but as of 6 weeks ago I've slept every night - and for on average more than 6 hours - without fail. I want to share my solution as I know there are lots of other people in a similar situation. However it won't work for everyone. But if you have insomnia and PCOS, diabetes, impaired glucose levels or insulin resistance, then my solution may also work for you. I have a common endocrine disorder - the polcystic ovarian syndrome (PCOS) - which I finally discovered to be the cause of my problems.

My insomnia started at the beginning of 2007 and lasted 2 years. There are a number of things that happened around early '07 that may have had a part to play in setting it off - neighbours playing music at all hours of the night, being woken by a pigeon at 5am each morning, the pressure of having started post-graduate study, undergraduate teaching... the list could go on. For the rest of '07 I dealt with the insomnia mostly by ignoring it. I became moodier and more emotional than usual and was often very tired, but I carried on. At this stage I was usually still getting some sleep each night. I did try to tire myself physically. I kept up my usual activities (yoga, gym, swimming) and also started training for a marathon. But even this didn't work - some nights I didn't get a wink of sleep even after running more than 20km! I sometimes used the over-the-counter sleeping pill Restavit, but found it quickly lost its effect. By the end of '07 I thought I'd try to relax more, and so quit my extra-curricular activities, reduced my physical activity, and stopped working after 6pm in the evenings.

In 2008 my sleep deteriorated further. I had a few sleepless nights a week and not much sleep on the other nights. Finally, before a 3-week trip overseas, my GP prescribed me Stilnox. I ended up sleeping the nights I took it and not sleeping the nights I didn't. After I returned home I was physically and emotionally exhausted, and put my studies on hold for 2 months.

After a net search I found a cognitive behavioural therapy (CBT) programme called "Sleep Better Without Drugs". I began the programme, as well as regular sessions with a sleep psychologist, acupuncture and continued with yoga. Overall my sleep improved (although I also made dietary changes over my 2-month break that with hindsight, would have been beneficial in regards to the PCOS/insomnia link). I continued using the techniques and resumed my study. However I was still frequently underslept and the emotional distress remained. After another trip overseas at the end of '08 - during which time I resumed taking Stilnox - I again hit rock bottom. The breakthrough came during another net search in early January when I found a link between insomnia and my other health problem (to which I'd given little thought for some years), the polycystic ovarian syndrome (PCOS). I found plausible pathways linking the two and read stories about women with PCOS who also had insomnia.

The following day I changed my diet and began taking supplements (supplements recommended online for women with PCOS and by the woman at the local health food shop my partner visited for me). I hardly slept for the next 2 nights (although we were camping), but have slept every night since. Most nights I now sleep for 5-7 hours.

I thought this background might be useful for some people. The entries to follow will describe in detail what were for me the solutions. I hope they will help you too.