What's New in S.H.I.N.E. — Part 1: Sleep
In the previous two newsletters, I discussed what people with CFS/FM should do "when all else fails" — what to do when the SHINE protocol (Sleep, Hormones, Infections, Nutritional Supplements, Exercise) doesn't work, or doesn't work as well as you'd like it to.
Of course, I'm happy to say that our research shows SHINE usually does work, helping more than 85% of CFS and fibromyalgia patients feel significantly better after just 3 months. And that's why I'm going to devote the next series of newsletters to a review of key elements of SHINE. Because it's always good to get back to the basics — to the foundational self-care and medical care regimen that can relieve pain, restore energy and counter the other symptoms of CFS/FM — by addressing the underlying causes of this condition.
In this multi-part series, "What's New in SHINE," I'll also talk about new elements in the SHINE protocol — recent advances that have made the protocol even more effective. This will be a good way to update everyone on what's new since I released my 3rd edition of From Fatigued to Fantastic!
The first two parts of the series address the very first letter of the protocol: S for Sleep.
In my opinion, disordered sleep is a major, underlying process that perpetuates fatigue and muscle pain (and many other types of pain). To eliminate those problems, it's critical to get 8 to 9 hours of deep sleep each night, on a regular basis. Does that seem like a lot of sleep? Let me put those hours in perspective.
Anthropologists tell us that 5,000 years ago the average night's sleep was 11 to 12 hours. When the sun went down, it was dark, boring and dangerous outside, so people went to bed. When the sun came up, they woke up. And the average time from sunset to sunrise is 12 hours — so we slept that long. The use of candles shortened sleep time. Then light bulbs were developed, followed by radio, TV, computers and the Internet. One hundred years ago, the average American was getting 9 hours of sleep. Now, we are down to an average of under 6.5 hours a night — and that amount simply isn't adequate to allow proper tissue repair.
In fact, insomnia has become a national pastime. An estimated 45 million Americans fit the official definition of chronic insomnia: having trouble falling asleep or staying asleep, or waking up too early, at least three times a month, for more than a month. Another 60 million have the same symptoms, but less often.
Some of those millions get inadequate sleep because of poor "sleep hygiene" — habits like consuming caffeine after 4:00 pm, staying on the computer into the wee hours of the night, or keeping the bedroom too warm.
Other types of poor sleep hygiene (like using the bedroom to work or pay your bills, instead of reserving it for sleep) occur because pain keeps us awake. And some have horrific insomnia from CFS and fibromyalgia because the sleep center in the brain (called the hypothalamus) is suppressed by the same process that is causing the pain.
But Mother Nature wants you to sleep like a baby. And her medicine cabinet is well-stocked with natural sleep aids.
Herbal Supplements That Promote Healthy Sleep
I recommend you begin with this wonderful type of supplement for insomnia. In addition, these herbals can help alleviate both pain and anxiety. You'll see results the first night you take it, though effectiveness increases with continued and regular use. You can use most sleep-support supplements with any natural or prescription sleep therapies. (You can also take it during the day to relieve pain and anxiety.)
What's New: Herbal Sleep-Support Supplements That Help Maintain Healthy Cortisol Levels
The sleeping problems of CFS and fibromyalgia are often triggered by your sleep center not working. When this happens, it can cause your adrenal stress hormone cortisol to be too low during the day (when it should be high) and high at night (when it should be low, so you can sleep). In other words, you feel "brain foggy" all day — and wide awake at bedtime, with a racing mind.
Now, there is an exciting, new remedy for sleep that has been shown to lower bedtime cortisol levels by 40% (while leaving them okay during the day, when you need them). This type of supplement works beautifully for some folks' insomnia, but not at all in others (depending on whether your insomnia is caused by high nighttime cortisol or not). If it is going to work, it often works the first night. You'll certainly know whether it's helpful or not by the time you finish one bottle. You can also use it along with any other natural or prescription sleep therapies.
Other Natural Sleep Remedies
Several other natural remedies can help you sleep include:
- Magnesium, 75 to 250 mg. Taken at bedtime, this mineral can help you sleep.
- Hydroxy L-tryptophan (5-HTP), 200 to 400 mg at night. When used for 6 weeks, a 300 to 400 mg dose has been shown to decrease fibromyalgia pain. (Bonus: it often helps people lose weight.) It works by providing the raw material for serotonin, a neurotransmitter that can improve the quality of sleep and decrease levels of substance P, your body's pain messenger. It takes 6 to 12 weeks to see the full effect of 5-HTP, and it is more expensive than other remedies. Nonetheless, it may be worthwhile in addressing chronic pain. One caution: if you are taking other therapies that increase serotonin, limit 5-HTP to 200 mg at night. These include antidepressants, Ultram (tramadol), Savella, Cymbalta, Desyrel, and the herbs St. John's Wort, or an herbal supplement that raises serotonin (the "happiness molecule").
- Melatonin. This is a hormone produced by the pineal gland. It is natural and available over-the-counter. For melatonin, the optimal dose for sleep is 1/3 to 1/2 mg — but the usual dose you find in stores is 3 mg, 6 to 10 times higher. For sleep, the 1/2 mg dose is every bit as effective as the higher dose. The only reason for using the higher dose would be if you have acid reflux that bothers you during sleep, in which case the 6 mg a night dose may settle this down.
Jacob Teitelbaum, M.D. is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.