Archive for: February 2009

Insomnia is a sleep disorder characterized by chronic problems  falling asleep, staying asleep or only sleeping for several hours and being wake unable to fall back to sleep. A typical thing following this is functionalimpairment while awake. Both organic and non-organic insomnia constitute a sleep disorder.

Sleep medicine is a recognized medical subspecialty. Doctors who specialize in sleep medicine help people who are unable to sleep well. Sleep doctors are able to detect and treat both common and rare sleep disorders. Some common sleep disorders are insomnia, jet lag, sleepwalking, snoring and obstructive sleep apnea.  And, it could be that you have intolerance to gluten.

Gluten is a type of protein compound in certain cereal grains – primarily wheat, barley, and rye - the basis of breads, baked goods, and pasta. These are foods that are helpful in getting good sleep.  But the inability to sufficiently digest gluten protein can lead to all sorts of symptoms, including skin rashes, irritability, aggression, moodiness, ‘brain fog,’ cognitive problems, cramping, bowel problems, pain, and sleep disturbances.  This is why it is so important to see a doctor if you are experiencing sleep disturbances as often the sleeping problems are really caused by a medical problem.

When intestinal cells are damaged for any reason, they cannot properly absorb nutrients, which results in malabsorption. Without healthy intestinalcells, you can become malnourished, no matter how much food you eat. Many people do not realize that a second key function of intestinal cells is to produce several key digestive enzymes. In particular, these cells produce specific protein and carbohydrate degrading enzymes needed for the thorough digestion of gluten (and other similar proteins such as casein).

The second type of gluten intolerance occurs when the gut is injured for some reason other than celiac disease, such as when there is a bacteria or yeast infection. This is the scenario commonly seen with leaky gut syndrome, autism conditions, carbohydrate intolerance, and most digestive disorders.

In these cases, the damage to the intestinal cells occurs initially, reducing the amount of the key intestinal enzymes produced there. Without these enzymes, any gluten or casein consumed is poorly digested and potentially problematic. The result of this gut injury is the subsequent loss of the intestinal enzymes leading to poor gluten (and casein) digestion. As the gut heals and the intestinal cells are restored, intestinal enzyme production can return. This is consistent and is a commonly reported experience. Some people find that although they cannot leave a gluten-free diet initially, after a couple months of allowing the gut to heal, they can then re-introduce gluten with gluten-targeting enzymes.

Avoiding gluten is quite challenging. Gluten is a common food additive, often used in small amounts, because it increases protein content inexpensively, as well as enhances taste and texture in food processing.

One of the great insights of recent medical research is that inflammatory reactions are commonly present in conditions that we never imagined were inflammatory. There is a degree of inflammation among most people with CFS (chronic fatigue syndrome and FMS, (fibromyalgia) although less severe and quite different from the inflammation that’s found in “normal” infections or in autoimmune conditions such as rheumatoid arthritis. Indeed poor sleep itself can cause inflammation, as can hardening of the arteries (arteriosclerosis) and even psychological depression; however, we don’t yet know what we should do with this knowledge. Would suppressing inflammation help our body heal, or are these inflammations part of the body’s self-defense? Again our research is not focused on our needs.

So, while we are waiting for more research and first rate controlled studies, what practical approaches have the best promise of improving your odds of improving how you feel and function, living with CFS/FMS?

In addition to non-restorative sleep that is almost always present, a substantial number of people with FMS and CFS also have a primary sleep disorder. The data is especially strong for CFS, where somewhere on the order of 10% of patients have a significant degree of sleep apnea.  On the order of 1-4% have a muscle twitching syndrome called periodic leg movement disorder (PLMD)

Usual opinion is that we should prefer non-addicting medicines, especially those that improve slow-wave sleep and which also often help fibromyalgia pain e.g. the tricyclic anti-depressants at low doses (Elavil, doxepin, Pamelor), the tricyclic muscle relaxant Flexeril, the anti-depressants trazadone and Serzone, the newer anti-depressant Remeron, and the newer sleep medicines Ambien and Sonata.

Usual opinion is that we should avoid diazepam/Valium like medicines except for occasional use because they are “habit-forming”, tend to disrupt rather than improve the EEG pattern during sleep, and because for some people over-time they tend to stop working. This is all true. However, it is the experience of some physicians that a proportion of people with FMS/CFS do surprisingly well with this class of medicines, even with long term use. So, don’t dismiss the benzodiapine group automatically, as many physicians tend to do. Among the benzodiazepines, many FMS/CFS specialists prefer Klonopin/clonazepam.

Symptoms of celiacdisease may include one or more of the following: gas, recurring abdominal bloating and pain, chronic diarrhea, constipation, pale, foul-smelling, or fatty stool, weight loss / weight gain, fatigue, unexplained anemia (a low count of red blood cells causing fatigue), bone or joint pain, osteoporosis, osteopenia, behavioralchanges, tingling numbness in the legs (from nerve damage), muscle cramps, seizures , missed menstrual periods (often because of excessive weight loss) , infertility, recurrent miscarriage,  delayed growth, failure to thrive in infants , pale sores inside the mouth, called aphthous ulcers, tooth discoloration or loss of enamel, itchy skin rash called dermatitis herpetiformis.

1. Eat at least five servings of fresh uncooked organic fruits and vegetables every day, and six to eight servings total. When you do cook veggies, cook them al dente on the stove with the lid off. This will preserve the most nutrients, not to mention keep their natural yummy flavors!

2. Eat plenty of healthy fats and legumes; they are good sources of vitamin E and protein, and essential for healthy brain function. Fats also provide the highway for the delivery of essential vitamins and minerals to your body, and a balance of fat, protein, and carbohydrates help you feel full. Olive oil, raw nuts, organic peanut butter, flaxseed, organic soy (if tolerated), grape seed oil, canola oil, etc. are easily mixed into the dishes you eat every day and are great flavor enhancers!

3. Eat your greens! The darker the better. Leave the iceberg lettuce on the grocery store shelf, and instead take advantage of the season and hit your local farmer’s market for organic and flavorful greens, such as spinach, arugala, kale, mustard greens, bok choy, rainbow chard, green leafy butter lettuce, and garden fresh green beans and broccoli. Your body will thank you for the extra iron and calcium!

4. Cook in cast iron. That’s right…raid grandma’s kitchen cupboards or hit the flea market. Make sure to re-season the pans to eliminate any prior cross contamination from gluten. Cooking in cast iron is a great way to naturally replenish the depleted iron stores in your body.

5. Eliminate your intake of corn syrup, processed white cane sugar, and the use of ‘fakes’ such as aspartame or saccharin. Even the calorie free sugar substitutes can trigger the brain to think it just ate sugar, leaving your body to the throws of fluctuating blood sugar,

6. Drink plenty of water. Forget the soft drinks and high octane sports drinks (which are often loaded with calories, caffeine, and/or chemical sweeteners). Your body is comprised of approximately 70 percent water; so replenish often. Replace your juice with whole fleshy fruits or berries and pair with a glass of water to stay hydrated and sustain energy during these hottest months.

7. Move! Break a sweat every day! Your heart, brain, metabolism, and overall well being will thank you for this benevolence on them. If you have never exercised before, start sensibly with a 20 minute walk every day, or break it up into two ten minute brisk walks.

8. Get plenty of sunshine. Natural sunlight can also ward off depression and lighten your overall outlook. Stressed at the office? Take a walk outside at lunch or go unwind for a few minutes at a nearby park.

9. Sleep and recover.  If you have trouble sleeping at night try these simple suggestions:

*Don’t eat right before bed, and keep your dinners light.
*Exercise early in the day, so you are tired at night.
*Before bed try light Thai Chi or relaxation yoga to unwind.
*Get to bed before 10pm; don’t wait until you get that second wind that will keep you up working until the wee hours. Yes, it’s true, “Early to bed, early to rise…” you know the rest.

10. Play! The kids are home; maybe driving you a bit crazy - the boss is on vacation, putting the workload on you; the house still hasn’t received its annual spring cleaning, etc. Take the kids to a movie, teach them how to cook kid-friendly vegan and gluten free recipes, go for a long bike ride, or leave the office early on a Friday after a long stressful week. Your digestive system will thank you for eliminating sources of stress, and you will harbor less anger and sleepless nights - all of which contribute to stomach upset and inadequate nutrient absorption.

So back to our original question – does gluten help sleep?  Yes, unless you have intolerance for it and then it can be the cause of your sleep problems.