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Too Stressed to Sleep?
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James Offline

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Too Stressed to Sleep?

Too Stressed to Sleep?

By Sandy Almendarez

“Ah. That pillow feels good. That new eco-friendly laundry soap I use is nice, and I’m glad I’m not hurting the environment. Of course, it costs more than the old stuff, and my commissions have been down at work. If I can just do a stellar presentation on Thursday, maybe I can get a raise. When do I have time to work on it? I can’t do it Tuesday because I have to meet with Kevin’s teacher; I wonder why he’s been acting up in class. Is it because Troy and I have been fighting more? But I thought we were keeping it quiet. Speaking of quiet, I need to calm down my brain to get some shut eye…."

This common scenario happens nightly to many shoppers. People are worried, stressed and tired. And, unfortunately, the awareness of the importance of sleep and how little they get of it causes more stress. Sleep and stress have a chicken-and-egg relationship that’s cracking up the psyche of much of the population.

“People in many walks of life are concerned about losing their houses, losing their jobs and losing the future for their children," said Robert Foster, CEO, Novus Life Solutions LLC. “Secondly, the environment in which we live continues to become more toxic. This condition is the result of the food we eat, the water we drink and the electromagnetic smog in which we find ourselves living."

Maybe the one worry that will help consumers end this sleepless cycle is the fear of pharmaceuticals and their side effects. “Consumers have gotten very wary of the pharmaceutical industry," observed Deanne Dolnick, vice president, Next Pharmaceuticals. “Who doesn’t know somebody who’s taken an anti-anxiety medication or a sleep medication and has had terrible side effects or they can’t get off the medication? Another huge concern of mine is that I know people who have been prescribed anti-depressants for anxiety. Isn’t that overkill?"

Natural nutrients can offer the same and even better results than drugs without the potential threats such as dependency, restless sleep and next-day grogginess. In fact, sleep supplements may work themselves out of necessity. “I think a person can take these as often as they need, but my experience has been that once they get into a pattern of sound, restful sleep, it begins to maintain itself," said Cheryl Myers, chief of scientific affairs and education for EuroPharma. “In other words, many people just need to take these sleep supplements for a short time until they re-establish quality sleep."

Many are seeking to re-establish the healthy sleep schedule to help reduce stress. “According to a 2010 CDC study, nearly 25 percent of all Americans experience occasional sleep deprivation—this means one out of every four people walking into a health food store has trouble sleeping," figured Autumn Blum, group vice president and founder, TheraNeem and TheraVeda Nutraceutical Corp.

The American Psychological Association (APA) said nearly 75 percent of Americans are stressed, which is no doubt a major contributor to a number of different illnesses including chronic fatigue, irritable bowel syndrome, weight gain, diabetes, heart disease, depression cancer and even death.

“Sleep time allows repair and recovery to occur, both mental and physical," said Neil E. Levin, CCN, DANLA, NOW Foods’ nutrition education manager. “The inability to recover from chronic stress can increase stress-related eating habits with a subsequent accumulation of abdominal fat on the one hand, and lead to physical and emotional exhaustion on the other. Energy deficits can lead to a diminished immune response. So we see a host of common complaints that can be at least partially attributed to a lack of sleep and the causes thereof."

People who are experiencing chronic stress have elevated levels of adrenaline and cortisol, explained David Winston, RH (AHG), founder and president, Herbalist & Alchemist. “High levels of cortisol increase stress-induced eating, stress-induced palpitations and stress-induced hypertension, and contribute to the process of what is known as metabolic syndrome or insulin resistance," he said. “Chronic stress affects literally every aspect of our bodies and our health. While small amounts of stress are necessary and actually beneficial, chronic high levels of stress are not. We also know people who have poor-quality sleep are at greater risk of heart attack, cancer, depression, anxiety and hypertension, as well as diabetes."

And then there’s the weight issue. A 2010 study from France found men consumed 22-percent more calories after a short night of sleep with an average increase of about 560 calories per day.1 The researchers suggested people may eat more after a short night of sleep because mammals have evolved to store up calories in the summer, when nights are short and food is plentiful. Conversely, weight loss reduced obstructive sleep apnea in obese men, with the greatest effect seen in patients with severe disease, in another 2010 study that involved 63 obese men aged 30 to 65 years.2

Maybe the reason stress and lack of sleep influences so many areas of health is because it both are perceived differently by each individual. This adds another layer of complexity to addressing this issue. “People may not sleep due to a number of factors, and their individual stressors makes it more difficult to figure out which products may help them to normalize their sleep and minimize their stress," Levin said. “Matching the person to the solution is always the biggest challenge, and some trial and error may need to be factored in before a solution is found."

Mary C. Borneman, media relations manager for Hyland's Inc., added, “There is an incredible multitude of products on shelf because there’s no great solution that fits all."

Everyone gets stressed for different reasons, and the effects are displayed in myriad ways; however, one thing we all experience during chronic stress is increased adrenal function. The adrenals are small, triangular glands located on top of each kidney that secrete hormones. Cortisol, one of these hormones, controls the body’s use of fats, proteins and carbohydrates, and also helps the body to cope with stress by secreting adrenaline, which increases heart rate and facilitates blood flow to the muscles and brain. Overworked and tired adrenal glands may not be able to produce necessary hormones, and then fatigue, anxiety and reduced immunity set in.

Botanical Bliss

However, certain herbs have been shown to aid adrenal function, stopping this stressful situation. “Adrenal Cleanse is a dietary supplement formulated expressly to provide nutritional support for the structure and function of the adrenal glands," explained Sunil Kohli, COO, Health Plus Inc. “Adrenal Cleanse, which combines potent antioxidants with adaptogenic herbs, features Ester-C Mineral Blend, amla extract, ashwagandha extract and astragalus root."

Jarrow’s Adrenal Optimizer® also contains a proprietary ingredient, specifically Sensoril® from Natreon, an extract of ashwagandha (Withania somnifera) that is clinically-tested to help reduce stress levels as well as biochemical indicators of stress such as serum cortisol levels, serum C-reactive protein (CRP) levels, pulse rate and blood pressure without adverse effects.3

Ashwagandha is known as an adaptogen, a class of herbs that help lower cortisol levels, enhance immune function, and reduce anxiety, insomnia and depression. “Adaptogens are herbs that help the body and mind adapt to physical, emotional and environmental stressors," Blum said, noting TheraVeda Organix Stress Ease contains ashwagandha along with its adaptogen cousin shatavari. “Adaptogens work on many body systems at once, including the immune system and nervous system. They work differently in each person, giving your body specifically the tools it needs. In some cases, they can be energizing (but not necessarily stimulating), and in other cases, they can be calming (but not necessarily sedating)."

Next Pharmaeuticals supplies Relora, a combination of a patented Magnolia officinalisbark extract and a proprietary Phellodendron amurense bark extract, for stress and Seditol, a combination of magnolia bark extract and a proprietary Ziziphus spinosa seed extract, for sleep. “Both products help to calm the HPA (hypothalamic-pituitary-adrenal) axis," Dolnick noted. “When the HPA axis gets ‘switched on,’ the brain can’t shut down. It leads to a cascade of hormones that eventually cause damage throughout the body." In aNutrition Journal study , Relora reduced perceived stress levels in healthy, overweight premenopausal females who eat more in response to stress.4 Relora also prevented weight gain for obese women who eat in response to stress as compared to placebo in a 2006 study where researchers supposed the combination reduced cortisol levels.5 Seditol was considered relaxing by 86.9 percent of subjects in an unpublished study from the LaValle Metabolic Institute, Cincinnati, that also found 82.8 percent of the subjects said it assisted in a restful sleep, and 82.8 percent said it reduced fatigue due to lack of sleep.

NOW uses Relora® along with other adaptogenic herbs, chromium and corosolic acid in Super Cortisol Support. This blend, Levin said, helps the body to manage the negative effects of stress such as excess abdominal fat deposition, overeating and low energy levels.

Capitalizing on the ability of adaptogens to help the body adjust to stress, Europharma combines four different extracts; the key botanical in the product is Rhodia (Rhodiola rosea), which exerts an anti-fatigue effect that increases mental performance, particularly the ability to concentrate, and decreases cortisol response to stress in patients with fatigue syndrome.6 Rhodiola also helped reduce mental fatigue in students during the stressful period of exam week.7

Mixing stress-reducing herbs is definitely a theme in this market, with valerian (Valeriana officinalis), hops (Humulus lupulus) and schisandra (Schisandra chinensis) all making cameos in a variety of products. With research backing, these adaptogens in combination are hits with consumers looking for a calmer mind. For instance, a combination of hops and valerian was superior to a placebo in keeping subjects asleep longer than did valerian extract alone.8 However, other studies on valerian have shown it works well alone, giving the German Commission E enough evidence to approve it as a mild sedative. A meta-analysis of 16 of these studies reported the botanical improved sleep quality without producing side effects.9 Schizandra is included in the National Pharmacopoeia of the USSR, and a review of Russian/USSR studies noted schizandra affords a stress-protective effect against a broad spectrum of harmful factors, and increases endurance and accuracy of movement, mental performance and working capacity.10 Other adaptogens include Asian ginseng (Panax ginseng), American ginseng (Panax quinquefolius) eleuthero (Eleutherococcus senticosus), Indian gooseberry (amla; Phyllanthus emblica), passion flower (Passiflora incarnate) and lycium (Lycium chinense).

Nervines, like adaptogens, are a class of botanicals that aid in stress relief, except they elicit a direct response from the central nervous system to help restore emotional foundation. Fresh milky oat (Avena sativa), lemon balm (Melissa officinalis), linden flower (Tilia argentea), American skullcap (Scutellaria lateriflora), passion flower (Passiflora incarnate), hawthorn (Crataegus monogyna), lavender (Lavandula), chamomile (Matricaria recutita) and St. John’s wort (Hypericum perforatum) are all considered nervines. Nervines also come with scientific clout. American skullcap—not Chinese skullcap—possesses possible anxiolytic and sedative qualities,11 and passion flower was noted in one German study to have pharmacological confirmation of sedative and anxiolytic effects.12 Both scientific and clinical data support the traditional uses of lavender, including its carminative (smooth muscle relaxing), sedative and anti-depressive effects.13 And a controlled clinical trial found chamomile extract reduced mean total HAM-A (Hamilton Anxiety Scale) score in patients with mild to moderate generalized anxiety disorder versus placebo.14 A lower HAM-A score indicates fewer depressive symptoms.

Blum said TheraVeda Organix Sleep Ease is a two-herb formula that contains the nervinesbacopa (Bacopa monnieri) and jatamansi (Nardostachys jatamansi). “The unique thing about this specific formula is that it is a non-sedative formula, so you don’t wake up groggy the next morning," she said. “This is an ideal formula for those who can’t sleep because their mind is constantly racing. For people with high-stress jobs or lifestyles, we recommend combining this formula with our Stress Ease for around the clock adrenal support." Bacopa showed the potential to modulate certain cell functions that allow the brain to be prepared to act under adverse conditions such as stress,15 and jatamansi demonstrated significant anti-stress activity, possibly due to its antioxidant activity.16

Soft Gel Technologies (SGTI) offers Posinol®, an extract from the leaves of Apocynum(Apocynum venetum L.) that contains 4 percent of the flavonoid glycosides isoquercitrin and hyperoside. “The leaves also have flavonols and other phenolic substances that possess antioxidant, anti-depressant and anti-anxiety activities," said Steve Holtby, president and CEO, SGTI. “Hyperoside is most efficacious in mental relaxation. It works with the brain’s neurotransmitters, including serotonin, norepinephrine and dopamine. Posinol differs from St. John’s wort in that it does not contain hyperforin, an active compound that interacts with the metabolism of certain pharmaceuticals. This patented extract is clinically evaluated for its positive effects on depression and anxiety, providing manufacturers with a scientifically researched compound for emotional wellness." An unpublished double blind, randomized, parallel group, pilot study sponsored by Soft Gel and Tokiwa Phytochemical Co. Ltd. found subjects with mild depression treated with Posinol experienced an overall reduction in HAM-D score by 47.3 percent. A lower HAM-D score means patients experienced fewer symptoms of depression. After eight weeks of treatment, 40 percent of the subjects in the Posinol group showed greater than a 10-point decrease in HAM-D scores, according to Holtby, who added the Posinol group also showed a trend toward a decrease in insomnia. The average mean insomnia score was reduced by 60 percent in the Posinol group, he said.

Kava (Piper methysticum) is also an often-used herbal solution to stress. “NOW® Kava Kava Extract is safety and ID tested to assure quality and helps people to relax, but does not act as a strong sedative," Levin said. “Kava has been used by people to stay calm before taking a test and may support mental focus and calmness."

Herbs that address these issues come from all over the globe, but Pac Herbs chooses to focus on Chinese herbal medicines in its iSleep Herb Pac. Cathy Margolin, L.Ac, Dipl. OM, Pac Herbs, said, “These herbs have been used for centuries, and there are many clinical studies proving the effectiveness of these herbal formulas. One study done in Taiwan in 2002 reviewed 16,000-plus cases of insomnia, and the Chinese herbs most commonly prescribed are the same herbs in our iSleep Herb Pac.17 Those experiencing a high degree of stress may also use iSleep during the day time to calm their over-active mind."

The herbs featured in the product include ophiopogon (Mai Men Dong; “used in this formula to nourish the yin, clear the heart and eliminate irritability"), poria (Fu Ling; “used for insomnia"), anemerrhena (Zhi Mu; “has properties of clearing excess fire and, at the same time, nourishing the yin"), arbortitae seed (yuan zhi; “excellent for insomnia due to blood deficiency along with excessive worry and forgetfulness"), light wheat germ (Fu xiao mai; “beneficial for those suffering from insomnia and irritability"), Polygoni multiflori(“along with insomnia, it’s also used in the treatment of emotional and mental confusion), spiny jujube (Suan Zao Ren; “used in Traditional Chinese Medicine [TCM] to treat irritability, insomnia, anxiety and palpitations") and ligusticum root (chuan xiong; “ability to regulate blood circulation"), according to Margolin.

From India, curcumin (Zingiberaceae), the principal curcuminoid of turmeric, is a member of the ginger family and may help those who can’t sleep because of pain. “One of our newest products, Curamin® PM, addresses the issue of pain and sleep, so it contains ingredients that reduce pain and help muscles—and mind–—relax," Myers said. The supplement includes the BCM-95® curcumin extract (from Dolcas Biotech LLC), BosPure® boswellia (also from Dolcas), DLPA (d,l–phenylalanine), the P-5-P (pyridoxal-5-phosphate) form of vitamin B6 and melatonin. “With this product, we’re really reaching out to those who have become too reliant on conventional over-the-counter (OTC) approaches and want to address pain that may interfere with a good night’s sleep."

A more easily recognized plant, at least to Western consumers, that aids sleep is the tart cherry (Prunus cerasus), according to a 2010 study. Drinking a glass of unsweetened cherry juice at bedtime was associated with statistically significant pre- to post-treatment reductions in insomnia severity (minutes awake after sleep onset).18

Hormonal Help

Cherries are rich in melatonin, a naturally occurring compound found in animals, plants, and microbes. In humans, circulating levels of the hormone vary throughout the day, allowing it to control circadian rhythms, e.g., the sleep/wake cycle. “The lack of a good night’s sleep can be related to a lack of melatonin; a natural hormone made from the amino acid L-tryptophan and its metabolite 5-HTP," Levin said. “Melatonin is formed from serotonin, a metabolite of 5-HTP that is made in the pineal gland during darkness. This means that falling asleep in a bright room or in front of the television may leave one less than fully engaged in sleep, and several stages of healthy brain waves allow true relaxation to occur. Melatonin is also an antagonist of the aforementioned stress hormone cortisol, and so adequate darkness/sleep/melatonin production is a key factor in controlling chronic stress and its negative effects on the body."

Of L-tryptophan and 5-HTP, Levin said, “These amino acids are precursors of the important neurotransmitter serotonin, as well as its metabolite melatonin."

Melatonin and all other hormones are a part of the endocrine system, which greatly affects how one sleeps and responds to stress. Certain hormones are known to play key roles, and they can be aided by natural substances. “There is a clear movement toward balance of the endocrine system, along with the recognition of general thyroid disturbance," Foster said. “It is now recognized that most people with chronic conditions have decreased levels of DHEA (5-dehydroepiandrosterone), and if they are much past 30 years of age, they suffer from a decrease in growth hormone. These issues need to be addressed actively." Foster explained vitamin C and methyl sulfonyl methane (MSM) are known to increase DHEA when taken together with an efficacy greater than taking DHEA orally.

Foster also noted the amino acid gamma aminobutyric acid (GABA) supports the production of growth hormone and the general function of the pituitary. Marci Clow, senior director of product research, Rainbow Light Nutritional Systems, further clarified: “In the central nervous system, GABA is the primary inhibitory neurotransmitter. It is synthesized in the brain by the decarboxylation of glutamate, and it reduces nerve impulse transmission between neurons. GABA exerts anticonvulsant, sedative and anxiolytic effects at the cellular level. In lay terms, GABA’s role is to inhibit over excitation in the brain and thereby control anxiety and stress, an area of significant interest and research." A 2006 Japanese study reported GABA could work effectively as a natural relaxant, and its effects could be seen within one hour of oral administration.19 Moreover, they found GABA administration enhanced immunity under stress conditions.

Jarrow’s GABA Soothe™ contains PharmaGABA™ (a GABA from Nutrition Formulators produced through natural fermentation of Lactobacillus hilgardii), Sensoril and theanine. “Theanine," described Dallas Clouatre, Ph.D., a Jarrow Formulas consultant, “is found in green tea, supports relaxation without drowsiness, and may improve learning by affecting brain dopamine and serotonin."

Added Clow, “It's thought that theanine might work for anxiety by increasing levels of GABA and serotonin, while under resting conditions.20 Behavioral animal studies suggest improvement in neuropharmacology as a possible neuroprotective and cognitive-enhancing agent, which warrants further research."21 One 2009 study reported taking supplements such as GABA, theanine, tryptophan and 5-HTP promoted relaxation.22 The researchers said they appear to act as GABA-receptor agonists or to boost GABA levels, and added 5-HTP may act through elevation of serotonin.

Help from the Periodic Table

Stress reduction is not only the game of plants. Minerals such as magnesium, calcium and zinc also play roles. “Magnesium is critical when it comes to stress," said Ken Whitman, president, Peter Gillham’s Natural Vitality. “It comes down to the action of two key minerals on a cellular level—calcium and magnesium. These important minerals need to be balanced. Calcium and magnesium are two different sides of a coin. Calcium excites nerves, while magnesium calms them down. Calcium makes muscles contract. Magnesium is necessary for muscles to relax. The problem arises with an imbalance of these two minerals. Too much calcium and not enough magnesium will result in stress and sleep disturbances. In America, we take three to five times the calcium we need and only half or less than half the amount of magnesium required." He added magnesium should be taken in supplement form every day.

Research has found optimal, rather than high or low, magnesium levels are needed for normal sleep regulation,23 and low levels of the mineral are associated with inflammatory stress in adults with poor quality sleep, as well as oxidative stress.24 Magnesium mixed with melatonin and zinc improved the quality of sleep and the quality of life in long-term care facility residents with primary insomnia in a 2010 study,25 and combined with alpha-tocopherol, magnesium reduced oxidative stress.26

Milky Stress Management

While calcium is associated with both increased stress and milk, a patented milk-protein hydrolysate (Lactium®, from Pharmachem Labs) has been shown to prevent sleep disturbance, help maintain slow wave sleep duration and increase paradoxical sleep (PS) duration in treated rats.27 It also decreased anxiety in rats.28 Lactium significantly improved the Pittsburgh Sleep Quality Index (PSQI) score, particularly improving sleep quality and decreasing sleep latency and daytime dysfunction in a Japanese trial involving 32 subjects.29

Mitch Skop, senior director of new product development, Pharmachem, added a 30-day double blind, crossover study conducted on 63 women with at least one stress symptom revealed those who took Lactium had a significantly greater reduction in stress symptoms versus placebo in the following areas: digestive, intellectual, social, cardiovascular and emotional. He also noted a second study was conducted on 44 healthy men and women with difficulty sleeping where subjects took Lactium for four weeks. Results showed Lactium improved sleep duration and efficiency, especially in subjects with a moderate anxiety or depression profile. Lactium was also shown to reduce daytime sleepiness. Thirdly, he said, an in vivo study demonstrated Lactium’s ability to reduce cortisol levels.

Stress-Free Packages

Lactium is currently available as a supplement, which Dolnick said is standard delivery for sleep and stress products because supplements are easy to take. Clouartre added most stress-taming and sleep products require only a small amount, making capsules and tablets good options.

Still, more shoppers are looking to beverages (think relaxing tea) and liquid shots for their fast-acting abilities. “We believe that the most popular delivery form remains pills (capsules and tablets) with functional beverages addressed at reducing stress and inducing relaxation a very close second and growing in popularity," Kohli said.

Margolin said iSleep comes in granules that dissolve directly in the mouth. “Many people report having indigestion after ingesting a handful of pills," she said. “iSleep Herb Pac eliminates that concern, and one packet is the equivalent of approximately 25 capsules of most other herbal products, because our herbs are cooked in highly concentrated batches."

Water-soluble powders are the best delivery method, according to Whitman, because of their high bioavailability.

Whatever delivery form gets shoppers to take these stress relievers, it’s up to retailers to help educate shoppers on the importance of sleep and stress reduction. With catchy store displays and offering a wide variety of science-backed botanicals, minerals and specially ingredients in multiple forms, retailers can help quiet busy minds for sleep and stress management.
07-10-2012 12:29 PM
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