A big welcome to the September 2024 edition of CMG Topic Series, where we look at the critical issue of sleep. Good sleep is essential for maintaining optimal health. With many people reporting poor sleep, there is a growing need for ways in which to improve sleep.
Sleep
By Dr Brad McEwen PhD, MHSc (Hum Nutr), MPH, BHSc
CMG Head of Products and Innovation
Good sleep is essential for maintaining optimal health and wellbeing. Sleep is a biological necessity. Healthy sleep is important for physiological functions, such as cognitive functioning, learning and memory, mood, mental health, and cardiovascular, cerebrovascular, and metabolic health.
Sleep plays a significant and vital role in modulatory neuroendocrine function and regulating glucose metabolism. The current recommendations for sleep duration suggest that adults should aim for a sleep duration of 7 to 9 hours, while older adults are recommended to obtain between 7 to 8 hours of sleep each night.
The effects of short-term sleep deprivation, prolonged sleep restriction, circadian misalignment, and untreated sleep disorders can significantly harm physical health, mental wellbeing, emotional stability, and public safety.
Persistent and chronic lack of adequate sleep has been linked to a heightened risk of mortality.
Sleep disturbances, including insomnia, often coexist with mental health and mood, particularly depression and anxiety.
A lack of sleep has been associated with:
- Impaired cognition
- Reduced attention and concentration
- Impaired memory
- Impaired executive control tasks
- Impaired neurobehavioural performance
- Diminished motivation
- Irritability
- Lower mood
- Depression
- Stress
Additionally, a lack of sleep has been associated with:
- Increased risk of mortality, type 2 diabetes, cardiovascular disease, coronary heart disease, and cardiometabolic syndrome
- Decreased insulin sensitivity
- Altered glucose homeostasis
- Impaired glucose tolerance
- Hypertension
There is a relationship between stress and sleep. The activation of the stress response system leads to the onset of insomnia. When insomnia becomes chronic and severe, it transforms into a significant stressor. Insomnia is characterised as a varied condition, manifesting as difficulties with initiating sleep, sustaining sleep, and experiencing early morning awakenings. Commonly reported sleep issues include a reduction in sleep duration, longer time to get to sleep, as well as a decline in sleep quality, depth, and overall efficiency.
A variety of herbal medicines and nutrients contribute to the enhancement of sleep through both direct and indirect mechanisms. The following examples illustrate various herbal medicines and nutrients that can be incorporated into your products. Contact CMG to discuss NPD opportunities for sleep and other products.
“Enhancing sleep quality can be achieved through a holistic and integrated approach that addresses the individual as a whole, utilising herbal and nutritional medicines via their mechanisms of action to target the underlying causes, such as stress. This can be achieved through optimised product formulation.”
Dr Brad McEwen PhD
Ashwagandha
Ashwagandha (Withania somnifera) is a popular herb of use. It is used for its nootropic effects, for improving memory, cognition, concentration, attention, and mood. Ashwagandha is an adaptogen, helping the body adapt to stress. It also reduces stress, anxiety, and depression, and improves sleep. Ashwagandha has tonic, anti-inflammatory, antioxidant, immunomodulatory, and neuroprotective properties. Research has shown that Ashwagandha can improve cardiorespiratory fitness, fatigue, and recovery.
A prospective, randomised, double-blind, placebo-controlled study was conducted to investigate the effect of Ashwagandha on sleep. After 12 weeks, participants had a significant increase in the quality of sleep, quality of life, and mental alertness on rising from sleep.
A randomised, double-blind, placebo-controlled study was conducted to investigate of Ashwagandha on sleep and anxiety. After 5 weeks and 10 weeks, Ashwagandha improved sleep quality. After 10 weeks, there was improvement in anxiety, sleep efficiency, total sleep time, mental alertness on rising, along with reduced sleep onset latency and waking after sleep onset.
Lemon Balm
Lemon Balm (Melissa officinalis) is a multipurpose versatile herb recognised for its various applications in cognitive and mental health. It is known to enhance memory, cognitive function and performance, mood, and improves stress and anxiety. Furthermore, Lemon Balm exhibits antispasmodic effects, along with beneficial properties for digestion and has carminative properties.
An open-label study found that after 15 days, Lemon Balm reduced insomnia, time taken to get to sleep, delayed insomnia (e.g. early awakening at dawn), anxiety, agitation, tension, and feelings of guilt, along with an improvement of fatigue.
Passionflower
Passionflower (Passiflora incarnata) exhibits a variety of pharmacological effects, such as sedative, anxiolytic, analgesic, and antispasmodic activities. Passionflower is utilised for multiple therapeutic purposes, including the alleviation of insomnia, anxiety, depression, stress, nervousness, and irritability. Passionflower has calming effects and reduces the time to fall asleep and increases the duration of sleep.
A randomised, double-blind, placebo-controlled clinical trial investigated the effect of Passionflower in people with stress and sleep problems. After 30 days, Passionflower improved total sleep time and reduced stress in participants with sleep problems and stress. The number of awakenings was found significantly lower in the Passionflower group on day 30 compared to the placebo group.
Relora®
Relora® is a proprietary blend of two botanical extracts, namely Magnolia officinalis and Phellodendron amurense. This blend is standardised to contain honokiol (found in Magnolia sp.) and berberine (found in Phellodendron sp.).
A randomised, parallel, placebo controlled clinical study investigated the effects of Relora® on anxiety, stress and sleep in healthy premenopausal women. After 6 weeks, Relora® significantly reduced anxiety compared to placebo, as determined by the Speilberger STATE anxiety questionnaire. This questionnaire measures temporary, transitory anxiety that includes feelings of apprehension, tension, nervousness and worry that increase in response to physical danger and psychological stress.
A randomised placebo-controlled, double-blind trial investigated the effect of Relora® on salivary cortisol exposure and psychological mood state. After 4 weeks, daily use of Relora® reduced cortisol exposure and perceived daily stress, depression, anger, and confusion, while improving fatigue and vigour.
Active Folate
Active Folate (5-MTHF) is emphasised in this discussion due to its multiple functions within the human body, where it may play an indirect role in improving issues related to sleep. Active Folate (5-MTHF) is essential for normal healthy growth and development and plays a critical role in cell growth and division. Active Folate participates in one-carbon metabolism, methylation processes, neurotransmitter synthesis, metabolism of homocysteine, and endothelial cell function.
The classical symptom of folate deficiency is megaloblastic anaemia. A deficiency of folate disrupts DNA synthesis and methylation and results in reduced DNA synthesis and altered cell division, altered synthesis of purines and pyrimidines, peripheral neuropathy, anaemia, cardiovascular diseases, hyperhomocysteinaemia, depression,6 and cognitive dysfunction and decline.
Vitamin K2
Vitamin K2 (Menaquinone-7) plays a significant role in various aspects of health, including brain health, brain signalling, coagulation, vascular health, and bone health. Vitamin K2 has anti-inflammatory and antioxidant properties. Vitamin K2 has shown beneficial effects in reducing arterial stiffness and vascular calcification, as well as improving microcalcification.
Menaquinone-7 has numerous clinical applications, some of these include osteoporosis, rheumatoid arthritis, arterial stiffness, coronary and vascular calcification, type 2 diabetes, and depression in women with polycystic ovary syndrome.
Magnesium
Magnesium ranks among the most widely recognised and favoured minerals, playing a crucial role in more than 300 enzymatic reactions. Magnesium is involved in the synthesis of ATP, DNA, and RNA, mitochondrial health, metabolic functions, energy metabolism, metabolism of carbohydrates, protein and fats, glycolysis, and oxidative phosphorylation. Magnesium is involved in nerve function, neurotransmission, neurotransmitters, nitric oxide metabolism, regulation of intracellular calcium levels, and transmembrane electrolyte flux.
In the musculoskeletal and nervous systems, magnesium is involved in the relaxation of smooth muscle, normal muscle function, muscle contraction, muscle relaxation, bone strength, bone metabolism, bone mineralisation, bone mineral density, and bone integrity. Magnesium is involved in the maintenance of normal muscle and nerve function, heart rhythm, and the immune system.
A deficiency of magnesium has been associated with depression, fatigue, anxiety, apathy, agitation, irritability, nervousness, and muscle spasms.
A longitudinal study followed a cohort of people from 1985. Participants self-reported sleep outcomes at years 15 and 20. People with a higher intake of magnesium were found to have better sleep quality and were likely to have the recommended sleep duration of 7-9 hours.
Zinc
Zinc is highlighted in this context because of its various roles within the human body, where it may indirectly contribute to alleviating sleep-related problems. This essential mineral is a constituent of approximately 300 enzymes and plays a critical role in the synthesis of DNA and RNA, regulation of gene expression, maintenance of cell structure, facilitation of neurotransmission, support of brain function. It is involved in the enhancement of immune system health, promotion of cardiovascular wellbeing, and exhibits both antioxidant and anti-inflammatory effects.
Conclusion
Good sleep is essential for maintaining optimal health and wellbeing. Healthy sleep is important for cognitive functioning, mood, mental health, and cardiovascular, cerebrovascular, and metabolic health. A variety of herbal medicines and nutrients facilitate the improvement of sleep through both direct and indirect mechanisms. Notable examples of these include Ashwagandha, Lemon Balm, Passionflower, Relora®, Active Folate, Vitamin K2, Magnesium, and Zinc. Contact CMG to discuss NPD opportunities.
References
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For information purposes only. Not a substitute for medical advice. If symptoms persist, talk to a health professional.