Bottom Line Inc

Why Am I Sleepless at Night and Tired in the Afternoon?

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The patient: Rebecca, a part-time real estate broker and a full-time mom of two grade schoolers in her mid-30’s.

Why she came to see me: Being able to fall asleep easily and stay asleep through the night and keeping up with the kids after school was becoming progressively harder. Rebecca’s husband suggested meditation tapes, learning yoga and getting more exercise. She tried them all but nothing helped enough. She still felt sleepless at night and tired in the afternoon. She then tried her primary care doctor, who prescribed sleeping pills at night and stimulants during the day, but Rebecca was troubled by the side effects and long-term consequences of feeling foggy and confused. She also found that her cholesterol levels were rising and her normal cheery mood was suffering.

How I evaluated her: We met for almost an hour and reviewed her medical reports and laboratory findings. Not only were total and LDL (“bad”) cholesterol levels rising with her sleep, energy and mood issues, but Rebecca’s triglycerides were rising as well. Additionally, C-reactive protein (CRP), a marker of inflammation was creeping up too. In analyzing her diet and lack of any nutritional supplementation, I noticed the association between a stressful life, demanding work, poor sleep and inadequate nutritional support. And then…a relatively simple solution emerged.

How we addressed his problem: The simple solution for her sleep disturbances, mood challenges and blood lipid challenges was supplemental multiple B vitamins and chromium. Research has shown that chromium dietary supplements for those with a deficiency help prevent metabolic syndrome (a common precursor to diabetes), stabilize blood lipids, improve mood and temperament—and in Rebecca’s case, help her get to sleep and sleep longer and more deeply. And better sleep promotes more energy during the day. The most common form of this trace mineral, a patented salt called chromium picolinate, was not my first prescriptive choice. I chose a chromium polynicotinate, a B-vitamin salt form that I find to be clinically preferable. A good multi-B vitamin, taken twice daily, is often a prerequisite for chromium to do its job as a regulator.

Rebecca’s eating habits were also contributing to her problems because she was snacking frequently, often eating sweets and not sitting down to regular meals with her family. As this pattern had been in place for quite a while, I was confident that we needed to do more than just remedy her diet. Besides the obvious advice about “3 square” meals a day, chewing thoroughly and drinking minimally at mealtime, I mandated a big salad with some high-quality protein at lunch every day and fresh fruit for a mid-afternoon snack.

The patient’s progress: Three days after Rebecca started on the regime, she e-mailed to report much deeper sleep, waking only briefly for a bathroom trip around 4 AM and being able to fall asleep quickly. She wondered if her brightening mood was just due to her improved sleep or would there be continued gains over time. I encouraged her to stick with the whole program and indeed her children told her that they were having more fun with their mom. She told me a few months later that she closed a big real estate deal and that made her whole family happy.

We continue to meet about once a month to address her “real time” needs for adjusting her diet and supplementation because as she felt better, she wanted to do more. When we did blood work six months after we started the regime, her blood lipids and CRP had improved so much that her primary-care doctor wanted to know what she was doing so that he could do the same. He’s now a patient of mine as well!

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