Sleep clinicians frequently ask patients to complete sleep diaries, but you might also consider requesting food diaries, as improving nutrition may help resolve—and certainly won’t hurt—sleep disorders.
Lauren Broch, PhD, boarded in behavioral sleep medicine and with a masters in human nutrition, is in private practice in New York; she attributes some of the significant decreases in her patients’ sleep disorder severity to dietary changes. “The digestive system really drives everything. It is integral in making the energy to keep our bodies going,” she told me over the phone.
Broch recalled a patient who upon entering menopause began experiencing hot flashes and sleeplessness. The woman had tried to resolve the insomnia via changing her bed times and had also tried hormone replacement therapy, but had not considered her nutrition. “I worked with her on changing her diet, which consisted of adding breakfast back in, curtailing snacking in the late afternoon and evening, increasing protein and fat intake earlier in the day, and educating her about the benefits of whole, natural foods,” Broch said, adding that she also recommended several natural botanicals. Over the 5 years Broch treated the patient, the woman “did very well. She lost 20 pounds and her hot flashes were infrequent. And I believe she was better able to utilize CBT-I techniques for middle of the night wake ups, after working on her digestive and hormonal imbalances.” Ultimately, the woman even had the energy to earn a second college degree.
Broch believes adequate nutrition should be part of every patient’s plan, but I also asked her to specifically address some of the sleep disorders that professionals most commonly see. Insomnia, she said, is an obvious one, saying “poor nutrition, digestive issues, and stress have been shown to affect cortisol, blood sugar, and other nighttime biorhythms that in turn can impact sleep maintenance.” With sleep apnea, she noted that weight loss helps with disorder management. She noted an abundance of studies looking at drugs to treat restless legs syndrome, including oral iron, but is not aware of well-controlled studies manipulating diet, particularly in populations suffering from malabsorption disorders. Similarly, diet is often overlooked in treating narcolepsy, though I noted information is available on specific diets that have shown anecdotal improvements in symptoms. (Read “Food as Therapy for Narcolepsy Patients” at www.sleepreviewmag.com/food-therapy-narcolepsy-patients.)
Start by asking your patients simple questions such as: Are you eating 3 meals a day? Are you eating protein early in the day? Are you drinking enough water? Are your mealtimes regular or do they vary on weekends? How much junk food are you eating? Use your basic knowledge of healthy nutrition to remedy any obvious bad habits gleaned from such a diet questionnaire or food diary. For more detailed information, Broch recommends several resources such as The Institute for Functional Medicine (see sidebar).
Broch also recommends all patients take a multivitamin and fish oil, get at least 20 minutes of sunlight a day (or take Vitamin D, if sun exposure is inadequate), and pay attention to their bodies’ reactions after digesting food or drinks that may be the source of sensitivities.
Improving a patient’s nutrition has the potential to improve outcomes, for their sleep and quality of life.
Nutrition Resources Recommended by Lauren Broch, PhD
- The Institute for Functional Medicine
- Eating Healthy with Walter Willett
- Harvard Healthy Eating Plate
Sree Roy is editor of Sleep Review. Email sroy[at]medqor.com.