Is Your Child Sleepy?

Sleep is essential for the healthy functioning of the immune, hormonal and cardiovascular systems, as well as regulating appetite, metabolic processes and brain function. However, all too often children often present with sleep issues, whether they are having difficulty falling or staying asleep, waking unrefreshed, experiencing circadian disruption exacerbated by excess screen time, or struggling to relax due to restless legs, muscle tension or cramps.  

Short-term sleep disruption has been linked with impaired glucose metabolism, elevated cortisol levels, increased hypothalamic-pituitary-adrenal (HPA) axis activation, cognitive impairments and mood issues including anxiety and depression. When poor sleep becomes a chronic issue, it is associated with metabolic abnormalities such as obesity, diabetes and cardiovascular disease, as well as the increased incidence of some cancers.

Therefore, it is crucial to support optimal sleep to enhance patients’ vitality and daytime functioning and promote long-term health. 

The Rhythm of the Night…and Day

Circadian rhythms are internal 24 hour cycles influenced by factors such as light-dark cues, feeding-fasting and activity-rest, with the sleep-wake cycle being the most well-known circadian rhythm. Central in this cycle is the body’s master clock, the suprachiasmatic nucleus, which is located in the hypothalamus and receives input from the optic nerves to control the production of sleep-promoting melatonin. The circadian rhythm is an orchestrated balance of melatonin (suppressed in response to light) and cortisol (released in response to light), to both allow sleep onset and enable the individual to wake easily to face the day ahead. Serum cortisol levels are normally highest in the morning on awakening and naturally decline throughout the afternoon, reaching their lowest point around 11 pm. However, individuals are increasingly eating and working at hours that are at odds with their biological clock, leading to circadian misalignment and disruptions. Sleep disturbance has been linked with elevated evening cortisol, while exposure to light at night suppresses melatonin production,exacerbating sleep issues and contributing to patients’ difficulty falling and staying asleep, in addition to reducing overall sleep quality.

Blue Light, Sleepless Night

In today’s fast-paced world, there is perpetual brightness and technology use is omnipresent, spending time on screens and watching television directly before bed. Electronic devices such as smartphones, tablets, computers and televisions all emit a large amount of short-wavelength blue light, which appears to be a particularly strong inhibitor of melatonin secretion at night, contributing to circadian disruption and compromising sleep quality by increasing sleep latency. Moreover, blue light exposure has been linked with increased reactive oxygen species (ROS) production in the cornea, leading to ocular inflammation and decreased stability of the tear film, with symptoms such as eye strain, visual fatigue and dry eyes, further impacting patients’ quality of life.

Slowly Does It – The Importance of Slow Wave Sleep

Adequate sleep goes beyond sleep length, the quality of sleep is also paramount. Sleep has generally been divided into four stages; rapid eye movement (REM) sleep and three sub-stages of non-rapid eye movement (NREM) sleep, which alternate throughout the night in roughly 90 minute cycles.21,22 Slow wave sleep (SWS), the deepest stage of NREM sleep, is characterised by delta waves23 and is essential for memory consolidation and neuronal plasticity,24 as well as glucose metabolism.25 Sleep also cleanses the brain, clearing potentially harmful substances and inflammatory by-products including beta-amyloid protein via the glymphatic system.26 Clinically, patients who report waking unrefreshed may have disruptions to these essential NREM cycles, particularly SWS.27

Let’s Not Forget Stress

The negative effects of both acute and chronic stress on sleep quality are well established. Acute stress is associated with HPA axis activation, culminating in the release of catecholamines and corticosteroids and increased urinary excretion of magnesium, while chronic sleep deprivation is associated with decreased magnesium levels.28 Magnesium deficiency is additionally linked with muscular cramps and spasms and restless legs,29 exacerbating poor sleep. 

Moving Beyond Sedation: Supporting Sleep Quality with Nutrients and Herbs

While traditional approaches to sleep support have emphasised sedation, it is essential to look to a more holistic approach that also addresses other contributors to poor sleep. Magnesium with Lutein and Zeaxanthin for Sleep Pattern Support provides nutrients and herbs to support a healthy circadian rhythm, enhance NREM and SWS sleep and address stress and HPA hyperarousal, helping patients to fall asleep easily, stay asleep longer and wake feeling refreshed.

Magnesium is a gamma-aminobutyric acid (GABA) agonist.30 GABA is important in sleep, beyond its sedative/calming effect, with GABAergic cells of the reticular thalamic nucleus involved in the production of sleep spindles during NREM sleep and the induction of delta waves in SWS.31In addition, magnesium enhances muscle relaxation and relieves spasm,32 helping to relax the body for sleep. In a study of 43 older individuals, 500 mg of magnesium per day over eight weeks was found to significantly increase serum melatonin levels and lower cortisol, while increasing sleep time and decreasing sleep latency,33 cementing magnesium’s essential role in sleep support.

Lutein and Zeaxanthin are dietary carotenoids that are deposited in the retina to form macular pigment (MP), a powerful antioxidant that protects photoreceptors from ROS.34,35 These carotenoids act as a blue light filter, absorbing the short-wave blue light emitted from electronic devices.36 Six months supplementation with lutein and zeaxanthin isomers was associated with significantly improved MP optical density and decreased frequency of eye strain and eye fatigue,37,38 as well as reduced incidence of sleep disturbance.39 In this way, endogenous melatonin production may be optimised, reducing the time taken to fall asleep and helping to maintain a restful night’s sleep, even in those patients exposed to excess screen time.

Withania somnifera (ashwagandha) has traditionally been used to induce sleep in Ayurvedic traditions40 and contemporary research supports this application. A standardised extract of ashwagandha root and leaf was found to reduce serum cortisol, anxiety scores and measures of inflammation in a double-blind, randomised, placebo-controlled study.41 Ashwagandha may also be beneficial in supporting essential NREM sleep, with a water-based extract decreasing NREM sleep onset latency and increasing the total amount of NREM sleep over 12 hours in mice.42GABAergic effects may be part of ashwagandha’s success in supporting sleep,43 calming an overactive stress response to enable patients to fall asleep promptly and enjoy revitalising sleep.

Ornithine is a non-essential amino acid that is usually only present in small amounts in food44 and may alter the circadian rhythm. For example, 400 mg of L-ornithine per day has been found to significantly reduce serum cortisol the morning after consumption,45 as well as increase perceived sleep quality and improve initiation and maintenance of sleep after eight weeks of supplementation.46 In a mouse model, ornithine was associated with reduced NREM sleep onset latency and increased NREM sleep for two hours following administration.47 This highlights ornithine’s utility in supporting patients to fall asleep faster and to improve quality NREM sleep, essential for glympathic clearance and brain health.

Becoming a Sleep Superhero

As stress and technology use is pervasive in modern life, it is essential to move beyond sedation to address circadian disruptions and support healthy sleep cycles. Magnesium with Lutein and Zeaxanthin for Sleep Pattern Support is perfectly placed to support those patients with circadian rhythm disruption, poor sleep hygiene and excess screen time, or those who benefit from magnesium at night to support restless legs and cramps. In patients with sleep difficulties due to overthinking and worry, California Poppy and Passion Flower for Sleep may be prescribed concurrently, for its GABAergic and anxiolytic actions. Together with sleep hygiene and lifestyle changes, Magnesium with Lutein and Zeaxanthin for Sleep Pattern Support will assist patients to achieve deeply restful, restorative and refreshing sleep, for optimal health.

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