Sleep Soundly: Safe, Natural Insomnia Solution

by Carole Jackson, Bottom Line Health

A good night’s sleep… there’s nothing more restorative — or elusive… for the 64% of Americans who report regularly having trouble sleeping. A disconcertingly high percentage of the sleepless (nearly 20%) solve the problem by taking sleeping pills, but you can guess how I feel about that! Not only do we know that sleeping pills are dangerous and potentially addictive, physically and/or emotionally — but swallowing a pill when you want to go to sleep doesn’t address the root cause of the problem. What, exactly, is keeping you up at night?

I have always felt strongly about this — and now even more so, since I had a conversation with Rubin Naiman, PhD, a psychologist and clinical assistant professor of medicine at the University of Arizona’s Center for Integrative Medicine, who called it “somewhat violent” that we expect to be able to climb into bed and fall immediately asleep… slumber soundly all night… and then rise and shine, on demand, at the buzz of the morning alarm! We discussed how to set more “natural” expectations, which can help bring about the “gentle experience” that he believes sleep is meant to be.

Slow Down…

According to Dr. Naiman, most of our sleep problems have to do not with our bodies, per se, but with our habits. The modern American lifestyle — replete with highly refined foods and caffeine-laden beverages, excessive exposure to artificial light in the evening, and “adrenaline-producing” nighttime activities, such as working until bedtime, watching TV or surfing the Web — leaves us overstimulated in the evening just when our bodies are designed to slow down… and, importantly, to literally cool down as well.

Studies show that a cooler core body temperature — and warmer hands and feet — make you sleepy. “Cooling the body allows the mind and the heart to get quiet,” said Dr. Naiman. He believes that this cooling process contributes to the release of melatonin, the hormone that helps to regulate the body’s circadian rhythm of sleeping and waking.

Deep Green Sleep

Dr. Naiman has developed an integrative approach to sleep that defines healthy sleep as an interaction between a person and his/her sleep environment. He calls this approach Deep Green Sleep. “My goal was to explore all of the subtleties in a person’s life that may be disrupting sleep,” he told me. “This takes into account your physiology, emotions, personal experiences, sleeping and waking patterns and your attitudes about sleep and the sleeping environment.” This approach is unique because it values “the subjective and personal experience of sleep,” he said — in contrast with conventional sleep treatment, which tends to rely on “computer printouts of sleep studies — otherwise known as ‘treating the chart.'”

It’s important to realize that lifestyle habits and attitudes are hard to change, so Dr. Naiman cautioned that it often can take weeks, even months, to achieve his Deep Green Sleep. The good news is that the results are lasting and may even enhance your waking life.

Here are his suggestions on how you can ease into the night…

Live a Healthful Waking Life

“The secret of a good night’s sleep is a good day’s waking,” said Dr. Naiman. This includes getting regular exercise (but not within three hours of bedtime) and eating a balanced, nutritious diet.

Cool Down in the Evening

It’s important to help your mind and body cool down, starting several hours before bedtime, by doing the following…

  • Avoid foods and drinks that sharply spike energy, such as highly refined carbohydrates and anything with caffeine, at least eight hours before bedtime.
  • Limit alcohol in the evening — it interferes with sleep by suppressing melatonin. It also interferes with dreaming and disrupts circadian rhythms.
  • Avoid nighttime screen-based activities within an hour of bedtime. You may think that watching TV or surfing the Web are relaxing things to do, but in reality these activities are highly stimulating. They engage your brain and expose you to relatively bright light with a strong blue wavelength that “mimics daylight and suppresses melatonin,” said Dr. Naiman.

Create a Sound Sleeping Environment

It is also important that where you sleep be stimulation-free and conducive to rest.

In your bedroom:

  • Be sure that you have a comfortable mattress, pillow and bedding. It’s amazing how many people fail to address this basic need — often because their mattress has become worn out slowly, over time, and they haven’t noticed.
  • Remove anything unessential from your bedside table that may tempt you to stay awake, such as the TV remove control or stimulating books.
  • When you are ready to call it a night, turn everything off — radio, TV and, of course, the light.
  • Keep the room cool (68°F or lower).

Let Go of Waking

Each day, allow your mind and body to surrender to sleep by engaging in quieting and relaxing activities starting about an hour before bedtime, such as:

  • Gentle yoga
  • Meditation
  • Rhythmic breathing
  • Reading poetry or other nonstimulating material
  • Journaling
  • Taking a hot bath

Sex seems to help most people relax and can facilitate sleep, in part because climaxing triggers a powerful relaxation response, Dr. Naiman said.

Consider Supplementing with Melatonin

If sleep is still elusive after trying these Deep Green Sleep tips, Dr. Naiman often suggests a melatonin supplement. Dr. Naiman believes that this is better than sleeping pills since melatonin is “the body’s own natural chemical messenger of night.” “Melatonin does not directly cause sleep, but triggers a cascade of events that result in natural sleep and dreams,” he said, adding that it is nonaddictive, inexpensive and generally safe. Not all doctors agree however, so it is important to check with your doctor first.

If you’re interested in learning more about Dr. Naiman’s Deep Green Sleep program, you can visit his Web site ( and take a free quiz that helps identify your particular sleep challenges. But, since it is computer-based, make sure you do it several hours before bedtime!


Rubin Naiman, PhD, is a psychologist specializing in sleep and dream medicine and clinical assistant professor of medicine at the University of Arizona’s Center for Integrative Medicine. He is founder and director of Circadian Health Associates, an organization that offers a broad range of sleep-related services, training and consultation. Dr. Naiman is author of the book Healing Night (Syren) and is coauthor with Dr. Andrew Weil, of the audiobook Healthy Sleep (Sounds True).

How Bad Will Your Arthritis Get?

by Carole Jackson, Bottom Line Health

It’s not exactly a crystal ball, but doctors have a new way to predict the future health of your knees — research shows that patients who have both osteoarthritis of the knee and bone cysts are headed for severe arthritis. But don’t get discouraged — if you’re not there yet, you still have time to change the outcome.

To understand what this means to arthritis sufferers, I turned to Patience White, MD, chief public health officer at the National Arthritis Foundation, pediatric rheumatologist and a professor of medicine and pediatrics in the department of medicine at George Washington University. She told me that bone cysts (abnormal pockets of synovial fluid, which is the liquid that normally lubricates joints) are present in about half of patients with osteoarthritis of the knee — most particularly if it is advanced. She said the relationship between the two is a chicken and egg dilemma — it’s unclear whether people have bone cysts because of their severe arthritis or it’s the other way around, that the arthritis is made more severe by the bone cysts.

To learn more about this relationship, researchers at Monash University in Melbourne, Australia, recruited and examined 109 people with knee osteoarthritis. About half of these people also had bone cysts. The group was then reexamined two years later, and researchers found that…

  • Patients whose previous MRI showed both bone cysts and arthritis at the start of the study experienced an average 9.3% loss of cartilage.
  • Those who’d had arthritis and bone marrow lesions — less serious abnormalities that may or may not lead to bone cysts — had a 6.3% cartilage loss.
  • Individuals with arthritis only — no cysts or bone lesions — experienced only a 2.6% cartilage loss.

With increasing bone abnormalities (i.e., lesions and cysts), the likelihood that a patient would require knee replacement also rose significantly. This research was reported in the March 2010 issue of Arthritis Research & Therapy.

Fight Arthritis Aggressively!

Dr. White told me that there’s more to be learned from a larger osteoarthritis study going on now at the National Institutes of Health. In the meantime, she said there’s not much you can do to treat bone cysts (they’re removed surgically only in rare cases where they present specific difficulties), but their presence should be viewed as a call to action. To that end, Dr. White urges anyone with knee osteoarthritis to…

  • Stay active — movement is the best medicine, Dr. White said. Physical activities such as swimming, walking, stretching and range-of-motion exercises keep your joints flexible and improve muscle strength, which helps take the strain off joints. If you are not sure about the right exercises for people with arthritis, check with your doctor and go to and look for the AF Life Improvement Series that offers programs and DVDs on how to exercise.
  • Shed pounds if you are overweight. The heavier you are, the more damage is done to weight-bearing joints like the knees — but the good news is, every pound lost reduces the load on each knee when you stand or walk by four pounds. That’s a big result from just a bit of weight loss!


Patience White, MD, vice president of public health, National Arthritis Foundation, pediatric rheumatologist and professor of medicine and pediatrics, department of medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.

The Many Faces of Epsom Salts — More Than Old Fashioned Medicine

by Carole Jackson, Bottom Line Health

Old-fashioned Epsom salts — the stuff Grandma used as a soak for her aching feet — is undergoing a very modern makeover… to the point where the “Epsom Salt Council” has its own Facebook page and Twitter feed! I’m all for spreading the word — magnesium sulfate (the scientific name for Epsom salts) is indeed a great go-to solution for a wide swath of modern-day maladies, including stress, joint problems, inflammation and even cardiovascular disease. It’s important to know, however, that some Epsom salts enthusiasm is misplaced, according to Daily Health News medical editor Andrew L. Rubman, ND. Although he is a proponent of Epsom salts for many purposes, he warns that some suggestions now floating around the Internet are not only off base, they’re dangerous.

First — Epsom Benefits

The two most popular longtime uses of Epsom salts are in the bath and to soak the feet. These are great ways to allow the body to absorb magnesium, a mineral that has many health virtues, including easing stress, improving mental focus and sleep, boosting muscle and nerve function, regulating enzyme activity, supporting circulation, increasing oxygen flow and more.

Bath: Soaking in Epsom salts is a superb way to facilitate absorption through the skin, which raises magnesium levels throughout the body, said Dr. Rubman. He recommends a pre-bedtime bath with Epsom salts as being “great for relaxation.” This is a far better way to get your magnesium than taking supplements, he said, since it avoids nasty potential side effects, including loose bowels or diarrhea. Dr. Rubman’s bath recommendation: Add several cups of Epsom salts to your running bath, allowing them to dissolve. Note: If you are being treated for a chronic disease and are on multiple medications — or are pregnant — check with your doctor first.

Foot soak: Your feet will benefit along with the rest of your body from the aforementioned bath — but if (as Grandma used to say) your “dogs are really barking,” Dr. Rubman has a recipe that will help immensely. For a super-saturated foot soak: Boil the water first, using a large pot, and then add several spoonfuls of Epsom salts until they dissolve… reheat the water until it boils again… add more salts… continue repeating until the salts no longer dissolve completely. When the solution has cooled down to “hot bath temperature” (around 104°F), carefully remove the pot from the stove and take it to the bathroom, setting it on the floor by the side of the bathtub. Soak your feet for seven to eight minutes, then douse your feet under cold running water from the faucet for a minute. People suffering from athlete’s foot or calluses (or other uncomfortable conditions) might want to repeat this two or three times a day. (It’s okay to reuse the solution, Dr. Rubman said.) If you have diabetic ulcers, poor circulation or a compromised immune system, check with your doctor first.

Toenail fungus: If you’ve got stubborn toenail fungus, Epsom salts are an easier solution than expensive laser therapy or medications with nasty side effects. Try this: First, make sure the affected nail is short. File across its surface before soaking, which enables the salts to easily reach the fungus. Add several tablespoons of Epsom salts to a shallow pan with hot water. Soak for 15 to 20 minutes two or three times a day. Dr. Rubman says this will help even more if you first add a few drops each of tea tree oil and oregano oil. Since toenail fungus is a tough adversary, be prepared for healing to take many months, and don’t be alarmed if your nail looks worse (“gnarly” as Dr. Rubman puts it) during the healing process.

Skin problems: Epsom salts can soothe skin eruptions such as poison ivy, allergic hives and sunburn. What to do: Depending on the severity of symptoms, you can either take an Epsom salts bath or, for more intense problems, soak a clean cloth in hot water that you have super-saturated with Epsom salts (as described above), and place it on the affected area for about 10 minutes several times a day. For even better results, Dr. Rubman suggests following the hot compress with an ice pack for one minute. For persistent skin problems, check with your dermatologist to make sure a different sort of treatment isn’t warranted.

Now… the Cautionary Note

The Epsom salts warnings concern the idea that it can be used in a drink or an enema to detox the colon and/or liver and gallbladder. The claim — seen on many Web sites — is that the magnesium in Epsom salts can help the digestive system better utilize oxygen, while the sulfate helps to improve digestion and produce useful enzymes. While magnesium sulfate theoretically does both, swallowing even small amounts can be dangerous and should be done only under medical advice and supervision, cautions Dr. Rubman. Epsom salts are powerful enough to disrupt the colonic environment, he explained, noting that in excess they can cause “hypermagnesemia,” which can be lethal. Another danger of using Epsom salts to internally “cleanse” is that it can upset the immune system, potentially even leading to chronic autoimmune problems. As far as using it as a laxative (another of those Internet ideas), Dr. Rubman cautions that drinking even small amounts as a laxative can result in unpredictable and possibly dramatic diarrhea — your bowels will indeed move, but likely not in the way that anyone would wish. Don’t even think about using Epsom salts internally without first discussing it with your doctor.

Andrew L. Rubman, ND, founder and director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut.