“If you don’t get a good night’s sleep, you’re not going to get well. It really is that simple”. Dr. Rodger Murphee
This is part IV in an ongoing sleep series from Health Rising that attempts to understand why the notoriously bad sleep in chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID and related diseases occurs and to find ways to fix it.
Unrefreshing or otherwise poor sleep is often the first symptom practitioners try to help in ME/CFS, FM, and related diseases. This blog compares sleep prescriptions from a diverse array of sources – a fibromyalgia doctor, an ME/CFS/FM doctor, a longevity expert, and a neuroscientist – to see what commonalities showed up, what differences existed between them, and hopefully uncover some new approaches to take. (Please note this is a very long blog and you may want to print it out using the print button on the bottom left of the blog.)
The health experts include:
- Dr. Rodger Murphree DC – fibromyalgia and ME/CFS practitioner and author. Blog source – Fibromyalgia and Deep Restorative Sleep – ebook
- Dr. Teitelbaum MD – ME/CFS/FM practitioner and author. Blog source – From Fatigued to Fantastic 4th ed.
- Dr. Peter Attia MD – former surgeon – now a longevity and wellness podcaster. Blog source – Peter Attia’s Sleep Protocol: Supplements, Tools, & Tips – from Brainflow
- Dr. Andrew Huberman PhD – Stanford neuroscientist and podcaster: Blog source – Sleep Toolkit: Tools for Optimizing Sleep and Sleep-wake Timing.
Please note this is a very long blog and you may want to print it out using the print button on the bottom left of the blog.
It should be noted that, except perhaps for Dr. Huberman and Dr. Teitelbaum, this overview does not cover all the prescriptions for sleep from these health experts. Dr. Attia, for instance, has done six podcasts on sleep (!) and this overview simply covers the sleep treatments that a website reported he takes and recommends. Likewise, the sleep prescriptions from Dr. Murphree came from an ebook provided to people who viewed his recent online summit.
Except for the section on Dr. Huberman, which contains a new take on sleep hygiene, this overview also does not explore sleep hygiene – often a crucial element in getting better sleep.
Almost 50 different sleep aids were suggested. Surprisingly, all four practitioners agreed on only one of them (see table below). Some broad observations:
- Dr. Murphree – who has focused on fibromyalgia – relies entirely on supplements and reports they work well with his patients.
- Despite his long association with supplements, Dr. Teitelbaum focused his sleep chapter almost entirely on sleep drugs and employs a number of them at the same time in low doses to get his patients to sleep. Dr. Teitelbaum was the only practitioner/researcher to advocate using sleep drugs.
- Perhaps not surprisingly, the two newcomers to the scene, Dr. Attia and Dr. Huberman (in particular) advocated for some high-tech solutions (cooling mattresses/pads) and apps to help with sleep. Huberman also advocated for some novel sleep supplements.
The next part of the blog dives into some of the more common suggestions and the second part of the blog covers the protocols proposed by each person.
Sleep Suggestions Table
|Rodger Murphree DO||Jacob Teitelbaum MD||Peter Attia MD||Andrew Huberman|
|Melatonin||3-9 mg sublingual plus 3-9 mg timed release - if waking up in middle of night)||Natures Bounty Dual Spectrum Melatonin 5 mg||Doc Parsleys Sleep Remedy||does not recommend|
|Magnesium||500 mgs (chelate) - in CFS/Fibro Mix||Attia has mentioned taking several kinds of magnesium over time (600- 800 mg per day: 2 tablets of SlowMag every morning and 400 mg of Magnesium Oxide by Nature Made at night - but focuses on Jarrow MagMind L-Threonate for sleep. Magnesium bisglycinate (200 mg) is also found in Doc Parsleys Sleep Remedy||145 mg magnesium threonate 1 hour before bed|
|5-HTP||300 mgs/400 mgs if taken with food||200 mg (Revitalizing sleep formula - Enzymatic therapy)||Doc Parsleys Sleep Remedy|
|L-trytophan||Murphree believes 5-HTP is much better||Doc Parsleys Sleep Remedy|
|Phosphatidylserine||Doc Parsleys Sleep Remedy|
|GABA||(if needed) - in Delta Sleep Formula||Doc Parsleys Sleep Remedy||2 grams every 3 or 4 days;|
|Vit D||Doc Parsleys Sleep Remedy 69 mcg|
|Niacin||Doc Parsleys Sleep Remedy 6.9 mg|
|L-Theanine||(if needed) - in Delta Sleep Formula||200 mg (Revitalizing sleep formula - Enzymatic therapy)||Doc Parsleys Sleep Remedy||100-400 mg 1 hour before bed|
|Apigenen||50 mg 1 hour before bed|
|Lysine||2 grams every 3 or 4 days;|
|Myoinositol||900 mg - every other day|
|Herbs and Herbal Extracts|
|Ashwaganda extract||(if needed) -- in Delta Sleep Formula|
|Valerian extract||(if needed) -- in Delta Sleep Formula||800 mg ((Revitalizing sleep formula - Enzymatic therapy)|
|Passion Flower||(if needed) - in Delta Sleep Formula||350 mg|
|Hops||120 mg (Revitalizing sleep formula - Enzymatic therapy)|
|Lemon Balm leaf extract||Terric Zzzz|
|Mandarin Zest Oil||Terric Zzzz|
|SLEEP DRUGS (Teitelbaum)|
|Ambien (zolpidem)||5-10 mg (top choice)|
|Trazodone (desreyel)||25-50 mg|
|Neurontin (gabapentin)||100-600 mg (bedtime)|
|Lyrica (pregabalin)||50-300 mg (bedtime)|
|Flexeril (cyclobenzaprine)||2.5-5 mg (bedtime)|
|Over the Counter Antihistamines (Unisom, Benadryl, Dramamine)||25-50 mg|
|Klonopin (clonezepam||0.5-1 mg|
|Zanaflex (tizanidine)||4 mg|
|Antidepressants (Teitelbaum - use only one at a time from this list)|
|Sinequan (doxepin)||5-10 mgs or 10 mg/cc|
|Elavil (amytriptyline)||10 mg|
|Remeron (mitrazapine)||15 mg|
|Zyprexa (olanzapine)||5 mg|
|Seroquel (quetiapine)||25-50 mg|
|Blankets and Mattress Pads|
|Weighted sleep blanket||Luna brand|
|Cuddle Ewe Mattress Pad|
|Ooler Sleep System||From $450 to over $1300|
|Eight Sleep Mattress or Mattress cover||From $2200 to $3900 (!);||x|
|Light Blockers and Enhancers|
|Blue-light blocking glasses||Gunnar Blue Light Blocking Glasses||x|
|Ring Light||Ring lights|
|Drawing Tablet||Drawing tablet|
|Sleep Masks||Alaska Bear Sleep Mask||x|
|Apps and Tapes|
Sleep Aids More Commonly Suggested
- Four of the four experts recommended L-theanine.
It’s no wonder that L-theanine was the most common pick. L-theanine, an amino acid found in tea – particularly green tea, has been found to improve sleep in both animal studies, in boys with ADHD (400 mg – taken throughout the day), in healthy men and women, and in people with generalized anxiety disorder. If you’ve taken some caffeine, you might want to boost your L-theanine levels as L-theanine stimulates the same GABA4 receptors that caffeine knocks out – and which are responsible for caffeine’s ability to induce insomnia.
A recent study suggested that future types of L-theanine’s effects may provide even more benefits. A mouse model study -which used a magnesium-L-theanine compound – found the combination was able to increase dopamine, serotonin, melatonin, and antioxidant enzyme levels, reduce glutamate activity and improve sleep latency (the ability to quickly go to sleep), sleep duration, and delta or deep sleep – even when administered in the presence of caffeine (!).
A 2022 placebo-controlled, double-blinded (:)) study found that alpha-S1-casein tryptic hydrolysate (CTH) and L-Theanine increased sleep duration by 45 minutes, improved sleep overall, sleep latency, sleep habitual efficiency, and daytime dysfunction.
(CTH is a milk compound that studies suggest increases GABA activity and may be able to help with sleep, reduce anxiety, improve cognition, and reduce blood pressure and cortisol levels. It is possible to buy hydrolyzed casein but I don’t know if it’s the same product.)
Magnesium may be a natural adjunct to L-theanine as both provide different effects. Both interestingly, however, oppose caffeine’s effects by stimulating the GABA4 receptors.
Three of the four experts recommended magnesium for sleep. Dr. Teitelbaum was the only practitioner not to recommend magnesium directly but generally does so in regard to other facets of ME/CFS.
Magnesium and Sleep – The study evidence for magnesium and sleep overall is mixed, with some studies showing an effect and others not. Since magnesium is often taken with other supplements, it might be better to assess multi-treatment studies. One interesting study found that a magnesium – melatonin – Vit B Complex (175 mg liposomal magnesium oxide, 10 mg Vit B6, 16 μg Vit B12, melatonin 1 mg, Extrafolate-S 600 μg) taken an hour before bedtime was helpful with insomnia. Another found that Magnesium, B Vitamins, Rhodiola, and Green Tea (L-Theanine) reduced stress levels and daytime functioning.
Magnesium Threonate – Both Attia and Huberman recommended magnesium threonate. Magnesium threonate or magnesium L-threonate is formed when magnesium is combined with threonic acid – a component of vitamin C. Unlike some other forms of magnesium such as magnesium citrate, studies suggest that magnesium threonate may be able to effectively boost magnesium levels in the brain – which needs a lot of magnesium. (It’s not clear if magnesium oxide, orotate, taurate, malate, carbonate, and chloride can easily get into the brain or not.)
Animal studies suggest that magnesium threonate is well absorbed into the brain – which apparently has a very high need for magnesium. According to Be Brain Fit, magnesium threonate over 12 weeks in seniors improved all 4 cognitive domains tested – making them appear 9 years younger than they were. An open-label study also found magnesium threonate effective and well tolerated in ADHD. While much more research is needed – magnesium threonate is one of the least studied formulations – it may be able to help with sleep, cognition, and nerve pain.
- Three of the four practitioners recommended melatonin. Citing melatonin’s wide-reaching effects and the dosages of melatonin in most products that exceed the amount of melatonin created in our body, Huberman worried that taking melatonin chronically over time could be problematic.
- 5-HTP was recommended by 3 of the 4 health experts, and is Dr. Murphree’s core sleep supplement. (see the Murphree section).
5-HTP is right in the thick of things. Derived from tryptophan, 5-HTP is metabolized into serotonin and melatonin, and according to one overview, plays “a major role both in neurologic and metabolic diseases”. According to the review, 5-HTP may have antidepressant and anti-anxiety effects, and improve sleep, and reduce migraines and the pain in fibromyalgia. Recently, a 5-HTP improved REM sleep and improved sleep quality in a small study of Parkinson’s patients.
- Three of the four experts recommended GABA supplements.
Sleep drugs often target gamma-Aminobutyric acid or GABA – a calming agent produced by the brain – which studies indicate may be significantly reduced in insomniacs. GABA knocks down excitatory factors such as glutamate and boosts parasympathetic nervous system activity. Like other sleep aids, GABA appears to boost serotonin and melatonin levels.
GABA sleep studies, however, have had decidedly mixed results, however. One mouse study which mixed GABA with L-theanine found the combination restored normal sleep latency and sleep times.
Blue-Light Blocking Glasses
Two of the four experts recommended blue-light blocking glasses.
Research by Harvard University has shown that by exposing our system to artificial blue light from electronic devices after the sun goes down, we actually disrupt our circadian rhythm and experience decreased levels of melatonin. On his blog, Dr. Attia mentions he uses the popular Gunnar brand of blue light-blocking glasses. You can also get Gunnar glasses on Amazon.
- Two of the four experts recommended Ashwagandha.
It was somewhat surprising that more didn’t, as a recent meta-analysis found of five randomized trials found that Ashwagandha extract (400-600mg) produced a small, but significant, effect on overall sleep and helped most in people with insomnia.
- Two of the four experts recommended valerian extract.
Valerian extract is commonly used for sleep and calming and probably achieves effects by enhancing serotonin and possibly GABA production and enhancing adenosine signaling. Several studies suggest it may promote deep sleep. A recent meta-analysis and review suggested that while valerian may help with sleep, herbal extracts of valerian that sit on the shelf for a couple of months may lose some potency. Preparations that use the whole root/rhizome may have more reliable effects.
Health Experts’ Recommendations
Dr. Murphree’s Core Sleep Supplement – 5-HTP
Dr. Murphree is VERY high on 5-HTP and recommends it to most of his patients. In fact, he reports that up to 300 mg of 5-HTP (or 400 mg with food) is all most of his fibromyalgia patients need to get a good night’s sleep. He loves 5-HTP because when used properly, it can increase serotonin and melatonin levels, thus improving sleep, digestion, pain, mood, and mental clarity.
Murphree that SSRIs, on the other hand, don’t really help because they don’t help you make serotonin – they just make more of what’s there available. What people with FM and ME/CFS need is more serotonin.
He recommends starting with taking 50 mg 5-HTP 30 minutes before bed on an empty stomach, along with 4 ounces of juice (apple or grape), and increase the dose up to 300 mg (400 mg with food) if needed. If you feel hung over the next day, decrease your dose of 5-HTP.
Warning – a few individuals who attempt to take 5-HTP at night will have an adverse reaction. Individuals with a sluggish liver (usually more pronounced in CFS) may have trouble breaking down 5-HTP fast enough. Instead of making them sleepy, it revs them up and they become more mentally alert. If this happens, simply take 1-2 5-HTP tablets with food 1-2 times a day, and discontinue using it at bedtime on empty stomach.
If 5-HTP doesn’t work within a week, he recommends trying 3 mg of sublingual melatonin. If that doesn’t work, then add his Delta Sleep formula (see below).
The Delta Sleep formula (2-4 capsules/night) contains GABA, L-theanine (500 mg), Ashwagandha (200 mg), valerian (200 mg), and passionflower (100 mg) extracts.
Plus, take magnesium – a natural sedative and muscle relaxer as well as a good multivitamin/mineral supplement. If you’re not having a bowel movement, Murphree recommends increasing magnesium (chelate, citrate, or taurate) by 140-150 mg at dinner each night until you have one.
Waking up in the middle of the night
If you’re taking the 300 mg of 5-HTP at night and melatonin and are still waking up in the middle of the night he recommends taking 3 mg of timed-release melatonin. If that’s not enough, you can even take 3-9 mg of sublingual melatonin before bed plus 3-9 mg of timed-release melatonin. You should start low, though, and only increase if needed.
Dr. Teitelbaum’s Sleep Drug Approach
Dr. Jacob Teitelbaum MD has been studying, treating, and writing about ME/CFS and FM for several decades. His Fatigued to Fantastic series of books – now in its 4th edition – has been notable for its breadth of treatments and creative approach to ME/CFS/FM.
Dr. Teitelbaum believes that disordered sleep is “one of the key processes that drives CFS/FMS”, and that the most effective way to eliminate fatigue and pain in these diseases “is to get eight to nine hours of solid, deep sleep on a regular basis”. His goal is basically to do whatever it takes to get good sleep.
He also believes that the sleep disruption in ME/CFS and FM is “usually too severe to be dealt with by any single prescription or natural remedy”.
Teitelbaum begins with sleep hygiene and natural remedies but states that most people with ME/CFS/FM will need prescription drugs at least for a time. In the 4th edition of From Fatigued to Fantastic, he lists some supplements, but the chapter on sleep focuses almost entirely on drugs.
Prescription Drug Approach
Teitelbaum does not recommend “many sleeping pills in common use”, like Valium, that worsen deep sleep. With the exception of Klonopin (clonazepam) and Xanax (alprazolam), he highlights the risks of long-term use of addictive benzodiazepines. Both these drugs may improve deep sleep.
Instead of focusing on one sleep medication, Teitelbaum uses low doses of different sleep aids – as many as 3-7 of them – together. Most of the benefits and fewer of the side effects of sleep drugs, he states, appear at the lower doses and they wash out of your body more quickly.
The best way to reduce your level of medication is to stay on the drugs for six months, after which you can usually start to reduce them. Most people can taper off all drugs after about 18 months, while some need to stay on them for years. During stressful times he recommends upping the dose a bit.
The Sleep Drugs
Teitelbaum reports that, with the rare exception of a few people on Ambien who develop depression, he does not see side effects cropping up after long-term use of these drugs.
Ambien (Zolpidem) – 5-10 mg
Teitelbaum’s first choice – usually effective and well tolerated, effective at helping people fall asleep. Short-acting; if someone wakes up in the night – take 2.5 mg under the tongue. Since rebound insomnia may occur when the drug is stopped suddenly, taper by 2.5 mg every 2 months.
A small double-blinded, placebo-controlled study found that Ambien (10 mg) significantly reduced time to fall asleep, increased sleep time, reduced awakenings, and produced overall improvement in sleep and daytime energy in FM.
Trazodone (Desreyel) 25-50 mg
An antidepressant, usually used in low doses for sleep in ME/CFS and FM. A small percentage of people may need higher dosing.
Trazodone improved global fibromyalgia severity, sleep quality, and depression, as well as pain interference with daily activities in FM. Combining it with Lyrica further enhanced its benefits. Trazodone was also successfully used to stop the hyperarousal that plagues some people with poor sleep. It may also be able to help with neuroinflammation.
Neurontin (Gabapentin) 1-600 mg/bedtime or Lyrica (Pregabalin) 50-300 mg/bedtime
Despite their close chemical relationship, one of these drugs will often be tolerated while the other will not. Teitelbaum usually tries Neurontin first. Both are effective for pain and restless leg syndrome and can markedly improve sleep quality. The main side effects are sedation and dizziness – plus, in Lyrica – weight gain.
Extended-release Neurontin improved the quality and quantity of sleep in one fibromyalgia study.
Flexeril (Cyclobenzaprine) 2-5 mg/bedtime
A muscle relaxant that can be “very effective” for both sleep and reduced pain in FM. A new formulation of Flexeril that may be effective for both sleep and pain is in the last stages of clinical trials.
Over-the-Counter Antihistamines (Unisom, Benadryl, Dramamine) – 25-50 mg
Teitelbaum reports that antihistamines are usually very effective, well tolerated, and only rarely do they aggravate brain fog.
If a person is still not getting good sleep, Teitelbaum tries the next batch of drugs:
- Klonopin (clonezepam) – 0.5-1 mg
- Zanaflex (tizanidine) – 4 mg (do not take with Diflucan (fluconazole).
Other antidepressants – use only 1 at a time:
- Sinequan (doxepin) – 5-10 mg or 10 mg/cc in liquid form; powerful antihistamine; some people get the greatest benefit with < 5mg.
- Elavil (amitriptyline) – 10 mg, may cause weight gain, very good for vulvodynia or nerve pain.
- Remeron (mirtazapine) – 15 mg, may cause sedation but worth a try when nothing else is working.
- Zyprexa (olanzapine) – 5 mg – an antipsychotic which is well tolerated at very low doses and helpful with sleep. Can cause weight gain but does help with deep sleep.
- Seroquel (quetiapine) – 25-50 mgs – similar to Zyprexa
Xyrem (GHB) – is the best deep sleep inducer on the market but is too expensive and difficult to obtain to recommend for most.
Peter Attia MD
Peter Attia, MD is a big name in longevity circles. Attia got his M.D. at Stanford, spent 5 years as a general surgery resident at Johns Hopkins, then two years as a surgical oncology fellow at the National Cancer Institute, and worked with the consulting company McKinsey and Company. For the last 8 years, Attia has focused on longevity, and for the last 4, he’s been producing a popular podcast called The Drive.
While podcasts that focus on things like strenuous exercise don’t resonate with ME/CFS/FM and long COVID patients, podcasts on things like diet, sleep, heart rate variability, glucose monitoring, rapamycin, metformin, and hydration may all provide insights into factors associated with chronic fatigue syndrome (ME/CFS), fibromyalgia (FM) and long COVID.
For me, Attia (and Huberman, below) are a cut above. They know the science inside and out, and Attia often passes a critical eye on study methodology and rigor. In short, both seem quite trustworthy.
Over the past couple of years, Attia devoted six podcasts to discussing sleep issues with Mathew Walker Ph.D. , the founder and director of the Center for Human Sleep Science, and author of the 2017 book, Why We Sleep: Unlocking the Power of Sleep and Dreams.
In April 2020, a website called Brainflow, which listed Attia’s sleep protocol, provided the data for this blog.
Peter Attia Sleep Supplements
Attia is big on magnesium, supplementing it, apparently, during the day and at night. According to Brainflow, low levels of magnesium can keep your brain from settling down at night, whereas higher levels of magnesium promote a night of deep sleep and have calming effects on the body as well. Attia has said he uses various kinds of magnesium over time, but in one interview, said he prefers magnesium threonate before bedtime for sleep.
Chillisleep OOLER Cooling Sleep System
Attia apparently loves Chillisleep OOLER Cooling Sleep System (which he upgraded to from the Chilipad Sleep System). Various iterations of the sleep system exist ranging from $439 to $1300.
The system was designed around one central fact: we sleep deeper when our environment and our bodies are a bit cooler.
In order to go to sleep, our bodies need to cool down a bit, which is why it’s better to have your room cooler at night. (The optimal bedroom temperature is apparently between 60-67 degrees. Chillisleep says 65-68 degrees is optimal for deep sleep)
It’s also one reason why “The Sleep Diplomat,” Matthew Walker, says that eating less than a couple of hours before bedtime can disturb our sleep. Digestion causes our bodies to heat up a bit.
In the Chillisleep system, temperature-controlled water gets circulated through the Chillisleep cooling pad. Since different people sleep better under different temperatures, you can set your optimal temperature. You can also get a couples system that cools down one side of the bed at different rates than the other side.
If you have the Ooler Chillisleep product, you can even have the temperature of the pad vary over the course of the night. For instance, if you tend to wake in the early morning, you can have the temperature of the pad drop during that time. If you want to wake up at a certain time, you can have the water in the pad heat up.
It’s a pricey product, but it gets good reviews on Amazon and elsewhere, and if you have the cash, it might be worth it.
Andrew Huberman, Ph.D.
Andrew Huberman is a neuroscientist and Professor in the Department of Neurobiology at the Stanford University School of Medicine. A McKnight Foundation and Pew Foundation Fellow, he was awarded the Cogan Award in 2017.
Huberman has worked on neural regeneration, on how vision and how we breathe affect performance, and is developing tools to enhance neural plasticity, reduce stress and optimize sleep. He’s been doing his Huberman Lab podcasts since 2021 – and he’s quite popular: in 10 days the Sleep Toolkit: Tools for Optimizing Sleep and Sleep-wake Timing podcast this part of the blog was taken from received over 200K views.
Huberman recently did a podcast with Peter Attia on hormones, fitness, and longevity. Like Attia, Huberman seems quite rigorous and trustworthy.
Except for this section, this blog does not cover sleep hygiene – a potentially important part of getting a good night’s sleep. Huberman has such a different take on sleep hygiene – which he believes starts when you wake up – that it’s being covered here.
Huberman was quite focused on two aspects of getting good sleep that don’t receive as much attention as they might: temperature and light.
In order to go to sleep, your body temperature must drop by 1-3 degrees, and every time your body temperature rises, your levels of cortisol – a stress hormone – increase. Health Rising recently featured a blog on researchers who believe they’ve identified a “hyperarousal” sleep disorder that’s associated with high cortisol levels which, in turn, cause interrupted sleep.
While we probably all know that bright, artificial lights are a no-no at night, Huberman reported that many studies show that getting natural light early in the day, and then late in the day, is quite important as well. He divides the day up into three critical periods.
First Critical Period: approximately the first 3 hours of daylight
Getting bright light – ideally from sunlight – early in the morning triggers an increase in cortisol (that’s precisely the time it’s low in ME/CFS) and serotonin levels, and washes out adenosine. Doing so helps the brain/body to wake up and starts a timer which should help you go to sleep at the right time at night. Not being exposed to natural sunlight may also contribute to depression and even possibly dementia.
How much you need depends on your makeup, and the amount of light present, but it generally doesn’t take a lot. Huberman said that on a clear day, about 5 minutes of sun exposure in the early morning should do it. On cloudy days, ten minutes is usually enough and on really overcast days, it may take 20-30 minutes. Even on cloudy days, the light intensity outside is much higher than anything you can produce at home.
It’s much, (much) better to get outside as it takes much longer to trigger the reaction while looking at the sun through windshields or windows. Alex Fergus states you should not wear eyeglasses (block UV light) as well. If you’re bedridden, try to get near a window or open the window and look outside.
- Check out Alex Fergus’s post on early sunlight
After that – getting under some cold water – just for 1-3 minutes – will increase your core body temperature, increase your cortisol and get you going. Eating earlier in the day will also trigger an increase in metabolism and heat that will increase wakefulness. Eating a very large meal, though, is going to divert a lot of blood and critical resources away from your brain, etc. and make you feel sleepy.
Caffeine – try to delay caffeine uptake for 90 minutes after waking in order to wash adenosine out of your system; it will delay the afternoon crash. Drinking caffeine after 4 pm can make it difficult to sleep and will disrupt your sleep architecture.
Second Critical Period – middle of the day
Naps are fine; in fact, Huberman himself loves naps. Just don’t nap so long that it disrupts your ability to fall and stay asleep. He suggests trying the Reveri app, yoga nidra, and NSDR scrips to get the best good naps.
Third Critical Period – late afternoon and evening
Getting sunlight in your eyes in the afternoon and early evening hours as the sun starts to descend is actually protective against problems with blue light problems. The different wavelengths of sunlight found as the sun goes down tell your brain/body to start getting ready for sleep.
Bright artificial lights of any color should be avoided at night. In the evening hours, it takes very little bright light to wake up your neurons and eliminate melatonin. Overhead fluorescent lights should not be used at night; instead, use desk lights and dim your lights and dim any screens.
Cooling is the key at night. Taking a 20-30 minute hot bath or sauna in the evening will cool the core of your body down and ready you for sleep. Sleeping in a cool environment is very helpful.
Every night: 30-60 minutes before bedtime
- Magnesium threonate – 145 mg – causes gut troubles in about 5% of people.
- Apigenin – 50 mg – is a flavinoid that’s especially abundant in chamomile and alcohol, and appears to have calming effects. According to one site, it should be taken with some fat. Diets high in apigenin were associated with better sleep in one study and enhanced sleep onset and sleep time in a mouse model.
- L-Theanine – 100-400 mg – can give some people vivid dreams.
Huberman believes these supplements are preferable to melatonin.
Every other night – 60-90 minutes before sleep
- Myo-inositol – 900 mg – Huberman reported that myo-inositol enhances ability to fall asleep quickly and go to sleep after waking and also reduces stress and anxiety. Myo-inositol or inositol (or B3) is found in oranges, pears, peaches, beans, brown rice, nuts, seeds, and various other fiber-rich foods and citrus fruits, and may be able to “help balance serotonin, dopamine, and other neurotransmitters”. The highest concentations of myo-inositol occur in the brain.
- A 2022 study found that myo-inositol supplementation (2,000 mg of myo-inositol and 200 μg of folic acid) improved global sleep quality, subjective sleep quality, and sleep duration during pregnancy. Reduced frontal cortex myo-inositol was found in adolescents with poor sleep and depression. Myo-inositol also improved thyroid functioning, and when taken in combination with melatonin, improved glucose metabolism in menopausal women.
He takes these every third or 4th night. Taking them too regularly does not work for him.
- Lysine – 2 grams
- GABA – 2 grams
Apps and Tapes
- Reveri App – Huberman is very high on this self-hypnosis app. Check out Huberman’s podcast with Reveri co-founder Dr. David Speigel. Huberman also recommends doing the Reveri sleep self-hypnosis app (10-15 minutes) 3x a week at any time of day to rewire your nervous system and help you relax faster.
- NSDR – Huberman uses NSDR (check it out on YouTube) to go back to sleep when he wakes up in the middle of the night.
- Yoga Nidra – he also uses Yoga Nidra (also on YouTube) to go back to sleep.
Tools and Breathing
- Eye mask – make sure the room is cool when you use it or it may heat you up.
- Ear plugs.
- Elevating feet – increases the depth of sleep; improves glymphatic flows (can exacerbate acid reflux in some).
- Nose breathing is very helpful – Huberman recommends that you try putting medical tape over your mouth at night. You can also train yourself to nose breathe over time. It’s hard to do at first but opens airways to the skull – allowing you to breathe more easily at night. (See Butyeko breathing.)
Other Sleep Resources From Health Rising
Our ME/CFS and FM Sleep Center contains everything Health Rising has on sleep, including links to sleep research, diagnosis, treatments, and more. Plus check out the overall results from Health Rising’s Mammoth ME/CFS and FM Sleep Survey as well as two adjuncts to it.
- ME/CFS and Fibromyalgia Patients on other sleep Drugs
- ME/CFS and Fibromyalgia Patients on the Drug Combinations That Help Them Sleep
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