Dr. Weeks Comment: GHB is now illegal to possess in America. Xyrem, a knock-off (patentable since they added a sodium to GHB) and therefore profitable version is available.
The Rest of your Days…
It is somehow reassuring to know that Tenzin Chodrak, the physician to his Holiness the Dali Lama, agrees with the august professors at the Beijing University School of Traditional Chinese Medicine, who agree with the former U.S. Surgeon General C. Everett Koop, who agrees with your grandmother. They all agree that you should get a good night’s sleep.
Where they disagree, though, is in HOW they think you should get that elusive good night’s sleep! Tenzin would have you inhale pungent and somewhat nauseating herbal incenses. Prof. Lu would impale you with acupuncture needles and have you sip bitter tea concoctions. Dr. Koop might suggest pharmaceutical-grade, prescription sleeping pills – despite their addictive nature. And grandma (the one who ALWAYS know the most) would suggest drinking more water, opening the window, wearing socks to bed, getting more exercise and watching less TV, saying your prayers, not taking yourself too seriously, stopping coffee and booze, and no late night snacking – and that is only for starters. She is just winding up at this point!
Ah Sleep!. The little sister of death. The phase of regeneration and restoration. The time for people who burn their candles at both ends to re-wax their candle in preparation for another day of brilliance. Good quality, deep sleep is our fundamental deficiency as we age. Sure, we might maintain the habit of being horizontal for six to eight hours a night, but our sleep typically deteriorates after our mid-thirties. Back pains, indigestion, prostate issues, financial concerns, existential angst – these and other plagues disrupt our sleep as we age. Find a colleague who is in robust good health and ask him his secret. He may shrug his shoulders, smile and say, “I don’t know. Maybe good genes.” But ask him how he sleeps and he’ll pause and say, “Like a baby.”
In this era where the mind-body health connection is front-page news, it is no wonder that the business of sleeping is big business. The “dis-eased” mind of the insomniac will make the body ill. Compromised sleep will pollute the healthiest among us.
So, what if there were a sleep aid that could put you into a deep restorative sleep and then evaporate like the morning dew? What if there were a substance that would drop you off like a taxi on the doorstep of Deep Sleep leaving you there un-medicated and enjoying a natural, stage 4 restorative sleep. (Contrast that to most sleeping aids that hold you under their influence so that you feel groggy or hung-over in the morning as you grope for the antidote, a cup of coffee). What if this sleep aid were non-addictive and enhanced natural sleep mechanisms while metabolizing safely to carbon dioxide and water – the non-toxic final common pathway of most of our natural biochemistry?
Well that remedy does exist. It is called GHB and it is now available by prescription as a drug called Xyrem (see www.orphan.com ) In my clinical practice experience, GHB, a naturally occurring molecule, is the best sleep aid on the market today. But your doctor may not want to prescribe it to you! In the words of an esteemed colleague who expresses a common sentiment:
“Dear Brad:
It will likely be difficult to explain to my patients why their physician is giving them the “date rape drug” for sleep. Some will find it humorous, some will have their worried kids calling me day and night, some will have nightmares worrying about whether they locked their doors and windows and others will ask so many questions that I just won’t get much else done during the visit. Some things are just tooooo political to use in my clinical setting.”
What is the controversy about? Well, let’s begin with a naturally occurring amino acid called GABA – gamma amino butyric acid. I describe GABA to my patients as: “back rub in a capsule” or “lullaby in a bottle”. The last time you felt relaxed, glowing, calm and at peace with your life and work, chances are your GABA levels were elevated. Conversely, GABA levels drop with the increase of stressful feelings of “flight or flight,” which enhance catecholamine release such as adrenaline and norepinephrine. Many biofeedback techniques aim at increasing your natural levels of GABA.
What happens to natural stores of GABA? They convert to GHB (gamma hydroxy butyric acid) which I have used in my practice for many years to the great benefit of my patients. Cancer patients used it to sleep through their terrible pain. Insomniacs used to get a good night sleep. Fibromyalgia and Chronic Fatigue patients use it to collect enough hours of restorative sleep to heal sore muscles and correct hormonal imbalances. People with the flu and other infections used it to fight the infection (a good night sleep enhances the immune system). Manic depressive patients used it to interrupt the spinning out of control problem of sleeplessness. Attention deficit hyperactive patients used it in low doses to replace Ritalin and other stimulants. Addicts found that it was a safe and effective aid to stopping alcohol and drugs since it binds to the same receptors as many drugs but is itself not addictive. Many of my patients around the country took GHB to their AA or NA meetings and helped others stop abusing drugs and alcohol. On a lighter note, some ladies, who couldn’t stand their mates’ snoring, used it to fall asleep before he started making a racket. I was feeling pretty helpful for all these folks until GHB was maligned as a “date rape drug” and taken off the market a few years ago.
Now we all know that alcohol is (and will always be) the real “date rape drug” so why was GHB taken off the market? Certainly, it was abused by some people and given in excessive doses by predators who slipped it into unsuspecting people’s drinks for the sedative effect. Combined with alcohol, and when taken in excess, GHB does, like the old Mickey Finn, sedate people. However, in my professional and scientific opinion, the reason GHB took the fall is primarily political/economic and NOT scientific in nature. [ For a comprehensive, extremely well-written presentation of the political/economic issues surrounding the use of GHB, see “GHB Report to the
Secondly, contrary to Mae West’s delightful quote: “Too much of a good thing is wonderful.”, too much GHB is NOT wonderful. Like all medicine, GHB should only be taken as prescribed to avoid side-effects. However, contrary to propaganda and politicized “date rape” allegations, there are no confirmed fatalities from the use of GHB alone. Meanwhile, hundreds of FDA approved prescription drugs have indeed proven to be FATAL in overdose (aspirin, anti-depressants, etc.) yet these drugs remain on the market.
Now, what would grandma say about GHB? Well, she would be suspicious of ANY medicine and urge common sense instead. She might say: “If you aren’t sleeping well, take GHB at the right dose, but only after you have tried these tips from Joe Mercola”:
· Avoid before-bed snacks, particularly grains and sugars. This will raise blood sugar and inhibit sleep. Later, when blood sugar drops too low (hypoglycemia), you might wake up and not be able to fall back asleep.
· Sleep in complete darkness or as close as possible. When light hits the eyes, it disrupts the circadian rhythm of the pineal gland and production of melatonin and seratonin. There also should be as little light in the bathroom as possible if you get up in the middle of the night.
· No TV right before bed. Even better, get the TV out of the bedroom or even out of the house, completely. It is too stimulating to the brain and it will take longer to fall asleep. Also disruptive of pineal gland function for the same reason as above.
· Wear socks to bed. Due to the fact that they have the poorest circulation, the feet often feel cold before the rest of the body. A study has shown that this reduces night wakings.
· Read something spiritual or religious. This will help to relax. Don’t read anything stimulating, such as a mystery or suspense novel, as this may have the opposite effect. In addition, if you are really enjoying a suspenseful book, you might wind up unintentionally reading for hours, instead of going to sleep.
· Avoid using loud alarm clocks. It is very stressful on the body to be awoken suddenly. If you are regularly getting enough sleep, they should be unnecessary. Try a dawn simulator which works by with an alarm to a dimmer switch that gradually turns the light on to full intensity over 45 minutes.
· Journaling. If you often lay in bed with your mind racing, it might be helpful keep a journal and write down your thoughts before bed.
· Melatonin and its precursors. If behavioral changes do not work, it may be possible to improve sleep by supplementing with the hormone melatonin. One can also use one of melatonin’s precursors, L-tryptophan or 5-hydroxytryptophan (5-HTP). L-tryptophan is the safest and my preference, but must be obtained by prescription only. However, don’t be afraid or intimidated by its prescription status. It is just a simple amino acid.
· Get to bed as early as possible. Our systems, particularly the adrenals, do a majority of their recharging or recovering during the hours of
· Check your bedroom for electro-magnetic fields (EMFs). These can disrupt the pineal gland and the production of melatonin and seratonin, and may have other negative effects as well. One doctor even recommends that people pull their circuit breaker before bed to kill all power in the house (Dr. Herbert Ross, author of “Sleep Disorders”).
· Keep the temperature in the bedroom no higher than 70%. Many people keep their homes and particularly the upstairs bedrooms too hot.
· Eat a high-protein snack several hours before bed. This can provide the L-tryptophan need to produce melatonin and serotonin.
· Also eat a small piece of fruit. This can help the tryptophan cross the blood-brain barrier.
· Reduce or avoid as many drugs as possible. Many medications, both prescription and over-the-counter may have effects on sleep. In most cases, the condition, which caused the drugs to be taken in the first place, can be addressed by following the guidelines elsewhere on this web site.
· Avoid caffeine. A recent study showed that in some people, caffeine is not metabolized efficiently and therefore they can feel the effects long after consuming it. So an afternoon cup of coffee (or even tea) will keep some people from falling asleep. Also, some medications, particularly diet pills contain caffeine.
· Alarm clocks and other electrical devices. If these devices must be used, keep them as far away from the bed as possible, preferably at least 3 feet.
· Avoid alcohol. Although alcohol will make people drowsy, the effect is short lived and people will often wake up several hours later, unable to fall back asleep. Alcohol will also keep you from falling into the deeper stages of sleep, where the body does most of its healing.
· Lose weight. Being overweight can increase the risk of sleep apnea, which will prevent a restful nights sleep.
· Avoid foods that you may be sensitive to. This is particularly true for dairy and wheat products, as they may have effect on sleep, such as causing apnea, excess congestion, gastrointestinal upset, and gas, among others.
· Don’t drink any fluids within 2 hours of going to bed. This will reduce the likelihood of needing to get up and go to the bathroom or at least minimize the frequency.
· Take a hot bath, shower or sauna before bed. When body temperature is raised in the late evening, it will fall at bedtime, facilitating sleep,
· Remove the clock from view. It will only add to your worry when constantly staring at it…
- Keep Your Bed For Sleeping. If you are used to watching TV or doing work in bed, you may find it harder to relax and to think of the bed as a place to sleep.
Personally, having myself sampled nauseating herbal incenses in India, acupuncture needles with bitter teas in China, seen how debilitating sleeping pills are to my patients, and having been chased around the kitchen table of my youth by a well-intended but overly determined grandma with her tablespoon of various foul tasting remedies, if the above tips aren’t doing the trick, I highly recommend GHB (Xyrem) for a good night’s sleep. Believe grandma when she tells you: “The Rest of your days depend(s) on the Rest of your Nights”.
Bradford S. Weeks, M.D. is a medical doctor practicing in Clinton whose training in general medicine and psychiatry allows him to work holistically with people suffering from chronic illnesses bearing in mind relevant biochemical, emotional and spiritual factors. Office visits by appointment only by calling 341-2303. See www.weeksmd.com