Seven to eight hours of uninterrupted sleep allow the body to recover and restore energy. In the approach described here, sufficient sleep is also important for adrenal hormone production. Many people with chronic fatigue have insufficient sleep or difficulty falling asleep or staying asleep. Sleep is therefore one of the first issues addressed.
Several non-drug approaches are used to promote sleep. Some people notice an improvement with one approach, while others may benefit from a combination.
- Relaxation therapy (with daily meditation as a basis).
- Natural herbal remedies such as valerian, lemon balm and passionflower. These are available as extracts (tablets or drops) or as dried herbs that can be brewed into a tea before bedtime.
- The amino acid tryptophan or 5-hydroxytryptophan is converted into serotonin, a neurotransmitter that has a calming effect.
- Melatonin: the dose varies between individuals, from 0.5 mg to 10 mg in the approach described here. The prescription product Circadin® contains prolonged-release melatonin.
- GABA is a neurotransmitter involved in communication between brain cells. It is used here as a supplement at doses of up to 500 mg.
- If these approaches do not help, I may prescribe a medicine intended to support a more natural sleep pattern. In my practice, trazodone is the preferred option. Mild headache and dizziness are possible side effects. My usual advice is to start with half to one tablet before bedtime.
I reserve benzodiazepine sleep medication for exceptional circumstances. Although it may help with sleep in the short term, prolonged use can disrupt normal sleep patterns and lead to dependence.