Insomnia and Traditional Chinese Medicine: a deep dive into Dr. Anna Gold's BUILD SLEEP
*This article originally appeared in Ayla Beauty Blog.
Designed in collaboration with master esthetician and skin health expert Kristina Holey, Dr. Anna Gold's Traditional Chinese Medicine-based supplements address skin health from the inside out, with formulas that target acne, dermatitis, and dry/depleted skin. And more recent additions to the Dr. Anna Gold lineup address mood (BALANCE: excellent for both stress and PMS, and a mental savior for many during lockdown!) and immunity (DEFEND: also a savior during lockdown, for different reasons).
Because we swear by Anna’s formulas for all of these challenges, we approached her with a request: so many of our community members, from our customers to our partners to our team, have been having trouble sleeping for the past year especially. Could she create a formula to help? She did, and it’s spectacular.
We couldn’t think of a better expert than the gifted Dr. Anna Gold to solve the complicated problem of troubled sleep. Read on to learn more about the innovative BUILD SLEEP formula.
Ayla: What inspired you to create a tincture for sleep?
DR. ANNA GOLD: Insomnia is one of the most common disorders I treat in my clinic. It spans all ages and socio-economic groups. Patients come in with all sorts of issues — infertility, painful periods, menopause, headaches, back pain — and they all seem to have (at least occasional) problems with sleeping.
According to the American Sleep Association, insomnia affects 30% of adults, 10% of which are chronic and long-term cases. Although experts recommend adults sleep between 7 and 9 hours a night, 35% of adults report getting less than 7 on average. During COVID, the number of people who report having trouble sleeping increased to 40%.
Can you tell from these statistics how sleep deprived we are as a society? Lack of sleep can cause emotional instability, disruptions in cognitive abilities, depression, and lowered immunity, not to mention long term health issues like high blood pressure, diabetes, and weight gain. Because of this prevalence, the CDC has declared insufficient sleep “a public health problem.”
Ayla: Sleep troubles have a variety of different causes and manifest themselves in different ways. What are some of the most common themes you’ve uncovered in your practice (both causes & symptoms)?
DR. ANNA GOLD: There are so many reasons why people can't sleep! These are the most common causes of sleep troubles I encounter in my practice:
The first reason people have sleeping that comes to mind is stress. We live in a fast-paced world where so much is demanded of us. We work hard. We stay up late. We may not have the support or help we need with our families. And this was before COVID! Lately, with lockdowns, there has been so much upheaval in the way we navigate our daily routines — from negotiating space with our spouses, to our Zoom schooled children, to simply being shut in our houses with the same people day in and day out. People are feeling depressed or anxious because they have been isolated from social circles and activities.
When our minds and bodies are stressed all day, it can be difficult to wind down at night. Our fight or flight mode, or sympathetic dominant mode, releases cortisol in situations of chronic stress. Over time, it becomes difficult to fall asleep because cortisol is being released in the evening when it should be decreasing (and melatonin increasing). Looking at screens after the sun goes down also contributes to increased cortisol production later in the day when it should be winding down. After a long day of working, many people spend their evenings watching TV or reading on a digital device to relax. And we are surrounded by artificial light that disrupts natural circadian rhythms.
I recently learned about a term, “revenge procrastination bedtime,” which describes so many people I know. It comes from a Chinese saying that refers to delaying one’s bedtime because we spend all day working and have no down time. So as a “revenge” on their daytime stress, we stay up later to reclaim some downtime for ourselves, some “me time.” Unfortunately, this kind of thinking draws from our total hours of sleep and negatively impacts focus and concentration in the short term — and overall health in the long term.
Another common cause of insomnia is hormonal imbalance. Our circadian sleep/wake cycles are guided by fluctuations of thyroid hormones, cortisol and melatonin levels, as well as metabolic processes that shift body temperature. Fluctuations of sex hormones also disrupt sleep. People often associate insomnia with menopause, but not many people realize that premenstrual syndrome can also be a cause of difficulty sleeping.
Ayla: BUILD SLEEP is a very different type of sleep supplement; how should we all be thinking about it and how it works?
DR. ANNA GOLD: This formula has soporific herbs like California poppy and Valerian root to help relax your mind and make falling asleep easier, which is why you can take it on an occasional basis if you are going through an especially stressful or emotional time.
The difference between this and other sleep supplements is that in addition to quieting thoughts and helping you fall asleep, it also has a blend of Chinese medicinal herbs that nourish the depletions that occur over long periods of sleep trouble. In TCM (traditional Chinese medicine), insomnia usually results from Heart Blood deficiency. In the TCM paradigm, there is an emotional component associated with each organ. Abundant and healthy Heart Blood anchors the emotions, or Shen (Spirit). Often, Heart Blood deficiency is coupled with Spleen deficiency.
Blood, the fundamental substance that nourishes the organs and connective tissue, is made in the Spleen and Stomach from food that you eat. The emotion attached to the Spleen is worry. When you worry too much, it depletes the Spleen, and vice versa.
BUILD SLEEP contains herbs that tonify Spleen and Heart, like Poria and Longan for example — so that when it’s taken over time, the propensity for troubled sleep is reduced. This is because each night that you take the tincture to fall asleep, the formula is also nourishing the deficiencies that made you prone to insomnia in the first place. Hence the name “build sleep.”
This formula not only has herbs to nourish the Heart Blood and Spleen, it also has ingredients like Jujube seeds to tonify Liver Yin, which can be lacking due to chronic overwork and stress. The Liver in TCM is responsible for many mechanisms, including, overseeing the nervous system and storing Blood.
I wanted the name of this tonic to reflect the overall benefits that it can provide for people. I wanted to convey that deep sleep is aspirational, and is a practice that can be built from good sleep habits and herbal rehabilitation.
I’m the type of person who has difficulty falling asleep if I have to get up early the next day. I personally use this tincture to ensure I sleep well if I know I have to get to sleep quickly and deeply because I have a particularly long and demanding workday the next morning.
The best time to take this tincture is when you know you “should” go to sleep, so it helps to wind down, as opposed to when you’re all wired because you stayed up too late. My recommendation is to take your last dose at least six hours before you have to wake up in the morning.
Ayla: What can most people expect to experience while taking it?
DR. ANNA GOLD: Most people feel the sleep benefits from the very first night they take the tincture. One of my trial testers commented, “It’s like being wrapped in a warm blanket as I fall into a deep sleep.” Most can expect to fall asleep within an hour of taking it at bedtime. If you tend to wake up in the middle of the night, you can expect to fall asleep faster.
In the most difficult and chronic insomnia cases, I have seen the sleeplessness get better when the tincture is taken nightly over several weeks. Unlike some sleep supplements, most people do not wake up feeling drowsy from this tincture. But if they do, they just need to ease up on the dosage.
Ayla: You’ve tested BUILD SLEEP with a large number of clients in your clinic. Understanding that dosage may vary from person to person, what have you found to be the best starting point? How should we think about adjusting dosage from there?
DR. ANNA GOLD: I suggest that you take 3 dropperfuls in ⅛ or ¼ cup hot water an hour before bedtime. If you are not sensitive to alcohol, you can also take it directly on the tongue.
If that one dose of 3 droppers didn’t help with sleep the first night, then the next evening, take three dropperfuls after dinner, and a second dose an hour before bedtime. In the study I conducted, 67% of test subjects benefited from this dosing. 33% preferred one dose at bedtime.
⅔ of subjects in the sleep study did not feel drowsy from the suggested dosing of 3 dropperfuls. However, for those that may feel drowsy in the morning, I would suggest cutting the dose to 1 or 2 dropperfuls at bedtime.
My products are alcohol based, so I usually direct patients to mix dropperfuls of herbal tincture in hot water, since the hot water burns off the alcohol. However, you can also drop the herbs directly in the mouth especially if you are prone to getting up in the middle of the night to urinate.
Ayla: Do you suggest using BUILD SLEEP for a specific length of time?
Can it be used on an occasional basis — or indefinitely? What might one expect?
DR. ANNA GOLD: For those who have had long term battles with insomnia, taking BUILD SLEEP nightly for a minimum of two weeks is essential to establishing a healthy circadian rhythm. You can use it short term when you are going through an especially stressful period. Since the tincture has herbs that tonify and nourish the Heart, Spleen, and Liver, you can take it long term, for an indefinite period, if you desire to maintain deep sleep overall.
Ayla: BUILD SLEEP is designed to be part of a larger effort towards healthy sleep habits. From your perspective as a practitioner of TCM, what do you think might be some of the most helpful habits to adopt along with this tincture?
DR. ANNA GOLD: This is a great question. From a holistic medicine perspective, no supplementation or prescription medication can be a magic pill to help correct sleep issues entirely; creating good, deep sleep during adulthood is a process, which is why I chose an active word ("BUILD") as part of this product's name. There are many ways you can help support good sleep habits.
At dusk, begin winding down. If you’re working from home during Covid, try taking a walk to break up your work day from your evening relaxation time.
Eat dinner at least three hours before bedtime so you give your body time to digest properly.
Take a hot bath with epsom salts to relax your muscles.
Turn off screens at least one hour before bedtime as blue light extends wakefulness.
Drink caffeinated beverages early in the day, preferable before 10 AM. For people who have a lull in energy in the afternoon, try taking a nap (no more than 20 minutes) or drink a glass of water instead of drinking more caffeine.
Go to bed with enough time to fall asleep by 11 PM. In Chinese medicine, the Qi or vital energy, systematically makes it way around to every elemental organ pair every four hours to replenish the system. The organ pair between 11 and 3 are the wood elemental organs, Gallbladder and Liver, which are responsible for balancing the nervous system, nourishing the connective tissue, and regulating hormones. Everyone should be asleep during those hours so that their nervous system can fully reset.
And finally, a good night’s sleep translates into energy during the day. Make sure you go outside and soak in some morning sun, preferably to exercise, to solidify a healthy circadian rhythm.
Ayla: Thank you for all of this great information! As always, we suggest our customers check with their doctors for guidance before taking supplements and medications, but can you provide us with some general advice on what BUILD SLEEP typically can and cannot be taken with?
DR. ANNA GOLD: As a general rule, always check with your doctor if you're pregnant, breastfeeding, or taking other medications. I don't suggest taking BUILD SLEEP with any prescription sleep medications.
It should be fine if you're taking thyroid medication or hormonal medication, but again, please check with your doctor.
I haven't tested this formula for use in cases of jet lag (it was developed during lockdown!), but if you're not sensitive to melatonin, you can probably take BUILD SLEEP with melatonin if you're traveling across time zones.
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About Anna: a Doctor of Acupuncture and Chinese Medicine, Licensed Acupuncturist, and Fellow of the American Board of Oriental Reproductive Medicine — with additional advanced degrees (in Traditional Oriental Medicine and Constitutional Facial Acupuncture), years of practice, and thousands of happy clients — Anna Gold is one of the most sought-after acupuncturists in the Bay Area, known not only for her skill in treating challenges ranging from infertility to asthma, but also for her partnership in treating skin conditions with Kristina Holey. Prior to her career in Traditional Chinese Medicine, Anna was an instructor at Jivamukti Yoga in New York. And before studying yoga, Anna graduated with a Bachelor's degree in Comparative Literature from Berkeley, where she also completed all the prerequisites for medical school.
Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.