There is a perception that time spent asleep is time wasted,

but it is widely recognized that inadequate sleep is associated

with multiple acute and chronic conditions,

and results in the increased risk of death and disease.

Force people to go one week with only six hours of sleep a night,

and you can change expression of more than 700 genes.

The most dire effect may be endothelial dysfunction.

The endothelium is the thin layer of cells that covers the internal surface

of blood vessels and is responsible for allowing our arteries

to relax and dilate back open properly.

Randomize people for about a week to get five rather than seven hours

of sleep, and just that two-hour difference a night resulted

in a significant impairment in artery function.

Okay, but what do these numbers mean? How bad is a week of 5-hour nights?

Sleep deprivation is no joke.

The magnitude of impairment is similar to that reported in people who smoke,

have diabetes, or have coronary artery disease.

No wonder people who sleep less than seven hours a night may experience

a 12% to 35% increased risk of premature death

compared to those who get a full seven hours.

Yet a significant proportion of the population may

routinely get less than that.

Sufficiently long, restful sleep sessions each night

are said to be an indisputable cornerstone of good health.

Okay, so what can we do about it?

Those who have sleep apnea, a common consequence of obesity

that interferes with sleep, benefit from the use of CPAP machines

while they're losing the weight to treat the underlying cause, hopefully.

But what if apnea isn't your problem?

What if you just have trouble falling asleep or staying asleep?

In my book How Not to Diet, I have a whole section on sleep enhancement,

where I go through the Four Rules of Sleep Conditioning

and the Four Rules of Sleep Hygiene.

What if you follow those guidelines but still can't get to sleep?

Any natural dietary remedies? I already have videos on using

kiwifruit to fight insomnia, and tart cherries, too.

Are there any vegetables that might help?

Lactuca sativa is a plant that has been traditionally used

in the treatment of insomnia.

What is this exotic sounding leafy vegetable? Lettuce!

Evidently lettuce extracts have been used from the time of the Roman Empire

as agents with sedative and sleep-inducing properties.

Lettuce actually does have a hypnotic substance in it called lactucin,

which is what makes lettuce taste a little bitter.

But you don't know if it actually works until you put it to the test.

And it works...in toads. But it also works in rodents.

Sleep in both mice and rats is enhanced by romaine lettuce.

They used romaine since it has a higher lactucin content

compared to other lettuces. Okay, but does it work in people?

About 10 years ago, a study was published in which insomnia sufferers

were randomized to receive lettuce seed oil, oil extracted from lettuce seeds.

Within a week, about 70% of those in the lettuce seed oil group

said their insomnia very much or much improved,

compared to only 20% in the placebo control group.

The researchers concluded that lettuce seed oil was found to be a useful,

safe sleeping aid in geriatric patients suffering from sleeping difficulties.

They chose to study older individuals because insomnia affects surprisingly

20 to 40% of older adults at least a few nights a month.

You think that's bad. Sleep disturbances can plague as many

as nearly 8 out of 10 women during pregnancy.

Of course, there's lots of different sleeping pills,

but they may endanger the fetus or mother.

For example, doctors frequently prescribe Ambien for pregnant women

who have trouble sleeping, but Ambien use is associated with a wide range

of adverse pregnancy outcomes

like low birth weight babies, premature birth, and cesarean section.

And the use of valium during pregnancy has been linked

to birth defects including limb deficiencies.

There has to be a better way. What about trying lettuce?

The lettuce oil study had a number of limitations.

For example, it was only single-blind, meaning the researchers knew

who was on the lettuce supplements and who was on placebo,

which could have introduced some bias. But the researchers essentially said,

"Give us a break. Big pharma has billions to spend on research.

No one wants to fund studies on lettuce."

Finally, we got a double-blind, placebo-controlled study,

but this time on a whole food, not just a lettuce seed extract.

Yeah, but how do you come up with a placebo lettuce?

How are you going to hide who gets lettuce and who doesn't?

Well, you can't fit a head of lettuce into a capsule,

but you can fit whole lettuce seeds.

And here we go: a double-blind randomized placebo-controlled trial

on lettuce seeds for pregnancy-related insomnia.

A hundred pregnant women with insomnia were randomized

to receive capsules containing either a quarter teaspoon

of ground lettuce seeds or a placebo for two weeks,

and those on the lettuce seeds saw a significant improvement

in a sleep quality index score

compared to placebo with no reported side effects.