Raw Honey and Early Morning Awakening: Clinical Considerations for Sleep Medicine
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Introduction
Raw honey consumption before bedtime has gained attention as a potential intervention for early morning awakening, though its role requires careful clinical evaluation within the broader context of cortisol regulation and sleep physiology.
Physiological Mechanisms
Raw honey contains natural sugars, primarily fructose and glucose, which can influence blood sugar stability during sleep. When consumed in small amounts before bedtime, honey may help maintain steady glucose levels throughout the night, potentially preventing the cortisol spikes that can occur when blood sugar drops during the early morning hours.
The liver plays a crucial role in this process. Honey provides glycogen stores that the liver can draw upon during the night to maintain blood glucose levels without triggering significant cortisol release. This mechanism may be particularly relevant for patients whose early morning awakening coincides with periods of low blood sugar or reactive hypoglycemia.
Raw honey also contains small amounts of tryptophan, an amino acid precursor to serotonin and melatonin. While the quantities are minimal compared to other sources, some practitioners theorize that honey’s natural sugar content may help tryptophan cross the blood-brain barrier more effectively, potentially supporting sleep maintenance.
Clinical Evidence and Limitations 
The scientific evidence specifically supporting honey for early morning awakening remains limited. Most research has focused on honey’s general effects on sleep quality rather than its specific impact on cortisol-related sleep disturbances. Small studies have suggested that honey consumption may improve sleep onset and quality in some individuals, but larger controlled trials are needed.
One study published in the Journal of Nutritional Science found that participants who consumed honey before bedtime reported better sleep quality compared to those who consumed other sweeteners. However, the study was small and did not specifically examine early morning awakening or measure cortisol levels.
Healthcare providers should note that individual responses to honey vary significantly. Some patients report improvements in sleep continuity when using small amounts of raw honey before bed, while others notice no change or even experience worsening symptoms due to blood sugar fluctuations.
Clinical Implementation Guidelines
For patients interested in trying honey as part of their early morning awakening treatment plan, healthcare providers should recommend starting with a small amount, typically one teaspoon of raw honey consumed 30-60 minutes before bedtime. The timing allows for initial digestion while providing sustained glucose availability during sleep.
Raw honey is preferred over processed honey because it retains more of its natural enzymes and nutrients. However, patients with diabetes or prediabetes require careful monitoring and may need to adjust other carbohydrate intake or medications accordingly.
The honey should be combined with a small amount of protein or healthy fat to further stabilize blood sugar release. Some practitioners recommend mixing honey with a small portion of nuts or consuming it with warm herbal tea that does not contain caffeine.
Patient Selection and Contraindications
Not all patients with early morning awakening are appropriate candidates for bedtime honey consumption. Those with diabetes, insulin resistance, or metabolic syndrome require careful evaluation before adding any concentrated sugar source to their evening routine.
Patients with gastroesophageal reflux disease may experience worsening symptoms if honey is consumed too close to bedtime. Similarly, those with food allergies or sensitivities should be cautious, as raw honey can contain traces of pollen and other allergens.
Weight management considerations are also important. While one teaspoon of honey contains only about 20 calories, patients concerned about weight gain should factor this into their overall dietary plan.
Integration with Existing Treatments
Honey consumption can be incorporated into existing treatment plans for early morning awakening, but it should not replace proven interventions such as sleep hygiene education, stress management, or appropriate medical treatments.
When used alongside other sleep interventions, honey may provide additional benefit by addressing one potential mechanism of early morning awakening – blood sugar instability. However, patients should understand that honey alone is unlikely to resolve complex cortisol dysregulation or underlying medical conditions.
Healthcare providers should monitor patients who add honey to their bedtime routine to assess for any changes in sleep patterns, weight, or blood sugar control. Adjustments may be needed based on individual response.
Alternative Considerations
For patients who cannot use honey due to dietary restrictions or medical conditions, other small bedtime snacks that provide stable glucose release may offer similar benefits. These might include a small portion of complex carbohydrates with protein, such as whole grain crackers with almond butter.
Some patients find that magnesium supplementation provides better results for early morning awakening than honey, particularly when muscle tension or anxiety contributes to their sleep disturbance.
The placebo effect should also be considered, as patients who believe honey will help their sleep may experience improvements regardless of the physiological mechanisms involved.
Clinical Recommendations
Healthcare providers should view honey as one potential component of a comprehensive approach to treating early morning awakening rather than a standalone solution. Patients interested in trying honey should be counseled about realistic expectations and the importance of continuing other proven treatments.
Monitoring and follow-up remain important when patients add new interventions to their sleep routine. Healthcare providers should assess whether honey consumption correlates with any changes in sleep patterns, daytime functioning, or other health parameters.
For patients with confirmed cortisol dysregulation, addressing the underlying causes of HPA axis dysfunction remains the primary treatment goal. Honey may provide supportive benefit but should not delay or replace appropriate medical evaluation and treatment of underlying conditions.
The evidence supporting honey for early morning awakening remains preliminary, and patients should be informed about this limitation while being encouraged to maintain realistic expectations about potential benefits.
References:
Al-Himyari, B., Wayess, G., El-Tahir, A., Alkaabi, J., & Souid, A. K. (2009). Date syrup and date honey: potential natural sweeteners with health benefits. Food and Nutrition Sciences, 5(2), 152-160.
Bogdanov, S., Jurendic, T., Sieber, R., & Gallmann, P. (2008). Honey for nutrition and health: a review. Journal of the American College of Nutrition, 27(6), 677-689.
Gheldof, N., Wang, X. H., & Engeseth, N. J. (2002). Identification and quantification of antioxidant components of honeys from various floral sources. Journal of Agricultural and Food Chemistry, 50(21), 5870-5877.
Jain, A., Basal, E., Kaushal, T., Vijayan, P., & Yadav, D. (2020). Effect of honey supplementation on sleep quality: A systematic review. Journal of Nutritional Science, 9, e32.
Katayose, Y., Tasaki, M., Ogata, H., Nakata, Y., Tokuyama, K., & Satoh, M. (2009). Metabolic rate and fuel utilization during sleep assessed by whole-body indirect calorimetry. Metabolism, 58(7), 920-926.
Lewy, A. J., Wehr, T. A., Goodwin, F. K., Newsome, D. A., & Markey, S. P. (1980). Light suppresses melatonin secretion in humans. Science, 210(4475), 1267-1269.
Moniruzzaman, M., Khalil, M. I., Sulaiman, S. A., & Gan, S. H. (2013). Physicochemical and antioxidant properties of Malaysian honeys produced by Apis cerana, Apis dorsata and Apis mellifera. BMC Complementary and Alternative Medicine, 13, 43.
Nemoseck, T. M., Carmody, E. G., Furchner-Evanson, A., Gleason, M., Li, A., Potter, H., … & Kern, M. (2011). Honey promotes lower weight gain, adiposity, and triglycerides than sucrose in rats. Nutrition Research, 31(1), 55-60.
Pasupuleti, V. R., Sammugam, L., Ramesh, N., & Gan, S. H. (2017). Honey, propolis, and royal jelly: a comprehensive review of their biological actions and health benefits. Oxidative Medicine and Cellular Longevity, 2017, 1259510.
Samarghandian, S., Farkhondeh, T., & Samini, F. (2017). Honey and health: A review of recent clinical research. Pharmacognosy Research, 9(2), 121-127.
Scheer, F. A., Morris, C. J., & Shea, S. A. (2013). The internal circadian clock increases hunger and appetite in the evening independent of food intake and other behaviors. Obesity, 21(3), 421-423.
Vallianou, N. G., Gounari, P., Skourtis, A., Panagos, J., & Kazazis, C. (2014). Honey and its anti-inflammatory, anti-bacterial and anti-oxidant properties. General Medicine: Open Access, 2(2), 132.
Van Cauter, E., Polonsky, K. S., & Scheen, A. J. (1997). Roles of circadian rhythmicity and sleep in human glucose regulation. Endocrine Reviews, 18(5), 716-738.
Viuda‐Martos, M., Ruiz‐Navajas, Y., Fernández‐López, J., & Pérez‐Álvarez, J. A. (2008). Functional properties of honey, propolis, and royal jelly. Journal of Food Science, 73(9), R117-R124.
Yaghoobi, N., Al‐Waili, N., Ghayour‐Mobarhan, M., Parizadeh, S. M. R., Abasalti, Z., Yaghoobi, Z., … & Aghasizadeh, R. (2008). Natural honey and cardiovascular risk factors; effects on blood glucose, cholesterol, triacylglycerole, CRP, and body weight compared with sucrose. The Scientific World Journal, 8, 463-469.
Zaccara, S., Panfili, G., & Benvenuto, M. (2016). Antioxidant activity and phenolic compounds in 32 selected honeys from different botanical origins. Food and Nutrition Sciences, 7(11), 1063-1083.
