Insomnia- Why Can't I get to Sleep?
Sleep is integral to good health. It used to be smoking, then it was sugar, and now the medical community is catching on to the importance of sleep. As a naturopathic doctor, much of what I do to restore people back to good health is focus on the very basics of human health-- nutrition, digestion, sunlight, emotions/mental health, and sleep.
Americans are notorious for priding themselves on lack of sleep. Forgoing hours of restoration in slumber for the sake of “working hard” and “pushing limits”. The bitter irony is that this ‘hard work’ instead wreaks havoc on the body and results in poorer outcomes long-term. This is because the vessel, your body, that you utilize to ‘to do work’ is the same one that you use for every other aspect of your existence. You are more than your job/career/the physical things you do.
Sleep is an amazing dance of human physiology. We are unconscious but still very much alive.
First our body has to trigger the production and release of melatonin. This first sleep domino requires cofactors like vitamin B6 and magnesium. Melatonin is produced by the brain in response to dark environments. This is why it is best to sleep in dark rooms with black out curtains and all sources of light covered. Melatonin has also been shown helpful in conditions like cancer and autoimmune disease showing its clear regulatory implications in immune function.
B6 rich foods: beef liver, beef, pork, poultry, salmon, tuna
Magnesium rich foods: beef, nuts, seeds
Difficulty getting to sleep and staying asleep can be influenced by elevated cortisol levels, endocrine disorders, poor melatonin production, excessive production of catecholamines, high caffeine levels or stimulants, and even mental/emotional stimulation (which often impacts cortisol production and catecholamines).
All of these can be tested for determine if they are a causative agent in insomnia or poor sleep patterns.
Example tests: AM & PM Cortisol serum, urinary or serum catecholamines, genetic SNP testing for COMT, emotional questionnaires like PHQ9 & GAD7, Thyroid testing (TSH, free T4, free T4), hemoglobin A1c & insulin (assessing for metabolic issues)
Oftentimes patients experience benefit from simply eliminating coffee and other sources of caffeine first, yes, all caffeine including energy drinks, chocolate, black tea/green tea, and kombucha (often made from caffeinated teas). Occam’s razor applies to this as well, often the simplest solution is best.
There are various stages of sleep that we cycle through. The restorative stage where our body does most of the regenerative work is in REM. Rapid eye movement. This is where you dream, where your body truly relaxes, where you restore and assimilate memories, this is where and why you learn. Our bodies cycle through many sleep cycles in a given night with varying degrees of depth into REM. The better our sleep quality the more REM we get and the better we feel, think, and learn.
You should wake rested and easily without feeling overly groggy in the mornings. If this isn’t the case, likely time to start adjusting your sleep schedule to ensure a proper bedtime & waketime as these should be consistent and routine. The more your body learns a routine the better your natural physiological rhythms will be.
The aforementioned cofactors to increase production of melatonin, as well as, supplemental melatonin can be helpful. Slow release melatonin is more beneficial to people that have issues waking throughout the night. In my clinical practice, I utilize different botanical prescriptions of different herbs based on patient presentation that help with mental/emotional causes of insomnia; as well as, others that offer sedative actions, hypnotic actions (ie ones that induce sleep!), and central nervous system trophorestoratives (this means herbs that help restore the normal function of the CNS).
Our bodies and minds are amazingly complex. As a doctor I am perpetually amazed and in a state of wonderment about it, I hope you are too! We are amazing biologic machines and vessels of consciousness. However, just like all things need rest and upkeep, so do we. Take your sleep seriously and I promise it will make a positive impact on your health.