Cortisol levels of sleepers (purple) and insomniacs (black) demonstrating more peaks during sleeping hours in patients with short sleep duration. Adapted from http://www.ncbi.nlm.nih.gov/pubmed/25905298 Cortisol levels of sleepers (purple) and insomniacs (black) demonstrating more peaks during sleeping hours in patients with short sleep duration. Adapted from http://www.ncbi.nlm.nih.gov/pubmed/25905298

Insomnia should be worked up by a health care professional to help you differentiate some of the possible causes of your poor sleep. Dietary deficiencies can create restlessness (iron, folate) and cramping (magnesium, calcium) and mood challenges can prevent you from initially falling asleep as can shift working.

Patients who wake ‘early’ or who consistently find themselves staring at the ceiling between 1-3 am should be evaluated for elevated cortisol levels. Cortisol and melatonin are our yin/yang balance between our sleep wake cycle, and when disturbed long term, can create patterns of repeated early waking and poor restorative sleep. Cortisol is our ‘get up and go’ hormone, that drives us out of sleep, and gives our body and mind a burst of energy to start our day. In the most healthy scenario, our morning cortisol is our high point of the day, and peaks during our regular waking time (not at 2 am!). Studies have shown that patients who chronically wake in the night have higher resting cortisol levels, and higher levels of inflammatory markers in the blood. Patients with short duration sleeping also are at an increased risk of high blood pressure, type 2 diabetes and cognitive deficits during their workday.

Insomniacs who sleep less than 5 hours per night when followed for 10-14 years were found to have an increased risk of death 4x higher than their sleeping counterparts.

Our stress axis of hormones can easily be disturbed, which can create increased levels of cortisol in the early morning, which drive patients out of their deep sleep, and leaves them fully alert in the middle of the night. Evaluating a 2 point cortisol (morning and afternoon sample) can open a door to understanding your sleep/wake/stress cycle, and help you understand the physical and hormonal effects your stress may be having on your body.

Treatments for cortisol-driven insomnia include measures to reduce your perception of stress (fish oil, B-vitamins and herbs such as Rhodiola) and nutritional support that reduces elevated cortisol levels (phosphatidylserine, melatonin and B12). Testing helps eliminate the guesswork, because even patients with chronically low cortisol will experience un-restful sleep, but obviously require a different treatment approach compared to their more “wired” counterparts.

Naturopathic approaches to insomnia are non-addictive, and get at the root of your symptoms rather than sedating you just to achieve sleep. Ask us how we can help.

Vgontzas AN, Liao D, Pejovic S, Calhoun S, Karataraki M, Basta M, Fernandez-Mendoza J, Bixler EO. Insomnia with short sleep duration and Mortality: The Penn State Cohort. Sleep 2010;33(9):1159-1164, 2010. [/fusion_builder_column][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][PMC free article] [PubMed]

Vgontzas AN, Liao D, Bixler EO, Chrousos GP, Vela-Bueno A. Insomnia with objective short sleep duration is associated with a high risk for hypertention . Sleep. 2009 Apr 1;32(4):491-7, 2009. [PMC free article] [PubMed]
Vgontzas AN , Liao D , Pejovic S , Calhoun S , Karataraki M , Bixler EO . Insomnia with objective short sleep duration is associated with type 2 diabetes: A population-based study. Diabetes Care 2009 Nov;32(11):1980-5, 2009. [PMC free article] [PubMed]
Fernandez-Mendoza J, Calhoun S, Bixler EO, Pejovic S, Karataraki M, Liao D, Vela-Bueno A, Ramos-Platon MJ, Sauder KA, Vgontzas AN. Insomnia with objective short sleep duration is associated with deficits in neuropsychological performance: a general population study. Psychosom Med 2010 may;72(4)397-403, 2010. [PMC free article] [PubMed]