Lindsey Harding, ND
Apr 1, 2024
Investigating the reason you're not sleeping well. A dive into what may be the culprit.
Sleep is a necessary part of life and health. The majority of fatal car accidents in the United States are caused by lack of sleep. The number of hours of sleep is not the only factor here. Quality of sleep is a major player. Frequent waking, especially in the early morning hours, is one of the most frequent concerns I hear. Interruptions in sleep lessen the amount of deep sleep (slow wave) one will get. Let's explore what interfering with your sleep.
Hormones
Hormone imbalances associated with poor sleep:
Low progesterone and/or estrogen dominance
Low testosterone
Hypothyroidism & subclinical low thyroid function
Hyperthyroidism
Low cortisol / high cortisol / irregular circadian rhythm
Blood Sugar
Blood sugar imbalances, especially drops in blood sugar (hypoglycemia), commonly cause early morning waking if blood sugar levels are not stable during the night.
Parasympathetic Nervous System Tone
The central nervous system has 2 opposing parts, the parasympathetic and the sympathetic. The sympathetic provides the "fight or flight" response. The parasympathetic response allows the body to rest and digest. Between high stress jobs and lives in addition to the activation of our minds as the stare at screens, engaged in various activities, these keep our body in Sympathetic mode, keeping us from falling and staying asleep.
Caffeine
The need for coffee or tea to wake up or get over a slump of energy during the day is part of the dependency cycle caffeine creates. Caffeine is a psychoactive drug, altering brain chemistry. Caffeine blocks the action of adenosine in the brain, a chemical that accumulates creating a sleep pressure, helping the body fall asleep each night. When caffeine blocks the action of adenosine by binding to adenosine receptors, that does not stop adenosine from accumulating. Adenosine cannot act because it is being blocked from its receptors, but as soon as the caffeine is used up, the rebound effect of that adenosine will occur, causing drowsiness. This may require you to have another cup of coffee or tea to mitigate this effect, thus continuing the cycle.
Alcohol
While alcohol may help you to fall asleep, it does not help you stay asleep. Alcohol reduces the amount of REM sleep (rapid eye movement sleep). REM sleep is crucial for healing, memory, and feeling rested.
Pain
Pain and discomfort are common reasons for difficulty both falling and staying asleep. Pain not only holds our focus and keeps us awake, but pain also triggers the Sympathetic nervous system activation, keeping our bodies from resting, literally.
Sleep Apneas
Sleep apneas are conditions where the body does not get enough oxygen and it causes minor or major interruptions in sleep. Apneas can vary in severity. Hypertension is a common symptom of sleep apnea.
How I address difficulty sleeping
Looking at your current lifestyle, stressors, and sleep hygiene are extremely important. But it's also important to check on what is happening internally. This includes lab testing, both bloodwork to examine hormones, blood sugar, and many other aspects of health, as well as salivary or urinary cortisol testing to obtain your circadian rhythm.