There are numerous reasons why we have difficulties sleeping, which we will discuss today. I can tell you one thing for sure though, it’s not a deficiency of Ambien/Zolpidem or Lunesta or Trazadon or Tylenol PM or what every other sleep medication you grabbed off the shelf in a sleepy haze from your local CVS! Some of these medications can be hard to get off, and can cause rebound insomnia making your sleep worse. Some help knock you out leaving you groggy the next day, and some deplete your body of the hormone melatonin that you need to sleep! If you’re tired of relying on a drug to help you sleep, and your ready to find out WHY you can’t sleep, and fix that, then read on my friend!
Start by identifying your most likely sleep type.
Type 1 Low Melatonin-no-Sleepers:
Normally when the sun goes down, darkness signals our brains to start making melatonin which tells us it’s time to sleep and we start to feel tired. Melatonin is a strong anti-oxidant protecting our mitochondria from oxidative stress aka ageing. Melatonin turns off our stress system at night which helps us to unwind. If your a Type 1 more than likely your sleep troubles are related to your brain not making enough melatonin.
Here are some reasons why:
- Screens: Screens (phones, ipads, computers, TVs) blasting our brains with blue light suppresses melatonin production. Avoid all screens at least 1hr before bed, even on the lowest light setting on your phone it’s to bright! And if you wake up at night don’t look at your phone!
External light: Thanks to Mr. Edison we can now defy natures dark-light rhythms, lighting up rooms in the house, street lights, car lights, blazing through bedroom windows, all interfering with melatonin production. Black out your bedroom, turn lights down closer to bedtime.
- Medications that deplete melatonin:
- The SSRI Fluoxitine.
- Corticosteroids such as asthma inhalers, Prednisone, Hydrocortisone.
- Heart medications specifically beta-blockers such as Atenolol, Metoprolol, Timolol.
- NSAID such as Ibuprofen, Naproxen, Diclofenac.
- Shift work & time travel: Our bodies love a consistent rhythm, our brains understand waking up when the sun comes up and going to bed when the sun goes down, in the same time zone. Traveling to different time zones, and working shift work gets our poor brains confused! In these cases you may not be low in melatonin, but taking some can help your brain understand when it’s time to sleep.
Tips for Type 1 Low Melatonin-no-Sleepers: try low dose melatonin 30 minutes before bedtime. After you take the melatonin start to wind down, avoid all screens, and dim the lights. If you are waking up about 4hrs after you go to bed then choose a sleep supplement with Melatonin & 5-HTP (don’t mixing with SSRIs).
Type 2 Stress-no-Sleeper:
Our stress system helps us to adapt to stress and it helps to regulated our sleep wake cycles with melatonin. In the morning cortisol rises which allows us to bounce out of bed rested and ready to take on the day. At night, melatonin turns on signalling cortisol to turn off allowing us to unwind and fall asleep. However, if our stress system is burn out, over worked, over tired, then our sleep gets messed up.
The following are sign cortisol dysregulation is your sleep challenge:
- You feel wired and tired at night, staying up to late.
- You lay in bed with your mind on overdrive struggling to fall asleep.
- You wake up in the middle night, your mind turns on and it’s hard to go back to sleep.
- You wake up after your alarm has gone off 10 times, drag yourself out of bed, and don’t want to see or speak to anyone until you have your morning coffee.
- You dislike those bright-eyed-happy-to-be-alive morning people.
Tips for Type 2 Stress-no-Sleeper you will probably have the most success with the following tools:
- Eliminate all caffeine from your diet! What? I can’t do that! At the very least NO caffeine after noon, drop the coffee and switch to green tea. But no green tea or decaf or other lightly caffeinated beverages or stimulants of any kind, after noon.
- Try a blend of cortisol lowering support such as phosphatidylserine, glycine, inositol, Ashwaghanda, Magnolia and melatonin.
- Avoid working out and working to close to bed, allow a good 2hrs to wind down in between.
- Try stress reduction techniques in the evening enjoy a hot magnesium bath with lavender oil, meditation, listening to a super boring sleep story on the Calm App or a sleep meditation on the Insight Timer App.
- Have your adrenals tested with a four-point cortisol salivary test, and get your stress system back on track. Ask your Naturopath.
- Lower stress in your life or improve the way you cope with stress.
- Increase daily exercise – keep it to mornings or mid-day.
- Get out into nature.
- Talk to a qualified friend or therapist.
- Get a hobby and make time for it.
- Try yoga and/or meditation.
- Move work closer to home.
- Say no, do less.
Type 3 Magnesium-Deficient-sleepers:
If you’re falling asleep and staying asleep more or less through the night, but feel restless, you are low in magnesium. If you suffer from restless leg syndrome, or clench your teeth, then you will benefit from some magnesium. Magnesium is an essential mineral involved in over 300 enzymatic reactions in the human body including muscle relaxation, bone building, and energy production and approximately 30% the population is deficient (1).
Signs you might be deficient in magnesium:
- Anxiety & irritability
- Muscle cramping & weakness
- Ringing in the ears
- Vitamin D deficiency
- Restless leg syndrome
- High blood pressure
- Tension headaches or migraines
- Craving chocolate 😉 It’s true!
Tips for they Type 3 Magnesium-Deficient-Sleepers:
Increasing magnesium rich foods such as pumpkin seeds, almonds, Brazil nuts, tofu, chocolate (careful it can be stimulating and keep you up), cashews, and avocados.
Have magnesium glycinate or citrate at night before bed, note some forms of magnesium can cause loose stools. Magnesium glycinate is well absorbed and easy on the digestion. One of my favorite supplements is Natural Calm by Natural Vitality.
Type 4 REM-Deprived-Sleepers:
If you are going to bed fine, sleeping through the night more or less, and waking up feeling unrefreshed you are not getting enough restorative REM sleep. REM is when we do most of our dreaming, it benefits memory, learning and mood. You don’t want to miss out on that. There are a few possibilities as to why this might be happening for you:
- Sleep Apnea: get checked, honestly if you have sleep apnea nothing is going to help unless you address it. Best way to find out is to do a sleep study. Ask your partner if you snore, or if you stop breathing momentarily in your sleep, or choke or cough. This is common with people who are overweight, on testosterone replacement therapy, or have sinus conditions. Sleep apnea is hard on your heart, ask your general practitioner for a referral.
- HPA Dysregulation aka adrenal fatigue causes low am cortisol, which results in you just not feeling overly refreshed in the am even after good nights sleep.
- Drugs & alcohol: A joint and 1/2 a bottle of wine will conk you out, but it won’t help you wake up refreshed. Alcohol reduces the amount of restful REM sleep, and I think THC does to as many of my patients who use THC report less dreaming and less restful sleep. Other medications like anti-depressants, stimulants like Ritalin and caffeine, decongestants, and over the counter sleep aids can also reduce REM sleep.
- Lack of sleep: we are suppose to cycle through REM sleep every 90 minutes with each cycle lasting longer as the hours go on, thus our most restful sleep happens in the 7th & 8th hours of sleep, if your getting less then 7hrs per night, you are sleep deprived!
- Discomfort: Maybe your mattress is uncomfortable, or your body is in pain and you’re just not able to get comfortable enough to get into a restful sleep.
- Trauma: are you waking up with nightmares? Afraid to sleep in the dark? Have you experienced some trauma and think it might be interfering with your sleep? You’re not alone and there is hope. I have a wonderful support network I am happy to refer out to for anyone suffering from trauma. Please don’t hesitate to ask me.
Tips for Type 4 REM-Deprived-Sleepers:
- Get checked for sleep apnea. Try using Sleep Cycle App to monitor how restless you are during the night.
- Establish healthy sleep routines, go to bed around the same time every night +/- 30 minutes, aim for 7-8hrs of sleep each night. Catching up on the weekends does’t work.
- Avoid alcohol and drugs, re-asses your medications with your doctor. Ask your Naturopath about healthier alternatives.
- Asses the comfort of your bed, maybe it’s time to replace your mattress.
- Get your adrenals checked by your Naturopathic doctor.
- Try R.E.M Maintenance by Metabolic Maintenance at night before bed along with the above recommendations.
Type 5 Sweaty-Sleeper:
Besides the obvious….your room is to warm! Why are you sweating at night? Are you hitting menopause? Is your thyroid running high? Are you catching a cold or flue? Or maybe the beers you had after dinner have turned into sugar, and are now fueling your internal thermostat! If you’re a women 45 or older and your cycles are getting irregular, your sweating at night, call me! I can help you breeze through menopause, sleep through the night, your whole family will thank me 🙂 If you notice you only sweat part of your cycle you bet your hormones are to blame. I can help with that too!
If your having troubles sleeping, don’t suffer, book an appointment with me. I have helped hundreds of my patients improve their sleep. Book online here.
Happy ZZZZZZs Dr. E!
DiNicolantonio, J.J., O’Keefe J.H., Wilson W. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. Open Heart BMJ. 2018; 5(1): e000668.