Why Cant You Get Good Sleep?
Why Cant You Get Good Sleep?
By Christy Sutton D.C.
We all find ourselves occasionally having a hard time falling asleep, staying asleep, waking up not feeling rested, or just not getting enough sleep in the first place. So why are so many people having sleep difficulties? I think that the answer is often stress, which causes our bodies to secrete more cortisol and fatigues our brains and bodies. Cortisol is a stress hormone that helps regulate your blood sugar during times of stress and fasting. Having the ability for your body to keep a constant blood sugar is necessary for survival—one can die very quickly from too low of blood sugar. However, too high of cortisol has many detrimental side effects that can contribute to diabetes, increased intestinal permeability, and difficulty falling asleep among many other serious health issues. This is opposed to too low of cortisol which can cause people to wake up periodically throughout the night. The waking up throughout the night is a result of low blood sugar that occurs from not having enough cortisol to regulate blood sugar while sleeping at night. Our bodies have a cortisol rhythm that follows the circadian rhythm ( See picture below).
The body’s natural cortisol rhythm is to be higher in the morning and lower in the evening. The reason for cortisol being higher in the morning is because your body has been fasting all night while you sleep; therefore, your body makes cortisol to allow you to have a stable blood sugar while you are not eating. Conversely, cortisol should be lower in the evening because the food consumed during the day should provide you with a stable blood sugar that would then not require you to need cortisol. If your body is not making enough cortisol throughout the night or if you are insulin resistance (which high cortisol can cause), then you may wake up due to the cells lacking sugar. The neurons in the brain are highly sensitive to low blood sugar, and will make you wake up so that you do not go into an acoma and die. In summary, often people with high cortisol level have a hard time falling asleep, and people with low cortisol level will wake up periodically throughout the night.
So what causes you to have high cortisol that keeps you up at night? Stress! In fact most people that are waking up throughout the night, and have too low of cortisol, are reactionary to having already gone through a stressful period of very high cortisol that eventually caused them to go into adrenal fatigue. I think everyone knows that they have stress, but many people don’t realize how many different things can cause our bodies to be stressed. We all know that family, work, and financial issues cause stress. Some of the less obvious and more commonly underestimated stressors include unknown infections, over training, eating highly processed foods, exposure to toxins, waiting too long between meals before eating, physical traumas, being anemic ( 70 percent of female athletes are anemic), stimulants such as caffeine and cigarettes, artificial sweeteners, mono-sodium glutamate, hormonal changes, nutritional deficiencies, drugs (both legal and illegal), not sleeping enough, lack of aerobic exercise, diabetes, hypoglycemia, any acute or chronic disease, taking corticosteroids such as prednisone, menopause, and andropause.
It is common for sleeping problems to develop as we age, and much of this has to do with the hormonal changes that occur due to menopause and andropause, but often lack of sleep can be a result of decreased brain function and neurotransmitter production—particularly serotonin. Serotonin is one of the neurotransmitters involved in helping us fall asleep and preventing depression. Serotonin’s involvement in sleep is due to the fact that it is converted to melatonin, which helps us fall asleep. It is possible to have depression and difficulty falling asleep from a serotonin deficiency. Cortisol actually decreases serotonin while insulin increases serotonin. The serotonins decrease due to cortisol further explains why it is hard to fall asleep with high cortisol and stress. Insulin is a hormone secreted when blood sugar levels are high to help lower blood sugar levels. The fact that insulin increases serotonin, the calming neurotransmitter, would further explain why people often crave sweets or alcohol in the evening before bed. If you are interested in knowing if you may have a serotonin deficiency then you can fill out the braverman assessment as a beginning point.
Menopause and andropause are other common periods of time for people to experience sleep disorders. During these periods of dramatic hormone loss our bodies struggle to find a way to keep in homeostasis. In doing so we make adaptations that often increase our adrenal cortex output of hormones as an attempt to get more sex hormones from the adrenal cortex. Before going through menopause and andropause the sex hormone production of the adrenal glands is normally insignificant in comparison to that of the gonads and testes. However, after going through” the pauses” out body starts to increase the overall production of all adrenal cortex hormones, including cortisol, in an attempt to get more sex hormones. Unfortunately, our adrenal glands are not as sophisticated as we would like, and the adrenal gland ends up producing higher cortisol in addition to the sex hormones that out bodies are primarily interested in getting from the adrenal glands. If you are interested in seeing if your hormones are contributing to your sleep difficulties then the metabolic assessment, a good physical exam, and possibly a salivary hormone test would be a good starting place.
There is no substitute for sleep. Not getting enough sleep, and then living off of coffee, cigarettes, sugar, and other stimulants is a poor short term solution that will end of causing you to go into an energy deficient. Living off of stimulants to counter a lack of sleep is much like living out of your means off credit cards that you only pay off the minimum balance. We live in a cause and effect universe, so if know that you are having sleeping problems then there must be a cause. The question then is what is that cause? As of yet I have not found someone with an ambient deficiency being the primary cause, although according to the New York Times, data from IMS Health showed there were 43.1 million prescriptions for hypnotics in the U.S in 2005, and this very well may be an underestimation.
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