Some well-researched mechanisms behind poor sleep quality


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Insomnia affects roughly 40% of the population. Getting proper, deep and restorative sleep is vital when it comes to maintaining good health. It gives the body a chance to properly recuperate, detoxify and rest. When we don’t get proper sleep we usually feel tired, sluggish and experience reduced stamina; kind of like unplugging your cell phone from the charger at 50% – it still works but doesn’t last as long.

For many people, proper sleep is a big issue. I frequently see clients in my practice who have some form of sleep disorder, ranging from mild to quite severe. Insomnia comes in two main forms. People typically have problems falling asleep or staying asleep, sometimes both. Problems falling asleep are fairly straightforward but not always easy to treat.

Problems falling asleep

Usually we are dealing with an overactive mind and are unable to wind down for the night. This is often due to high stress levels and having too much on the go. This impacts the adrenal glands and functional lab testing often reveals that these individuals have high night time cortisol (it should be low at night) which produces a ‘wired but tired’ feeling. I’ll talk more about adrenal glands shortly.

We might also be dealing with a serotonin/melatonin imbalance. Serotonin regulates the day/light cycle and is elevated during the day time. Melatonin is the hormone that is involved with regulating our night cycle. As night falls and it gets dark, melatonin levels rise. This signals the body that it is time to go to sleep and makes us feel sleepy. When serotonin is low, melatonin can also be low, resulting in insomnia. Supplementing with 5-HTP is well known to raise serotonin and thereby melatonin. One could also cut to the chase and supplement with straight melatonin but I would caution against long-term use as we don’t have enough data on the effects. The sedative herbs valerian, passion flower and chamomile won’t necessarily help raise melatonin but they will help put you to sleep.

Problems staying asleep are a little different and quite varied.

Low blood sugar/hypoglycemia

A typical pattern for this type of insomnia is that the person often has very erratic energy patterns throughout the day. They might also have cravings for carbs, coffee, alcohol and sugar to help keep their blood sugar up and give them ‘energy’. At night they typically get tired quite early on and have no problem falling asleep but will wake up at the same time every night. Why? After dinner blood sugar goes up but it steadily drops while they are sleeping. If blood sugar drops too low, the adrenal glands kick in. The adrenals secrete a hormone called cortisol which stimulates the production of glucose and raises blood sugar.

Unfortunately the adrenals also secrete other hormones, some of which promote alertness, increased heart rate, ‘energy’ and stimulation (this is the ‘fight or flight’ response). There are a couple of ways to tackle this. Increasing proteins, fats and fibre in the diet will go a long way in stabilizing blood sugar.

Adrenal support in the way of b-complex, vitamin C, magnesium, sodium, potassium, and adaptogenic herbs like ashwagandha, licorice root, maca and ginseng will help strengthen the adrenals overall and support blood sugar balance. A handy tip at night is to eat a small snack made of unsweetened organic apple sauce with cinnamon and freshly ground flax seed. Tastes amazing and will help prevent blood sugar from dropping too low overnight.

 Liver Issues

According to Chinese medicine, each of the organ meridians is more active at different times of the day. The liver does most of its work at night between the hours of 1 and 3 am. Waking up consistently between these hours every night might signify a liver problem. Things that you can do to help the liver include avoiding heavy, fatty meals late at night, cutting back on fried foods and cleaning up the diet so as to minimize chemicals in food. When the liver is having issues, it is often a sign that the toxic load is high (the liver is the primary organ of detoxification). Herbs like turmeric, milk thistle and dandelion are fantastic liver cleansers. Supplementing with n-acetyl cysteine (NAC), glutathione and/or taurine also work on multiple liver pathways. Increasing sulfur-rich foods like broccoli, cauliflower, onion, garlic and eggs also support the liver.

Prostate problems

The prostate gland is a small gland found in males that sits right next to the bladder. It is part of the reproductive system and produces a fluid that is a component of semen. Once men hit middle-age, it is common to experience something called benign prostate hyperplasia or BPH. Simply put, this is an enlargement of the prostate gland.

As it enlarges it puts pressure on the bladder causing it to ‘shrink’. This reduces the capacity of the bladder to hold urine which leads to more frequent urination and increased night time urination. These men will often tell you that they have to pee all the time and wake up 2-3 times a night to do so as well.

Brazil nuts are high in selenium and zinc which are minerals that are key for prostate health. The herbs saw palmetto and stinging nettle work well for prostate issues while turmeric, cloves and omega 3 fatty acids will help reduce any inflammation.

Menopause and hormonal imbalances

Women who are peri-menopausal or menopausal may experience insomnia to varying degrees. This is largely due to a shift in the hormones estrogen and progesterone, but can also involve melatonin (as discussed above). Progesterone works by calming moods and making us sleepy. Estrogen balances body temperature. When estrogen levels drop during midlife, women start to develop hot flashes and night sweats, which cause them to wake up frequently at night. Estrogen levels are at their lowest at two o’clock in the morning, hence the 2am wake up call. Implementing some of the liver recommendations listed previously can help a lot with balancing out estrogen since estrogen is detoxified by the liver. Organic soy (tofu, tempeh, etc), red clover and flax contain phytoestrogens which can help smooth out the rapid decline in estrogen. Black cohosh and Dong quai (aka chaste berry or vitex) have a long history in alleviating menopausal symptoms.


Stress comes in many different forms and it is always a good idea to identify the sources and take measures to minimize exposure. That said, everyone handles stress a little differently. If you are prone to crumbling at the first sign of stress and have insomnia, then implementing some of the adrenal supporting tips I listed above will go a long way. This together with relaxing exercises such as Tai Chi, yoga and Pilates (not stimulating cardio, spinning, etc!) will help to manage stress better and make inroads into balancing cortisol levels.

The evaluation hormones can be tricky when it is solely based on symptoms. This is why in my clinical practice I usually run saliva and or urine hormone tests to accurately assess hormone levels. It is a lot more precise which means that a more targeted approach can be implemented. They can also be measured before and after treatment; ensuring that one will not slide back down the hill once treatment stops.



Eichling PS; Sahni J. Menopause related sleep disorders. J Clin Sleep Med 2005;1(3):291-300



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