According to the American Sleep Association (AMA), sleep disorders currently affect somewhere between 50 and 70 million Americans. As an integrative practitioner, this is not a surprising number as some days it can seem that every patient in the office is there to either sleep better, have less fatigue during the day, or usually both. Often, as we enter our forties, fifties, or sixties, sleep difficulties develop that weren’t there before. There are several types of sleep disturbances, each with numerous causes. However, what every sleep disorder has in common is that it is not good for your health. Aside from the obvious affect of causing daytime fatigue, disordered sleep has been linked to elevated blood pressure, heart disease, blood sugar imbalance, and even decreased longevity.

The most common types of sleep disturbances include insomnia, restless legs syndrome (RLS), and sleep apnea. All of these disturbances become more common as we age and can be related to hormone changes, medications, other changes in health, or weight gain.

Insomnia includes any type of difficulty falling or staying asleep. It can have a myriad of causes, from stress to neurochemical imbalance. Insomnia that begins during a person’s 40s or 50s often is caused by hormonal imbalance or as a side effect of medication. Both testosterone and progesterone deficiencies have been linked to poor sleep, especially with difficulty staying asleep. The hallmark of declining progesterone in women is waking between 2am and 4am with difficulty falling back to sleep. Replacing progesterone and testosterone with prescribed hormones can correct sleep for many. Other times, the hormones disturbing sleep have to do with our cortisol production that helps to drive our circadian rhythm. We can often use nutrients or herbs to help to support morning cortisol levels (when cortisol should be high), and decrease cortisol at night (when it should be low). Although I recommend you find an expert to help you with any chronic insomnia, some find relief using anxiolytic herbs such as lavender, hops, passionflower, and Melissa to promote relaxation before bed. Magnesium, as magnesium citrate or glycinate, is calming for many and is a mild muscle relaxer. If you find yourself tense before bed or during the night, this addition can be very helpful. The hormone melatonin in low dosages is sometimes effective; although in study, it works the best for those who have insomnia related to either shift work or travel, and can lead to daytime grogginess for some. Neurotransmitter support such as GABA and 5-HTP can also be helpful but should be managed for you by a practitioner to rule out contraindications.

Insomnia can also be a side effect of other medications, especially anti-depressants, some blood pressure medications, and steroids. If you have an onset of insomnia within a few months of beginning a new medication, speak with your doctor about ruling out the medication as a cause.

Sleep apnea, likewise a common cause of sleep disturbance, is characterized by a sudden and usually repeated cessation of breathing while sleeping. There are three types: obstructive, in which the airway becomes physically blocked by the palate; central, in which the nervous system does not properly trigger a breath; or mixed, which is a combination of the two. Unlike insomnia, those with apnea may not report trouble sleeping at all, but instead feel grogginess during the day. They are often snorers, and their partners can often describe the episodes of disturbed breathing, which inevitably lead to poor sleep. Obstructive apnea is associated with carrying extra weight and many can have an improvement in symptoms with weight loss. Others do well with a CPAP (ContinuousPositive Airway Pressure) machine, which ensures proper air and oxygen flow for a more restful sleep. Sleep apnea could arguably be the most dangerous type of sleep disturbance, as it is significantly related to increased cardiovascular disease.

Restless leg syndrome (RLS), typically presenting as the sensation of needing to move your legs around especially as you are trying to fall asleep, can be very disturbing to sleep as well. Although RLS can be associated with diabetes and anemia, most cases are of unknown cause. If you begin to have RLS symptoms, a visit to your physician should be made to rule out any traceable cause. If no cause is found, some find relief with nutrients including vitamin B12, folic acid, and vitamin B6. Others do well with a neurologically supportive anti-oxidant called alpha-lipoic acid. Some RLS sufferers find relief with a simple dietary addition of potassium (i.e. a banana or avocado before bed).

If you have a chronic sleep issue that doesn’t improve with basic lifestyle improvements, it is vital that you pursue further diagnostic work with your doctor, including completing a sleep study when appropriate. You may think that you are simply seeking to improve your energy, but in fact, you could change the entire course of your health by addressing your sleep issue. Regardless of the cause of your sleeplessness, there are options for treatment that could likely improve your nights.

FIRST STEPS TOWARDS GOOD SLEEP

Stick to a Routine
Try to wake up and go to sleep at consistent times every day. If you can wake as the sun comes up and sleep after it goes down, that’s even better.

Have a Relaxing Evening
In the hour or two before bedtime, be relaxed, dim the lights, have a routine that calms you, and try to avoid TV or other screens.

Exercise Daily .
.. preferably in the morning or afternoon, when your cortisol levels should be naturally higher. But, if you are poor sleeper, don’t skimp on sleep for an early morning work-out.

Make Your Bedroom Dark, Quiet, and Cool
Most people sleep better in a house that is cooler at night. Get rid of any lights, including those coming from your clock, cable box, etc. If there is noise you can’t get rid of, try a white noise machine.

Don’t Drink Too Much Water
Drink water early during the day and remember most of us can stop around 65-85 ounces (more in Phoenix summer). If you are sacrificing sleep due to too much water, you might be over-doing it.

If these lifestyle adjustments don’t work, get help to rule out common causes of sleep disturbance – there are treatment options.

Stay healthy & be well!

-Amy Whittington, NMD