Trouble Sleeping? Top 3 Reasons Why
by Erika Horowitz, ND

Sleeplessness can have lasting effects on your health, disturbing your metabolism, cognitive and neurotransmitter function, immunity and adrenal function, and overall hormonal balance. If you have trouble sleeping every night for more than a few weeks, it is characterized as chronic insomnia. The causes of insomnia are many and varied, but they can be divided into two groups:

Primary insomnia is a sleep disorder for which there is no specific underlying condition and is the most common form of insomnia. Stress, low-level worry, environmental changes, disruptions to your normal sleep pattern, and the side-effects of many medications can all give rise to primary insomnia. Primary insomnia is a relatively short-term problem that is more likely to be brought on by poor “sleep hygiene.” Other contributory factors include the excessive use of drugs, alcohol or caffeine and taking naps during the day.

Secondary insomnia may be harder to trace because it occurs alongside a medical or psychological condition that upsets sleeping patterns, and can be exacerbated by medication, environmental factors, or physical issues. These include other sleep disorders such as sleep apnea, narcolepsy, restless legs syndrome and circadian rhythm disorder. Physical and psychological conditions that often give rise to insomnia include depression, hormonal imbalances, adrenal dysfunction, neurotransmitter deficiency, respiratory problems, insulin resistance, heart problems, arthritis, and hyperthyroidism. For many, insomnia can quickly become as concerning as the condition causing it. Relief of secondary insomnia is most successful when both the primary health concern and the accompanying insomnia are addressed.

Adrenal Stress Syndrome
Stress can be good or bad, and everyone responds to stress in different ways. However, for most people, too much stress can cause health problems. Excessive levels of stress can lead to insomnia, which can be associated with adrenal stress syndrome. The adrenals produce cortisol, the hormone that responds to stress. If you have adrenal hyper-function, you will experience an inability to fall asleep. With adrenal fatigue, the symptom is exactly opposite; you can fall asleep, but can’t stay asleep. In both scenarios if the adrenal dysfunction is not dealt with directly, then you will continue to suffer with insomnia.

With adrenal fatigue your body does not produce enough cortisol to keep blood sugar steady as you go through your nightly fast. As blood sugar levels start to drop during the middle of the night, normally your adrenal glands secrete cortisol to help push blood sugar levels back up. If your glands cannot produce enough cortisol to keep your blood sugar levels maintained, you will shift to a backup system, which is the release of epinephrine and norepinephrine. These hormones are Central Nervous System stimulants and will wake you up. This is why you may seem to wake up, wide-awake, at the same time every night.

In adrenal hyper-function, higher than normal cortisol levels are released at bedtime. This will keep you from falling asleep, because higher than normal cortisol levels as you are trying to fall asleep will prevent you from falling into a normal sleep pattern. In either case it is important to look at all the factors that contribute to adrenal fatigue and hyperactivity. There are many factors that must be considered including circadian rhythm of cortisol release, lifestyle factors, emotional stress, and food sensitivities, among other things.

Neurotransmitter Dysfunction
Sleep disorders are among the most common neurotransmitter-related conditions. Others include anxiety disorders, compulsive behaviors, depression, and migraines. Environmental and biological factors—including stress, poor diet, neurotoxins or genetics—can cause imbalances in the levels of neuro-transmitter chemicals in the brain. These imbalances can trigger or exacerbate insomnia symptoms.

Neurotransmitters are chemicals that relay signals between nerve cells, called “neurons.” They are present throughout the body and are required for proper brain and body functions. Serious health problems, including depression, insomnia and anxiety, may occur if certain neurotransmitter levels are too high or too low. Some neurotransmitters are inhibitory and tend to calm, while others are excitatory and stimulate the brain.

Deficiencies of the central nervous system’s neurotransmitters—serotonin, dopamine and nor-epinephrine—are linked to the development of sleep disorders. One way to address the cause of chronic insomnia is to optimize serotonin, dopamine, and nor-epinephrine. By restoring the balance of the neurotransmitters that control sleep to optimal levels needed to maintain normal sleep, we can address the underlying cause of chronic insomnia.

Hormonal Imbalances
Insomnia in women seems to be linked at least partly to lower estrogen levels, which is why women often tend to develop insomnia at menopause. Estrogen helps with the uptake of magnesium into the soft tissues, and magnesium is the main nutrient needed to relax muscles and turn off the “flight or fight” response. So when estrogen levels are low, magnesium deficiencies and conditions they can cause such as insomnia, heart palpitations, anxiety and fibromyalgia may become more problematic.

A deficiency in progesterone can cause climacteric changes such as hot flashes and night sweats; both of which can be a major cause of insomnia in menopausal women.

The connection between adrenal stress, neurotransmitter dysfunction and hormonal balance is that if one is out of balance, they all tend to be out of balance, leading to a multi-factorial reason for insomnia. Here at San Francisco Natural Medicine we can test for and treat these top three reasons you may not be sleeping to help you find balance and a goodnight’s sleep.

What is Your Nutritional Status?

If you’ve been wondering whether your body has the nutrients it needs to function optimally, now you can find out. Even if you are eating a good diet and taking vitamin supplements, you may want to know if your cells are getting the nutrients they need. We are excited to offer MicroNutrient Testing by SpectraCell Laboratories.

With an in-office blood draw, you can be tested for the functional levels of 32 specific vitamins, minerals, antioxidants and other nutrients. The cost for the test is usually $160 with most insurance plans, and $320 without insurance. This test can help your doctor to target your supplementation and dietary changes to help support any needs your body may have. You may have additional nutrient needs due to a variety of issues such as biochemical individuality, poor absorption, chronic illness, aging and lifestyle factors such as exercise, smoking, alcohol and medications.

Knowing your nutritional status at the cellular level helps you to make the best choices for your health now and into the future. Call today to talk to your doctor to see if this test may be helpful for you.

Neurotransmitter a Key to Acupuncture's Effectiveness

The compound adenosine is key to acupuncture’s effectiveness, according to a study in Nature Neuroscience. Despite acupuncture’s 4,000-year history, little is known about the biological pathways that enable carefully placed needles to relieve pain in many patients. Researchers mimicked acupuncture in mice by placing and gradually rotating a needle at a point just below the knee, for 30 minutes. Levels of adenosine, a neurotransmitter, rose 24-fold in the tissue fluid surrounding the needle. Mice injected with an inflammatory substance in their paws and given acupuncture displayed fewer pain symptoms than mice that didn’t get acupuncture. But mice genetically engineered to lack a certain adenosine receptor didn't benefit from the acupuncture session at all—further evidence of adenosine’s role. Blocking enzymes that break down adenosine made the acupuncture much more effective, tripling the level of adenosine near the needle and extending pain relief from about one hour to about three hours.