Why Can’t I Get Enough Sleep?

Sleep Deprived

Author: Dr. Stephen Gangemi

Most people don’t sleep well. You should be able to go to bed, fall asleep within ten minutes, and not wake up until morning, after 7-8 hours. You should feel refreshed upon rising. Sound familiar? Not for most people.

The majority of people get too little sleep or poor quality of sleep. Many people do not go through the necessary 4 stages (plus REM) of sleep to keep them healthy. A sleep study may tell you how you are (or are not) sleeping, but often it does little to address the issue. Medications such as Ambien, Sonata, and Lunesta or herbs such as kava kava or valerian may help you sleep, but if you need them, you really need to investigate why you can’t get the adequate sleep you need on your own. If you’re addicted to melatonin (the sleep hormone made by your pineal gland) too that’s not addressing the problem – taking any hormone for a prolonged period without understanding why you’re not able to make adequate amounts on your own is not healthy.

Can’t fall asleep:
This is most commonly due to high cortisol levels at night. Cortisol, one of the hormones secreted by the adrenal glands, should normally be low at night. High levels due to stress will keep you up. Cortisol and melatonin are inversely related to one another. So high cortisol levels mean suppressed melatonin levels, and melatonin needs to elevate at night to provide restful sleep. The stress can be emotional/mental, chemical/nutritional (too much sugar or caffeine are very common – even if you only consume caffeine in the early part of the day, it can affect your sleep many hours later), as well as physical (working out too hard, pain and injuries).

Always wanting to sleep: 
This could be from an adrenal or thyroid issue, carbohydrate intolerance, an undiagnosed food allergy, immune system problems, or an energy production problem (lack of the proper nutrition to make energy – ATP).  Often people are more toxic then they are actually tired. Tired is more of a “lack of something” whereas a toxicity will make you feel tired. Not breaking down hormones well, such as estrogen in women, will result in a toxic liver and make a woman toxic. Insulin from too many carbohydrate foods will make you toxic too. Not eating often and/or not consuming enough protein will make you ammonia toxic – this is very common actually. Ammonia is a byproduct of protein breakdown when protein is converted into sugar to be used for energy. Unhealthy digestive flora will produce ammonia byproducts too. Ammonia will overwhelm your system and make you feel unmotivated, sluggish, and very tired. It’s very common, especially in endurance athletes who don’t consume enough food or recover properly with the right amount of protein and carbohydrates.

Wake up in the middle of the night at the same time:
Waking up in the middle of the night at a specific time and always at that time has a lot to do with the acupuncture meridian system 24-hour clock. For example, 3am to 5am is the time for the lung meridian to be more active. Constantly waking up during that time could very well be due to something irritating the lungs – poor air quality, lung congestion, smoking, etc. Waking up earlier than you’d like, say every day at 5:30am, and you can’t get back to sleep, is related to the large intestine. This could be due to something you ate, or shouldn’t be eating. The most common times someone wakes up at night is between 1-3am as this is when the liver is most active. As mentioned above, the liver can become toxic quickly for a number of reasons – caffeine, hormones, histamine from a food allergy, ammonia from overtraining or an improper diet, and of course medications.

Waking up throughout the night/tossing and turning:
Provided you don’t have all your pets on your bed, this is usually due to spikes from the adrenal gland hormone cortisol, a result of too much emotional, nutritional, or physical stress. The number one nutritional stress I would say is too much sugar, a close second is caffeine, even if you only drink it in the morning.

Waking up to urinate:
This is not normal. Check out the explanation in “Is It Normal? as well as the correlating article.

Waking up tired:
Could be from all the waking up or from a low thyroid function or low adrenal function.

This is most often caused by congestion and/or a weight issue. Many times the congestion is a result of a food allergy, a fat metabolism issue, or unfriendly yeast/bacteria/fungus living in the digestive tract creating excessive mucous. Too much sugar can be the culprit, because that will make a person gain weight and it is the fuel (food) for all those unhealthy critters that want to nest in your gut.

Teeth grinding (Bruxism): 
As usually reported by your significant other, or your dentist when he/she tells you you’re wearing your teeth down and prescribes a night guard. The number one reason for grinding your teeth is too much stress. Interestingly, the number two reason is a parasitic infection – which although true, there is no direct explanation on this one, it’s a clinical observation shared by many. Here’s a fun fact: Did you know that when you grind your teeth at night it is 5-6 times harder than what you are possibly able to do while you’re awake? That’s amazing. Remember, a night guard saves your teeth, but it actually doesn’t fix the grinding – which can still result in jaw (TMJ) problems, headaches, neck pain, and other ailments.

Growing pains and restless leg syndrome (RLS):
I put these two “conditions” together because they are very similar – kids get what is referred to as “growing pains” and adults with the same type of sensation are diagnosed with restless leg syndrome. Sure there are various degrees to each condition, but ultimately they are one in the same.

I had growing pains when I was a kid – bad enough that I would head to my parent’s bedroom at night as ask them to beat on my legs hard enough to block the pain. Sure I was “growing” but I wasn’t having pain for that reason. Growing pains is one of those conditions that I love to treat because it is usually so easy to resolve as long as the kid follows the dietary recommendations. It’s like Osgood-Schlatter’s Syndrome – a lot of kids have it and it’s so unnecessary for them to deal with for months, sometimes years. Growing pains are typically due to either a toxicity or a deficiency. The toxicity often is from hydrogenated “trans” fats which most kids eat a lot of. I did at that age. The toxicity can also be from histamine, which the body makes when there is an allergy – food or environmental. So food allergies are common reasons for this toxicity. Gut toxicity from unhealthy bugs in the digestive tract can also result in growing pains, and this is many times fueled by a high carbohydrate/sugar diet. So since a lot of kids eat a high sugar and hydrogenated fat diet, you can see why they may get those “growing pains.” The other reason is the deficiency. So the other side of the coin here in respect to trans fats is the good fats – meaning a deficiency of healthy fats such as omega 3 (fish, flax, walnuts) and omega 6 (nuts and  seeds) fats. Sometimes a deficiency in the saturated fats from dairy are the answer too. I see many kids deficient in these fats because their pediatrician or parents think they are bad for them. Heavy cream, butter, cheese, and to some extent ice cream provide fats kids need, (adults too, but lower amounts). My kids eat a lot of butter, cream, and whole raw milk. Only once did one of them get “growing pains” and it was because she needed more fat in her diet. If you’ve read about trans fats on my website you know that if you ever take an anti-inflammatory drug (NSAIDs) and feel any improvement, it means you have a fatty acid deficiency and/or a trans fat excess in your diet. Minerals such as calcium, magnesium, and phosphorus that are lacking in the diet can also be the reason for growing pains. Interestingly, these minerals are responsible for healthy bone growth but it is just a coincidence that their deficiency can result in growing pains.

RLS – again, very similar to the growing pains in kids, but with slight exception. An adult can have restless leg syndrome due to an imbalance of fatty acids and/or a mineral deficiency as noted above, but sometimes RLS is due to the autonomic nervous system being over-sympathetic or “too hyped up.” Of course we have to look at stress here – isn’t that ultimately the reason for every ailment? Too much stress in one’s life creates an imbalance between the parasympathetic (relaxed) nervous system and the sympathetic “fight or flight” system. Ultimately prolonged and excessive stress whether from working too hard, exercising too hard, mental/emotional stress, poor dietary habits, pain, and injuries pushes the nervous system too much to the “fight or flight” mode and RSL results. I often use specific minerals, B vitamins, and fats to help calm the nervous system down, as well as dietary and lifestyle modifications. Yes, this can be corrected without the latest and greatest drug. Typically before RLS begins or gets very bad there are other warning signs that one might not have realized – a twitchy eyelid – a limb that jumps/jerks as they’re falling asleep – sensitivity to lights and sounds – dizzy when standing up quickly – a razor burn from shaving – and bloodshot eyes.

** The function of the pineal gland, which secretes melatonin, is very important for sleep. While all the other hormonal glands turn themselves down at night for a rest, your pineal wakes up. You can easily measure melatonin levels as well as cortisol levels via saliva through certain labs. Many people take high doses of melatonin for extended periods of time. This is not a good idea – you’ll throw off your hormonal balance. I consider a high dose to be over 1mg of melatonin and an extended period of time to be more than 3 days. A lot of people take over 3mg of melatonin for months, even years. Not a good idea. Figuring out why you’re not sleeping is a good idea. Help turn your pineal on at night by eliminating all light sources from your room, including most alarm clocks (cover it up). Also recommended is removing all electronic devices from your bedroom – specifically TVs and computers. Those electromagnetic waves can disrupt hormones. So no TV or laptop in bed – keep your bedroom for two things – sex and sleep, not Sex and the City and Sleepless in Seattle.

My article, “The Power of Sleep”, addresses other common sleep problems.

photo credit:   Smath