Sleep Issues

Many folks believe that sleep is not a big deal. You miss a few hours and you make up for it the next night, or the night after that. Some folks actually brag about how little sleep they get by with. Lucky, yes?

It turns out that sleep is not a big deal, it’s a HUGE deal. According to T.S. Wiley, author of Lights Out, sleep deprivation is actually seasonal and for those who get less than 9.5 hours during the 7 “winter months” may actually be setting themselves up for serious health issues. Dr. Eve Van Cauter found that the metabolic and endocrine changes resulting from sleep deficit look just like aging. “We suspect that chronic sleep loss may not only hasten the onset but could also increase the severity of age-related ailments such as diabetes, hypertension, obesity and memory loss.”

There have been over 1000 studies looking at the effects of sleep so why haven’t we heard about important it is? When queried, Dr. Wehr of the Department of Seasonal Circadian Rhythmicity at the National Institute of Health replied” Well, yes, [the public] has a right to know. They should be told, but it won’t change anything. Nobody will turn off the lights”.

We are a sleep deprived nation. Over 42% are unable to stay awake and another 26% can’t get to sleep. Sleep has become an issue since the advent of electric light. In nature, a person would sleep 12 hours per night. Eighty years ago, the annual value fell 9.3 hours. Now we are sleeping around 7 hours a night.

How does sleep affect my health?

Sleep involves complicated systemic interactions throughout the body. It is involved in removing cellular debris, protecting our mitochondria and DNA from damage, repairing and replacing old cells, cooling inflammation, and generating neurotransmitters.

Sleep deficiency has been linked to all types of degenerative disease including cancer. Let’s talk about just a few of these mechanisms. 

Cortisol Awakening Response

Light/dark cycles or circadian rhythm is an important part of our physiology. Our bodies adapt to periods of feast/famine by the ability to store fat from carbohydrates (and a few amino acids) via the hormone insulin.

During the summer when food is abundant, our ancestors would consume lots of food to produce fat and cholesterol as a means of surviving the harsh “carbohydrate-less” winter. Hormones turned-off appetite suppression. We became insulin resistant which allowed us to store as much fat as possible. This not only nourished us, but the cholesterol would keep our cell membranes from freezing. So basically, long summer days meant plenty of time for food storage and procreation, and the dark cycle (both winter and sleep), allowed regeneration to occur.

With  artificial light, continual short nights simulate summer and the storage of fat. This “long day” causes high levels of cortisol/insulin throughout the evening. And since these levels do not fall until we reach a very deep sleep, our cortisol doesn’t rise normally in the morning as it should. This results in a reversal of our natural hormonal rhythm. It’s no wonder why many of us are not waking up easily!

This response called the Cortisol Awakening Response (CAR) is really important to allow us to wake up correctly. 

First, we release cortisol to reduce inflammation so we can react quickly for our survival. Second, blood sugar quickly rises to allow us to function after the long night’s fast. Third and most important, cortisol also allows thymus glands to check/remove any unhealthy immune cells so as not to help induce an autoimmune condition.

In addition to insulin resistance, high cortisol reduces production of growth hormone and robs our amino acids stores which makes it even more difficult for the body to repair itself.

Blood Sugar Regulation

One of the most profound effects of limited sleep is on blood sugar regulation—which in itself is the source of many degenerative diseases. In this study, researchers enlisted 11 healthy young men to sleep in a specific manner for 16 consecutive nights. During the first 3 nights, the men slept for 8 hours (11 p.m. to 7 a.m). The next 6 nights, 4 hours (1 to 5 a.m). Finally, they were allowed 7 nights of 12 hour uninterrupted sleep (9 a.m. to 9 p.m.) Diets were identical for all periods and subjects.

What they discovered is that there was so much sugar dysregulation during the periods of limited sleep that they participants actually started to demonstrate patterns of type-2 diabetes. They required 40 percent longer than normal to regulate their blood-sugar levels and insulin sensitivity decreased by about 30 percent. Sleep deprivation also interfered with many other important hormones including TSH, sex hormones, and neurotransmitters.

It is important to note, that these abnormalities quickly returned to normal and actually improved by the end of the 12 hour sleep cycle. This indicates that even eight hours of sleep may not be long enough! 

Melatonin 

The sleep cycle also controls melatonin secretion. In addition to triggering sleep, melatonin is a powerful antioxidant–hundreds of times more powerful than Vitamin C or E. Melatonin penetrates right into the mitochondria to protect it from harm by oxidative stress. So without adequate sleep, we lose our source of metabolic fuel and cellular defense. We wonder why we may be tired, brain dead, weak, susceptible to chronic and degenerative disease, etc..

Autophagy or Cellular Recycling

An important event that occurs during the nighttime is autophagy, or cellular recycling. This is the time when damaged cells and mitochondria are broken down, recycled, and replaced with brand new cells. Without good cellular maintenance, our cells do not get “upgraded”. This leaves us prone to the same issues as above, with accelerated aging to boot.

Cardiovascular Risk

Sleep deficiencies can also increase our cardiovascular risk. Researchers believe that homocysteine might be elevated in some individuals due to the destruction of a crucial pathway enzyme (that can also be deactivated by a blue light cryptochrome watch your electronic use at night).

For others, it could be the shear stress due to seasonal high blood pressure caused by elevated cortisol levels (along with carbohydrate water weight and serotonin/insulin resistance).

Mitochondria and free radicals

Researchers have begun to examine what happens at a cellular level when the body is deprived of sleep. Some studies suggest a connection between limited sleep and oxidative stress, pointing to mitochondria as a possible target of sleep deprivation.

Chronic stress exposure can downregulate mitochondria function leading to cellular fatigue.  Mitochondria have a potential role at two levels: as a target of stress and as a mediator of stress pathophysiology, suggesting that one of the biological functions of sleep may be to protect against oxidative stress.

What can interfere with getting a good night’s sleep?

A few issues quickly come to mind regarding factors interfering with sleep.

Inability to make melatonin

Melatonin is a hormone produced by the pineal gland in the brain and released into the bloodstream. Darkness prompts the pineal gland to start producing melatonin while light causes that production to stop. As a result, melatonin helps regulate circadian rhythm and synchronize our sleep cycle with night and day. In doing so, it facilitates a transition to sleep and promotes consistent, quality rest.

Melatonin is made from the neurotransmitter serotonin. If we are unable to make serotonin (see reasons why here), we won’t have enough melatonin to initiate sleep.

Even with enough serotonin, if we are low on cofactors such as B vitamins and minerals, we can’t convert serotonin to melatonin. As methylation is also necessary for this conversion, those with genetic issues may be compromised. 

Free radicals or oxidative stress with those with nitric oxide issues can also deplete melatonin production. 

Exposure to light

In addition to interfering with melatonin production, exposure to light and especially the use of electronics can affect circadian rhythm and sleep due to the blue light it emits. A couple of interesting studies:

Stress and blood sugar

Stress also interferes with our circadian rhythm– forcing cortisol release at inappropriate time which disrupts sleep. Keep in mind, that since stress can be of any origin: physical, spiritual, and/or emotional, increased sleep requirements might be due to our bodies response to the daily stress of our “normal” lives.

Blood sugar effects sleep and sleep affects blood sugar! One of the signs of blood sugar dyegulation, is interrupted sleep especially between 2-4am. if you are having issues waking during the night, you may not be storing enough sugar during the day. When this happens, cortisol is released (with a shop of adrenaline) to try to normalize sugar levels.

What can I do to improve my sleep?

Obviously it is important to reduce any forms of stress including food intolerance, subclinical infections, dehydration, hormone dysregulation, lifestyle, genetics, adrenals, etc.

Diet should be designed to support blood sugar dysregulation and minimize inflammation.

You might consider:

  • Eating an all protein or fat snack an hour prior to bedtime. No carbs at that time.
  • Try to get to sleep by 10pm every night.
  • Use room darkening shades.
  • Employ evening relaxation practices.
  • Supplements such as magnesium, L-theanine, tryptophan, or herbal teas help many folks to relax.
  • Try avoiding electronic use before bedtime (or use blue light blocking glasses), turn off electricity to room at night or other EMF reducing strategies to help reset your circadian rhythm. 

Can I take melatonin?

For those that supplement with melatonin, please note that long term use might cause a reduction in size of the pineal gland over time reducing naturally produced melatonin.

A better bet might be the use of L-tryptophan, an essential amino acid. This is a precursor to melatonin and in addition to sleep, can help enhance mood, reduce anxiety, help with cravings, etc.

Signs of overproduction of melatonin include needing an alarm or waking up “hungover” since light is no longer suppressing melatonin spontaneously.

What tests can I have run?

There is no direct laboratory test. You can look for underlying dysfunctions discussed above starting with a Functional Blood Chemistry Analysis.

Sleep requires the action of many hormones–cortisol levels, circadian rhythm, melatonin, oxidative stress, and sex hormones which can be measured via hormone testing.

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