A subject near and dear to my heart: sleep.

Did you know that the CDC reports that over 40 million Americans get less than 6 hours of sleep at night. And if you know anything about sleep, all the clichés are true. You really do need adequate sleep so that you can heal right down to the cellular level. If you’re somebody dealing with insomnia, I’ve got news for you – I’ve been there. Prior to a career in holistic health care, I worked for a fortune five consumer products company where my ten-twelve-hour days were fueled by venti-lattes. When I couldn’t sleep at night, I turned to over-the-counter medication and when that didn’t work my internist eventually prescribed me something stronger. None of it ever worked for me, in fact, I always felt like all those drugs gave me “fake sleep,” ultimately, leaving me feeling even more un-rested, irritable and uneasy.

Insomnia, Sleep Deprivation and Sleep Deficiency

When you suffer from insomnia, you basically have the opportunity to sleep but lie awake in bed all night. Sleep deprivation is an ongoing sleep loss where you are experiencing a shortening or complete loss of sleep, daily, due to factors such as working late, celebrating, etc.

Sleep deprivation and sleep deficiency have a lot in common, but according to the National Heart, Lung and Blood Institute, “sleep deficiency” is said to occur if you meet one or more of the following qualifications: (1)

You don’t get enough sleep (you experience regular sleep deprivation).
You sleep at the wrong time of day. This may mean not being able to sleep at night, but then taking naps during the day as a result of daytime fatigue. An abnormal sleep schedule is a sign that your body’s “natural clock” is not operating properly.
You don’t get the type of restorative sleep that your body needs. This includes deep REM (rapid eye movement) sleep. REM is the type you need to restore many bodily processes and keep your body in balance.
You have a sleep disorder. Various disorders can keep you from getting enough sleep, such as sleep apnea, insomnia, anxiety disorders or others. These can cause you to struggle to fall asleep, or to periodically wake up throughout the night.

I’m a busy mom now, but nearly two decades ago I was a corporate work-a-holic trying to do my job while dealing with a sleep disorder: insomnia. I was told by my mother that I was “never a good sleeper,” so I assumed that I would always have to deal with sleep issues. Fast forward fifteen years to balancing my hormones through functional medicine and a newfound eight-nine hours of uninterrupted sleep regularly. What I discovered was life-changing (and if you are struggling with insomnia I wish the same for you!)

3 Causes of Insomnia

If you’re dealing with insomnia, there’s probably one of three reasons why you can’t sleep. The main causes are: a serotonin deficiency, a GABA deficiency or chronically high cortisol.

Serotonin Deficiency

Serotonin impacts every part of your body, from your emotions to your motor skills and is the chemical that helps with sleeping, eating, and digesting. (2) Over 90% of your body’s serotonin is produced in your gut, so if you’re still eating lots of sugar, processed food, fast food, convenience foods, you’re probably destroying your gut’s ability to make adequate serotonin. Low Serotonin levels are believed to be linked with depression, insomnia and when levels of serotonin are brought up to normal, sleep falls into place (3). Without serotonin we cannot convert to an adequate amount of melatonin. And if you know anything about melatonin, this is the neurotransmitter that’s responsible for helping us have a restful night’s sleep. These are the patient’s that typically present to me as “night owls,” not knowing they have a serotonin deficiency. They are awake at night come ten o’clock, and they are ready to do whatever without having to get sleep. The best functional lab test for determining if there is a serotonin deficiency is blood serum testing. Once diagnosed, we may supplement with tryptophan and sometimes even melatonin to get back on track and get great results. (Suspect a serotonin deficiency? Let’s come up with a plan.)

GABA Deficiency

GABA, also known as gamma amino butyric acid, is a “calming” neurotransmitter because it blocks impulses between nerve cells in the brain. (4) These patients generally present to my practice feeling overwhelmed. They’re burnt out, they can’t loosen up, they’re dealing with anxiety, maybe even sometimes panic attacks. GABA is really important to give yourself that calming effect. Generally, this patient presents to his/her internist with these symptoms and is a candidate for anxiety medication because nobody’s going to test for GABA. Unfortunately, while no good blood serum or urine tests exist right now to adequately measure GABA, the good news is that there are great supplements like L-theanine, melatonin or tryptophan to get those GABA levels back up. (Not sure if GABA is the issue? Ask me).

Chronically High Cortisol

Busy moms and high cortisol seem to go hand-in-hand and what we now know is that a vicious cycle exists between elevated cortisol and low serotonin. Under chronic stress, the capacity for an increase in serotonin has reached its limit due to chronically elevated blood cortisol. (5) So for all intents and purposes, if your adrenals are working over-time and producing a lot of cortisol, you’re actually suppressing your body’s ability to produce serotonin which further suppresses the ability to convert to melatonin. You also exhaust more GABA! My patients with chronically high levels of cortisol often times are dealing with an exorbitant amount of stress, maybe drinking a little bit too much alcohol as well as caffeine. When I suspect high cortisol, I immediately order the Dutch test for my patient so we can not only look at nighttime cortisol but the total cortisol, arriving at the most accurate picture. Once diagnosed, I let the lab results guide me in determining how much L-theanine or melatonin to supplement with to get the best result.

Functional Medicine as an Approach to Treating Insomnia

After reading this, if you are certain that you are dealing with insomnia, you are not alone. If I can solve the mystery of my decades long sleep disorder so can you. And I can help you if you need me. The functional medicine approach to treating insomnia will go way beyond the traditional blood test and get you sustainable results. More importantly, if you know somebody that is struggling with sleep in general, I would be so honored if you shared this post with them so they too can explore some possible solutions and ultimately: Get Some Sleep.