Let’s investigate a few reasons why your sleep may be off!

1. Hypothyroidism or low thyroid hormone production can cause trouble with falling asleep and staying asleep. Low thyroid hormones also are associated with reduced growth hormone levels which is necessary for promoting healing, muscle growth and more. Ask your doctor to run a FULL thyroid panel (TSH, Free T3, Free T4, TPO Antibodies, and Thyroglobulin Antibodies), to fully assess your thyroid.
2. Stress – High levels of stress leads to raised levels of cortisol (stress hormone) and lowers melatonin. Stress is not always felt physiologically, due to its chronic implications in our modern world. Any perceived level of stress can increase cortisol, which in turn causes you to feel “wired but tired” before bed and disrupt sleep further exacerbating your circadian rhythm. Salivary cortisol testing is something I run often in my practice to assess a person’s level of stress.
3. Continuous light exposure – Light plays a vital role in the synchronization of the circadian rhythm. Light suppresses melatonin, disrupts sleep, and can change your biological rhythm (aka your hormones!). Sleeping in a dark room and waking up to natural light is imperative to regulating sleep. Make it a habit to lower the lights before bed and go outside in the morning for full spectrum light.
4. Low melatonin levels – this can be caused from a variety of reasons such as medications, blue light, high cortisol levels, and high blood sugar.
5. Dysregulated blood sugar – if you have high levels of blood sugar before bed it can make it harder to fall asleep and stay asleep. If you are urinating often at night, it could be your blood sugar! High blood sugar levels also cause the kidneys to compensate by causing patients to urinate more often. Eating a high protein snack before bed can help to stabilize blood sugar, such as nut butter, nuts, Greek yogurt, or protein powder mixed in water.
6. Medications – Checking the side effects of your current medications can be eye opening. Almost all antidepressants suppress REM sleep, and worsen sleep (except for trazodone, trimipramine and mirtazapine). Often patients on SSRIs (such as Prozac or Zoloft) are prescribed sleep promoting agents to manage this side effect. Other medications that impact sleep include beta blockers, medications for ADD/ADHD, steroids, medications for Parkinson’s disease, appetite suppressants, cold medicines, and decongestants (This is not what you want when you are sick!), and more. Talk with your doctor about the side effects of your medications.
7. Alcohol – Not only does alcohol decrease REM sleep or deep sleep, it can cause disruptions in your sleep, making it harder to go back to sleep after waking. To help get rid of this habit, I recommend switching out alcohol for Kombucha, carbonated water with lemon/lime or perhaps the best option – Nighty Night Tea by Traditional Medicinals.
8. Caffeine – Even your morning cup of coffee can cause insomnia for some who are slow metabolizers of caffeine. Ideally you should avoid caffeine past 12pm for an optimal sleep cycle. If you consistently reach for caffeine around 3pm, it is a sign of blood sugar or cortisol imbalances. Consider what you ate for lunch as there may not be enough protein or fat.
9. Disruptions – These can range from having the TV on when you go to sleep to kids waking you up to animals disturbing your sleep. If this is a consistent issue for you, there must come a time to train your dog or cat to sleep in a different room. Also consider moving your biological clock to go to sleep earlier and waking before your kids wake up.
10. Gut Dysbiosis– parasitic infections are known to cause insomnia or disrupted sleep patterns. Read more about dysbiosis here.
11. Restless Legs’ Syndrome – this can be a sign of a nutrient deficiency such as iron or magnesium. Have your doctor check your blood levels of ferritin, iron, and RBC Magnesium.
12. Sleep Apnea – If you wake up with a dry mouth or are told that you snore when you sleep consider sleep apnea. This is best diagnosed with a sleep study.

Complications of lack of sleep can cause chronic metabolic disease and pose a public health crisis. Read more about how sleep affects metabolic health here.

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.