Insomnia
Get the holistic support you need to sleep better and overcome insomnia.
Looking to discover the functional medicine approach to insomnia? This page covers:
Understanding your condition
What is insomnia?
There’s no specific test to diagnose insomnia. However, if you consistently struggle with falling asleep, staying asleep, resuming sleep after waking, wake up too early, or feel unrested after sleeping (despite having the chance to sleep well), then you’re likely experiencing insomnia.
The causes of poor sleep can be due to other health conditions (secondary insomnia), underlying issues with overstimulation of the brain and nervous system (causing disrupted REM sleep), nutrient deficiencies, poor sleep habits, or an imbalance of neurotransmitters. Sleep troubles can be episodic, short-term, or become chronic.
Insomnia
Functional medicine for insomnia.
Regular, high-quality sleep is essential for good health and wellbeing. Insufficient or poor sleep can disrupt your performance at work and home, affecting your memory, mood, and ability to manage stress. This can contribute to mental health issues and cardiovascular problems, creating a vicious cycle that becomes harder to break over time. That’s why it’s important to seek help as soon as possible.
The good news is that functional medicine practitioners are experts at providing effective strategies to improve your sleep quantity and quality. By getting to the root cause of your sleep issues, they can help you achieve the restful, rejuvenating sleep you need for long-term health and wellness.
What is normal sleep?
Sleep typically occurs in 90 to 120-minute cycles, with two distinct stages:
Rapid Eye Movement (REM) Sleep: This stage makes up around 25% of your night’s sleep, except for babies where it accounts for most of their sleep. During REM sleep, your eyes dart around rapidly under your eyelids due to high electrical activity, and this is when most dreaming occurs.
Non-Rapid Eye Movement (NREM) Sleep: This stage makes up the rest of your sleep and can vary in duration depending on your age and sleep deprivation level. NREM sleep has 4 stages:
- Stage 1 – Drowsiness/dozing, hovering between being awake and asleep
- Stage 2 – Body temperature drops, breathing and heart rate slow down, and you lose awareness of your surroundings
- Stages 3 & 4 – Delta sleep or deep sleep, where your blood pressure, breathing, and heart rate slow down, and your muscles relax. This is when growth and repair processes occur.
Sleep requirements by age.
Our sleep needs change as we age. Newborns require the most sleep, up to 17 hours per day. As we get older, our recommended sleep time gradually decreases:
- Newborns (0-3 months): 14-17 hours
- Infants (4-11 months): 12-15 hours
- Toddlers (1-2 years): 11-14 hours
- Preschoolers (3-5 years): 10-13 hours
- School-age children (6-13 years): 9-11 hours
- Teens (14-17 years): 8-10 hours
- Adults (18-64 years): 7-9 hours
- Older adults (65+ years): 7-8 hours
While this is the general guideline, some people may need a little more or a little less sleep and still be healthy. However, regularly getting less than 7 hours of sleep as an adult is associated with poorer health outcomes.
Sleep patterns.
As we age, our sleep patterns change considerably. Newborn babies develop a circadian rhythm (an internal day-night cycle) that causes them to sleep more at night, starting around 2 months old. By 6 months, 25-50% of babies will wake up during the night and nap during the day. Most children stop taking daytime naps before age 5, unless they aren’t getting enough sleep at night.
Teenagers experience a shift in their circadian rhythm, feeling their energy levels dip in the early morning until around 9-10 am (when adults are usually more alert). Their body temperature then rises through the morning, peaking around 1 pm when they are most alert. Teenagers also tend to experience an afternoon slump between 2-5 pm (which happens earlier, around 1-3 pm, for most adults) and they don’t start feeling sleepy until about an hour later than adults, around 11 pm.
Adult sleep patterns stabilize around age 20, with most people needing 7-9 hours of sleep per night to feel properly rested and function at their best.
Sleep chronotypes.
Our natural circadian rhythms and unique sleep “chronotypes” work together to influence when we feel sleepy or awake. Circadian rhythms are regulated by light exposure and melatonin release, while chronotypes are likely determined by our genetics. These chronotypes are often described using animal behaviors – some people are “early birds” who wake up early, while others are “night owls” who stay up late, reflecting differences in their individual melatonin patterns.
What causes insomnia?
Chronic insomnia, where symptoms last longer than a month, affects around 10% of Americans. It’s more common in people with other medical conditions, especially older adults. Up to 33% of people regularly experience bouts of insomnia, struggling to fall or stay asleep. This can become chronic if a normal sleep pattern isn’t regained.
Insomnia can be both a cause and consequence of other factors. For example, poor sleep can impact behaviors and health conditions that make it harder to fall asleep, like anxiety. Practitioners now avoid using “primary” and “secondary” insomnia, as the relationship is often complex. Insomnia isn’t usually considered insomnia when there’s simply a lack of opportunity for good sleep, like for new parents. However, it can develop as a consequence of long-term poor sleep.
Common sleep disorders.
Common sleep disorders can include:
- Circadian rhythm disorders, where your ability or desire to sleep is out of sync with your social environment, such as shift work sleep disorder or jet lag.
- Central sleep apnea, insomnia syndrome, periodic limb movement, and dysfunctional beliefs about sleep (like adapting to getting little sleep regularly).
- Restless legs syndrome (also called nocturnal myoclonus).
- Other health conditions, hormonal changes like perimenopause or menopause, psychiatric disorders, or chronic use of drugs, stimulants, tobacco, alcohol, or too much caffeine.
- Side effects from certain medications like cold/flu tablets, beta blockers, diet pills, bronchodilators, or thyroid medication.
- Food sensitivities, pain, discomfort, indigestion, or other digestive issues.
- Poor sleep habits and hygiene, like lack of a sleep routine, napping during the day, too much time in bed awake, frequent travel, watching TV or using screens in bed.
- An unsuitable sleep environment with too much noise, light, or extreme temperatures.
- Dysregulated blood sugar levels.
- Snoring, obstructive sleep apnea, breathing difficulties, or sinus issues.
- Hormonal imbalances like hyperthyroidism.
- Mineral deficiencies, commonly in calcium, magnesium, and zinc.
Sleep apnea and insomnia – what is sleep apnea?
Despite being a common factor in insomnia, many people are still unsure what sleep apnea is. Sleep apnea specialists describe the most common form, obstructive sleep apnea, as occurring when the muscles in the throat relax, allowing the soft tissues to obstruct breathing. This can become a chronic issue, happening multiple times per hour and causing poor oxygenation during sleep, which interrupts the sleep cycle.
In contrast, central sleep apnea happens when the brain fails to send the signals that control breathing. And complex sleep apnea, also known as treatment-emergent central sleep apnea, is when both obstructive and central sleep apnea occur simultaneously.
Risk factors of poor sleep and insomnia.
Getting sufficient, high-quality sleep on a regular basis is essential for restoring and rejuvenating your entire body and brain. When you consistently don’t get enough good-quality sleep, it can negatively impact a variety of important bodily systems and processes. Insufficient sleep can have far-reaching impacts on our health and well-being.
Risk factors.
- Cardiovascular Disease: People who regularly sleep less than 7 hours per night are more prone to cardiovascular disease and high blood pressure.
- Inflammation: Chronic sleep deprivation is linked to increased inflammation, which is associated with conditions like sleep apnea, depression, skin issues, and cardiovascular disease.
- Memory and Learning: Sleep is crucial for consolidating memories and learning. It’s often better to focus on getting quality sleep rather than cramming before an exam. Poor sleep can make your memory feel “foggy.”
- Productivity and Performance: Lack of sleep can cause drowsiness, forgetfulness, and low motivation, impacting your ability to safely and effectively complete important tasks. This can lead to increased anxiety and stress.
- Growth and Development in Children: Even minor sleep restriction can affect a child’s mood, behavior, immune function, cognitive abilities, motor skills, and growth – sometimes mimicking ADHD.
- Weight and Metabolism: Insufficient sleep disrupts the circadian rhythms that regulate hormones like ghrelin (increases appetite) and leptin (suppresses appetite). This can contribute to weight gain and type 2 diabetes risk.
- Melatonin and Overall Health: Poor sleep habits can disrupt melatonin production, which is vital for regulating sleep, as well as tumor suppression, DNA repair, and immune function. Blue light exposure from devices can suppress evening melatonin.
- Stress and Anxiety: Not getting enough sleep is linked to higher cortisol levels, increasing anxiety, irritability, and a lower tolerance for stress – which can further worsen insomnia.
- Brain Health: The glymphatic system, which clears waste from the brain, is most active during sleep. Disruptions to this system may contribute to neurodegenerative diseases like dementia and Alzheimer’s.
- Athletic Performance: Even elite athletes commonly struggle with poor sleep quality and quantity due to training demands. However, optimizing sleep is essential for speed, endurance, attention, memory, weight management, and injury/illness prevention.
Insomnia treatment – the conventional approach.
Your doctor or sleep specialist may recommend good sleep hygiene practices if you’re dealing with short-term, acute insomnia. They may also prescribe short-term medication, but this requires close monitoring for:
- Dependence on the medication
- Changes in your psychiatric status
- Unproductive behaviors and strategies around sleep
- Development of maladaptive thought processes, like panic, anger, social phobias, anxiety, or depression
The current guidelines for conventional insomnia treatment recommend cognitive behavioral therapy as the first line of defense against long-term, chronic insomnia. This approach is preferred over medication as the primary treatment.
Pharmaceutical medications.
The 2018 American Family Practice Guideline reported that several common pharmaceutical sleep aids showed little to no improvement in sleep outcomes compared to placebo. These included:
- Nonbenzodiazepine hypnotics: eszopiclone, zolpidem, zaleplon
- Orexin receptor antagonists: suvorexant
- Melatonin agonists: ramelteon
- Antidepressants: doxepin
- Benzodiazepines: temazepam
- Over-the-counter sleep meds/supplements: diphenhydramine, doxylamine, melatonin
Given the poor effectiveness and high risk of side effects with these medications, many people with short-term or chronic insomnia seek help from insomnia specialists or explore more natural solutions to improve their sleep long-term.
The BionwoRx functional medicine approach.
Alternative treatment for insomnia.
In our initial in-depth consultation, we take a comprehensive look at the factors that may be contributing to your insomnia. We’ll investigate:
- Your sleep history, symptoms, and sleep hygiene practices
- Your lifetime medical history
- Medications and supplements you’re taking
- Any past surgeries or accidents
- Your family and genetic history
- Environmental exposures that could be impacting your sleep
- Your symptom history
- Your nutrition, diet, and absorption
- Lifestyle factors and stress levels
By conducting this thorough investigation, we can identify the root causes of your insomnia and develop a customized functional medicine treatment plan to address them. Our goal is to help you overcome your sleep issues and achieve the restful, restorative sleep you need.
Functional testing.
Your functional medicine specialist may recommend various functional tests to help get to the root cause of your insomnia or to assess your overall health. These tests could include:
- Microbiome and stool testing to check for gut imbalances or parasites
- Markers for inflammation, digestion, and nutrient absorption
- Food sensitivity and allergy testing
- Screening for heavy metal or environmental toxin exposure
- Evaluation of hormone levels, especially cortisol
- Mineral analysis
- Cardiovascular profile
Targets of treatments.
Depending on your specific health needs, a personalized functional medicine approach may help address the underlying causes of your sleep disturbances. This natural treatment plan could target issues such as:
- Improving sleep hygiene habits like reducing blue light exposure in the evenings, avoiding stimulating foods/drinks, and creating a relaxing sleep environment
- Addressing pain, inflammation, or conditions like restless leg syndrome that interfere with sleep
- Reducing stress, anxiety, and depression to restore healthy cortisol and melatonin production
- Rebalancing gut health and the microbiome, which can impact hormone and neurotransmitter levels vital for sleep
- Optimizing hormonal balance, especially for women during perimenopause
- Stabilizing blood sugar and insulin levels to prevent middle-of-the-night wakings
- Addressing nutrient deficiencies that disrupt sleep, such as low magnesium, iron, vitamin D, zinc or selenium
- Resolving intestinal permeability and inflammation that can disturb sleep
- Minimizing the sleep-disrupting effects of medications or other health conditions
The goal of this personalized functional approach is to identify and treat the root causes of your insomnia for long-term, natural sleep improvement.
Natural remedies.
Natural remedies that may help improve your sleep and overall health could include:
- Trying an autoimmune, anti-inflammatory, or personalized diet plan to eliminate any food intolerances, allergies, or sensitivities
- Adjusting your diet to boost sleep hormone production
- Reducing or eliminating alcohol, which can disrupt sleep quality
- Taking supplements or making dietary changes to improve your vitamin status
Herbal medicines can also be a gentle way to help calm the mind and aid sleep onset. Some options to discuss with your healthcare practitioner include passionflower, California poppy, hops, kava, St. John’s wort, schisandra, ashwagandha, lemon balm, chamomile, and valerian. Unlike pharmaceutical sleep aids, these herbs won’t leave you feeling groggy in the morning. However, it’s important to ensure there are no interactions with any medications you’re taking.
The sleep expert at BionwoRx can help you wake up each morning feeling refreshed and energized, so you can fully enjoy life. Quality sleep is the foundation of good health, and our specialist is here to help you achieve the restful, rejuvenating sleep you need.
FAQs.
Why can’t I sleep?
There are many factors that can affect your ability to sleep well. The two most common are poor sleep hygiene (such as unhealthy habits and practices around preparing for sleep in the evening) and chronic stress.
Some other common sleep disruptors include:
- Central sleep apnea, insomnia syndrome, and periodic limb movement
- Restless legs syndrome (nocturnal myoclonus)
- Other health issues, hormonal changes, psychiatric disorders, or chronic use of drugs, stimulants, tobacco, or alcohol
- Certain medications like cold/flu tablets, beta blockers, diet pills, and bronchodilators
- Food sensitivities, pain, indigestion, and digestive problems
- Poor sleep routines, excessive time in bed awake, frequent travel, blue light exposure at night, TV/computer use in bed
- Unfavorable sleep environment (too much noise, temperature, or light)
- Circadian rhythm disorders like shift work sleep disorder or jet lag
- Snoring, sleep apnea, breathing difficulties, and sinus issues
- Hyperthyroidism and hormonal imbalances
- Mineral deficiencies in calcium, magnesium, or zinc
Consulting an insomnia specialist can help restore quality sleep through a personalized, holistic approach. If you’re seeking insomnia treatment, BionwoRx can provide support.
What is the best thing to do if you can’t sleep?
If you’re having trouble sleeping, try these tips:
Good sleep hygiene is key. Establish a consistent sleep routine by going to bed and waking up at the same time each day. Sleeping in a very dark room and then exposing yourself to light in the morning can help regulate your body’s circadian rhythm.
Avoid disrupting your natural melatonin production in the evening. Wear blue-blocking glasses after sunset, or better yet, limit screen time and bright lights before bed. You can also try using soft red lights in your bedroom.
Engage in relaxing pre-bed rituals. Take a warm bath or shower to lower your body temperature, and sip a calming herbal tea like chamomile to help your nervous system unwind.
Steer clear of stimulating activities right before bed. Avoid exciting TV shows, scary movies, intense conversations, or engaging books, as they can raise your cortisol levels and interfere with melatonin production.
What is the best herbal medicine for insomnia?
During the day, certain herbs can calm your nervous system and help you sleep better at night, without making you drowsy. These are called “adaptogens” or “anxiolytics” and include herbs like Withania, Siberian ginseng, Rhodiola, Chamomile, and Lemon Balm.
On the other hand, “hypnotics” or “soporifics” are herbs that can actually make you sleepy, and are best taken right before bedtime. Examples include Passionflower, California poppy, and Hops.
However, it’s important to have an expert, like a functional medicine practitioner, prescribe the right herbs for you. They can ensure the herbs don’t interact with any medications you’re taking and address any underlying conditions, like sleep apnea, that could be impacting your sleep.
Your practitioner may also recommend certain nutritional supplements, such as theanine or glycine, to further support high-quality sleep.
If you’re struggling with insomnia, working with a functional medicine expert can help get to the root cause and develop an effective treatment plan to have you sleeping like a baby in no time.
How do sleep specialists help fix chronic insomnia?
Functional medicine practitioners are highly experienced in treating insomnia and sleep issues naturally. Since sleep is a cornerstone of overall health, they take an in-depth approach to identify and address the root causes.
First, they’ll conduct a comprehensive case history to pinpoint the underlying factors contributing to your insomnia. Then, they’ll create a personalized treatment plan utilizing lifestyle modifications, sleep hygiene strategies, herbal remedies, and targeted supplements.
The functional medicine expert at BionwoRx, based in Indiana, can help you overcome all types of sleep disorders and disrupted sleep patterns. With her guidance, you can reclaim long, restorative, and natural sleep.