Why do we need sleep? How much sleep is the right amount of sleep? Why do some people feel okay with six hours while others could sleep for weeks if given the opportunity?
There is definitely no one-size-fits-all approach to sleep. What works for one person might not work for another. With so much information out there, I thought it was time to explore this topic further.
So before considering sleep aids, check out the below article on the many reasons you may be having a hard time sleeping; some might surprise you.
This article highlights what tests I consider when someone with sleep concerns visits my office and how to approach supplementation based on the test results. Because we really should be getting into the habit of testing, not guessing. We could help more people if we actually got to the root causes of what’s going on.
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Sleep Deprivation Signs & Symptoms
While sleeping, the body supports the immune system, helps balance blood sugar levels, activates the brain, and regulates hormones.
If a person does not get enough sleep, they may be at risk of experiencing various health challenges, including weight management issues, changes in insulin sensitivity, a less robust immune system, and difficulties with focus and memory.
Symptoms
- Daytime Drowsiness
- Reduced mental alertness
- Poor hand-eye coordination
- Poor concentration and focus
- Micro Sleeps
- Changes in insulin sensitivity
- Lower immunity
How Much Sleep Do We Need for Optimal Health?
Sleep Deprivation Possible Causes
Lack of sleep can be from many causes; a new baby, a strange house, too much caffeine, etc. All of those reasons can be adapted to and managed. But if you are one of the many who experience ongoing sleep challenges, consider some of these commonly overlooked reasons.
Micronutrient Considerations
Micronutrients play a role in the pathways involved in sleep. Ensuring they stay at supportive levels may help maintain proper sleep rhythms.
Magnesium
- Magnesium supports GABA, a brain neurotransmitter, which is involved in calming the mind and helping you fall asleep
- Increasing magnesium may help those with restless legs syndrome
Vitamin D
- Vitamin D may help improve sleep quality, reduce the time it takes to fall asleep, and support longer sleep duration.
Vitamin B6
- Vitamin B6 aids in the production of the hormones serotonin and melatonin. A lack of vitamin B6 has been linked to sleep challenges and mood changes.
Hormone and Neurotransmitter Balance
Cortisol and Melatonin Balance
In a balanced state, the stress hormone cortisol should be in sync with the sleep hormone melatonin. Each hormone counterbalances the other in a rhythm. When cortisol is high (morning), melatonin should be low, and when melatonin is high (evenings), cortisol should be low.
Imbalances in cortisol and melatonin levels can be influenced by many factors, including stress and irregular work hours.
Neurotransmitter Balance
Neurotransmitters are chemical messengers the nervous system uses to relay information from one nerve to another.
Genetics, environment, chemicals, and nutritional factors can impact neurotransmitter production.
Imbalances in neurotransmitters can affect how the brain and body function, potentially leading to sleep disturbances, mood changes, and fatigue.
Imbalances in neurotransmitters like Glutamate, Histamine, Dopamine, GABA, and Serotonin are often linked to sleep disturbances.
Functional Medicine Labs to Explore for Sleep Concerns
Micronutrient Test
By checking nutrition status, you can identify what nutrients may be lacking and consider appropriate supplementation.
Reference Range for Magnesium (whole blood sample)
Standard Reference Range: 3.6~7.7 mg/dL
Functional Medicine Optimal Range: 3.6~7.7 mg/dL
Reference Range for Vitamin D (whole blood sample)
Standard Reference Range: 20 and 40 ng/mL
Functional Medicine Optimal Range: 40-70 ng/mL
Reference Range for Vitamin B6 (whole blood sample)
Standard Reference Range for: 4.0~83.0 ng/mL
Functional Medicine Optimal Range: 4.0~83.0 ng/mL
Top Micronutrient Test Ordered by Rupa Health Practitioners
Genova (Serum, Whole Blood, & Urine)
Cortisol and Melatonin Test
Many functional medicine practitioners may measure cortisol and melatonin throughout the day to observe their patterns. Ideally, cortisol is highest in the morning and melatonin is highest in the evening.
The Sleep Balance Profile is a comprehensive test that measures the daily fluctuations of melatonin, cortisol, and cortisone to assess the sleep/wake cycle.
Reference Range for Cortisol (urine)
Morning: 5-25 mcg/dL
Reference Range for Melatonin (urine)
Evening 4.3 – 25 pg/mL
Neurotransmitters Test
As mentioned earlier, neurotransmitters play a role in sleep and mental health. Our current environment can influence neurotransmitter balance. Sometimes these imbalances can go unnoticed for years because their symptoms can resemble other conditions.
Reference Range for Glutamate (urine)
Standard Reference Range: 1213-4246 μg/g Cr
Functional Medicine Optimal Range: 1515-2710 μg/g Cr
Reference Range for Histamine (urine)
Standard Reference Range: 3.6-44.3 μg/g Cr
Functional Medicine Optimal Range: 5.2-15.3 μg/g Cr
Reference Range for Dopamine (urine)
Standard Reference Range: 103-282 μg/g Cr
Functional Medicine Optimal Range: Optimal 144-240 μg/g Cr
Reference Range for GABA (urine)
Standard Reference Range: 167-463 μg/g Cr
Functional Medicine Optimal Range: 193-367 μg/g Cr
Reference Range for Serotonin (urine)
Standard Reference Range: 47.6-140.3 μg/g Cr
Functional Medicine Optimal Range: 61.0-103.2 μg/g Cr
Top Neurotransmitter Test ordered by Rupa Health Practitioners
Functional Medicine Approaches for Sleep Support
The first step in addressing sleep concerns is finding the underlying factors. Testing can be an important step to consider in the plan. There is a common phrase in medicine “test don’t guess.” This is true for many situations. Identify where there may be imbalances and then consider ways to address them.
Nutrition
What you choose to eat can influence how well you sleep. Focus on whole foods that are rich in the nutrients that may be lacking based on the micronutrient test. Studies also show that people who follow a low-inflammatory diet may experience fewer sleep challenges.
Micronutrient Supplements
High-quality single or multivitamin/mineral formulas can help address underlying nutrient needs. Vitamin injections and IV drips may also be considered for those with significant deficiencies. Work with a practitioner to find the right supplement for your needs.
Neurotransmitters and Hormones Supplements
Only consider supplementing neurotransmitters when needed. Many people try to self-treat with over-the-counter supplements, which may not always be beneficial.
A common example is melatonin. Not everyone with sleep issues is melatonin deficient, yet it is often suggested for sleep support. If you are already producing appropriate amounts of melatonin, adding more may not be effective and could have side effects like sleepiness or grogginess the next day.
Sleep Hygiene Schedule
A proper sleep hygiene schedule is another step in supporting sleep. This can be challenging as many people are attached to their phones or TVs, which can affect melatonin and cortisol levels at night.
Our devices can also influence neurotransmitters like serotonin and dopamine, depending on what you read or watch. Ever received a nice message or comment at night? That can boost serotonin and dopamine. What about watching a scary movie late at night? That can trigger stress responses affecting cortisol levels.
As mentioned earlier, these neurotransmitters play a role in the sleep/wake cycle.
It’s important to create a calming routine before bed to help balance hormones and neurotransmitters, promoting restful sleep.
Humans are naturally inclined to wind down after sunset (melatonin production) and wake with the first light (cortisol production). Try to maintain a regular bedtime routine that includes dimming lights at least an hour before bed.
Another tip is to engage in physical activity during the day to use up energy. If moving is challenging, start small with a goal of 5,000 steps a day, and gradually increase. Movement can also support hormone and neurotransmitter balance.
Using blackout curtains and keeping the room cool can also help the body prepare for rest.
Supplements for Sleep
Like many other integrative practitioners, I appreciate supplements as a temporary support. However, they should be used as part of a broader approach to help the body regain balance.
For the sake of this article, here are some supplements that may support sleep.
Suan Zao Ren Tang (SZRT)
SZRT is a traditional Chinese herbal formula used for centuries to help the body relax and support natural sleep. This formula may be suitable for those who have trouble calming their minds before bed. It’s also used for those who experience anxiety before bed. This formula has been studied for its effects on sleep in individuals with anxiety and has shown potential benefits.
Chamomile
Chamomile is a well-known herb often found in "sleepy" teas.
Herbal teas are popular choices for relaxation, and chamomile is one of my favorites.
For centuries, chamomile has been used worldwide as a natural support for sleep and relaxation. It may also help calm the stomach, which is beneficial for those with digestive concerns.
I personally enjoy sipping on chamomile while winding down at night as part of my sleep routine. This is one supplement that I feel comfortable using regularly as it’s a generally safe herb with many potential benefits.
Valerian Root
Valerian root should be used with caution. I usually suggest pairing valerian root with SZRT or chamomile. Many over-the-counter teas include valerian root in their “sleep” formulas.
Valerian Root is sometimes referred to as a "mild sedative" and is often called “nature’s Valium.” It should only be taken when you are ready to settle down for the night and not for extended periods. Research suggests that valerian is generally safe for short-term use by most adults and may support relaxation and sleep.
Summary
Sleep challenges affect many people. Understanding what’s happening at the cellular level can help individuals support their body's natural balance and, in turn, promote a healthy sleep routine.
Before considering sleep aids, talk to your healthcare provider about potential testing options.
Some tests to consider include Micronutrient testing, Cortisol, Melatonin, as well as Neurotransmitters. They may also want to check hormone production and thyroid health.
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