Why do we need sleep? How much sleep is the right amount of sleep? Why do some people thrive off of six hours while others could sleep for weeks if given the opportunity?

There is definitely no one size fits all approach to sleep deprivation. What works for one person can have no effect or even worse and adverse effect for another. With so much information out there, I thought it was time to explain this topic thoroughly.

So before reaching for those sleeping pills, 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 test I use when an insomnia patient walks into my office and how to supplement based on the test results. Because we really should be getting into the habit of testing, not guessing. 🤓 We could help a lot 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 immune system is regenerated, blood sugar levels are balanced, the brain is activated, and the hormones are regulated.

If a person does not get enough sleep, they can be at risk of developing many health issues, including obesity, insulin resistance, a weakened immune system, and cognitive issues.

Symptoms

• Daytime Drowsiness
• Reduced mental alertness
• Poor hand-eye coordination
• Poor concentration and focus
• Micro Sleeps
• Insulin Resistance
• 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 easily adapted to and overcome. But if you are one of the millions of chronic sleep-deprived sufferers who can’t quite figure out what’s “wrong,” check out some of these commonly overlooked reasons.  

Micronutrient Deficiencies

Micronutrients affect the hormonal and neurotransmitters pathways involved in sleep. Making sure they stay at optimal levels is necessary for proper sleep rhythms.

‍Magnesium

• Magnesium increases GABA, a brain neurotransmitter, which is responsible for slowing your thinking down and helping you fall asleep
• Increasing magnesium can help those with restless legs syndrome

‍Vitamin D

• Vitamin D helps to improve sleep quality, reduces sleep latency, and raises 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 symptoms of insomnia and depression.

Hormone and Neurotransmitter Imbalance

Unbalanced of Cortisol and Melatonin production

In a perfect world, the master stress hormone cortisol should be in sync with the master sleep hormone melatonin. Each hormone counterbalances the other in a precise rhythm. When cortisol is high (morning), melatonin should be low, and when melatonin is high (evenings), cortisol should be low.

Unbalanced cortisol to melatonin levels can be caused by many factors, including adrenal fatigue, night shift work, and stress, to name a few.

Neurotransmitter Imbalances

Neurotransmitters are chemical messengers the nervous system uses to relay information from one nerve to another.

Genetics, environment, chemicals, and nutritional deficiencies are a few factors that can impact neurotransmitter production.

Imbalances in neurotransmitters can cause the brain and the body to be over or under-stimulated, producing neurological or psychological symptoms like sleep disturbances, anxiety, and chronic fatigue.

Imbalances in the neurotransmitters Glutamate, Histamine, Dopamine, GABA, and Serotonin are often linked to sleep disturbances and insomnia.

Functional Medicine Labs to Test for Sleep Deprivation

Micronutrient Test

By checking nutrition status, you can narrow down exactly what nutrients your patients lack and, therefore, can properly supplement as needed.  

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

‍Spectracell (Whole Blood)

‍Genova (Serum, Whole Blood, & Urine)

‍Cortisol and Melatonin Test

Most functional medicine practitioners will measure cortisol and melatonin throughout the day to ensure they are rising and falling during the appropriate time frames. We want to make sure cortisol is highest in the am and melatonin is highest in the pm.

The Sleep Balance Profile is an all in one 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 stated above, neurotransmitters play a very important role in sleep as well as mental health. Our current environment can cause chronic stress throwing neurotransmitters out of balance. Many times these unbalances can go overlooked for years because their symptoms can mimic other chronic 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

‍ZRT (Urine)

Functional Medicine Treatment for Sleep Deprivation

The first step in treating sleep deprivation is finding the root cause. Testing is an important and easy step to add to the treatment plan. There is a common phrase in medicine “test don’t guess.” This is true for almost everything. Find exactly where your patients are deficient or have excess and then address those imbalances.

Nutrition

What you choose to eat is one of the most important factors determining how well you sleep. Focus on whole foods that are high in the nutrients that the patient was lacking based on the micronutrient test. Studies also show that people who follow a low inflammatory diet had less issues with sleep.

Micronutrient Supplements

High quality single or multivitamin/mineral formulas can help address underlying deficiencies. Vitamin injections and IV drips also work quickly to give higher doses in very deficiency patients. Work with a practioner to get the proper supplement for your needs.

Neurotransmitters and Hormones Supplements

Only supplement neurotransmitters when needed. I see so many people trying to self-treat with over-the-counter supplements and they could be causing more harm than good.

A great example is melatonin. Not everyone with sleep issues is melatonin deficient, yet it is a commonly advised supplement for insomnia. If you are already making appropriate amounts of melatonin, adding in more will most likely not be effective. Worse, it could have side effects like sleepiness or grogginess the next day, perpetuating the chronic fatigue cycle.

Sleep Hygiene Schedule

A proper sleep hygiene schedule is the next step in helping sleep-deprived patients. And this is a tricky subject as most people are addicted to their phones or TVs, which can actually decrease melatonin and increase cortisol at night.

Our devices can also fluctuate our happy chemicals serotonin and dopamine, depending on what you read or watch. Ever got an amazingly sweet message or comment at 9 pm? Guess what? Serotonin and Dopamine rush. What about a scary movie late at night? Fight or flight will be all over the place affecting cortisol levels.

As stated above, these neurotransmitters play an essential role in the sleep/wake cycle.

It’s important to go back to our roots (at least for a few hours before bed) to allow our hormones and neurotransmitter to balance, so we can get restful sleep throughout the night.

Humans are meant to wind down after the sun goes down (melatonin production) and rise with the first light (cortisol production). Do your best to stick with a regular bedtime routine that allows you to dim all blue lights at least an hour (preferably more) before bed.

Another tip is to move your body during the day to burn off extra calories (calorie consumption equals energy). If moving is complicated for you, start small, reach for a goal of 5k steps a day, and then continuously add up. Movement can also balance hormones and neurotransmitters.

Black-out curtains and lower room temperature in the house have been shown to help the body prepare for rest.

Supplements for Sleep

Like many other integrative practitioners, I love supplements just as much as the next person. But fair warning, they should only be used short term as a “band-aid treatment.” We need to focus on bringing our body back to balance to do the job it is meant to do.

But for the sake of this article, here are my top 5 favorite supplements for sleep.

Suan Zao Ren Tang (SZRT)

SZRT is a traditional Chinese herbal formula used for centuries to help the body relax and promote natural sleep. This formula is suitable for those who have trouble turning their minds off before bed. It’s also used for those who suffer from anxiety before bed. This formula has been studied for its effects on insomnia in anxiety patients and has repeatedly proven its effectiveness.

Chamomile

Yup, I said it… Boring old chamomile, nothing fancy but don’t discount it! There is a reason why it shows up in almost every “sleepy” tea on the market.

Herbal teas are popular beverage choices when it comes time to relax and unwind, and chamomile is one of my favorites.

For centuries, chamomile has been used worldwide as a natural sleep and anti-anxiety remedy. It also helps calm stomach contractions, which is an added bonus in a world where over 45 million people in the United States suffer from gut health issues.

I personally like to sip on chamomile while winding down at night as part of my sleep hygiene routine. This is one supplement that I don’t mind taking daily as it’s a fairly safe herb with many health benefits.

Valerian Root

Valerian root should be used sparingly. I usually recommend paring valerian root with SZRT or chamomile. Many over-the-counter teas will also have valerian root in their “sleep” formulas.

Valerian Root is a mild sedative and is often referred to as “nature’s Valium.” It should only be taken when you are actually ready to settle down for the night and not for extended periods of time. Research suggests that valerian is generally safe for short-term use by most adults and can be used for insomnia and anxiety.

Summary

Sleep issues affect millions of people nightly. Uncovering what’s happening at the cellular level can help patients restore the body back to homeostasis and, in return, restore a natural sleep routine.

Before reaching for a sleeping pill or supplement, talk to your provider about specialty testing.

The top ones I recommend are Micronutrient testing, Cortisol, Melatonin, as well as Neurotransmitters. They may also want to check hormone production and thyroid health.