About one third of North Americans report sleep disturbance, which can include difficulties falling asleep, frequent waking in the night or poor quality sleep that leads to the feeling of exhaustion in the morning. Fingers are pointing towards our round-the-clock hectic lifestyles and access to technology as more and more people struggle to get a good night’s sleep, but there can be many factors – some we are not even aware of.
Sleep plays a vital role in brain health, longevity and optimal functioning. We can all relate to the mental dullness and changes in the way we think after a poor night’s sleep, but we are now beginning to understand the long-term effects of sleep disturbance on brain health. Studies have shown that one purpose of sleep may be to help restore the brain by flushing out toxins that accumulate during the day. One toxin that researchers found was lowered in the brain during sleep was beta-amyloid; the substance that accumulates in the brains of people with Alzheimer’s disease.
The effects of sleep deprivation can also be disastrous. Following the 1986 Space Shuttle Challenger explosion, an investigation into the cause of the explosion pointed to the lack of sleep and fatigue of NASA employees. The commissioner in charge of the investigation stated that “fatigue produces broad declines in multiple measures of performance. Those declines affect our mood and motivation, high-level cognition, decision-making, multitasking, situational awareness, basic reaction times and vigilance”.
Long-term effects of insomnia can include: hormonal dysregulation, hypertension, cardiovascular disease, obesity, type II diabetes, cancer and worsening of gastrointestinal disorders such as inflammatory bowel disease, IBS and GERD (heartburn). Questions about sleep difficulties are some of the most important questions that I ask my patients as disturbed sleep can be a major barrier to health and wellness.
As a naturopathic doctor, my job is to get to the root cause of a person’s insomnia. Some of these include: chronic pain, heart disease, unbearable hot flashes, overactive thyroid, restless leg syndrome, asthma, COPD, sleep apnea, psychological illness (anxiety and depression), medications (alcohol, caffeine, nicotine, beta-blockers) shift work, recent stressful events, biological clock alterations (jet lag) and poor sleep habits. A detailed sleep history, physical exam and ordering the appropriate labs and tests help us to investigate what the contributing factors may be.
Sleep difficulties can also be intertwined with the way we think about how we sleep. Sometimes we get into a rut of thinking that we will never get to sleep and a good night’s sleep is impossible. This creates anxiety and worry when trying to fall asleep while we continue to check the clock. Part of our work is using proven sleep therapies to change that mindset, which only gets in the way of success.
Sedative medications are the mainstay conventional treatment for insomnia, but they are meant to be used for only a short term (usually 2 weeks or less) or when the root cause cannot be addressed as they can be habit-forming. Naturopathic physicians are trained to safely and effectively help people taper-off pharmaceutical sleep aids when appropriate. When it comes to insomnia, naturopathic physicians have many tools in our toolkit for helping with sleep, whatever the root cause may be. Herbal medicine, supplementation, acupuncture, bioidentical hormone therapy, lifestyle and dietary changes are just some of the ways that we address that root cause.
As an example, I worked with a patient diagnosed with restless leg syndrome (RLS), a neurological condition that makes sleeping difficult as its name would suggest. Through lab work, we discovered that she was deficient in both B12 and iron, both of which are associated with RLS when deficient. Using a combination of appropriate supplementation with minerals, vitamins and mild sedative herbs along with cognitive behavioural sleep therapy improved her sleep significantly within weeks.
Insomnia can have many different root causes and can be a sign of some greater dysfunction in the body. Sleep is critical to brain health, daily functioning and quality of life. It can be improved or corrected by identifying and treating the cause using a combination of therapies and techniques that align with your values.
1. Center for Disease Control and Prevention. (2013). Insufficient Sleep is a Public Health Problem. Accessed from: https://www.cdc.gov/features/dssleep/index.html on July 22, 2017.
2. Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 3, Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19961/
3. Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of sleep disruption. Nature and Science of Sleep, 9, 151–161.
4. National Institute of Health. (2013). How Sleep Clears the Brain. Accessed from: https://www.nih.gov/news-events/nih-research-matters/how-sleep-clears-brain June 12, 2017.