Ask Dr. Shiroko

The importance of sleep
Have you spent nights tossing and turning without being able to rest? Some people spend every night that way. I’m amazed at how many people tell me that they sleep only one to four hours a night.
Sleep is necessary for a healthy immune system, normal hormonal function, and recovery of your body and mind. Not sleeping causes your sleep hormones to become imbalanced, and as they get more imbalanced, your sleep gets worse. It becomes a vicious cycle. Lack of sleep can lower your serotonin and raise your cortisol levels. It can also contribute to fibromyalgia and other chronic pain problems.
When trying to figure out what is causing the sleep problem, as always, it is best to consider the simplest things first. Is there a dietary problem? Do you drink coffee or other caffeinated beverages too late in the day or too much? You may not be aware that they interfere with sleep. George was drinking a 12-pack of coke daily. He wondered why he had sleep problems and was always tired? Marissa was drinking a whole pot of coffee every day. Each of these things may not be a part of your awareness because you do it daily; it’s not usually something that comes to mind. If you eat too late in the day or the meal is too heavy it can contribute to sleep problems. Gina has sensitivity to chocolate (of all things!) and can’t sleep on nights when she has eaten it.
Some people get busy at night and just don’t go to bed when they need to. If you don’t go to bed at the right time of night, you can throw off your body’s natural sleep cycle. Try sticking to a pattern of going to bed regularly, your body will get used to it. Melatonin is the body’s sleep-wake cycle hormone. It seems to have a lot to do with changes in sleep patterns. When you travel to a different time zone, melatonin is what causes the jet lag symptoms. By the same token, you can take melatonin if you have trouble with balancing your sleep wake cycle, either while traveling or at home.
Hormonal changes that occur as people age can contribute to increasing sleep difficulty. Progesterone seems to be the main problem here. A low dose of natural progesterone can help resolve it. Each person is different in her needs, however, and some people can’t sleep because of thyroid, estrogen, cortisol, or testosterone levels being off. We can use hormone tests to evaluate which hormones might be contributing to the problem.
Brain chemistry is another factor that contributes to sleep problems. Serotonin, GABA, epinephrine, and dopamine are just some of the chemicals produced by the brain to affect sleep. We can measure these chemicals now with a simple urine test. Often supplements that include amino acids, vitamins, and herbs will help balance these chemicals naturally.
Sleep apnea is becoming more and more of a concern. As people who have sleep difficulties are getting tested, they are finding that they are not breathing well at night. There are sleep labs where this can be tested and diagnosed. If you have sleep apnea, a machine called a CPAP can help. It is quite loud and cumbersome, so it could contribute to sleep disturbance itself but many of my patients find so much relief that the noise doesn’t bother them.
Don’t give up if you’ve tried a few different things for sleep without a solution; there are many options that could help. Angela had difficulty for years, and became addicted to sleep medication. When she came to me, we tested her hormones, and her neurotransmitters. It turned out that she was high in cortisol, low in progesterone, and low in serotonin. She began taking supplements to balance her chemistry. Over the course of a few months she was able to begin going off her medications.
Dr. Shiroko Sokitch’s belongs to the Heart to Heart Medical Center and her column appears monthly. She can be reached at: dr*****@ht***.com.