ASK DR. SHIROKO: 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.
When a person doesn’t get enough sleep at night nothing works
right. Sleep is necessary for a healthy immune system, normal
hormonal function and recovery of the body and mind. Lack of sleep
is even connected to an inability to lose weight.
When trying to figure out what is causing the sleep problem, as
always it is best to first consider the simplest things. 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. One patient I had was drinking a 12pack of
coke daily and wondered why he had sleep problems and was always
tired? Another patient 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 so it’s not usually something that comes to
mind. Eating too late in the day and too heavy a meal can
contribute to sleep problems. One person I know who has sensitivity
to chocolate (of all things!) 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. For a person who has
difficulty sleeping, going to bed at the same time each night is
helpful, it creates a pattern that allows the body to 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 and is very
effective when you are traveling to a place where the time zone is
different.
Hormonal changes as people age contribute to increasing sleep
difficulty for many. Progesterone seems to be the main problem here
and a low dose of natural progesterone can help resolve it. Each
person is different in his/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 get tested and find 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 column appears monthly. She can be
reached at: dr*****@li***.net.