This is a webinar I did about how to overcome insomnia naturally.
If you want additional information on how to beat insomnia you can read my detailed article here.
Okay, well, welcome, everyone. This is Dr. Nik Hedberg, and tonight we’re talking about sleep disorders. And this one of my favorite topics, just because it’s something that I encounter a lot in practice. Many, many people have issues with sleep, many chronically people. And it’s really one of those fundamental things that it’s just very difficult to help someone get healthy when they’re not getting a good night’s sleep.
Sleep is when your body repairs itself; it’s when your body releases the greatest amount of growth hormone; it’s when a lot of your neurotransmitters in the brain, like serotonin, dopamine, etc. are restored and regenerated while you’re sleeping. Sleeping, of course, reduces stress, and it’s definitely becoming a bigger and bigger problem in today’s society for a variety of reasons.
So tonight we’re going to talk about three different types of sleep disorders that we see. People can have one of these types, or they can have a mixed type. But we have pretty good success getting people to sleep once we figure out what kind of type they are and what they do well on. Then, of course, the underlying cause.
So, these are really the main things that really cause sleep disruption, stress is obviously going to be number one. Stress raises cortisol levels, and then cortisol, when it’s high, that will prevent you from sleeping. And then of course caffeine, coffee, black tea, chocolate, things like that. Caffeine, of course, stimulates the thyroid and the adrenal glands, giving you a false sense of energy. But there is a price to pay when you do consume caffeine for energy.
Sugar and of course poor dietary choices, blood sugar imbalances. And one of the things that happens when you sleep is you’re actually in a fasting state, a very long fast, up to six to eight hours on average. And so when you’re fasting, your body has to maintain a stable blood sugar level, and if you’re body is not able to do that, that’s mainly regulated by the liver, the pancreas and the adrenal glands. If you’re body is not able to do that, regulate blood sugar while you’re asleep, that can wake you up. We’ll talk a little bit more about that later.
Light in the bedroom, and that can be anything, like from a clock radio, street lights coming in, computer lights, things like that, any kind of light. Even though your eyes are closed, the brain still picks up on light in the room, and that will disrupt your sleep. Lack of exercise, chronic infections, food sensitivities. Really the big food sensitivities are going to be gluten, dairy, corn, soy, and eggs.
A magnesium deficiency, because magnesium has an overall calming effect on the nervous system, the brain and the muscular system. Just kind of relaxes everything.
And television, watching television in bed, watching violence or traumatic movies or shows before bed, all of these things can contribute to sleep disruption.
You would also want to add in there sex hormone imbalances, especially in peri-menopausal and post-menopausal women. When progesterone levels begin to drop, that can make it more difficult to get a good night’s sleep.
So let’s begin with the Type 1 sleep disorder. This is going to be the most common type of sleep disorder out there. This is mainly a serotonin or melatonin deficiency. So melatonin is the hormone produced in the brain that really puts you to sleep. Serotonin is the precursor to melatonin.
The reason that people become depleted in serotonin and melatonin is basically due to chronic inflammation. So it’s matter of figuring out where the inflammation is coming from. This can be genetic, these people tend to be the worrier, always worrying about things, and these people will typically either have difficulty falling asleep, and or staying asleep.
The Type 1s, they’re the night owls, it’s harder to get them to go to sleep. Some of them say they function the best at night. Disturbed sleep, premature awakening. These people tend to have negativity, possibly depression, worrying, anxiety, irritability and rage. Some of these people will have the diagnosis of fibromyalgia, TMJ, or migraines.
And then we have afternoon sugar cravings, and alcohol or marijuana. The reason is because all of those can help give you kind of a false rush of serotonin. Low self-esteem, that goes hand in hand with the low serotonin. Obsessive compulsive thoughts and behaviors, hyperactivity or ticks, feeling like a perfectionist and always feeling like you have to be in control. So if you find yourself thinking about your partner, trying to control them, or trying to perfect the things that they are doing, or what other people are doing, that just goes back to the low serotonin.
Winter blues, these people tend to not like really hot weather, like the summer. And some of them will have panic attacks, or phobias. So they have a fear of heights, small spaces, snakes, things like that. These are some of the classic signs of a serotonin or melatonin deficiency.
So, the amino acid tryptophan can basically go down two pathways. Tryptophan can go down the serotonin and melatonin pathway. So tryptophan actually converts first into 5-hydroxytryptophan, which you probably know as 5-HTP. And then after 5-HTP, that converts to serotonin, and then serotonin converts into melatonin, so that’s that pathway.
Now, if someone’s chronically inflamed, if there’s inflammation from an infection or food sensitivities, from stress and things like that, the tryptophan is going to go down an inflammatory pathway they call the kynurenine pathway. Sometimes you will test kynurenic acid to see if it’s high. Quinolinic acid is the other one that’s produced when tryptophan goes down the inflammatory pathway. So if there’s chronic inflammation, your tryptophan is going to be robbed down the inflammatory pathway instead of going down the serotonin/melatonin pathway, and that’s why you develop the deficiency.
So, one of the worst things you can do is to take tryptophan if you’re chronically inflamed. So if the patient does not have any signs of inflammation, then tryptophan is usually safe. If there’s a lot of inflammation, you’re really just going to get worse, and that’s probably why some of you know that either you’ve taken tryptophan, or you know someone who has, and it really didn’t help, or just made them worse. So I just explained the reason for that, biochemically.
So, for the treatment for the Type 1 we’ll use anywhere from 0.5 to 5 milligrams of melatonin. Tryptophan, like I said, as long as there’s no inflammation. Melatonin may negatively affect autoimmune disease, so be careful with that. And these really should be taken under the supervision of a physician. Definitely never mix any of these with any medications, especially psychotropic medications, if you’re taking anything for depression or anxiety or insomnia. Never, ever mix these with any of those.
So this type is fairly straightforward. Like I said, basically we’re trying to identify the cause of the chronic inflammation. So therapeutically, if we do use the melatonin or the tryptophan, we obviously don’t want to do that for a long period of time, because we want to get rid of the inflammation, so the tryptophan and the serotonin and melatonin can continue down a healthier pathway. So that’s the Type 1.
Type 2 sleep disorder is a GABA deficiency. GABA, gamma aminobutyric acid, this is an overall calming neurotransmitter. GABA becomes depleted when someone is overstressed or burned out. So these people tend to be very tense, a lot of muscle tension, stiff muscles, unable to relax or loosen up. These people tend to feel overwhelmed, there’s just too much going on. They can’t handle it. They may have panic attacks. If they do take sleep medication, they do best with benzodiazepines. So the people with the GABA deficiency, there’s going to be a lot of tension there, physically. They might be lying in bed, and there’s just so much tension in their body they just can’t relax and fall asleep.
So the way that we help these individuals is number one, of course, we want to figure out why they’re so tense. If it’s because of the relationship that they’re in, or they hate their job, or they’re going through a very stressful period, things like that, obviously we want to talk about that, but there are some supplements that may help, like L-theanine. 200 to 400 milligrams before bed has a calming effect on the nervous system. Theanine acts like GABA in the nervous system. Theanine is actually found in green tea and some other natural sources, but we’ll just use the capsules. And then sometimes we’ll just use straight GABA. Anywhere from 100 to 500 milligrams, and sometimes that just works really well for some people. You really only want to use one of these, either just the GABA or just the theanine.
Now if someone is a mixed type, if they’re Type 1 and Type 2, you can combine the supplements. So if they’re a Type 1 and a Type 2, we might use melatonin and GABA, or melatonin and theanine. And like I said, if there’s no inflammation, we’ll combine the tryptophan with the theanine or the GABA. So that works really well for the Type 2s.
And then the Type 3 sleep disorders, these are going to be related to the adrenal glands. We talked a little bit about that before, in relation to blood sugar. So these people have very high levels of the stress hormone cortisol, which is made by the adrenal glands. These people are always ready to work, agitated or hypervigilant.
A classic sign is if you’re asleep, and you’re very easily startled or shocked out of sleep, then that’s a good sign that your sleep disorder is related to adrenal gland dysfunction. People who are very light sleepers, and very easily awakened. Sometimes just by the slightest thing.
So we have to really do a good workup, and figure out where the adrenal stress is coming from. Part of that can be blood sugar, like we talked about earlier. The adrenals are a part of stabilizing blood sugar while you’re asleep. The other thing is that adrenal hormone is required to manufacture melatonin, so there has to be a small amount of more epinephrine made from the adrenal gland to actually make melatonin optimally.
So, there are many, many possibilities that can be causing the adrenal stress. Could be anemia, could be a chronic infection, food allergies, leaky guts, environmental toxins, etc. etc. Just any kind of physical or emotional stress, and so we have to figure out where that’s coming from. So, usually we’ll test cortisol levels, either in blood or in saliva, and we can see what the cortisol levels are. I already mentioned some of the causes of adrenal stress.
One of the things we do is we use a product called Seriphos, which is a phosphorylated serine, and this helps to blunt the stress response, so it will bring down cortisol levels. So if someone is under a lot of physical or emotional stress, the Seriphos is a nice band aid for reducing the amount of cortisol that the adrenal gland will produce. So we’ll use that, taken at night, sometimes actually we’ll start them at dinner, take some at dinner and then also before bed. That really helps to calm down the adrenals.
And then if there’s further adrenal dysfunction, we’ll use some adrenal adaptogens. Ashwagandha is probably the best adrenal adaptogen when there is a sleep issue. Some of the ginsengs. American ginseng is probably the best of those ginsengs. There’s Panax ginseng, Siberian ginseng. Ashwagandha is actually Indian ginseng, but the America ginseng is really the best. Rhodiola as long as it’s not taken too late in the day, and then reishi mushroom can also help with blood sugar and the adrenals. Those are the kinds of things that we’ll do.
If the DHEA is extremely low, we might use a little bit of that, although DHEA can be stimulating. Again, it’s just a matter of identifying where the stress is coming from, but the Seriphos and adrenal adaptogens can work really well.
There are some herbal medicines that can help. Kava kava, mainly used for anxiety, but it does have an affect on GABA receptors and if anxiety is a part of the sleep issue, kava can help. And then most of you are probably already familiar with these, especially Valerian root, we see a lot of people who have tried that. Passion flower, hops, chamomile. Chamomile tea is a popular one at night. Blue skullcap, poppies. Lemon balm has nice calming effect on adrenaline. If there’s too much norepinephrine, epinephrine, too much adrenaline, lemon balm can help with that. It also has a calming effect on the nervous system. And then lavender is good essential oil, or scent, to have in the room to help calm things down. So lavender can work quite well.
Most of these that you see here, actually all of these, are not really a long-term solution. Some of the various sleep products out there will have a few of these in them, and they do help, they do work really well, but again, it’s not really a long term solution. And the same thing with the melatonin and the tryptophan. You don’t want to take any of these herbs if you’re on any medications. Like I said before, especially the psychotrophics for anxiety, depression, insomnia, things like that. You don’t want to mix any of these with the medications.
And here are some other strategies that you can do to begin sleeping better. The first is establish an alkaline pH, and optimize magnesium intake. I do have a lot of information on my website about establishing an alkaline diet. That’s one of those fundamental things we work with on everybody.
And then you want to start balancing your blood sugar. You want to eat protein, about 15 to 30 grams every meal. Some people do well on a small bedtime snack that’s a good balance of protein, carbs and fat. Some people, this can really help to keep the blood sugar stable throughout the night while they sleep. You don’t want to eat too many carbs, because that will actually suppress growth hormone. You have the greatest amount of growth hormone produced before midnight, so that’s why we recommend going to bed as early as possible. Usually about 10:30 is a good time on average for a lot of people.
And then you do want to get hormones checked. I briefly mentioned before about sex hormones, especially if progesterone is low and estrogen is high. Estrogen, if it’s too high, can be a little excitatory. And then the progesterone, when that’s low, you lose that inhibitory effect, and the balancing effect of the progesterone. Thyroid definitely can be a major player with insomnia, either too little thyroid hormone or too much thyroid hormone can cause insomnia.
Make your room pitch black. We put up some nice blinds we got, relatively inexpensive, that really cover the whole window. That really keeps all of the light out of the room. We do like to have a good air purifier in the room to take stress off of the immune system. I have one that I recommend, if anyone is interested, let me know. They’re very, very inexpensive, and work really well. That will eliminate any kind of allergens in the room, dust, pollen, viruses, anything airborne. Mold spores, all that stuff. That can really help your sleep quality, as well.
Taking a hot Epsom salt bath at night, about half a cup to a cup of Epsom salts, and doing some, about five minutes of deep belly breathing in the bath, breathing like a baby breathes, this will also help to alkalize the body. Most people are shallow breathers. They don’t really take deep breaths, full breaths throughout the day.
I mentioned this before, avoiding violent or traumatic movies and television before bed. This can excite the brain, possibly cause a stress response. So I recommend not watching TV before bed, or at least leaving at least an hour or two before you go to bed.
This is a really key point; you want to consistently go to bed every night at the same time. Your body likes balance and consistency, so if you go to bed at 10:00 one night, and then the next night you go to bed at midnight, and then the next night 10:00, your body is not going to like that. It’s going throw off your rhythms. That’s what sleep is, it’s really about rhythm. We fall asleep when the sun goes down, and we wake up when it comes up.
There was actually recently an interesting article, paper I read, about the sleep cycles that really actually aren’t that bad. Some people will sleep for about four hours, and then they wake up for about an hour or two, and then they go back to bed and sleep for another four hours. That’s actually not that bad on the system. There are some people that do quite well with that.
Because we just take people and studies, and we put them in isolated environments, where they really don’t have any stress, there’s really nothing going on in their life. They don’t have to worry about anything. That’s what happens, they go four hours of sleep, and then they get up for an hour or two, and then they go back to sleep for four hours. So that’s just with basically no stress at all, in a controlled environment.
Those are the main things that I wanted to cover about sleep disorders. We’re at about 25 minutes, so I’d like to open it up for questions. There we go. So I’m going to go ahead and put it into Q&A, and basically, you can just type your messages into the chat window, and I’ll go ahead and answer them.
So the first question is about, “What about taking 5-HTP?” That’s a good question. 5-HTP does work for some people. The good thing about 5-HTP is that you can raise serotonin and melatonin without the risk of going down the inflammatory kynurenine pathway that I talked about before. So you know, I said tryptophan will go down the inflammatory pathway, but 5-hydroxytryptophan, the only way it can go is to serotonin and melatonin. So that’s a good question.
There is some speculation that 5-HTP can actually raise cortisol levels. A couple speculations with 5-HTP, you really need to take it with vitamin B6. So if you take the 5-HTP supplement, make sure it has B6 in it, because you can cause a vitamin B6 deficiency if you just take 5-HTP. And then if you become B6 deficient, that will further perpetuate the serotonin and melatonin deficiency. 5-HTP I use more throughout the day, like breakfast, lunch and dinner combined with tyrosine when there is a very, very low mood. So you use about 500 milligrams of tyrosine with 50 milligrams of 5-HTP three times a day, and that will raise dopamine and it will raise serotonin, and that just helps the mood overall for the day. And then sometimes that can secondarily help with sleep. So that’s kind of how I use 5-HTP. You can take it at night, and if it works for you, that’s fine.
Okay, so if you have a question just go ahead and type it into the message box, and I can go ahead and answer that. I’ve covered quite a bit of material tonight, going over the three different types of sleep disorders.
Okay, we have another question about magnesium. The preferred form of magnesium is magnesium glycinate, and I usually base the dose based on the pH of the individual. So if you get the Hydrion pH paper, and you test your first morning urine pH, five days in a row, and you throw out the high and the low, and then average the middle three, then that gives you a fairly good idea of your pH.
Ideal pH is going to be between 6.4 and 7.4. If it’s below 6.4 that means you’re acidic. If you’re above 7.4 it means you’re probably too alkaline. And then we’ll have the patient take about 200 milligrams of magnesium to start before bed, and then measure their pH the next morning. If they’re still acidic, then we’ll have them take two the following night, and then we just keep doing that until the pH become alkaline.
So, magnesium, you’re looking at a dose of anywhere from 200 to 800 milligrams, just anywhere in that range. If you take too much, you’ll know because you’ll get diarrhea, too much magnesium will cause loose stools. So, good question.
Again, if you have a question, just type it into the question box. Really great questions so far. So like I was saying before, sleep disorders are just a major, major problem in our society. Sleep medications are on the rise, and we all know that anti-depressants, I think I read that almost half of the population now is on some kind of psychotropic medication, whether it’s for depression, or anxiety, or insomnia, so major, major problem.
The other thing I didn’t really mention tonight was electromagnetic radiation. There’s not a lot to do with that, other than just, my advice is, of course, if you have a clock radio right by your head, that might not be a good idea. Some people like to have white noise, and I think that’s fine, like a fan going in the room to block out any sound that could wake you up.
Okay, so here’s a great question. “What do you recommend for menopausal insomnia?” That’s a good question. Menopausal insomnia can be a number of things. I can’t make one recommendation. The most common is going to be progesterone deficiency. The creams just don’t really work as well as the sublingual pellets that we use. We use the sublingual progesterone pellets. Those work really, really well for sleep. If there’s too much estrogen, not enough progesterone, that can definitely cause a sleep issue.
The other thing about menopause is that the adrenals try to pick up some of the slack of what the ovaries were doing, so that can further cause adrenal stress. That will cause sleep problems, as well. So post-menopausal women will do the check all the sex hormones, and then we’ll also check the adrenal hormones, and try and figure out what’s going on there. Some of the herbs I mentioned can work well. But if the insomnia is due to a true sex hormone imbalance, those hormones definitely need to balanced, so we’ll use the natural bioidentical hormones for that. They usually work immediately, but really just the first night that they’re taken you’ll notice a big difference. Great question.
Again, if you have a question, just go ahead and type it in. Next question, “Can we get a copy of your slides?” This is actually recorded as a video, so you will be able to download the video, so you’ll be able to recap all of those slides. So best not to take an estrogen cream at bedtime. Again, that really depends.
For the women with vaginal dryness, or thinning of the vaginal wall because of post-menopausal issues, we’ll use an estrogen cream, apply to the vaginal labia. And that’s really not, you’re not going to get a huge systemic effect through the whole body because it’s such a low dose. But that could potentially cause some issues there. Again, if there’s not enough progesterone, so, again, that’s kind of an individual case to be looked at. But you do want to balance it with some progesterone if the estrogen is causing insomnia. Good question.
Okay, next question. “How do you go about getting someone off of their prescription sleep medications, like Ambien?” That’s a really good question, because you can’t, it’s just not a good idea to combine any of the alternatives with the medications. They’re really contraindicated.
So, step one is, of course, like I said, identifying the cause of the inflammation, or the cause of the stress that’s keeping the patient up. Then it’s just a matter of discussing the Ambien with the prescribing physician, and they’re usually very receptive to trying alternatives and working with you to wean yourself off of that. If that is an option.
Great questions tonight. Again, if you have a question, just type it into the chat window so I can see it. This lecture is being recorded, and it will be available for view. Do you work with people out of state? Probably about 40 to 50% of our patients don’t live in North Carolina. We do phone consults all over the country, and we actually have quite a number of people overseas. We’ve managed to reach out to the United Kingdom, Sweden, Australia, India, etc., etc. It doesn’t really matter where people are, we can work with them. Another good question.
Another great thing about technology is just the emergence of telemedicine, a lot of medical doctors are doing that more. A lot of holistic practitioners are doing that more. Communicating through Skype, chats, and telephone, email, all that stuff. It’s great.
Okay, any more questions? If you have a question, just type it into the chat box. And we’ll see if anything else comes through, and if not we’ll go ahead and stop the recording for tonight. Okay, well, thanks everyone for joining us. If you have any questions, you can contact our office through DrHedberg.com, or email@example.com.
Again, this is being recorded, so it will be up on the website soon, through YouTube, you’ll be able to view it that way. And we do have a lot of resources at DrHedberg.com, under the resources section. I have a whole e-book that I wrote on sleep disorders where you can find it in the resources section, so you can download that, as well. And there’s also a lot of information there on the alkaline diet, which we talked about tonight. And some other useful information, as well. So, thanks everyone for joining us. We’ll see you at our next webinar. Take care, everyone.