Approximately half of us have trouble falling asleep,
staying asleep or simply never feel rested or refreshed. Before seeking help in
a doctor’s office, I suggest people make all the sleep hygiene changes they can
and see if that eases their situation.
Dr. Scott Theirl, DC, DACNB, FACFN |
Over the last 15 years, urinary neurotransmitter and saliva
hormone testing has been developed. Two key hormones are involved in sleep. Melatonin is key to initiating sleep
and helping to sustain sleep the first part of the night. Melatonin levels
should begin rising approximately two hours prior to bedtime, so long as the
light of the room is dim and tranquil. (Melatonin levels can be greatly reduced
by too much light, especially blue spectrum light or screen light.)
Cortisol is a hormone
released by the adrenal glands that promotes wakefulness and energy. Under
optimal circumstances, it follows a diurnal rhythm, meaning it should be
significantly higher during the day than it is at bedtime. Elevated cortisol at
bedtime can make it difficult to fall asleep. To make matters worse, under
chronic stress—which may include chronic sleep loss—daytime cortisol levels
deplete further, contributing to daytime sleepiness.
Neurotransmitter test results can be helpful in driving the
treatment plan tailored to an individual’s needs. The clinician can then see a
patient’s current state of balance in both excitatory
biomarkers (those which excite and motivate us) and inhibitory biomarkers (those that calm us down) to more accurately
choose how and when to supplement these hormones and neurotransmitters. Serotonin, GABA, glycine and taurine are all inhibitory (calming)
neurotransmitters. Dopamine,
norepinephrine, epinephrine (adrenaline), glutamate and histamine are excitatory
neurotransmitters.
The beauty of an at-home test lies in its customization. If
you have difficulty falling asleep, you simply collect the urine and saliva
samples prior to going to sleep. If you have difficulty staying asleep, then you
collect the samples in the middle of the night when you wake up. Think of these
results as a snapshot of your unique physiology at the particular time of the
night when your symptoms are the worst.
There are 5 common imbalances discovered after testing:
- Melatonin levels are low
- Cortisol levels are high
- Inhibitory neurotransmitters are low
- Excitatory neurotransmitters are high
- Inflammatory markers are elevated (such as histamine and glutamate)
Testing provides a baseline for each patient. A patient can
have one or all five of these findings. Couple this information with observed
and reported symptoms and you achieve a more complete picture of an individual’s
neuroendocrine function.
The experienced and integrative clinician uses all this
gathered information to prescribe targeted amino acid supplements that can
rebalance neurotransmitters. They can also prescribe calming herbal remedies to
quiet overexcited hormone/neurotransmitters and/or a low inflammatory diet to
take the load off the immune system.
This more holistic approach may work better than
prescriptions for pharmaceutical sleep aids such as Ambien (zolpidem), which tend
to affect only the GABA receptors. Instead, integrating these other therapies
may help achieve more stability in the neuroendocrine system, which can lead to
better support for your best overall sleep.
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Dr. Scott Theirl is the creator of Insomnia Insight, a 3-part clinician training series, is a physician educator for NeuroScience, Inc. and practices privately in southeastern Wisconsin. 800.385.1655 www.yourbestbrain.com, www.yourbestsleeping.com || Twitter @HolisticNeuroDr
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SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.