Sleep disorders are extremely common, and include a range of symptoms such as difficulty falling asleep, waking up throughout the night, nightmares/terrors, enuresis (wetting the bed), night sweats, and bruxism (teeth grinding).
What Does Normal Sleep Look Like?
You should be able to fall asleep within 20 minutes or less and remain asleep until the morning. Men should aim for 7-9 hours of sleep, and women should aim for 8-10 hours of sleep, slightly longer than men. When you wake in the morning you should feel well rested. Of course, this is assuming you are not being waken at night, such as by a child or your snoring spouse 🙂
Difficulty Falling Asleep
One of the most common issues here is high cortisol (stress hormone). Cortisol and melatonin (the hormone you need to sleep) essentially have opposite functions. Your cortisol should be highest in the morning when you wake up and slowly decrease throughout the day. You need to have enough cortisol in the morning to help you feel awake and energized. However, if your cortisol is too high at the end of the day, you may have difficulty falling asleep and feel to energized or “amped up.” You need to have enough melatonin to sleep well, and if your cortisol is too high, your melatonin will be low. Cortisol could be high for many reasons – emotional stress, too much physical stress to your body, or chemical stressors such as low protein intake, nutrient deficiencies, too much caffeine, or too much sugar. Another possible factor is serotonin, which is a precursor for melatonin. I have seen some patients struggle with sleep because they do not have enough serotonin, or have trouble converting serotonin to melatonin. Increasing protein and nutrient dense foods can help here, or you may need a specific nutrient or herb.
Waking At Night
It is common to wake up at night if your blood sugar drops. If your blood sugar is unstable and dips during the night, your stress hormones spike to signal the liver to convert glycogen into glucose. Although this may wake you at any time, the most common is 1-3am, as this is the time the liver is most active (based on the acupuncture meridian system). If you wake up hungry, this is a telltale sign that your body is breaking down muscle to convert protein into glucose. While some people wake at random, fluctuating times each night, others find that they always wake around the same time. This can provide some insight into which organ may be stressed. For example, 11pm-1am indicates gallbladder stress, 1-3am is liver, 3-5am is lung, and 5-7am is large intestine. If you are waking to urinate (and not just urinating because you’re already awake) this may be an aldosterone issue, or for men, a prostate issue. Provided that you didn’t drink a large amount of water before bed, you should not have to get up to urinate at night at all.
Nightmares and Night Terrors
This is commonly a liver issue. This could be influenced by your blood sugar, like discussed above, or by liver detoxification functions. The liver could be stressed by hormones (such as excess estrogen), caffeine (even if you only drink coffee in the morning), medications, histamine (which could be high due to an allergy or infection), and more.
Bruxism – Teeth Grinding
The two main issues here are blood sugar (read above) and airway issues. Grinding your teeth can be your body’s way of trying to open up your airway. If you have breathing issues or a small/collapsed airway, it can result in bruxism. Another common symptom of an airway issue when sleeping is snoring. You should be able to breathe in and out through your nose, with your tongue on the roof of your mouth, and maintain this while sleeping. If you are waking up with drool on your pillow and a dry mouth, you are likely mouth breathing. Focus on improving your breathing throughout the day, and consider working with a myofunctional therapist.
What Can You Do To Sleep Better?
Improve your sleep hygiene. Keep the room dark and cold. Reduce your blue light exposure before bed. This means not looking at your phone or a TV screen right before trying to fall asleep, and especially not in the middle of the night if you wake up. Ideally you should keep your phone in a different room or away from your bed.
Improve your nutrition, and stabilize your blood sugar. You should be able to eat 3 meals a day and feel good in between, not needing to snack. Eating many small meals throughout the day can become problematic for your blood sugar regulation. Make sure you are eating enough protein – most people are not! I recommend aiming for 1.5 grams of protein per kilogram of your body weight. This means that if you weigh 155lbs (70kg) you should be eating approximately 105 grams of protein each day. This number should be even higher if you are active or exercising. When you eat carbohydrates, consume them with a protein or fat (ideally both). This will help prevent a sharp spike and then drop of your blood sugar. For example, rather than just eating an apple, have some cheese as well. It can take 2-3 days of good nutrition to start seeing improvements, so stay consistent.
Decrease or remove caffeine. Some people are more sensitive to caffeine than others. Even one cup of coffee early in the morning could be affecting your sleep. Try completely removing all sources of caffeine and see if your sleep improves. If you are consuming high amounts, you may want to decrease slowly to avoid unpleasant symptoms such as headaches.
Identify supplements or medications that could be affecting your sleep. For supplements or over-the-counter medicines, you may consider decreasing the dosage or pausing taking them. It is possible that the wrong supplements or over-the-counter products such as NSAIDS could be putting extra stress on your liver or other body systems, affecting your sleep. If you are taking prescription medications, discuss with your prescribing physician.