Getting to sleep and staying asleep is a balance between the forces that promote sleep and those that keep you awake. The longer you are awake, the greater the build up of the need to sleep. This is called “sleep pressure”. Opposing this are the things that make getting to sleep difficult.
A 2001 study, identified individuals most likely to suffer from fatigue. The results showed:
- Females were more fatigued than males (45% vs. 34%)
- Those with children (50% vs. 32%)
- Shiftworkers (52% vs. 36%)
- Those with low levels of marital satisfaction (52% vs. 35%)
- Those with depression (58% vs. 32%)
- Care-givers of a child or person unable to live independently (50% vs. 34%).
These results indicate some of the reasons why women suffer additional sleep problems.
Insomnia, as a potential cause to fatigue is the most common sleeping problem in women. Women are twice as likely as men to have difficulties falling asleep, staying asleep or waking too early. This is partly due to women suffering from higher rates of stress, anxiety and depression.
There are a few types of insomnia. The first is trouble getting to sleep. In this pattern, a person takes between 30 minutes and 2 or more hours to get to sleep.
A second type is waking several times a night. In this pattern, the person typically wakes between 3 and 5 times a night.
The third type is waking up very early in the morning despite a need for more sleep. In this pattern, the person gets to sleep easily enough but wakes much earlier than necessary, often after only 4 or 5 hours sleep, and long before they planned to get up.
The consequences to sleep deprivation have been studied extensively. A Norwegian study determined that people who had trouble falling asleep were involved in 34 percent of fatal car accidents. And those with symptoms of insomnia are nearly three times more likely to die from a fatal injury.
Amongst a number of other lifestyle factors, another study found that adults aged 45 years or older who sleep less than 6 hours a night are 200% more likely to have a heart attack or stroke in their lifetime, as compared with those sleeping seven or eight hours a night.
Sleep deprived individuals are also more susceptible to weight gain. Among the reasons for this is the fact that inadequate sleep decreases levels of the satiety-signalling hormone, leptin, and increases levels of the hunger-signalling hormone, ghrelin. An individual then consumes more unhealthy foods.
An important hormone that controls our sleep and wake cycles, melatonin, is secreted from the pineal gland. A lack of melatonin has been linked to higher rates of breast, ovarian, and prostate cancers.
Melatonin has much more than sleep enhancing effects. Many studies have been conducted to prove the effectiveness of melatonin. Other benefits and effects of melatonin beyond improving sleep include behavioural improvement, fewer headaches, improvement in symptoms such as tinnitus, cluster headaches and irritable bowel improvement.
Melatonin also induces less excitation to the brain, thereby acting as an indirect glutamate antagonist while reducing cortisol, the major hormone of stress. It is important to note that when you increase the glutamate level, cancer grows like wildfire, and then when you block glutamate, it dramatically slows the growth of the cancer.
When moving between time zones, the administration of melatonin at certain times may help overcome the effects of jet lag and sleep disorders.
The hormone progesterone, has very profound effects on sleep and is somewhat underestimated in it’s profound effects on enhancing sleep. It is a natural hormone that stimulates gaba enhancing sleep and relieving anxiety and actually improves breathing as well as sleep apnoea.
Estrogen has been shown to decrease sleep latency decrease the number of awakenings after sleep occurs¨ increase total sleep time and decrease the number of night time arousals. Estrogen improves the quality of sleep in women too.
Estrogen also affects sleep via its effect on cortisol Menopause is associated with higher levels occurring earlier in the sleep period. Stress is a major factor in increasing cortisol levels and affecting sleep.
Dhea in low doses can help counteract the effects of cortisol as well as stabilizing cortisol levels. Pregnenelone is a very useful hormone to counteract the effects of cortisol and is the ‘mother hormone’ of all steroid hormones.
Testosterone is known to have a minor effect on sleep in humans, except testosterone is related to developing or worsening obstructive sleep apnoea. Dr Golding suggests transdermal testosterone to men when required as this could improve sleep and does not seem to exacerbate obstructive sleep apnoea.
Studies have also been done on natural medicines that include passion flower, valerian, corydalis, magnesium and taurine to show that sleep can be improved naturally. Anti-aging physician, Dr Golding has found the nutrient phosphatidylserine very useful in lowering cortisol, improving memory and improving sleep.
There are a number of answers to solving the insomnia challenge. With advances in technology we are now able to, in the comfort of your own home, determine the various causes to either falling asleep, staying asleep or waking during the night.
Written by Peter Smanjak with additional input by Dr C. Golding