Insomnia and Your Hormones
by Brock Smith, RPh
June 2008
brought to you by Bellevue Pharmacy, a ProjectAWARE
sponsor
Why can’t I sleep like I used too? Is it my bed, my age,
stress, heredity, hormones or is it something else? What are possible
causes and treatments? The following article will discuss common
causes and treatment options for insomnia.
HISTORY:
What is Insomnia? Definition: Prolonged and usually abnormal inability
to obtain adequate sleep. Insomnia is characterized by difficulty
falling or staying asleep and waking too early in the morning. Approximately
60 million Americans each year suffer from insomnia.
Is insomnia a symptom of a physical or psychological condition?
It may be a combination of the two. Sleep is essential to good health.
Just how much sleep do we need? If you consistently get less than
7-8 hours of sleep per night you are probably sleep deprived. If
you get more than 8 hours and still are tired in the morning you
may also have a sleep disorder from getting poor quality sleep.
CAUSES:
There are a myriad of causes for insomnia. Insomnia can be primary
or secondary—primary insomnia means the inability to sleep
is not caused by other health conditions; while secondary insomnia
means other health conditions interfere with sleep.
Sleeping problems can run in families, about 35% of persons with
insomnia have a family history of it, with the mother being most
affected. Overall 10-18% of the general population may suffer from
insomnia.
Brain chemicals at abnormal levels have been observed in some people
with insomnia. Low levels of melatonin, the hormone secreted by
the pineal gland, have been observed in chronic insomnia. The stress
hormone cortisol in high levels (stressful situations) over a prolonged
period have been shown to reduce REM sleep. Reduced levels of growth
hormone also contribute to insomnia. Thyroid disorder, anxiety,
depression and bipolar disorder, medications, illegal drugs and
alcohol may also be factors. Poor lifestyle factors also increase
chances of insomnia.
Declining levels of estrogen and progesterone during perimenopause
and menopause may cause many women to experience insomnia at times
of fluctuations in gonadal hormones, such as the late-luteal phase
of the menstrual cycle, during pregnancy and the postpartum period,
and in the menopausal transition. Among the challenges is that,
while there has been an assumption that sleep disruption is caused
by the levels (or changes in levels) of the gonadal hormones, primarily
estrogen and progesterone, the relationship between symptoms and
hormone levels cannot be established. Sleep disorders become more
common in women as they progress past menopause and can become debilitating
if suffered long-term. Women have more trouble falling asleep and
staying asleep. When they do sleep, it has been documented that
they spend less time in rapid eye movement (REM) sleep and, therefore,
when they wake up, they report that they feel less rested.
One basis for this assumption is that progesterone may have a sedative/hypnotic-like
effect and women tend to have symptoms when progesterone levels
fall.
Estrogen replacement therapy appears to bring sleep patterns closer
to normal and improve sleep quality in a group of postmenopausal
women, according to a report in the February issue of the American
Journal of Obstetrics and Gynecology.
Treatments:
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- Regular sleep times
- Comfortable bed, quiet room, cooler temperature
- Regular exercise, but not closer than 4 hours before bedtime
- Avoid caffeine, large meals, alcohol and tobacco
- Relaxation techniques
- Avoid naps during the day
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| Over the Counter: |
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- Melatonin is a hormone made by a part of the
brain called the pineal ("pin-ee-all") gland. Melatonin
may help our bodies know when it's time to go to sleep and when
it's time to wake up. Melatonin deficiency may cause sleep disorders,
immune deficiency conditions, and depression. Melatonin has been
found to alleviate sleep disorders and boost the immune system.
- Passion Flower is the herb of choice for treating intransigent
insomnia. Passion Flower is a naturally grown medicinal herb. The
sedative effect of Passion flower has made it popular for treating
a variety of ailments, including nervousness and insomnia. Research
had indicated that passion flower has a complex activity on the
central nervous system, which is responsible for its overall tranquilizing
effects.
- Valerian, a member of the Valerianaceae family, is a perennial
plant native to Europe and Asia and naturalized in North America.
It has been used for thousands of years as a folk remedy for insomnia.
Valerian is a common ingredient which is used as a mild sedative
and sleep aid for nervous tension and insomnia.
- Tryptophan: L-Tryptophan is an essential amino acid, meaning the
human body does not produce it naturally, but is required for the
body's healthy functioning. L-Tryptophan is present in a wide range
of foods including beans, nuts, milk, and poultry. L-Tryptophan
is a precursor to 5-hydroxytrytophan (5-HTP) (which is a precursor
to serotonin) and is sold as a sleep aid and mood enhancer.
- Sleep Naturally® - a dietary supplement to encourage sleep
containing: magnesium, melatonin, vitamin B complex, and 5-HTP.
This product can be found at Bellevue
Pharmacy.
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| Options by Prescription Only: |
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- SSRI (Prozac, Paxil, Effexor)
- Sedative/hypnotics (Valium, Ambien, trazodone)
- Hormones: (estrogen, progesterone, melatonin)
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Unfortunately, there is a surprising lack of clinical research
regarding insomnia and gonadal hormone changes. It is important
to carefully assess symptoms of insomnia and hormonal fluctuation
to rule out other factors. For instance, if insomnia is generated
by behavioral factors then it should be treated accordingly.
References
- Krystal, Andrew D. “Gonadal Hormone-related insomnia in Women”,
2004. Medscape.
- The Institute of Endocrinology and Preventive Medicine
http://www.drmarinajohnson.com/Articles/ChronicInsomnia/tabid/196/Default.aspx
- University of Maryland Medical Center Archives http://www.umm.edu//patiented/articles/what_insomnia_000027_1.htm
For questions and further information, contact Bellevue Pharmacy.
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