The Dr. Lam Show

Poor Sleeping Habits and What They Mean

Dr. Lam

Do you struggle to fall asleep or wake up in the middle of the night? There are a lot of different issues that can cause these problems and they must be addressed to protect your health. Here’s how to start identifying what could be causing your poor sleeping habits.

1:30 - Inability to Fall Asleep
2:55 - Saliva Cortisol Curve Connected to Sleep
4:35 - How to bring high cortisol down
8:10 - Inability to Stay Asleep
11:55 - Why women might have difficulties staying asleep
13:20 - Natural Sleep Aids

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Dr. Carrie Lam, MD:

There is nothing better than a good night's sleep. It gives you energy, releases stresses, and helps you heal. But there's a downside to the importance of sleep. When you don't sleep well, it will leave you feeling lousy, exhausted and then it can even affect your memory and ability to think. Studies have shown that it makes you more prone to accidents, which is troubling if you drive a lot. This is the Dr. Lam show. And we're here to empower you to take control of your life. As we talk about integrative medicine. Today we're going to talk about poor sleep, the difficulty in falling asleep, and even staying asleep. What are the causes and what you can do about it? I'm Dr. Carrie Lam. For years, I've been working with people from all walks of life, helping them to feel better using natural and holistic strategies.

Dr. Jeremy Lam, MD:

I'm Dr. Jeremy Lam, I'm an expert in preventative medicine and chronic conditions. I have a particular interest in combining both conventional medicine as well as holistic medicine to promote health and well being. You can't underestimate the importance of sleep, or how it will impact your body when you don't sleep well. So without further delay, let's talk about some common sleep complaints and what causes them. Dr. Carrie, can you tell us about why someone complains of not being able to fall asleep?

Dr. Carrie Lam, MD:

This is a very important and common complaint that we see in adrenal fatigue sufferers. As you know, in adrenal fatigue, the body goes through different stages. First, the alarm reaction, then the resistance response. As the body gets more and more stressed, the cortisol output at first goes up. Cortisol is a miracle hormone, because it stabilizes the body, it gives the body energy to overcome stress by helping breakdown of sugar. And if you have too much cortisol, especially if it comes out too much during the daytime, you can feel more energy. However, cortisol normally starts out high in the morning to wake you up and get you started in your day. But it has to be broken down throughout the day. It has to get lower at night so that you are able to fall asleep. If you have low cortisol throughout the day, you're gonna wake up slumpy. And when you have high cortisol, you can feel anxious. If your cortisol is high at night, let's say 8 or 10 o'clock, even though it's supposed to be low, it's actually high, you can have the difficulty going to sleep. How do you normally see this on that diurnal saliva curve Dr. Jeremy?

Dr. Jeremy Lam, MD:

So we would see a reverse curve. And like we said, the cortisol should be low at night, but instead, it stays high and cannot come down. So it takes some people longer to be able to fall asleep. So one of the reasons could be that you have high cortisol at night. But cortisol is only part of the picture. Sometimes we see people make common mistakes: if he cortisol is high at night, th n let's just normalize it an try to press it down. When yo try to press it down, the body may not like it, especially if y ur body has been used to this type of high cortisol for a v ry long time. And you c n crash yourself. So what do you do when you have high cor isol or problem falling asleep? ou have to look at all the other systems that might be i volved, different body systems and how to balance those throug out the whole day, not jus at the ni

Dr. Carrie Lam, MD:

So when you have adrenal issues, and the cortisol output is inappropriate, you want to first make sure that adrenals, the neurotransmitters, the bioenergetic circuit and the cardiovascular circuit, are doing well and all of them are working well together first, before you can bring that cortisol down. There are supplements to bring cortisol down, like phosphorylated serine or herbal nervines. These are found in bedtime teas that try to bring cortisol down. The main principle is that you want to be able to support your adrenals throughout the day and over time the cortisol will come down by itself. Right Dr. Jeremy?

Dr. Jeremy Lam, MD:

That's correct. And that's the key to give the body the nutritional support it needs and allow the body to self regulate. Then the body can affect the feedback loops that it has to regulate itself and calm itself down. Otherwise, you can take, sleep aids and sleep medications, which you can get hooked on. They can have many side effects that are not very good for your body. It's very important to find the root cause of the inability to sleep, whether it be cortisol, hormones, norepinephrine, or epinephrine, and address it.

Dr. Carrie Lam, MD:

One thing that is very helpful that you can do is to do some adrenal breathing. At night, if you feel very wired and tired and you're unable to fall asleep, you're just tossing and turning, just think about breathing. And doing this belly diaphragmatic breathing, will increase your parasympathetic response and balance out that sympathetic wiredness that you're feeling. Bring down that whole threshold of feeling high and wired to be more calm and restful, especially at night. And breathing is not only important at night, we tell our patients or clients to do it every hour if they can, throughout the waking day. Because if your cortisol is high throughout the day, you need to also work on bringing that cortisol down during the day and not just at night for your sleep. Getting your body used to that type of breathing is important. Especially if the high cortisol is one of the root causes in your ability, to fall asleep.

Dr. Jeremy Lam, MD:

So if you have trouble falling asleep, it doesn't matter how early you go to bed, you just lie there even longer, bored, frustrated, and tired, and really unable to fall asleep. And that can be pretty frustrating. So if you would like some help with finding out the root cause of what is going on with your sleeping, particularly as it also relates to adrenal fatigue, then call us at 714-709-8000 to talk to someone who really understands and can help. Now struggling to fall asleep isn't the only sleeping problem that people often complain about. If you fall asleep easily, but then you wake up in the middle of the night, you are wide awake, your mind racing and struggling to go back to sleep, then you're not alone.

Dr. Carrie Lam, MD:

We call this the inability to stay asleep. A lot of people might not really know how to approach this issue. And they get more and more frustrated as they look at the alarm clock and see the time ticking. And usually, if you go see your doctor, they might put you on a sleep medication, rather than explaining why is this happening and just give you a sleeping aid to suppress your neurotransmitters and fall asleep. But that doesn't really fix the root cause. In the long term, you can build tolerance to it. If you don't get to the root cause, it will probably stop working after some time. So you have to understand what can be causing these sleep maintenance issues. We talked about having the high cortisol, that can prevent you from falling asleep. But having high cortisol in the middle of the night can also spike and make you wake up too early. Dr. Jeremy, can you tell us a little about that.

Dr. Jeremy Lam, MD:

If you have high cortisol in the middle of the night, instead of spiking around four to six o'clock which is supposed to be waking you up in the morning, it spikes up earlier around two or three o'clock. That could be the reason why you feel very wired and tired when you wake up. Also, when you look at your neuro metabolic stress response, and the circuits involved could be your bioenergetic circuit, where if you have a blood sugar imbalance, then you have reactive hypoglycemia which could wake you up as well. And so Dr Carrie, what is one of the challenges that we kind of give our patients to see if their blood sugar issue could be causing them to wake up.

Dr. Carrie Lam, MD:

So if you're having blood sugar issues that might be waking you up, a simple thing that you can do is eat a handful of nuts before you go to bed or in the middle of the night. Make sure that these nuts are soaked ahead of time, so that the tannins are stripped off it and they're easily absorbed. After you soak them overnight, you can either slow roast or dehydrate them so they don't get soggy or moldy and you can keep them for longer. Giving yourself some protein, mitigates the sugar spike. If you can't tolerate nuts, try almond milk, pumpkin seeds or other protein before you go to bed or when you wake up. This means maybe it's a metabolic issue that's actually causing you to wake up in the middle of the night.

Dr. Jeremy Lam, MD:

Some people are often afraid, to eat in the middle of the night, because it's not healthy, or feel like they wont be able to digest very well. People with adrenal fatigue, need to often eat every two to three hours, whether if that's happening during daytime, or at night. And so you need to be able to feed your body what it needs when it needs. When your body stabilizes, and your body recovers, then those things will improve as well.

Dr. Carrie Lam, MD:

Some other issues that especially affect women, to wake up at night is estrogen and progesterone imbalance, during menopause, the hot flashes and night sweats wake them up due to that ratio difference between the estrogen and progesterone. Most women also have a difficult time with holding their urine at night especially if they have had many childbirths and therefore their bladder can't contain that amount of liquid. So they wake up in the middle of the night and have a hard time falling asleep. If you have hormonal issues, it is very important that you get some testing done where you can actually try to balance these hot flashes. Because hot flashes have actually been normalized, the society think that hot flashes are normal, you're gonna go through it in menopause. But if you're healthy, you go through menopause, and you don't necessarily have to have hot flashes. And we can definitely help with that transition when you are about to hit menopause or if you're still dealing with hot flashes and night sweats waking you up in the middle of night. Helping with your adrenals output of reproductive hormones can help with hormone imbalances that you're feeling.

Dr. Jeremy Lam, MD:

And some aids that you can try taking is you know, taking melatonin that's more natural Theanine, GABA and five HTP. And then if that fails, then sleep medications. But doing this is not solving the root problem, it's only going to suppress the symptoms until it becomes problematic. So ultimately is about investigating what that root problem is and addressing that.

Dr. Carrie Lam, MD:

We also try to investigate the melatonin levels. You can do a morning melatonin or a high melatonin. Melatonin is opposite to cortisol. So if cortisol is low at night, melatonin is high, and help you fall asleep. This hormone comes from the pineal gland is produced at night to help you fall asleep and in the morning, the level drop down low as your cortisol goes up. So there's opposing forces. Melatonin can be easily tested. If you want to get tested, you can call our office and we can order those tests for you. We are at 714-709-8000 and see your levels of hormones cortisol and melatonin, when you have sleep issues. If you found this information helpful, or if it helps you to reduce stress or anxiety about your inability to sleep, fall asleep or stay asleep, then please subscribe and share the Dr. Lam show podcast. The more you understand the damage that poor sleeping habits and adrenal fatigue can do to your body, the more you will feel comfortable looking for help for these problems. We thank you for spending the time with us today, as we're here to empower you to take control of your health.

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