Hormone Imbalances That May Cause Insomnia
I can’t sleep! When a patient comes to you with complaints of insomnia, you’ll likely work through a tried-and-true checklist of possible triggers to pinpoint the cause.
- How’s their nutrition?
- Are they exercising?
- Is the patient obese?
- How’s their mental health?
- Are they managing a trauma?
- Is an external factor to blame?
- Are they experiencing sleep apnea?
- Is there a temporary situation causing stress?
- Is the patient in perimenopause or menopause?
Are there diagnoses, medications, or supplements noted on the patient’s chart that trigger insomnia as a side effect?
If you haven’t revealed a lifestyle factor or preexisting condition that keeps the patient awake at night, it’s possible a hormone imbalance is influencing the internal body clock, or circadian rhythm, in turn causing insomnia.
How Hormones Affect Our Sleep Cycles
Let’s refresh our memory on how our body’s circadian rhythm functions in relation to sleep. Inside the hypothalamus, you’ll find the suprachiasmatic nucleus (SCN) regulating how we perceive changes in light, from night to day.
When we wake in the morning and look out the window to see the sun, the SCN releases energizing cortisol to help us get moving. In the evening, as darkness sets in, the SCN tells the pineal gland to release melatonin to make us sleepy and ready for a night of rest. Additional hormones are released throughout the night, including the neurotransmitter acetylcholine during the REM sleep stage to slow our heart rate, according to Johns Hopkins Medicine.
Of course, this process can malfunction. Sometimes the body releases too little or too much of one of these sleep hormones. Or, the body gets confused about when to release hormones. In turn, we notice patients experiencing sleep disturbances or sleep deprivation related to hormone regulation.
This internal process of the endocrine system is not top-of-mind for the everyday patient, especially when they’re coming into the office sleepy. Educate them and assure them that hormone testing is available to get to the root of their sleep problems. These test results help to determine if hormone replacement therapy or supplementation might be a solution for their insomnia.
Medical Conditions Related to Trouble Sleeping
As you evaluate patients with poor sleep quality, review their medical history. Lack of sleep and disturbances to the circadian rhythm — and resulting hormone level fluctuations — can be a side effect of an existing (or undiagnosed) medical condition.
The Mayo Clinic and Cleveland Clinic share the following are influenced by, or linked to, trouble sleeping:
- Alzheimer’s Disease
- Arthritis
- Anxiety disorders
- Asthma
- Cancer
- Chronic pain
- Depression
- Diabetes
- Fibromyalgia
- Gastroesophageal reflux disease (GERD)
- Heartburn
- Hypertension
- Hyperthyroid
- Heart disease
- Life stress related to jobs, relationships, finances, health, etc.
- Medications or supplements
- Menopause and menstruation issues
- Parkinson’s Disease
- Obesity
- Restless legs syndrome
- Stroke
- Thyroid diseases
Is it possible your patient is presenting with one or more health conditions or lifestyle situations that affect sleep, in turn triggering the circadian rhythm and hormone functioning to downgrade their well-being? Treatment should involve dealing with the underlying disease directly and resetting the sleep-wake cycle. Assaying for the hormones at the proper time of day will certainly help a clinician to make appropriate treatment protocol adjustments.
Poor sleep and hormone dysregulation create a vicious cycle, one feeding into the other in a loop. Hormone testing, and regulation through hormone replacement therapy, hormone supplementation, or physician-guided lifestyle changes, can help break this cycle.
Which Primary Hormones Influence Our Sleep?
According to the International Journal of Endocrinology, hormone regulation and metabolism are highly influenced by the circadian rhythm system. When looking for more answers for your patient, consider reviewing various hormone levels to get a biological view of their sleep disruption.
Here are the sleep-related hormones to look at more closely:
-
Cortisol: This hormone should rise rapidly in the middle of night-time sleep, then peak in the morning. When a patient is experiencing stress, cortisol levels spike, which may trigger insomnia.
-
Gonadotropic hormones: Disrupted sleep is common during a woman’s menstrual cycle, specifically during the late postovulatory luteal phase and premenstrual phase. Consider testing with a female-focused panel offering estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone tests.
-
Ghrelin: This hormone is released just before mealtime to stimulate hunger. When ghrelin is taken as an intravenous supplement, it may trigger an increased release of growth hormones.
-
Growth hormone: These levels increase during sleep, and find their peak just after drifting off. Patients with post-traumatic stress disorder (PTSD) often have disturbed sleep and lower growth hormone levels.
-
Melatonin: These secretions should be elevated during the nighttime. Melatonin is also responsible for maintaining sleep patterns, reducing sleep latency, and boosting total time slept.
-
Prolactin (PRL): Sleep onset stimulates the production of PRL. This hormone stops secreting upon awakening.
-
Thyroid Stimulating Hormone (TSH): This hormone tends to rise throughout the evening, then decline during the sleeping hours.
In addition to hormone testing, looking closer at the patient’s ability to metabolize glucose is recommended. The body uses glucose during physical activity and upon waking. The circadian rhythm is known to regulate and steady glucose. When blood sugars are not managed well (by the body naturally or with external insulin treatments), sleep disorders may result.
How To Determine Sleep Hormone Levels in Patients
Access Medical Labs offers personalized hormone testing with an efficient 24-hour turnaround so you can share timely insight with your patients, and they can be on their way to better sleep. When testing for hormones related to insomnia or other sleep disturbances, consider ordering the following:
For more information about our blood, saliva, and urine testing options and supplies, please reach out. Our comprehensive program offers everything you need, from syringes, needles, and vials, to gauze and bandages. Let Access Medical Labs be your go-to specialty diagnostics partner.
