Insomnia and Sleep Quality

What is Insomnia And why does it Happen?

Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or having non-restorative sleep, despite having the opportunity to sleep. It can affect both the quality and quantity of sleep, leading to daytime fatigue, irritability, and difficulty functioning during the day.

How do we fall asleep?

When you are awake, the electrochemical activity in your brain produces various chemical byproducts. Throughout the day, the accumulation of these chemicals, known as sleep-promoting factors, increases.

When these chemicals in your brain start to build up, you start feeling the need for sleep. Once this need reaches a certain level, it tells other parts of your brain to stop keeping you awake. It also helps activate the parts of your brain that help you fall asleep at night.

What Happens when we sleep?

Adenosine gradually accumulates in the brain throughout the day as a byproduct of energy consumption. It inhibits regions that keep the brain awake. Adenosine levels build up and create a sense of sleepiness. This is why we tend to feel more tired as the day progresses. During sleep, adenosine levels decrease, helping us wake up feeling refreshed.
Melatonin is produced by a particular gland located at the base of your brain called your pineal gland. It is mainly released during the night under the regulation of your Suprachiasmatic Nucleus. Melatonin release is also sensitive to light signals from the retina and works to entrain your internal sleep-wake cycle to an external clock.
Nitric oxide is actually a small gaseous molecule which is synthesized by enzymes in the brain. One of the ways it promotes sleep is by promoting the release of adenosine.
Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter that helps promote sleep and relaxation and reduces brain activity. Aids in N-REM sleep

How do we stay awake?

We have specific neurochemicals that can keep us from falling asleep easily:

Excitatory neurotransmitters:
- Norepinephrine (and its related hormone, epinephrine), helps your brain stay alert and active and attentive. It plays a role in maintaining wakefulness and promoting vigilance.
- Cortisol levels naturally rise in the morning, peaking shortly after waking up. This morning surge of cortisol helps to increase alertness in the brain and body, and readiness for the day ahead.
Orexin/Hypocretin to keep you awake and alert when you're up and moving around. This helps prevent you from suddenly falling asleep at inconvenient times, even when you're feeling very tired.
Serotonin is involved in regulating mood, appetite, and sleep. During the day, when it's bright and light outside, serotonin levels tend to be higher, keeping us awake and focused. Low levels of serotonin can contribute to feelings of drowsiness and fatigue. High levels in N-REM sleep (deep sleep).
Acetylcholine helps keep us alert and focused during the day. Decreased levels of acetylcholine are associated with sleepiness and may contribute to the transition from wakefulness to sleep.
Dopamine is a neurotransmitter involved in various functions, including mood regulation and reward processing. It helps promote wakefulness and motivation. Disturbances in dopamine levels can affect sleep patterns and contribute to sleep disorders.
Histamine helps regulate the sleep-wake cycle by promoting wakefulness during the day. Medications that block histamine receptors are often used as sedatives.

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Symptoms of Insomnia:

The most Common Causes of Insomnia:

Fatigue
Find it hard to go to sleep.
Wake up several times during the night.
Lie awake at night.
Wake up early and cannot go back to sleep.
Still feel tired after waking up.
Find it hard to nap during the day even though you're tired.
Feel tired and irritable during the day.

Stress, anxiety or depression
Noise
A room that's too hot or cold
Uncomfortable beds
Alcohol, caffeine or nicotine
Recreational drugs
Jet lag
Shift work
Emotional stress and trauma

How I approach Insomnia...

Insomnia needs to be approached from all angles. First, I study any systemic inflammation (diet and gut health). Serotonin is mostly bound in the gut so it's important to have optimal gut flora as well as minimal inflammation. Next I can study the neurotransmitters/imbalances in hormones & circadian rhythms, that can cause wakefulness. We can also use testing such as the Organic Acids test to observe your neurotransmitter levels. Third, I address mental & emotional health (Anxiety, stress, depression etc) that can affect the brain. Observing the case though a Traditional Chinese lens also gives clues on emotional and physical health.

I use supplements, herbs, acupuncture and homeopathy to help balance the body & mind, while rewiring the nervous system. I also help you learn how to rewire your stress response in your body using hypnotherapy, breathing and cognitive restructuring.

Book in with Dr Rena