Good sleep and good health go hand in hand. While you sleep, your body works to support healthy brain function and emotional well-being. Regular, quality sleep also helps you pay attention, make decisions, and be creative during the day. Studies show a good night’s sleep even improves learning and problem-solving skills.
On the flip side, sleep deficiency is linked to risky behavior, depression, and suicide.1Bernert RA, Joiner TE. Sleep disturbances and suicide risk: a review of the literature. Neuropsychiatr Dis Treat. 2007;3(6):735-743. https://doi.org/10.2147/ndt.s1248
Sleeping for Immunity, Heart Health, and Hormonal Balance
There’s no question that sleep deprivation has an adverse effect on overall health. Ongoing sleeplessness increases the risk of heart disease, kidney disease, hypertension, diabetes, and stroke.2Evbayekha EO, Aiwuyo HO, Dilibe A, et al. Sleep Deprivation Is Associated With Increased Risk for Hypertensive Heart Disease: A Nationwide Population-Based Cohort Study. Cureus. 2022;14(12):e33005. Published 2022 Dec 27. https://doi.org/10.7759/cureus.33005 Sleep deficiency also increases the risk of obesity. Improper rest changes your body’s reaction to insulin, the hormone that controls blood sugar levels, and upsets the balance of hormones that make you feel hungry or full. Your immune system relies on consistent sleep for resilience. Without it, your body works harder to fight off common infections.
Good Sleep = Brain Power
While you’re sleeping, your brain is forming new pathways to help you learn and remember information. Sleepy people tend to take longer to finish tasks, have a slower reaction time, and may make more mistakes. Studies show sleep deficiency affects your judgment while driving as much as—or more than—being intoxicated.3Colten HR, Altevogt BM, Institute of Medicine (US) Committee on Sleep Medicine and Research, eds. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006.
Underlying Causes of Insomnia
Most people experience a bout of insomnia every now and then. Everything from increased stress to a late-day cup of coffee can affect our sleep. But prolonged sleeplessness is more complicated. Lifestyle and environmental factors, psychosocial issues, and medical conditions can all contribute to long-term sleep problems. A naturopathic doctor (ND) starts by searching for the cause of sleep disturbance and deficiency. Common reasons often stem from poor nutrition, improper sleep hygiene, emotional and psychological state, and hormone imbalances.
Nutrition
Alcohol, caffeine, and nicotine may all contribute to insomnia. Refined sugar in desserts, sodas, and simple carbohydrates, like white bread and barbecue sauce, can also interfere with restful sleep. In general, what, when, and how much you eat affects how well you sleep.
Studies show that partial sleep deprivation alters the gut microbiome. Lower levels of microbiota (specifically phyla Verrucomicrobia and Lentisphaerae) are associated with poor sleep quality. In simpler terms, this means enhancing gut microbiota could help to improve sleep. Diet is the easiest way to rectify GI imbalances. Eat high-fiber foods like vegetables, legumes, beans, and fruit to stimulate gut bacteria and digestion.
Environment
Noise, light, room temperature, and other environmental factors often affect sleep. NDs look for and address environmental exposures that may cause irritation and inflammation, disrupting circadian rhythms. Common irritants include pollen, dander, and blue light from phones and other devices. Adequate exposure to full-spectrum light outside is also important for maximizing melatonin production.
Emotional and Psychological Factors
There is a complex, cyclical relationship between sleep and mood. Broken sleep can lead to emotional changes, clinical depression, and anxiety (as well as other psychiatric conditions) and further disrupt or prevent sleep. Research shows people with insomnia have higher levels of depression and anxiety than those who sleep regularly.4Riemann D, Krone LB, Wulff K, Nissen C. Sleep, insomnia, and depression. Neuropsychopharmacology. 2020;45(1):74-89. https://doi.org/10.1038/s41386-019-0411-y
Hormone Imbalances
Imbalances in serotonin, cortisol, melatonin, estrogen, and testosterone may all contribute to sleep problems. Additionally, people with hypothyroidism, a condition where the thyroid gland doesn’t make enough thyroid hormones, are also at higher risk of developing insomnia.
Medication Side Effects
Medications, including treatments for the common cold, nasal allergies, high blood pressure, heart disease, thyroid disease, asthma, and depression (and even birth control), can cause insomnia. Side effects tend to vary by dose. Other drugs prescribed for sleep trouble, such as Ativan, may cause daytime sleepiness.
Natural Remedies for Better Sleep
Whole-person treatment focuses on lifestyle changes by optimizing diet, environment, and sleep hygiene; removing stimulants; increasing physical activity; and establishing healthy routines. Clinical nutrition plays a significant role, as naturopathic doctors thoroughly investigate and address microbiome imbalance.
When emotional and psychological factors are involved, NDs work with patients and mental health professionals to identify and treat depression, anxiety, and stress. Practices like mindfulness, controlled breathing, and meditation are recommended strategies. When appropriate, NDs may prescribe botanical medicine to address anxiety and depression, including GABA,5Lydiard RB. The role of GABA in anxiety disorders. J Clin Psychiatry. 2003;64 Suppl 3:21-27. L-theanine,6Lu K, Gray MA, Oliver C, et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Hum Psychopharmacol. 2004;19(7):457-465. https://doi.org/10.1002/hup.611 passionflower,7Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001;26(5):363-367. https://doi.org/10.1046/j.1365-2710.2001.00367.x and adaptogens such as Ashwagandha.8Kaushik MK, Kaul SC, Wadhwa R, Yanagisawa M, Urade Y. Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction. PLoS One. 2017;12(2):e0172508. Published 2017 Feb 16. https://doi.org/10.1371/journal.pone.0172508
Sleep Testing and Supplements
When naturopathic doctors suspect a hormonal imbalance is at play, they may order lab testing and recommend nutraceuticals, including melatonin,9Ferracioli-Oda E, Qawasmi A, Bloch MH. Meta-analysis: melatonin for the treatment of primary sleep disorders. PLoS One. 2013;8(5):e63773. Published 2013 May 17. https://doi.org/10.1371/journal.pone.0063773 glycine,10awai N, Sakai N, Okuro M, et al. The sleep-promoting and hypothermic effects of glycine are mediated by NMDA receptors in the suprachiasmatic nucleus. Neuropsychopharmacology. 2015;40(6):1405-1416. https://doi.org/10.1038/npp.2014.326 and tryptophan,11Silber BY, Schmitt JA. Effects of tryptophan loading on human cognition, mood, and sleep. Neurosci Biobehav Rev. 2010;34(3):387-407. https://doi.org/10.1016/j.neubiorev.2009.08.005 as appropriate. NDs can also pinpoint prescription medications that may be affecting a patient’s sleep and, working with the prescribing physician, support patients in reducing or discontinuing such drugs.
The AANP and the INM would like to acknowledge Amy Rothenberg, ND, for contributing to this article.
Footnotes
- 1Bernert RA, Joiner TE. Sleep disturbances and suicide risk: a review of the literature. Neuropsychiatr Dis Treat. 2007;3(6):735-743. https://doi.org/10.2147/ndt.s1248
- 2Evbayekha EO, Aiwuyo HO, Dilibe A, et al. Sleep Deprivation Is Associated With Increased Risk for Hypertensive Heart Disease: A Nationwide Population-Based Cohort Study. Cureus. 2022;14(12):e33005. Published 2022 Dec 27. https://doi.org/10.7759/cureus.33005
- 3Colten HR, Altevogt BM, Institute of Medicine (US) Committee on Sleep Medicine and Research, eds. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006.
- 4Riemann D, Krone LB, Wulff K, Nissen C. Sleep, insomnia, and depression. Neuropsychopharmacology. 2020;45(1):74-89. https://doi.org/10.1038/s41386-019-0411-y
- 5Lydiard RB. The role of GABA in anxiety disorders. J Clin Psychiatry. 2003;64 Suppl 3:21-27.
- 6Lu K, Gray MA, Oliver C, et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Hum Psychopharmacol. 2004;19(7):457-465. https://doi.org/10.1002/hup.611
- 7Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001;26(5):363-367. https://doi.org/10.1046/j.1365-2710.2001.00367.x
- 8Kaushik MK, Kaul SC, Wadhwa R, Yanagisawa M, Urade Y. Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction. PLoS One. 2017;12(2):e0172508. Published 2017 Feb 16. https://doi.org/10.1371/journal.pone.0172508
- 9Ferracioli-Oda E, Qawasmi A, Bloch MH. Meta-analysis: melatonin for the treatment of primary sleep disorders. PLoS One. 2013;8(5):e63773. Published 2013 May 17. https://doi.org/10.1371/journal.pone.0063773
- 10awai N, Sakai N, Okuro M, et al. The sleep-promoting and hypothermic effects of glycine are mediated by NMDA receptors in the suprachiasmatic nucleus. Neuropsychopharmacology. 2015;40(6):1405-1416. https://doi.org/10.1038/npp.2014.326
- 11Silber BY, Schmitt JA. Effects of tryptophan loading on human cognition, mood, and sleep. Neurosci Biobehav Rev. 2010;34(3):387-407. https://doi.org/10.1016/j.neubiorev.2009.08.005
