09 Feb Hormones Affect Sleep
Sleep and Hormones By Dr. Brent Barlow, ND
Low-functioning adrenal gland can make it difficult to fall asleep or stay asleep because of poor production of stress hormones. The signs of the adrenals being involved in the sleep difficulty include difficulty sleeping after stressful days and waking recurrently through the night especially after a stressful day. In this week’s column, we will review hormone therapies that may be helpful in treating poor sleep due to adrenal gland dysfunction.
Hormone replacement therapy is becoming more and more prominent in the healthcare system. In fact, many physicians are focusing their practices on this area of work. HRT is like most therapies in that it has its pros when used appropriately and its cons when it’s abused. I offer hormone replacement therapies as part of my practice because they can provide support in many situations that other therapies can’t offer. HRT can also be part of an overall holistic treatment plan that is designed to fix the problem and not just temporarily treat the symptoms.
I find that HRT can help improve sleep in people who are having difficulty sleeping due to imbalances of sex and stress hormones. In particular, this seems to be most useful for women in the peri-menopausal to menopausal years. This is especially highlighted if the adrenal glands are functioning sub-optimally. The reason for this is that as a woman progresses towards peri-menopause and menopause, the ovaries begin to produce less and less sex hormones like estrogens, progesterone, and testosterone. The adrenal glands then have to pick up some of this slack by increasing their production of sex hormones. Eventually, when a woman enters menopause, her ovaries cease to produce sex hormones and the body becomes largely dependent on the adrenal glands for sex hormone production.
The transition of peri-menopause to menopause typically occurs in the mid 40’s to mid 50’s for most women. However, women who’ve had hysterectomies, other surgeries, or family history of early menopause may experience this transition earlier in life. For many of my patients, their sleep problems significantly worsened during this type of hormonal transitioning and treating sleep with basic sleep medications rarely helps completely resolve the majority of symptoms they experience. The typical symptom picture includes difficulty falling asleep, waking frequently, night sweats, hot flashes, waking unrefreshed yet unable to sleep longer, fatigue during the day, and mid abdominal fat accumulation.
The treatment of poor sleep due to these types of hormonal imbalances largely depends on the stage of peri-menopause or menopause the patient is in, the symptom picture they present with, and the results of hormone testing. There is a wide variety of HRT options that we can prescribe but we always want to make these prescriptions in a targeted way with a short-term, intermediate-term, and long-term plan. Unfortunately, I meet many patients who started some form of HRT without a future plan in place. Often, the initial prescription was well targeted but due to lack of follow up the plan becomes less effective.
If you feel that your sleep difficulties may be a result of hormonal imbalances I highly recommend you seek advice from a physician (MD or ND) who is well versed in therapies designed to address hormonal imbalances. This should include not just HRT but also botanicals, vitamins, minerals, amino acids, glandulars, nutrition, and other holistic therapies. Make sure your not just being treated for the symptom of poor sleep but the treatment is focused on the causes of poor sleep. Don’t immediately jump into hormone prescriptions without a thorough evaluation including some form of hormone testing.