Good sleep is on top of the pyramid because it is the most important ingredient. Without good sleep you won’t have good eating habits (when you’re tired you don’t care what you put in your mouth and you feel more hunger than usual). You won’t exercise a lot (lack of energy and motivation) and you will definitely feel overwhelmed by everything in life whether it be job, family, physical health because not sleeping enough leads to poor physical and mental performance. There is no way you will be pleased with your achievements when you are under-performing.
The reverse is also true. You will not get proper sleep if your diet is lacking specific nutrients, if you are sedentary most of the time and certainly not if you are under a lot of stress. If one or all of these elements are present, they will negatively impact the chemistry of your body, causing imbalances in the neurotransmitters or hormones essential for getting good sleep. The neurotransmitter/hormone imbalances are not per se the cause of the insomnia but a symptom of underlying deficiencies, illness or unhealthy lifestyle. However, by using the criterion of the dominant chemical messenger affected, we can distinguish three main types of insomnia.
Type 1: The Night Owl
People who suffer from this kind of insomnia have a hard time falling asleep. They feel like they can’t turn off their minds, constantly worrying about unfinished business or what the next day will bring, twisting and turning in bed until the wee hours of morning. Most of them even give up on sleep altogether and go about their business as usual or watch TV all night until, eventually, they fall asleep from sheer exhaustion. These people usually claim they function better at night, earning them the nickname “night owls”.
This type of insomnia is characterized, metabolically speaking, by a deficiency of melatonin, a hormone that regulates sleep. Melatonin is released in the evening as a response to increasing darkness. If you expose yourself to bright light right before sleep (screens in particular), your circadian rhythm is disrupted and melatonin cannot be produced. Thus, you will not be able to fall asleep.
Melatonin deficiency can also be a result of low serotonin levels, as serotonin is a precursor to melatonin. If you are an indoorsy-type of person who doesn’t like to exercise, for example, your serotonin levels will not be adequate because serotonin production requires plenty of oxygen and sunlight (vitamin D).
Moreover, melatonin production naturally decreases as we age, creating plenty of sleep trouble in menopausal women, though men can be affected as well. But, at the end of the day, people can be affected by insomnia at any age if they are in a stressful job (especially shift workers), if they suffer from severe blood sugar swings (such as in diabetes or insulin sensitivity), or abuse alcohol or caffeinated-products.
Type 2: The Light Sleeper
The light sleepers may or may not have problems falling asleep, but what is peculiar about them is that they wake up easily, sometimes at the slightest thing. Or they might have a pretty good sleep for a few hours and then jump out of sleep, usually around 3 or 4 AM, and not be able to fall asleep again. Their biggest nightmare is to have to get up to use the toilet at night, sure recipe for a sleepless night.
This type of insomnia is characterized metabolically by GABA deficiency, the main calming neurotransmitter, essential in maintaining sleep. You might not have heard of GABA, but you will surely have heard of adrenaline, the famous “fight-or-flight” hormone/neurotransmitter. The primary function of GABA is to balance adrenaline and the other stress hormones. In times of acute stress, it is GABA’s job to help us calm down.
When you are under constant stress GABA production might dwindle, leaving you unable to calm down and have a deep, relaxing sleep. That’s why it is important to manage your stress levels and to eat a healthy diet, because GABA production is dependent on a lot of nutrients, vitamin B6 and magnesium in particular, and negatively affected by food additives such as aspartame or MSG. Other causes of GABA deficiency can be viral infections (e.g. rubella, strep, candida), diabetes, hypoglycemia, serotonin deficiency.
Type 3: Tired But Wired
In this type of sleep disturbance people have difficulty in both falling asleep and staying asleep. Although it may sound like a simple combination of the previous two types of insomnia (and in a way it is), this one is a more advanced form of sleep dysregulation. These insomniacs do not feel sleepy at all, even at bedtime, unable to switch off their minds. It’s like their mind is always on stand-by, vigilant, ready to wake up and get to work. If they do manage to go to sleep, their sleep will be very shallow, with frequent wakings. Needless to say that in the morning they are very fatigued, like they have not slept at all.
This type of insomnia is caused by irregular nighttime levels of the stress hormone cortisol, too high when it should be low and vice versa. Cortisol is very important to our body, affecting all our other hormones (thyroid, adrenal, sex hormones), regulating blood sugar and blood pressure, digestion, and even our immune system. That is why when we are stressed, our health is affected as well.
When people are under prolonged physical and/or mental stress, their neuroendocrine system -the HPA axis, the thyroid, the ovaries - is overwhelmed and it cannot produce cortisol at normal levels. Many times this causes nighttime fluctuations in blood sugar, causing us to wake up, possibly for a midnight snack. The problem is further aggravated by the fact that the less sleep we get the more the cortisol imbalance worsens, leading to a vicious cycle where hormonal problems cause sleep deprivation and vice versa.
The best approach to handle this type of insomnia is to try to manage the stress in our lives and our blood sugar levels because insomnia is just a symptom of a deeper hormonal issue.
It it is a difficult task to try to classify insomnia into types because the differences are not always clear cut. Yes, looking at the big picture, we can see certain neurotransmitter trends in the brains of people affected by insomnia. But you can be affected by more than just one type of insomnia at any given time, depending on the seriousness of the underlying cause.
It is important, however, to try to differentiate because not all insomnia is created equal and adhering to standard treatment protocols might not yield the desired results. By knowing the cause of your sleepless nights, you can individualise the healing approach to suit your needs.
All in all, it also becomes evident that we should start viewing insomnia not as mere sleep loss but as a state of emotional and physical hyperarousal brought on by the stress in our lives or aging. Treating insomnia is not as simple as taking some pills but requires that we address the underlying cause, which most of the time boils down to stress. First of all, skipping sleep intentionally is never a good idea, it only leads to more sleep problems down the road. Second, we would all benefit from taking up meditation, yoga classes, exercise or even simply taking walks every day, to manage the stress in our lives. Then we would not have sleep problems at all.