Other clues to the cause of insomnia include some studies showing physiological signs suggestive of an hyper-arousal or sympathetic state. One recent MRI study found a global reduction in gamma-aminobutyric acid (GABA) amongst subjects with insomnia compared to controls. GABA is generally a very strong inhibitory or sedating neurotransmitter. These and many other studies point to chronic stress and its underlying changes in elevated in adrenaline, and eventually depletion of noradrenaline and even GABA as root causes. Insomnia often begins with a stressful event, such as the death of loved one, loss of a job, chronic illness, moving, and any other physical or emotional stressor that continues to be a stressor over time in some form or fashion.
Often stress is multi-layered such as an onion has multiple obvious layers, each one having to be peeled away to eventually get to the root or initial cause of the insomnia. Some patients with insomnia find it difficult to turn off their minds. It is always racing with thoughts. The bedroom itself becomes a cue to begin to think to much. These patients sleep better in novel or new environments. Yet the most common presentation of a patient with sleep disorder is one with depression. Patients can become overly fixated on the insomnia and not recognize or minimize their other symptoms of depression. Depression, especially in older patients, causes sleep disturbance characterized, by the inability to stay asleep and by waking early. Younger patients with depression, may have more difficulty with falling asleep. Anxiety patients usually has difficulty in falling asleep. In addition, many of us have very poor sleep hygiene. We do things which stimulate the mind and body, not allowing ourselves to relax and wind down near the end of the day. Too much caffeine, alcohol, exercise, napping during the day, working or doing projects in bed, OTC use, late eating, TV watching, and absence of a bed time routine. Sometimes children have difficulty in going to bed or staying asleep. One of the only conditions that is difficult to treat with natural medicine of course is an obstructive sleep disorder, such as sleep apnea, which requires a CPAP(other treatment options do exist). We have found at East Valley Naturopathic Doctors, that low dose melatonin is extremely helpful in down regulation over stimulated or high strung children, particularly ones who refuse a normal bedtime. Melatonin is completely natural and side effect free.
The understanding of what causes sleep disorders is extremely varied. Although there is not a lot of evidence for natural medicine present in studies, most patients with sleep disorders improve quickly on natural alternatives without the use of strong or potentially addictive hypnotics.
