What is insomnia

Understanding insomnia

There is no specific test for the clinical diagnosis of insomnia, however, if you consistently have trouble falling asleep, staying asleep, resuming sleep after waking, wake too early or feel unrefreshed following sleep (despite having the opportunities to sleep well), then it’s likely you are experiencing insomnia.

The factors that contribute to poor sleep can be due to another health conditions (secondary insomnia), or underlying problems with overstimulation of the brain and nervous system (causing REM sleep disruption), deficiency of nutrients, poor sleep hygiene, or an imbalance of neurotransmitters. Poor sleep can be episodic, short term and can become chronic.

person sitting on bed with doona over head holding cup coffee
middle aged man sitting on couch with cup of coffee smiling

Functional medicine for insomnia

Regular, good quality refreshing sleep is integral to good health and wellbeing. Poor sleep can disrupt performance at work and home, affecting memory, mood, and stress resilience contributing to mental illness and poor cardiovascular health. All of these factors can contribute to further sleep issues, creating a cycle that can be harder to break, so it’s important to seek help as soon as possible.

The good news is that functional medicine practitioners are specialists in providing strategies for improving sleep quantity and quality. Understanding and treating the root cause of your sleep issues is the most effective way to improve sleep for long-term health. Insomnia functional medicine treatment is available in Melbourne, and is accessable Australia-wide.

Before
After
Before
After

What is normal sleep?

Sleep occurs in 90 - 120  minute cycles, of two distinct stages:

Rapid eye movement (REM) - which makes up around 25% of your night’s sleep (except for babies where it accounts for most of their sleep). REM is the time of highest electrical activity causing the eyes to dart around under the eyelids. This is the time when most dreams occur.

Non-rapid eye movement (NREM) - makes up the rest of your sleep. NREM can vary with age and the amount of sleep deprivation. The 4 stages of NREM sleep include:

  • Stage 1 - drowsiness / dozing, hovering between being awake and asleep
  • Stage 2 - body temperature drops, and breathing / heart rate slows down and you lose awareness of your surroundings
  • Stages 3 & 4 - delta sleep, or deep sleep. Your blood pressure, breathing, and heart rate slow down and your muscles relax. In these stages, growth and repair processes occur

Our sleep requirements are determined by age, but in general, the younger we are, the more sleep we require.

By age, the recommended amount of hours are:

  • Newborn - 3 months  - 14 to 17 hours
  • 4 - 11 months - 12 to 5 hours
  • 1 -2 years - 11 to 14 hours
  • 3 - 5 years - 10 to 13 hours
  • 6 - 13 years - 9 to 11 hours
  • 14 - 17 years - 8 to 10 hours
  • 18- 64 years - 7 to 9 hours
  • Over 65 years - 7 - 8 hours

This guide does not reflect how some people need a little less sleep, and some a little more, however less than 7 hours regularly for an adult is associated with poorer health outcomes.  

Sleeping patterns also change with age. Babies develop a circadian rhythm (or internal day-night cycle) favouring sleep at night from around 2 months old. At 6 months around 25-50% of babies will wake at night and nap during the day. Daytime naps usually stop before 5 years of age, or may indicate insufficient sleep at night if they continue.

Teenagers see an alteration to their circadian rhythm, feeling their lowest energy dip early morning until around 9 - 10 am (where adults are usually more alert) then their body temperature rises through the morning until around 1 pm, when they are most alert. An afternoon slump is seen between 2 - 5 pm (where adults will likely see this earlier around 1 - 3 pm) and they will start to feel sleepy around 1 hour later than adults, around 11 pm.

Adult sleep stabilises around the age of 20, with variations in the length of sleep, that usually falls between 7 - 9 hours to feel properly refreshed and function at one’s best.

In addition to our natural circadian rhythm, we each have different sleep ‘chronotypes’ , a natural disposition to sleep or be awake at certain times. Circadian rhythm is regulated by light exposure and melatonin release, whereas chronotypes are most likely to be a genetic predisposition. Chronotypes are often characterised by animal behaviours, such as an ‘early bird’ or ‘night owl’, which reflects variations in the time melatonin subsides in the morning and is released during the evening.

What causes insomnia?

Chronic insomnia, where symptoms last longer than 1 month, affects around 10 % of the Australian population and is more common in people with other medical conditions, particularly older people. Regular bouts of insomnia affect up to 33% of people on a regular basis, having difficulty in getting to sleep or staying asleep, and this can become chronic if a regular sleep pattern is not regained.

Insomnia can present as both the cause and consequence of other factors. For example, poor sleep can impact behaviours and health conditions that directly impact the capacity to fall asleep e.g. anxiety can inhibit the onset of sleep, which can increase anxiety. For this reason, practitioners have moved away from the terms primary and secondary insomnia. Insomnia is not generally considered insomnia when there is a lack of opportunity for good sleep  e.g. parents of new babies, however it can develop as a consequence of long term poor sleep.

Common sleep disorders can include:

  • Circadian rhythm disorders, central sleep apnoea insomnia syndrome, periodic limb movement, dysfunctional beliefs about sleep (adapting to little sleep, regularly)
  • Restless legs syndrome (nocturnal myoclonus)  
  • Other health conditions, perimenopause or menopause, psychiatric disorders or chronic use of drugs, stimulants, tobacco or alcohol, too much caffeine or drinking it too late in the day
  • Some medications - cold and flu tablets, beta blockers, diet pills, bronchodilators, thyroxine
  • Food sensitivities, pain and discomfort, indigestion, digestive disturbances
  • Poor sleep hygiene (habits around sleep), lack of sleep routine, napping during the day, too much time spent in bed awake, frequent travel by air, watching TV in bed, or using a computer in bed, blue light screen exposure after dark
  • Poor quality sleep environment - too much noise, too hot, too cold or too much light
  • Circadian rhythm disorders - where ability or desire to sleep is out of sync with social environment, such as shift work sleep disorder or jet lag
  • Dysregulated blood sugar levels
  • Snoring and obstructive sleep apnoea, breathing difficulties, sinusitis
  • Hyperthyroidism and hormone imbalances
  • Mineral deficiencies - commonly calcium, magnesium and zinc

Sleep apnea and insomnia - what is sleep apnoea?

Many people are unsure what sleep apnoea is, despite it being a common factor in insomnia. Sleep apnoea specialists describe obstructive sleep apnoea, the most common form, as the muscles of the throat relaxing, allowing the soft tissues of the throat to obstruct breathing, which can become chronic obstructive sleep apnoea. This can occur multiple times per hour, causing poor oxygenation during sleep and interrupting the sleep cycle.

Central sleep apnoea occurs when the brain omits to send the signals that control breathing, and complex sleep apnoea (AKA treatment emergent central sleep apnoea) is where both conditions occur simultaneously.

What causes eczema?

Genetics

Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.

These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.

Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected. 

Food allergy and sensitivity

Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.

Compromised gut health

The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.

Nutritional deficiencies

Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).

Weather and environment

Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.

Hormones

Hormones also play a role in the course of atopic dermatitis, including the stress hormone cortisol which triggers an inflammatory immune response affecting all organs of the body, including the skin.

Mould exposure

Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.

Sleep better, naturally

Start now

Risk factors of poor sleep and insomnia

Regular, sufficient and good quality sleep is required for the restoration of all of the body and brain. The following systems and processes can be affected when we consistently have insufficient quality or quantity of sleep:

  • Cardiovascular disease and high blood pressure are more common in individuals who regularly get less than 7 hours sleep per night.
  • Chronic inflammation is associated with sleep deprivation and is correlated with sleep apnoea, depression, skin conditions, and multiple disease states, in particular cardiovascular disease
  • Memory and learning - Sleep is a time we consolidate learning and memory therefore, it is more effective to focus on sleep than cramming for an exam. If you feel your memory isn’t what it used to be, ask yourself if you’re getting enough good quality sleep
  • Productivity and performance - lack of sleep can contribute to drowsiness, forgetfulness and lethargy, affecting your ability to safely and competently complete high functioning tasks. When you are less motivated and unattentive, this can lead to anxiety and stress from not completing tasks at work or home
  • Growth and development in children - even minimal sleep restriction can affect a child’s mood (as every parent knows), with mood and behaviour symptoms which can mimic ADHD. Poor sleep can contribute to allergic rhinitis, poor immune function, cognitive and academic performance, motor skill development, and especially growth in early infancy
  • Weight management and metabolism - the circadian rhythms that regulates sleep also regulates the production of hormones for metabolism, appetite and digestion. Insufficient sleep can lead to increased production of the hormone ghrelin, which increases appetite, and decreases the production of leptin, a hormone responsible for suppressing appetite. Insulin sensitivity decreases with disrupted sleep, which can lead to an increased risk of developing type 2 diabetes. Poor blood sugar regulation can interfere with sleep.
  • Melatonin production can be affected by poor sleep, as well as being the hormone which regulates sleep. Melatonin has a role in tumour suppression, DNA repair, and immune health. Melatonin is released from the pineal gland in response to the diminished light and red colour of the setting sun, and is inhibited by the blue light of the morning sun.  Exposure to blue light from devices can suppress evening melatonin production and disrupt sleep onset.
  • Stress resilience/anxiety - insufficient sleep is associated with increased cortisol release, causing higher levels of anxiety, nervousness, anger and a lower tolerance to stressors, which can contribute to insomnia. Cortisol and melatonin act in an inverse relationship to each other. Like a seesaw, when one is high the other is low.
  • Brain health and dementias - The glymphatic system (part of the lymphatic system), is an essential cleansing of the brain of waste products from normal cellular processes including beta-amyloid plaque and tau proteins associated with dementias such as Alzheimer’s disease. Occurring 10x more frequently during sleep, and at particular stages of the sleep cycle, the glymphatic system plays a vital role in the health of the central nervous system. Emerging evidence shows a potential relationship between poor glymphatic function and neurodegenerative diseases / neurological disorders.
  • Athletic performance elite athletes commonly have low sleep quality and quantity due to training demands, however, the evidence shows that for optimal speed and endurance, attention and memory, weight management and avoidance of injury and illness, strategies optimising sleep quality and duration are essential.

Insomnia treatment - the conventional approach

Current guidelines for conventional treatment of insomnia recommend cognitive behavioural therapy as the first line of defence against insomnia.

Your doctor or sleep specialist may recommend good sleep hygiene practices if you are experiencing short term acute insomnia in combination with short term medication. Patients prescribed medication require close monitoring for:

  • Dependance on medication
  • Psychiatric status
  • Unproductive behaviours and strategies around sleep
  • Development of maladaptive cognition processes e.g. panic, anger, social phobias, anxiety, depression

The following pharmaceutical drugs were shown to have none to little improvement in all sleep outcomes when compared with placebo in a 2018 study used by the American Family Practice Guideline:

  • Nonbenzodiazepine hypnotics: eszopiclone, zolpidem, zaleplon
  • Orexin receptor antagonists: suvorexant
  • Melatonin agonists: ramelteon
  • Antidepressants: Doxepin
  • Benzodiazepines: Temazepam
  • Over the counter sleep medications and supplements: Diphenhydramine, doxylamine, melatonin

Given the poor outcomes of pharmaceutical medications, combined with the high risk of significant side effects, many people with short or long term insomnia seek the help of insomnia specialists, or more natural solutions to improve their sleep long term.

Alternative treatment for insomnia - the functional medicine approach

Natural functional medicine insomnia treatment starts with an in-depth investigation to identify the root cause and contributing factors.

In an in depth initial consultation we investigate:

  • Your sleep history, symptoms and sleep hygiene practices
  • Your lifetime medical history
  • Medications and supplements
  • Surgeries and accidents
  • Family and genetic history
  • Environmental exposures
  • Symptom history
  • Nutrition, diet and absorption
  • Lifestyle factors and stress

Your functional medicine specialist may recommend functional testing to help determine the cause of insomnia, or to investigate baseline health, with tests such as:

  • Microbiome and stool testing - looking for gut flora dysbiosis, or parasites
  • Specific markers for inflammation, digestive function & nutrient absorption
  • Food sensitivities and allergy testing
  • Heavy metal or environmental toxin exposure
  • Hormone levels, especially cortisol
  • Mineral analysis
  • Cardiovascular profile

Depending on your results and symptoms, a personalised functional medicine insomnia natural treatment may target the following causes of sleep disturbance:

  • Removing causative factors such as poor sleep hygiene practices such as blue light / screen use in the evening, stimulating foods, drinks or substances, lack of routine, too much light, or noise, and bedroom temperature
  • Improve pain and discomfort of injury, inflammation or conditions such as restless legs syndrome
  • Improve stress resilience, depression and anxiety to reduce excess cortisol production which can inhibit the ability to make the hormone melatonin required for sleep
  • Restoring a healthy microbiome - many conditions are related to poor digestion and dysbiosis and can precipitate poor sleep. Your microbiome species manufacture some hormones and neurotransmitters. Restoring a healthy microbiome may help restore neurotransmitter production required for sleep and mood improvements
  • Restoring hormonal balance - the thyroid is the master regulator, however, if not functioning optimally, it can affect sleep. Hormones such as oestrogen and progesterone can fluctuate in women during perimenopause, causing sleep disturbance. The imbalance of hormones generally can affect men and women of all stages.
  • Regulating blood sugar and insulin levels - as blood sugar dips can stimulate cortisol, causing waking in the middle of the night around 2am - 3am, ensuring balanced blood sugar and insulin levels can improve sleep
  • Nutrient absorption and vitamin deficiencies - due to poor diet or digestive dysfunction may mean insufficient levels of important vitamins and minerals required for sleep, such as magnesium, iron, vitamin D, zinc and selenium
  • Intestinal hyperpermeability (leaky gut) - can allow foreign particles to cross over from the intestines and into circulation, causing inflammation and triggering the immune system to overreact, creating gastrointestinal disturbances such as indigestion that can disrupt sleep
  • Reduce the impact of medications and other health conditions - with holistic functional medicine treatment strategies

Natural remedies including dietary, lifestyle,  herbal and supplemental strategies may include (depending on your condition):

  • Autoimmune diet, anti-inflammatory diet, or a specific diet plan personalised to your body’s needs - eliminating any food intolerances, allergies or sensitivities
  • Dietary recommendations for improving sleep hormone production
  • Reducing or eliminating alcohol consumption which can impair good quality sleep
  • Improve vitamin status with dietary changes and supplemental medicines
  • Herbal medicines are a gentle way to help calm and assist with sleep onset, such as - passionflower, california poppy, hops, kava, St John’s wort, schisandra, ashwaganda (withania), lemon balm, chamomile and valerian. Herbal sleep support does not sedate in the same way as pharmaceutical medicines do, so do not leave you feeling drowsy on waking. It is however important that these herbs are prescribed by a practitioner to ensure that there are no interactions with medications, and are appropriate for you

Sleep is a key foundation to good health, and the sleep specialists at Melbourne Functional Medicine can help you wake each morning feeling refreshed, with the energy and vitality you desire to enjoy life.

In our unique 6-month program, you’ll have the support of your functional medicine insomnia practitioner who will guide and direct your sleep treatment, and a health coach who will support you in achieving your sleep and wellness goals.

If you’d like to know more about how we can help you achieve the bliss of regular, long and deep sleep, contact us today to arrange a free discovery call to what the insomnia functional medicine approach can do for you.

Case study

See how functional medicine is helping our patients achieve better health and richer lives.

Are you ready for a personalised, natural functional medicine treatment? Our unique model of care was designed with you in mind. Find out how, then book a call today

FAQs

Why can’t I sleep?

There can be a number of factors that affect your ability to sleep. The two most common are poor sleep hygiene (i.e. the habits and practices around preparing for sleep in the evening) and chronic stress states.

Some other  common factors are:

  • Central sleep apnoea insomnia syndrome, periodic limb movement, dysfunctional beliefs about sleep and having too little sleep on a regular basis
  • Restless legs syndrome (nocturnal myoclonus)  
  • Viral conditions, including COVID induced insomnia
  • Other health conditions, perimenopause or menopause, psychiatric disorders or chronic use of drugs, stimulants, tobacco or alcohol, too much caffeine or drinking it too late in the day
  • Some medications - cold and flu tablets, beta blockers, diet pills, bronchodilators, thyroxine
  • Food sensitivities, pain and discomfort, indigestion, digestive disturbances
  • Poor sleep hygiene or sleep routine, napping during the day, too much time in bed awake, frequent travelling by air, blue light screen exposure after dark, watching television in bed, or using a computer in bed
  • Poor sleep environment - too much noise, too cold, too hot, or too much light
  • Circadian rhythm disorders - where ability or desire to sleep is out of sync social environment, such as shift work sleep disorder or jet lag
  • Snoring and obstructive sleep apnoea, breathing difficulties, sinusitis
  • Hyperthyroidism and hormone imbalances
  • Mineral deficiencies - commonly calcium, magnesium and zinc

Seeking the support of an insomnia specialist in Melbourne can help to restore quality sleep through a holistic, personalised approach. If you’re looking for insomnia treatment, Melbourne Functional Medicine can help.

What is the best thing to do if you can’t sleep?

Practicing good sleep hygiene every night (and day) can help prepare your body for sleep. The circadian rhythm is regulated by the light / dark cycle of the day and night of the earth’s cycles, so practices such as sleeping in a very dark room, then waking and opening the blinds, going out into the light on first waking can help your body set this rhythm.

Wearing blue blocker glasses after sunset, or better still, avoiding screens and bright lights in the evening, can help prevent disruptions to the production of melatonin, our sleep regulating hormone. Swapping out bright lids for red lights in your bedroom can also help.

Warm baths or showers before bed can help the body adjust to a temperature that prepares it for sleep, and calming herbal teas such as chamomile can help the nervous system relax.

Avoid exciting, stimulating, scary TV, movies, conversations or books before bed, as they can inhibit sleep by stimulating cortisol that suppresses melatonin.

What is the best herbal medicine for insomnia?

Herbs that calm the nervous system during the day can help sleep at night, without making you drowsy. These herbs are in a group called adaptogens, or anxiolytics, and include Withania, Siberian ginseng, Rhodiola, Chamomile, Lemon Balm.

Herbs that help make you sleepy, taken just before bed, after called hypnotics or soporifics and include Passionflower, California poppy or Hops.

However, all herbs should be prescribed by someone who understands which herbs are best for you, and can check that they don’t interact with any medications you are taking. It is important to rule out any other conditions like sleep apnoea, medications or health conditions that may be impacting your sleep.

Certain nutritional products may also be prescribed by your practitioner to support good quality sleep such as theanine or glycine.

For insomnia, a functional medicine practitioner can help identify the root cause of your insomnia and provide you with a treatment strategy that will have you sleeping like a baby in no time.

What specialist treats restless legs syndrome? How to treat restless leg syndrome naturally?

Insomnia specialists, or functional medicine specialists in our clinic, may help improve restless legs syndrome.

Often, this syndrome is due to nutritional deficiencies like magnesium, and an insomnia specialist will prescribe a form of magnesium that will be best for you.

A naturopathic insomnia treatment may also include lifestyle, supplemental or herbal medicines depending on the root cause of your issue.

How do sleep specialists fix chronic insomnia and disrupted sleep naturally?

Functional medicine practitioners treat insomnia naturally, and as sleep is one of the pillars of health, it is something they are very experienced in treating.

Initially, they will take an in depth case history to identify the root cause of your insomnia. Then, using lifestyle medicine, sleep hygiene strategies, herbal medicines and supplemental medicines, they will personalise a treatment strategy for you.

Based in South Melbourne, the functional medicine practitioners at Melbourne Functional Medicine can help with all kinds of sleep disorders, insomnia and disrupted sleep patterns helping you to regain long, healthy restorative sleep, naturally.

Is there an insomnia specialist in Melbourne?

Yes, insomnia treatment is available in Melbourne. Insomnia naturopathic treatment delivered by functional medicine specialists is natural, safe and effective.

Melbourne Functional Medicine, based in our beautiful clinic space in South Melbourne, are specialists in helping with insomnia.

One of the pillars of good health is long, restorative sleep, so functional medicine practitioners have many strategies to help you regain your sleep. They include natural treatments such as herbal medicines, stress resilience practices, sleep hygiene practices, supplemental medicine, diet and lifestyle medicines.

Can’t find what you’re looking for? Reach out to the team directly – we’ll be happy to assist.