Why Can’t I Fall (or Stay) Asleep?

Mike CarragherAge Management, Anti-Aging, belly fat, Dr. Carragher, Dr. Mike's Tips, fatigue, Hormone Optimization, loss of energy, low energy, Melatonin, stress, The Body Well, weight gainLeave a Comment


When a patient comes in saying that they’re having trouble falling (or staying) asleep, the first thing I do is check in with their sleep hygiene. Sleep hygiene is everything you do before bed; good sleep hygiene helps you fall asleep, stay asleep, and sleep deeply. Much of sleep hygiene relates to your exposure to light before and during sleep.

Here’s a quick breakdown of some good sleep hygiene vs. bad sleep hygiene habits for you, as they relate to light exposure:

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The common factor: light

You’ll notice a common factor here: light. It could be the lights in the bedroom, the glow of a laptop screen, or the green blip of a computer charger. Light is one of the most significant factors for being able to have a restful night’s sleep.

Why? Both light and the electromagnetic fields (EMFs) emitted from devices affect the pineal gland and stimulate brainwaves, respectively.

If you reach up and touch between your eyes, you’ve located your pineal gland; it’s right between the eyes, in the brain. The gland perceives light right through the skin and skull, which is why it’s sometimes referred to as the “third eye.”

The “goodnight hormone”

When the sun sets and it starts to get dark, the pineal gland begins to secrete melatonin, which is a hormone that registers cycles of darkness and corresponding rest. Melatonin helps your body move into a relaxed sleep state, but irregular patterns of light can disrupt melatonin cycles and secretion. And it doesn’t matter if the light is artificial: the glow of your iPad in the evening delays and disrupts sleep rhythms by inhibiting melatonin production and secretion.

On top of that, melatonin production starts to decrease for most people around their eighteenth birthday, and steadily decreases for the rest of their lives. That’s one reason why children (after infanthood) have an easier time falling asleep, sleeping through noise, and sleeping deeply: they have more melatonin than adults.

When it comes to treating sleep disorders, I prescribe melatonin, along with good sleep hygiene to help patients fall asleep. I recommend patients take melatonin a half hour before bedtime in the case of the sublingual (dissolved under the tongue), or an hour before bedtime if it’s a capsule to swallow. Because the supplement industry is so unregulated, a lot of raw materials for supplements come from disreputable sources. That’s why it’s important to get good source melatonin. I usually use compounding pharmacy to create a supplement individualized to each patient, or use a standardized dose from a pharmaceutical-grade supplement manufacturer.

Individualized melatonin dosing is good for a couple of reasons. First, the effective dose for melatonin varies widely from patient to patient. Some people need 1/2 a milligram, others need 30 milligrams. I can’t think of any other medication that has such a wide effective dose range. Too low a dose will be ineffective. Few people experience serious side effects of too much melatonin, but a dose that’s too high may cause overactive dreams and nightmares, as well as a sort of melatonin “hangover,” which can lead to grogginess the next day.  The second reason I turn to a compounding pharmacy for individualized melatonin prescriptions is that I can add other supplements to the melatonin to aid sleep, such as magnesium, L-theanine, and/or Vitamin B6; whatever is appropriate for each patient’s case.

What if I’ve tried melatonin?

Restoring healthy melatonin levels and regulating light-related sleep hygiene are two of the best things you can do to help yourself fall and stay asleep. But sometimes that’s not enough.

At The Body Well, I also attend to other factors that might be stopping patients from getting a good night’s sleep:

  • Exercise: I try to make sure they exercise earlier in the day rather than in the evening, when they might inadvertently trigger spikes of energy.
  • Hormones: I assess other hormone levels: high thyroid or cortisol, low progesterone, low testosterone, low HGH and other hormone abnormalities can all disturb sleep.
  • Sleep Aids: I inquire whether or not they take sleeping pills of any kind, which are a short-term fix but eventually lead to restlessness, poor quality sleep, and dependence.
  • Room temperature: I ask whether or not the room is cool enough, because at night the body works to regulate its temperature. Lowering the temperature at bedtime leads to less regulation time, which allows us to fall and stay asleep more easily.  The ideal sleep temperature is somewhere around 65°-67°F.
  • Booze: I ask what patients’ alcohol consumption is like. Even though we associate alcohol with “passing out” (sometime literally), having any alcohol actually inhibits quality sleep.
  • Stress: I also find out about stress levels. Serious stress can cause all sorts of problems at bedtime.  In addition to addressing the underlying cause of stress, having a “wind-down” ritual of listening to soft music, meditating or reading a book (not a device) can be helpful.
  • Travel: Finally, I ask if they’re traveling a lot. Traveling across time zones can interrupt regular rhythms and melatonin secretion.

Not being able to fall or stay asleep at night can be extremely frustrating. Often, one night of difficulty can cause stress the next night, and create a viscous cycle that gets worse and worse.

As an Age Management & Hormone Optimization physician, addressing sleep is a key factor when it comes to taking care of my patients. Lack of sleep almost inevitably causes (or is caused by) hormonal disorders. It leads to fatigue, weight gain, lack of sex drive and sexual function, loss of memory and concentration, lower strength, and other medical problems. If you’re having difficulty with sleep, schedule an evaluation and we’ll work with you to improve not only your sleep, but your overall health and risk for further degeneration of your body.

Call The Body Well today at (323) 874-9355 and schedule a hormonal evaluation. Or email us at info@thebodywellusa.com

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