Causes of Insomnia: When Melatonin Supplements Aren’t Nearly Enough

Almost everyone experiences short-term insomnia or the occasional poor night’s sleep, but sometimes it becomes chronic, lasting weeks, months, or even years. The ideal amount of sleep varies, especially between men and women, but chronic sleep deprivation can severely affect mental and physical health. This disturbing fact prompts an exploration of the underlying causes of insomnia and strategies to restore restful sleep.

What is Insomnia?

According to the American Academy of Sleep Medicine (AASM), insomnia is the most common sleep complaint. It’s characterized by difficulty falling or staying asleep despite having ample time to get a full night of rest. [1]

The AASM recognizes two types of insomnia based on occurrence:

Short-term (acute) insomnia: This type only lasts a brief time – up to three months. Up to 20% of people experience short-term insomnia at any given time.
Chronic insomnia: This type of insomnia is defined by its occurrence at least three times a week for three months or more. One in ten people deals with chronic insomnia.

Insomnia is also described by how it manifests over the night: [2]

Sleep Onset or Initial Insomnia occurs when a person has difficulty falling asleep but doesn’t wake up until morning.
Maintenance or Middle Insomnia occurs when a person wakes up multiple times throughout the night. They cannot maintain slumber through the night.
Late or Terminal Insomnia occurs when a person wakes up too early in the morning based on when they went to bed. They usually cannot fall back asleep after waking up at 3 or 4 am.

Insomnia can also be categorized into two types based on its association with other underlying conditions. When another known condition such as sleep apnea, GERD, Fibromyalgia, or another condition is identified as the cause, it is referred to as secondary insomnia. If there’s no apparent cause, it’s called primary insomnia.

Conditions Associated Insomnia

Some other medical conditions and situations that may contribute to insomnia include the following:

Acid reflux or gastroesophageal reflux (GERD) can cause sleep issues due to heartburn, indigestion, coughing, or choking.
Obstructive sleep apnea (OSA) causes intermittent episodes of awakening when the patient stops breathing.
Restless legs syndrome (RLS) makes sleeping difficult by creating discomfort and a need to move the legs throughout the night.
Fibromyalgia is associated with poor sleep quality as one of its main symptoms.
ADHD (Attention Deficit Hyperactive Disorder) may lead to insomnia due to the imbalance of neurotransmitters in the brain – particularly an overabundance of glutamate.
Menopause can cause sleep issues in women due to dropping hormone levels.
Heart disease, particularly congestive heart failure (CHF), is associated with difficulty breathing and non-restful sleep.
Mental health conditions like anxiety disorders, depression, and bipolar disorder also have insomnia as one of their many symptoms. Again, this may be due to elevated inflammatory chemicals in the brain and an imbalance of neurotransmitter activity.
Neurological conditions like Alzheimer’s disease and Parkinson’s disease are like other mental health conditions in that they tend to have higher levels of inflammation and neurotransmitter imbalance.

Addressing these conditions and their contributing causes is crucial to overcome chronic sleep disturbances.

Symptoms of Insomnia

While the symptoms of insomnia may vary from person to person and from day to day, here are some common insomnia symptoms:

Trouble falling asleep
Trouble staying asleep
Waking up too early
Poor sleep quality
Daytime sleepiness or fatigue
Lack of energy or motivation
Difficulty paying attention or concentrating
Irritability or mood swings
Aggressive behaviors
Frustration around sleep

Eventually, the lack of sleep leads people to seek help from a medical professional to get diagnosed and, hopefully, some relief.

How is Insomnia Diagnosed?

Diagnosing insomnia and its associated sleep deprivation generally begins with a health history questionnaire or assessment. It’s often followed up by a sleep study to rule out other conditions like sleep apnea and other sleep disorders. According to Cleveland Clinic, some test options include: [3]

Polysomnogram – Overnight lab test for sleep apnea.
Electroencephalogram (EEG) – A test that records brain waves and looks for unusual brain activity that may be causing insomnia.
Actigraphy – Testing using a device similar to a smartwatch to track sleep cycles to watch for abnormalities. This test is especially used to check for circadian rhythm disorders.
Multiple sleep latency test (MSLT) – Test to see whether a person is likely to fall asleep during the day – especially used for diagnosing narcolepsy.
Maintenance of wakefulness test (MWT) – Test to see how challenging it is to resist falling asleep during stationary activities like sitting in a car driving.

There’s not one definitive test to diagnose insomnia. It’s mostly a matter of ruling out other causes. If none are found, the doctor will usually prescribe “primary insomnia.”

The Fireman vs. The Carpenter in Healthcare

At The Wellness Way, we talk about the mainstream perspective on healthcare versus our perspective and methods as the “fireman approach” or the “carpenter approach.”

The Wellness Way doctors are more like carpenters. They assess the body with testing and then create a personalized plan to rebuild using nutrients from foods and supplements.

While these things are considered “complementary medicine” or even “alternative medicine,” scientific research backs up their effectiveness in healing.

Mainstream Medicine’s Approach to Insomnia

Mainstream medicine looks at insomnia as a common sleep disorder brought on by mental disorders or life circumstances like stress, shift work, and changing time zones. They also acknowledge the impact of other underlying conditions, as mentioned above, but they can’t usually explain the mechanisms behind insomnia.

Their solutions for insomnia tend to focus on medications and basic lifestyle changes, like improving sleep hygiene and limiting caffeine.

Common Medications for Insomnia

Conventional treatment of insomnia usually includes sleep aids of some sort. These may fall under antihistamines, anti-anxiety medications, and antidepressants. Here are some common medications used for insomnia:

Antihistamines: Diphenhydramine (Benadryl) is the most recognizable antihistamine for occasional insomnia. You’ll also find this compound in medications like Unisom, Tylenol PM, and Advil PM.
Benzodiazepines: Benzodiazepines are drugs that may be used for both anxiety and insomnia. Examples include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin).
Non-benzodiazepine hypnotics: These are similar to benzodiazepines: zaleplon (Sonata), zolpidem (Ambien), and eszopiclone (Lunesta).
Tricyclic antidepressants: Examples include amitriptyline (Elavil) and doxepin (Silenor).

Sleeping pills may help with symptoms. However, they all have negative side effects and can cause other health problems. Those side effects are often the reason people seek out natural remedies or natural ways to overcome insomnia.

Causes of Insomnia: Trauma, Toxins, and Thoughts

So, what causes insomnia? While mainstream medicine acknowledges excess caffeine, stress, jet lag, or poor sleep habits may contribute to insomnia, they rarely have a solution beyond pharmaceutical drugs. They also tend to separate chronic insomnia from other health imbalances.

At The Wellness Way, we think differently! The most common causes of insomnia fit into one or more of three categories: traumas, toxins, and thoughts.

Traumas (Physical Stressors)

Traumas or physical stressors can be acute or chronic. Chronic subluxations in the spine can inhibit nerve and blood flow to the small intestine, leading to dis-ease, and triggering an inflammatory response. An inflamed gut is an inflamed brain, and an inflamed brain may not allow you to relax into a restful sleep. Other traumas that may be causes of insomnia include:

Concussions
Traumatic Brain Injuries (TBIs)
Severe illness or infection
Witnessing violence or a natural disaster
Military combat – PTSD (Post Traumatic Stress Disorder)
Surgery
A death in the family or a close friend
Having a baby – leading to post-partum depression

Chronic pain from an injury or surgery is another reason for insomnia. It’s difficult to relax and fall asleep when you’re in pain. Pain may also cause multiple nighttime awakenings. Physical traumas and the potential of chiropractic care should not be underestimated. Lowering inflammation by taking stress off the central nervous system can go a long way toward improving sleep.

Toxins (Biochemical Stressors)

Toxins are biochemical stressors that may be either natural or synthetic. Toxins associated with insomnia include:

Medications – Certain medications can cause sleep problems, including both over-the-counter (OTC) and prescription drugs. Antidepressants like SSRIs and medicines for high blood pressure, ADHD, or Parkinson’s can contribute to insomnia. [1]
Alcohol – Alcohol can serve as a toxin, worsening your sleep by disturbing your sleep cycles. [4]
Non-native EMFs – Electromagnetic frequencies from cell phones, WIFI, and smart meters may also contribute to insomnia. A study published in 2013 found that EMF exposure disrupted melatonin levels in healthy people, leading to sleep problems. [5] In another study of 132 people, daily EMF exposure worsened sleep quality and increased depression and anxiety compared to those not exposed to EMFs. [6]
Artificial blue light exposure – The overuse of screens, especially after sunset, is also associated with circadian rhythm disruption and altered sleep patterns. In clinical trials, exposure to blue light at night made it more difficult to fall asleep and lowered sleep quality, including the time spent in deep sleep. [7][8]
Shift work – Shift work means an irregular sleep schedule, which can really mess with your circadian rhythm and ability to fall asleep and stay asleep. [9]
Sugar – Sugar increases inflammation throughout the body, including the brain. [10]
Gut dysbiosis – An imbalance in your gut bacteria can also contribute to insomnia by altering the activity of the immune system and the enteric nervous system. [11]
Hormone imbalance – Estrogen dominance, particularly when there’s too much of an estrogen called estrone (E1), can increase feelings of anxiety, aggravating sleep.
Lyme disease – Believe it or not, there’s such a thing as Lyme insomnia! Spirochetes in the brain can contribute to inflammation and chronic wakefulness. [12]
Toxic metals – Metal toxicity may also negatively affect sleep, especially in post-menopausal women. [13]
Vitamin B1 & Anxiety – A deficiency in vitamin B1 (thiamine) can increase feelings of anxiety, making it harder to fall asleep and stay asleep. [14]
Vitamin B12 deficiency – Low stomach acid, digestive disease, stress, and other factors may lead to a chronic vitamin B12 deficiency. Low B12 can contribute to circadian rhythm disorders, chronic insomnia, and/or unrefreshing sleep. [15]

Traumas and toxins are made worse by negative thought patterns and emotional stress.

Thoughts (Emotional Stressors)

Emotional stress can take a significant toll on sleep. The racing thoughts and feelings of overwhelm make it difficult to fall asleep and stay asleep through the night. Here are some potential emotional contributors to chronic insomnia.

Watching or reading the news (fear/worry)
Emotional stress from marriage, financial, career, or other issues
A state of overwhelm by major life changes, such as marriage, a new baby, graduation, divorce, or even moving to a new city.
Grief/feelings of loss
Pent up anger
A toxic workplace
Skipping vacations

Thoughts are powerful! Focus on gratitude at bedtime as a part of your new nighttime sleep routine.

The Wellness Way Approach to Chronic Insomnia

At The Wellness Way, we dig deeper to solve the health challenges others can’t. We start with testing to see where there may be imbalances and then develop a personalized nutrition and supplement plan to help your body heal itself.

Important Tests for Assessing Your Gut and Brain Health

Here are some commonly recommended tests at The Wellness Way:

Food Allergy Test: Immuno Food Allergy Test
Gut Health Test: Genova GI Effects with Parasitology
Thyroid Panel: Thyroid Panel
DUTCH Test: DUTCH Complete Hormone Panel

Testing depends on which ones your Wellness Way practitioner considers most important based on your symptoms and health history.

Dietary Changes for Those with Chronic Insomnia

First, it’s imperative to lower inflammation so the gut can heal. A chronically inflamed gut leads to elevated levels of histamine, cortisol, and glutamate in the brain, causing it to be overstimulated.

No sugar or processed foods – Both increase inflammation. [10] Balancing blood sugar is also important for avoiding nighttime wakefulness.
Avoid alcohol – Alcohol compromises the intestinal lining and increases inflammation. It also lowers sleep quality and leads to disruptions, particularly over the second half of the night. [16][17]
Avoid caffeine and other stimulants – Caffeine reduces sleep efficiency, quality, and time spent asleep. [18][19]
Follow a Personalized Nutrition Program, based on your food allergy test results. Those with chronic insomnia may also be more sensitive to glutamates and glutamine-rich foods. These foods can over-excite brain cells, leading to feelings of wakefulness at night.

Sticking to a healthy diet is essential, but supplements can help the body heal the gut and brain.

Potential Supplements for Those with Chronic Insomnia

Herbal and other dietary supplements can be incredibly helpful in getting a good night’s sleep. They can also improve a person’s overall quality of life.

B Vitamins – B Complex vitamins are required for the proper functioning of the nervous system. They support the production of healthy serotonin and other neurotransmitter levels, which help promote restful sleep. Deficiencies in certain B vitamins (B1, B6, B9/folate, and B12) have been linked to sleep disorders, and supplementation may help. [20]
5-HTP – 5-hydroxytryptophan or 5-HTP is a precursor to the feel-good neurotransmitter serotonin and the sleep hormone melatonin. 5-HTP is an ingredient in our supplement for supporting the nervous and immune systems: Alcedonia.
California Poppy – California poppy combined with valerian decreased nighttime awakenings, improving sleep quality in adults with insomnia. [21]
Chamomile – Chamomile may improve sleep quality while also reducing generalized anxiety. [22]
Kava – Kava may improve deep sleep and help insomniacs feel more refreshed upon awakening. [23]
Passionflower – Passionflower may help induce sleep for those with trouble with sleep onset. [24]
Valerian – This herb is well-known for its positive effects on sleep. In a randomized controlled trial of postmenopausal women with sleep disorders, valerian combined with lemon balm experienced an improvement in their insomnia symptoms. [25] In another clinical trial, valerian extract was comparable to the antianxiety and sedating drug oxazepam for improving insomnia. [26]
CBD – CBD is a common “go-to” for sleep issues, as it’s known to relieve anxiety and lower feelings of stress. [27]

Everyone is different – herbal remedies that work for one person may not work for another. Part of that is due to body chemistry, including genetics and allergenic responses, and part is due to differences in the contributing causes of insomnia.

Lifestyle Changes & Complementary Therapies for Chronic Insomnia

Other natural treatments for insomnia are lifestyle changes and other brain-balancing therapies, such as:

A favorable sleep environment – One of the first things to do if you have trouble sleeping is to ensure your sleeping environment is cool and dark. Consider getting a white noise machine or using a fan if there are disturbing noises.
Good sleep hygiene – Maintaining healthy sleep habits can majorly improve insomnia. Good bedtime habits like keeping a consistent schedule, establishing a relaxing bedtime routine, getting off electronics at least 30 minutes before bed, and limiting exposure to bright lights in the evening can make it easier to wind down and get restful sleep. [28]
Avoiding naps during the day – Napping during the day, especially late in the afternoon, can make it more difficult to fall asleep and stay asleep through the night.
A weighted blanket – Weighted blankets may be helpful for insomnia associated with depression, bipolar, anxiety, and ADHD. [29]
Cognitive Behavioral Therapy – Cognitive behavioral therapy (CBT) may also be supportive for chronic insomnia. Experts have created a subtype of CBT designed specifically for insomnia: CBT-I. [30]
Regular chiropractic care – Chiropractic care helps improve blood flow and nerve flow while decreasing overall physical stress on the body. It also supports balance in the autonomic nervous system, which may support sleep. [31]
Physical activity – Regular exercise has been shown to help symptoms of chronic insomnia. Thirty minutes of moderate to vigorous intensity activity per week over 6 months improved insomnia symptoms and improved mood and daytime fatigue. [32]

Getting enough sleep is essential for restoring your health and avoiding chronic health issues in the future. Be a well-informed patient! Here are some resources for learning more about insomnia and achieving healthy sleep.

Educational Resources for Chronic Insomnia

Videos & Webinars Related to Chronic Insomnia

Sleep | A Different Perspective | Episode 126 – YouTube

Articles to Support Those with Chronic Insomnia

Sleepless Nights: Do Hormones Affect Sleep?
Healthy Z’s: 8 Tips to Get Better Sleep – The Wellness Way
Ladies, Put the Night Owl to Bed: 7 Tips for Becoming a Morning Person
Serotonin: The “Feel Good” Neurotransmitter
Do Women Need More Sleep than Men?
Sleep Apnea: Do You Just Need A CPAP?

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We invite you to connect with us! Find an event at a clinic near you! Follow us on social media. Tune in to A Different Perspective each Saturday morning LIVE to get cutting-edge training directly from Dr. Patrick Flynn. Set up a no-obligation health consult with one of our doctors today. The best is yet to come! Think differently – and THRIVE. Reach out to a Wellness Way clinic today to get thorough testing and start on your health journey. We are here to help!