Middle of the Night Insomnia

If this happens to you trust me you’re not alone in the middle of night wondering if and when you will fall back asleep. It happens to everyone at some point and a lot of people suffer from “Middle of the night insomnia” on a regular basis. Don’t bother Googling “Middle of the night insomnia”. I made that term up to describe what my patients are going through. Happens to me too occasionally. And it always happens at the worst time. It’s the night before your new job interview. Or you have to give a lecture. Or your first day at college. Always the night when you really need to sleep well. When it happens to me it is usually at 2 am and I wake up and I just start thinking about stuff. Could be anything. It’s like I want to fall back asleep but my brain just won’t shut up and let me! And then I wake up tired and not ready to get out of bed. If this happens to you sometimes here is the probable cause. You are experiencing a cortisol shift.

Cortisol is a hormone produced by the adrenal gland. Most of us know what adrenalin is. Adrenalin is the hormone that makes you want to get in there and fight. Adrenalin can make you aggressive and agitated. Cortisol can be just as stimulating as adrenalin. But instead of making you angry at a situation is makes you hyper focused. Cortisol makes you want to solve the problem instead of just getting angry at it. So cortisol is a very good hormone to have when you need it. But it gets in the way when you don’t. Cortisol levels rise when we are under stress. And if the cortisol levels stay elevated this can cause irritability, that wound up too tight feeling, and insomnia.

Cortisol levels should start to drop naturally around 10PM and reach their lowest points around midnight. As your cortisol levels drop you are able to go further into deep restful sleep. Your cortisol levels should start rising again around 5AM and reach peak levels around 9AM just in time for your board meeting or job interview. It’s the reason most people say they are at their best first thing in the morning.

Ideally your cortisol level rhythm of highs and lows coincided with your sleep patterns. When you’re sleepy they should be low and when you awake they should be high. A cortisol shift can occur in the timing of your high and lows. So if your cortisol levels remain high at bed time you will stare at the ceiling and not fall asleep. If you get a cortisol level spike in the middle of the night you will wake up and start thinking about “stuff” wondering why you can’t stop thinking and fall back asleep. It can be very frustrating causing an even further spike in cortisol. Now you’re really awake! I call this “frustrated sleep”. No point in Googling this one either. And the opposite will then be true during the day. Inside your brain there are cells that respond to too much cortisol by making it less active. When this happens your cortisol levels can drop too low and you feel sluggish like you walking in mud or you may just want to go home and crash on the couch. This happens to all of us from time to time. But it should not be an everyday occurrence. If your adrenal gland continues to make too much cortisol for a long period of time you can develop Adrenal Fatigue Syndrome. This one you can Google as I didn’t make up the name. When you have adrenal fatigue syndrome it seems like no matter what you do you feel tired all day.

Ok so what do you do if you seem to wake up in the middle of the night and can’t get your brain to stop talking? Easiest thing to do is prevent a cortisol shift from happening. Diet is the biggest factor. When I give lectures in New York or Boston my sponsors always want to take me out for a nice Italian meal. And I love Italian food. But with the time difference that means I am eating lots of pasta (carbs) along with red wine (alcohol) at midnight my time. So this will certainly cause a cortisol spike and I won’t sleep half the night. Sucks because I really like spaghetti! And shrimp Alfredo! And Ravioli! But I pass on all the pasta if I have to be at my best in the morning. What about when I am not traveling and I am staying home. My problem is I am running two practices, Smiles by Soileau and Louisiana Sleep Solutions. And I own a Hunting Lodge, Aj’s Lake. And I have a six year old son. So I am always go go go! How do I get my adrenal gland to calm down and stop making so much cortisol so I can rest? When I can’t sleep I use phosphorylated serine. One brand is Seriphos. There are several brands to choose from. It’s over the counter so you don’t need a prescription. I would still strongly advise you to check with your doctor before taking anything. You just never know what the combination with other medicines you are taking might be. Phosphorylated serine does not make you sleep. It simply calms down your adrenal gland so your brain will stop talking and you can go to sleep.

As with any medical problem diet and exercise always makes you better both inside and out. So that is my first choice. But if that is not working then there are over the counter remedies. And of course you can always see you doctor for something stronger if you feel you may have Adrenal Fatigue Syndrome.

Tony Soileau DDS

Tony Soileau DDS

Dr Tony is a general dentist from Lafayette, Louisiana. He was born and raised in Pine Prairie, Louisiana. His practice focuses on restorative, cosmetic, and family dentistry as well as sleep apnea treatments other than a CPAP and TMJ. Dr Tony graduated from LSU School of Dentistry in New Orleans in 1994. He has been president of his local dental society and is an associate professor at LSU School of Dentistry. He has been a faculty member of the Institute of Oral Art and Design (IOAD) in Tampa, Florida and the Pacific Aesthetic Continuum (PAC~Live) in San Francisco. He is a member of the ADDA, LDA, ADA, AGD, AACD, and has his Fellowship in the Academy of Comprehensive Esthetics. He has published over 50 articles on cosmetic dentistry. In addition to being a published author he has and continues to lecture both nationally and internationally on cosmetic dentistry as well as treatment of sleep apnea.

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