Sleeping Disorders - Ask Dr. Lani

Question:

Dr. Lani, I have had a sleeping disorder ever since my total hysterectomy in December 2003. I wake up every 1.5 to 2 hours. I suspect it has something to do with my hormones because even if I am dog-tired, I still wake up often. I have been dieting and exercising for the past two months and am still not sleeping well.  I need sleep.

Susan

Answer:

Hi Susan,

Sleep issues are one of the top reasons people (mostly women) come to see me.  Poor sleep quality can stem from a variety of areas; emotional, spiritual, physical. If lack of sleep has been going on for a period of time, all areas are involved.  If you have had insomnia for a period of time, then your adrenal glands need support. Top on the list is eating smaller amounts of food throughout the day and maintaining a good blood sugar level.  In other words, do not wait until you are hungry!  Second is to take vitamin C every 3-4 hours – vitamin C is one of the primary nutrients that the adrenal glands need to function.   Unlike dogs, cats, and most mammals, human beings do not make their own vitamin C, so the idea is to keep it in the system constantly to make sure it is available when needed. Hormones including estrogen, progesterone, thyroid and adrenals can be the cause or at least involved in insomnia as well. Since your insomnia began following the hysterectomy, with or without ovary removal, can result in hormone imbalance.  For those who are menstruating it is important to note if there is a connection to your menstrual period, which often is the case. Insomnia requires an individual response: what works for one person will not necessarily work for the next person.  Make sure that the doctor you work with is willing to do proper testing, which may involve both blood and saliva testing. Vitamin D deficiency may also be relevant, since vitamin D increases calcium absorption. Another good idea is to take calcium and magnesium before bedtime – both help deepen sleep quality. I cannot make exact recommendations on the exact quantity because I would need a food diary and other information to know for sure. Yes, you do need sleep and yes, for most people there is a reason and a solution to their insomnia.

You can find more information on sleep on my website.

Question:

Dear Dr. Lani,

I am 56 years old and have not slept through the night since 7th grade. I wake up every hour and a half and usually eat something. I also use the bathroom each time I wake up. By morning, I’m exhausted! I was recently diagnosed with a large nodule on my thyroid. I wonder if there’s a connection between my thyroid problem and my sleep disorder and eating habits. I’m afraid my doctor will want to remove my thyroid after my next ultrasound. Being on drugs for the rest of my life scares me to death, not to mention surgery.
K.M.

Answer:

Hi K,

You are waking according to the normal sleep cycle of 90 minutes. Good sleepers usually wake and fall right back asleep.  However, something is waking you fully. Since you've been experiencing this since you were a child, your doctor should be very well versed in all possible causes of this type of sleep disorder. Hypothyroidism, elevated nighttime cortisol, sex hormones, depression and anxiety are all possibilities.

The most likely diagnosis of the nodule on your thyroid is a goiter due to hypothyroidism, and an ultrasound of the thyroid is the way to diagnose it.   Please see a doctor who will spend time with you to get to the bottom of what is going on.  When in doubt, always seek a second opinion.  You can regain your health!!!

Warmly,

Lani