Even though the science is complex, the premise is simple: Neurotransmittersand hormones are the chemical messengers thatcontrol the body’s sleep–wake cycle. Balance in these chemicals arenecessary for proper sleep. Determining which chemicals to targetcan help healthcare providers develop programs designed to specificallyaddress neuroendocrinebalance related to sleep disorders.
Biochemistry of Sleep Sleep is an amazingly complex biologicalprocess that is influencedbymany interrelated neurotransmitterand hormone systems.These systemsexert their effectsin a number of areas within thebrain, includ ing the retinaof theeye, the hypothalamus, and thepineal gland.
The onset of sleep results from acascade of neurochemical eventswhich begin in the eye. The brain, sensing a lack ofdaylight, employs numerous neurotransmittersand hormones totransition the mind and body intosleep. Inhibitory neurotransmittersand hormones including GABA,serotonin, and melatonin reducethe activity of wake–promotingbrain centers that communicatevia the excitatory neurotransmittersglutamate, histamine, norepinephrine,and hypocretin.
Normal sleep patterns depend onproper communication betweenthe neural circuits involved in thesleep process. Conversely, perturbationsof the sleep cycle canoccur when miscommunicationbetween these circuits exists. Inadequateactivation of the sleeppromotingbrain centers due toimbalances in neurotransmitterand hormone levels can lead toexcessive activity in the wake–promotingbrain centers, thus contributing to sleep difficulties.
Neurotransmitter balance within the human nervous system issusceptible to both external and internal factors. Chronic stress,inadequate diet, infections, toxins and aging negatively affect neurotransmitterbalance, potentially leading to low levels of sometransmitters and excessive levels of others. Left unchecked, imbalancesin the nervous system can be a contributing factor to theimpairment of many of the body’s most basic functions, includingsleep.
The role of neurotransmitters, hormones, and the nervous systemas a whole in the sleep–wake cycle is reinforced by the interventionsused to address disruptions in sleep. Pharmaceutical and nutritionalinterventions act on specific pathways/circuits within thesleep–wake cycle. Since none of these are capable of resolving sleepissues in all circumstances, how can healthcare providers make more informed decisions regarding what intervention may resultin the best outcome?
Expanding the Sleep Disorder Toolbox The answer may lie in the understanding of biochemical brain maps(neurocircuits) and utilization ofneuroendocrine assessments.Neurocircuits show us that disordersof the nervous system aretruly spectral in nature and rarelyinvolve biochemical alterations ina single neuroendocrine parameter.The brain, in all of its complexity,does not rely on a singlechemical or “switch” to inducesleep. In fact, even simplifiedsleep–wake neurocircuits suggestthat no less than 10 differentneuroendocrine parameters playa role in the sleep process. Consideringthat miscommunicationbetween any one of these pathwayscan lead to sleep difficulites,the need for truly individualizedapproaches to addressing sleepdifficulties is paramount.
An equally valuble tool in addressingsleep difficulties is theuse of neuroendocrine assessments.Non–invasive urine andsaliva samples collected at nightprovide a snapshot of the uniquebiochemistry influencing anindividual’s sleep cycle. The informationprovided in these assessmentsthen serves as a guidefor developing programs tailoredto the individual’s unique biochemistry,thus improving thelikelihood of positive clinical outcomes.To illustrate this point,refer to the lab results in Table 1.Each of the subjects included inthe table presented with the inabilityto fall asleep. Age and sexvaried, however none of the subjectswere using medications or natural sleep aids.
Subject 2 demonstrated a deficiency in melatonin and excessivecortisol output. Subject 5 demonstrated excessive levels of the excitatorytransmitters PEA and glutamate. Both subjects presentedwith similar concerns, however, their lab results were entirelyunique. As such, a program designed for Subject 2 may includeinterventions targeting melatonin and cortisol. A program bestsuited for Subject 5 may include interventions targeting excessivePEA and glutamate activity.
If you are searching for more effective ways to target neuroendocrinebalance, consider adding neurotransmitter and hormonetesting to your toolbox. NeuroScience, Inc. will work with you toincorporate this valuable concept into your practice.
