Sleep Disturbances

Common sleep disturbances include a delay in falling asleep, early waking, and restless leg syndrome.

Some common contributors to these sleep disturbances include mineral imbalances, sex hormone changes, altered cortisol release, pain, muscular fatigue, and an increase in daily stressors.

Some examples of these causes…

Sex hormone changes- an example is decreased available progesterone. Endogenous or oral available progesterone acts as a GABA alpha agonsit. GABA is an inhibitory neurotransmitter which among other things increases a feeling of calmness and increases sleep time. GABA alpha receptor agonist also include L-arginine HCL.

Mineral imbalances

Restless leg syndrome is associated with low iron availability in an area of the brain named the substantia nigra. Research suggests that though the substantia nigra may have low iron availability, peripheral iron levels are not necessarily low when measured. Research also suggests, that iron repletion when peripheral iron deficiency anemia is present does in fact increase the iron availability to the substantia nigra. However, when repleting iron it is important to measure stored iron levels to reduce any negative side effects correlated with iron overload. Iron supplementation is not always helpful and other treatment options are needed. The data in one paper noted that within the general population, there is a subgroup of people with approximately a 33% risk of developing restless leg syndrome with iron deficiency whereas the rest of the population is resistant to developing restless leg syndrome even with significant iron deficiency.

Restless leg syndrome is also correlated with decreased oxygen availability and is notably higher in people residing in higher altitudes, as well as people suffering from COPD and obstructive sleep apnea. This may be related to a decrease in available iron since iron carries oxygen throughout our bodies.

Additionally, magnesium and calcium supplementation appears to reduce the severity of restless leg syndrome.

We can assess these potential causes with lab analysis and/or a review of history.

Treatment options include appropriate mineral formulas, botanicals to modulate cortisol and sex hormone changes, manual therapies, and biofeedback training to help correct the sleep disturbance.

References:

Connor JR, Patton SM, Oexle K, Allen RP. Iron and restless legs syndrome: treatment, genetics and pathophysiology. Sleep Med. 2017 Mar;31:61-70. doi: 10.1016/j.sleep.2016.07.028. Epub 2016 Nov 10. PMID: 28057495; PMCID: PMC5334282.

Jadidi A, Rezaei Ashtiani A, Khanmohamadi Hezaveh A, Aghaepour SM. Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial. BMC Complement Med Ther. 2022 Dec 31;23(1):1. doi: 10.1186/s12906-022-03814-8. PMID: 36587225; PMCID: PMC9804944.