Hormone testing for insomnia: Is a hormonal imbalance to blame for your sleep troubles?

Our modern lifestyles do a lot to interfere with our sleep --- so it can be hard to pinpoint a root cause when you’re experiencing insomnia.

Sure, it could be any number of lifestyle factors like overexposure to blue light, too much caffeine, excessive stress, or another identifiable and alterable behavior. But it could also be much less obvious: an imbalance of hormones happening below the surface, or some other invisible cause that you can only determine through lab testing.

There are a variety of hormones that play a part in sleep. Melatonin is the most obvious, but cortisol, testosterone, estrogen, insulin, and a few other hormones also play their own particular roles in establishing a healthy circadian rhythm. If you’re experiencing insomnia and you think your hormones could be to blame, this article will help you understand what exactly that means.


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What is insomnia?

First off, if you’re experiencing insomnia, you’re not alone. Insomnia is a common sleep disorder affecting up to 70 million Americans per year that can present in a variety of ways. People with insomnia may have difficulty falling asleep, staying asleep, or achieving high-quality sleep in spite of having the appropriate time and bedroom environment for sleeping well.

This condition interferes with day-to-day life, and it can make you feel sleepy or unfocused during the day. Short-term insomnia, which typically lasts a few days or weeks, can come on suddenly as a response to stress or a shift in your typical schedule. Chronic insomnia, on the other hand, occurs three or more nights per week, lasts over three months, and can’t be explained by a different health condition or medication.

Symptoms of insomnia may include:

  • Trouble falling asleep initially

  • Waking up in the middle of the night

  • Waking up early in the morning without being able to fall back asleep

  • Experiencing low energy or fatigue during the day

  • Mood swings, irritability, or depression

  • Brain fog or memory problems

What happens if you have insomnia?

In addition to the daily disruptions caused by insomnia, there are also potential long-term health issues related to chronic sleep loss. Studies suggest that insufficient sleep --- i.e., sleeping for fewer than seven hours per night --- is associated with anxiety, depression, diabetes, heart disease, hypertension, alcohol use, and other wide-ranging negative effects on the immune, nervous, cardiovascular, and endocrine systems.

Is insomnia the cause of your sleep loss?

As with most health concerns, it’s a good idea to talk to a doctor when you’re trying to pinpoint the cause of chronic sleep issues. But this is the primary question to ask yourself in determining whether insomnia might be to blame for your sleep loss: are there other possible culprits interrupting your sleep? If yes, it’s probably not insomnia.

More specifically, if you have another health condition that can disrupt sleep or you’re taking any medication that keeps you awake, then insomnia may not be what you’re experiencing. But if no other potential cause for sleep disruption is apparent yet you’re still struggling to fall or stay asleep, then you might very well have insomnia.

Typically, chronic insomnia is the result of stress, sleep-disrupting habits, or other life events, which is a pretty wide range of causes. Here are a few more details:

  • Stress: General day-to-day stress and stressful or traumatic life events can both lead to insomnia. This might be related to anxious thoughts at bedtime or to a cortisol hormone imbalance.

  • Sleep-disrupting habits: Poor sleep hygiene --- like an irregular bedtime schedule, nighttime device usage, an uncomfortable bedroom environment, or daytime naps --- can interrupt your sleep/wake cycle.

  • Work schedule or travel: Working a late or early shift, frequently changing shifts, or traveling across time zones can disrupt your body’s circadian rhythm and lead to insomnia.

  • Eating schedule: Eating too much before bed can cause physical discomfort or heartburn that prevents sleep.

Hormonal imbalances that can cause insomnia

Your sleep/wake cycle is very connected with your body’s hormone production and secretion. In fact, the interaction of various hormones is what regulates your circadian rhythm, so if any of your sleep-related hormones are out of whack you might experience insomnia.

Melatonin

Let’s start in the most obvious place: with the aptly named “sleep hormone.” While you may be most familiar with melatonin as a dietary supplement on the shelves at your local pharmacy, it’s actually a hormone produced by our bodies in response to darkness that helps us fall and stay asleep (if everything is working as it should).

Nighttime exposure to screens and artificial light can interfere with melatonin production, as can poor sleep hygiene habits of any kind. If your body’s melatonin production is insufficient, you could very well experience insomnia, since a deficiency in this hormone may make it difficult to fall asleep and/or stay asleep.

Cortisol

Though cortisol is the hormone most associated with stress, it also plays an important role in regulating our sleep/wake cycle. Whereas melatonin helps you relax and fall to sleep at night, cortisol helps you feel alert and awake during the day. The balance of these two particular hormones has a significant impact on your circadian rhythm, so they both need to be balanced for you to achieve restful sleep and wakeful days.

Stress and anxiety can overstimulate cortisol production, and too-high levels of the hormone can interfere with sleep and potentially lead to insomnia. On the flip side, insufficient sleep can actually elevate cortisol levels, which can then lead to chronic insomnia.

Sex hormones

Estrogen, progesterone, and testosterone each have their own relationship to sleep, and every person has all three of these hormones at varying levels. Whereas testosterone is more a product of sleep rather than a precipitant, estrogen and progesterone can actively affect your quality and quantity of sleep.

Estrogen has a complex role with regard to sleep; among other functions, it helps with the metabolism of neurotransmitters that affect sleep, increases total sleep time, helps you fall asleep more quickly, decreases instances of nighttime awakenings, and keeps core body temperature lowered during sleep. Progesterone has both calming and sedative effects that can help you wind down and fall asleep. That’s why people experiencing disruptions to these two hormones, especially menopausal people, are at higher risk of developing sleep disorders --- including insomnia.

Thyroid hormones

If your body makes either too many or not enough thyroid hormones, it can disrupt your circadian rhythm.

  • Too much thyroid hormone (hyperthyroidism) can lead to night sweats, frequent waking in the night to pee, or waking up feeling cranky or anxious.

  • Too little thyroid hormone (hypothyroidism) is even more common, and it can lead to difficulty falling asleep or staying asleep as well as a general inability to stay asleep long enough. This condition may also cause extreme daytime sleepiness.

Hormone testing for insomnia

If you suspect that a hormone imbalance may be to blame for your insomnia, there’s good news: it’s both possible and easy to get your hormone levels tested. You can visit your doctor to get labs done, or you can opt for an at-home service like Base.

Custom home testing like Base’s sleep kit is appealing because you don’t have to go to in-person doctor’s appointments, which makes it easier to keep track of your hormone levels over time --- an important facet in addressing chronic insomnia. Plus, Base offers an interpretation of your results. What good is knowing your hormone levels if you don’t know how to address any issues that are found?

Either way, it’s a good idea to get hormone levels tested before you just assume that’s the root of your insomnia. Adding new supplements or changing your lifestyle without any health data to inform your approach could end up exacerbating your sleep problems, or even creating new ones.

Is at-home hormone testing for insomnia accurate?

If you are considering an at-home testing service to check your hormone levels, you’re likely wondering whether those are worth it. After all, don’t you need to see a doctor in order to get accurate health information?

The short answer: if you’ve chosen a reliable at-home testing service and you complete all steps of the at-home test correctly, then your results should be accurate. Base offers a good example here: while you’re able to complete lab work at home, there is still a board-certified physician involved who will order and review your tests. Both salivary testing and blood testing of hormones have been shown to return accurate readings, and both of these are available in at-home test kits.

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