| Common Sleep Disturbance #1: Elevated Cortisol at Bedtime |
11.16.11 12:00:00 |
Video Transcripts:
Hi. I’m Dr. Christopher Mote, and today is another ARK Clinical Pearl. I want to talk to you about lab results and specific markers that correlate with poor sleep. The most common of which that we see, by far, is a patient who gets a lab test result and the bedtime cortisol is elevated.
When somebody has an elevated bedtime cortisol, we can assume that they don’t sleep well. In fact, poor sleep is almost ubiquitous. Almost any time somebody has HPA axis dysfunction on their adrenal test results, assume that they don’t sleep well. And the first marker we look at is that bedtime cortisol. If it’s elevated, the HPA axis is being activated instead of shutting down. So, even the patients who are exhausted at the end of the day, and they basically pass out, their metabolic functions are not being released or engaged. So they won’t get a good growth hormone release. There’ll be the suppression, maybe up to 30 percent, of the release of TSH, amino acid absorption from the gut and deposition in lean muscle mass, immune activity.
All of those are being disrupted in a patient whose bedtime cortisol is coming up. So, what do we do with those patients? Well, there’s a practical way to disengage the HPA axis utilizing a supplement called phosphatidylserine. Phosphatidylserine can help reduce the HPA axis activation and the cortisol output so that a patient doesn’t have that elevated cortisol and can naturally fall asleep. We give patients between 1 and maybe 300 milligrams of phosphatidylserine about four hours before we would like them to fall asleep, and that first or maybe the second night that they take that dose, they should notice a difference and fall asleep naturally.
If that patient comes back and says, “I’m falling asleep but now I’m still waking at 2:00 or 3:00 in the morning,” a second dose taken just before they go to sleep can work two to three hours later and help with that late awakening.
So the bottom line is, patients who don’t sleep don’t see the restoration of their tissues and the restoration of the HPA axis, and it is probably the first thing that should be addressed with any patient. And the most common reason we see is that elevated bedtime cortisol, the phosphatidylserine can bring it down. We hope you see success with that approach.