Even though the science is complex, the premise is simple: Neurotransmitters and hormones are the chemical messengers that control the body’s sleep-wake cycle. Balance in these chemicals are necessary for proper sleep. Determining which chemicals to target can help healthcare providers develop programs designed to specifically address neuroendocrine balance related to sleep disorders.

Biochemistry of Sleep
Sleep is an amazingly complex biological process that is influenced bymany interrelated neurotransmitter and hormone systems. These systemsexert their effects in a number of areas within the brain, includ ing the retinaof the eye, the hypothalamus, and the pineal gland.

The onset of sleep results from a cascade of neurochemical events which begin in the eye. The brain, sensing a lack of daylight, employs numerous neurotransmitters and hormones to transition the mind and body into sleep. Inhibitory neurotransmitters and hormones including GABA, serotonin, and melatonin reduce the activity of wake-promoting brain centers that communicate via the excitatory neurotransmitters glutamate, histamine, norepinephrine, and hypocretin.

Normal sleep patterns depend on proper communication between the neural circuits involved in the sleep process. Conversely, perturbations of the sleep cycle can occur when miscommunication between these circuits exists. Inadequate activation of the sleeppromoting brain centers due to imbalances in neurotransmitter and hormone levels can lead to excessive activity in the wake-promoting brain centers, thus contributing to sleep difficulties.

Neurotransmitter balance within the human nervous system is susceptible to both external and internal factors. Chronic stress, inadequate diet, infections, toxins and aging negatively affect neurotransmitter balance, potentially leading to low levels of some transmitters and excessive levels of others. Left unchecked, imbalances in the nervous system can be a contributing factor to the impairment of many of the body’s most basic functions, including sleep.

The role of neurotransmitters, hormones, and the nervous system as a whole in the sleep-wake cycle is reinforced by the interventions used to address disruptions in sleep. Pharmaceutical and nutritional interventions act on specific pathways/circuits within the sleep-wake cycle. Since none of these are capable of resolving sleep issues in all circumstances, how can healthcare providers make more informed decisions regarding what intervention may result in the best outcome?

Expanding the Sleep Disorder Toolbox
The answer may lie in the understanding of biochemical brain maps (neurocircuits) and utilization of neuroendocrine assessments. Neurocircuits show us that disorders of the nervous system are truly spectral in nature and rarely involve biochemical alterations in a single neuroendocrine parameter. The brain, in all of its complexity, does not rely on a single chemical or “switch” to induce sleep. In fact, even simplified sleep-wake neurocircuits suggest that no less than 10 different neuroendocrine parameters play a role in the sleep process. Considering that miscommunication between any one of these pathways can lead to sleep difficulites, the need for truly individualized approaches to addressing sleep difficulties is paramount.

An equally valuble tool in addressing sleep difficulties is the use of neuroendocrine assessments. Non-invasive urine and saliva samples collected at night provide a snapshot of the unique biochemistry influencing an individual’s sleep cycle. The information provided in these assessments then serves as a guide for developing programs tailored to the individual’s unique biochemistry, thus improving the likelihood of positive clinical outcomes. To illustrate this point, refer to the lab results in Table 1. Each of the subjects included in the table presented with the inability to fall asleep. Age and sex varied, however none of the subjects were using medications or natural sleep aids.

Subject 2 demonstrated a deficiency in melatonin and excessive cortisol output. Subject 5 demonstrated excessive levels of the excitatory transmitters PEA and glutamate. Both subjects presented with similar concerns, however, their lab results were entirely unique. As such, a program designed for Subject 2 may include interventions targeting melatonin and cortisol. A program best suited for Subject 5 may include interventions targeting excessive PEA and glutamate activity.

If you are searching for more effective ways to target neuroendocrine balance, consider adding neurotransmitter and hormone testing to your toolbox. NeuroScience, Inc. will work with you to incorporate this valuable concept into your practice.