I get many questions on the blog about problems with sleep: not able to fall asleep, not waking rested and waking in the early hours and not being able to go back to sleep. By far the most common question is “Why do I still wake at 4am and can’t go back to sleep?”
So let me share one of the typical questions I receive and my feedback in the hope that something you read here may help you or someone you’re working with. Here is the question:
I purchased Lidtke l-Tryptophan and time release melatonin and notice a big difference in my sleep. Instead of waking up every two hours I’m sleeping better but still wake up at 4 am and can’t get back to sleep. GABA hasn’t helped. What can I take to get back to sleep and what are your thoughts on Seriphos Phosphorylated Serine? I think my anxiety has to do with my adrenals because I wake up in a sweat and am way past menopause.
Since she is seeing a big difference with tryptophan and timed-release melatonin, low serotonin is the likely root cause of her insomnia or at least one of the root causes. We always want to capitalize on what is already working. Too many people don’t see expected results with 1 x 500mg tryptophan at bedtime and 1mg timed-release melatonin and start looking for other solutions when the answer may be right in front of them.
Here are the steps I’d follow with a client with similar sleep challenges:
- Try more tryptophan, increasing it slowly over the course of a few weeks in the hope that it more will provide more serotonin support. This is what I call an amino acid trial where you rate and log your improvements as you incrementally increase – with the goal of finding an optimal amount for your needs. We all have different needs and post menopause it’s not uncommon for women to experience anxiety, depression and insomnia related to low serotonin and fluctuating sex hormones. We also always want to capitalize on what is already working.
- Also, to add to what’s working, add tryptophan mid-afternoon if it’s not already in place. When someone scores high on the low serotonin questionnaire the typical timing of tryptophan is mid-afternoon and an hour before bed (always away from protein). Serotonin levels start to decline mid-afternoon hence the benefits of a mid-afternoon dose. Start low and increase slowly.
- I would also suggest trying the tryptophan opened up (at both times) to see if this makes a difference.
- Taking a tryptophan at the 4am waking can help you go back to sleep so this is worth trying. For some people 500mg at 4am is too much and using 125mg or 250mg works well. You determine the amount based on how you feel when you do get up. If you were able to go back to sleep easily buy wake groggy then it’s too much.
- Some people are reporting better results with Lidtke Tryptophan Complete (which has all the co-factor nutrients) so this may be worth trialing too. I’d start by adding to what is already in place.
- If we get benefits with any of the above by are not quite there then I would suggest additional timed-release melatonin until sleep improves.
This is always done slowly and methodically over the course of a few weeks. I always have my clients carefully log what they try and what is working and not working.
Other factors we’d make sure are addressed:
- What GABA was used, was it trialed (starting low and increased) and was it used sublingually?
- Is high cortisol at night a factor? Doing an adrenal saliva test will provide the answer. If it is then the Interplexus Seriphos is the best for lowering it. It’s best to take 1-3 x Seriphos about 2-3 hours before the high cortisol. [UPDATE: INTERPLEXUS SERIPHOS WAS REFORMULATED IN 2016 – PLEASE SEE BELOW FOR MORE ON THIS]
- Is gut health a factor? Look into SIBO, gluten sensitivity, other food sensitivities, dysbiosis and parasites (which are often active in the early hours and can cause night sweats)
- Is there a sex hormone imbalance? Even with someone way past menopause, the night sweats mean this should be ruled out. The addition of amino acids starts to balance the hormones but more support may be needed.
- Is any caffeine (even decaf) still being consumed?
- Is blood sugar stable? Make sure to have breakfast with animal protein and healthy fats and the same at each meal and for snacks. Consider a trial of glutamine during the day and just before bed for added blood sugar stability
- Are medications a factor? Current medications or prior use of benzodiazepines or SSRIs can affect sleep even long after they have been tapered.
- Is sleep apnea a factor?
We also address all the usual sleep hygiene factors: dark room, cool room, quiet room, no cell phone or clock radio on the bedside table, no late night computer use and getting some early morning light.
Many essential oils can provide added benefits when diffused at night or mixed with a carrier oil and used topically. One lovely combination I share on the Essential Oils Revolution 2 (happening now) is lavender, roman chamomile and neroli which helps both insomnia and anxiety.
There can be many other possible root causes of insomnia: autoimmunity, Lyme disease, pain, past trauma or grief and even genetic polymorphisms, all covered on the recent Sleep Success Summit.
Have you used tryptophan or other amino acids like GABA (for the more physical tension) and melatonin to reduce or eliminate early morning waking episodes?
If you’re a practitioner, have you helped your clients/patients with this methodical approach?
What else has helped you?
Update August 27, 2016 : INTERPLEXUS SERIPHOS HAS BEEN REFORMULATED -I am doing research to find suitable alternatives. For now, feel free to read through the comments below for discussions about this. Once I have some useful information I’ll create a new blog post.
Update November 18, 2016: Here are some possible alternatives to Seriphos
Update January 20, 2017: The Original Formula of Seriphos has been reintroduced you can read more about this here