Sleep: The Key to Healthy Aging
by Mary E. Miller-Wilson
After more than a decade managing Functional Medicine patients, the single biggest issue plaguing men and women alike is a lack of quality sleep. Life in 2022 is fast-paced, stress levels are high for most people, and managing/balancing home and work life is a challenge for us all. I tell patients all the time in the office that their ability to age gracefully and turn back the aging clock lies primarily in their ability to get good quality sleep. Sleep is important for many physiologic functions, but it’s most significant for repair and recovery. As we age, the ability to achieve stage 4 REM sleep decreases. If we cannot achieve stage 4 sleep, human growth hormone cannot be released from the anterior pituitary. Never before have Functional Medicine providers had so many tools in their arsenal to enhance and improve sleep patterns.
For both men and women, being hormonally balanced is a key factor in enhancing sleep patterns. For men, it’s a matter of optimizing testosterone levels. If a man is not sleeping well, restoring testosterone levels induces improved sleep. For women, both estrogen and progesterone play a role in the sleep cycle. Progesterone is of the utmost importance in enhancing the sleep cycle and allowing patients to achieve quality REM sleep. While menopause is notorious for interrupted sleep patterns, because progesterone levels often drop before menopause occurs (peri-menopause), sleep for women can be interrupted often starting in a woman’s thirties and extending into the fourth decade of life. Progesterone is “nature’s valium.” It has a calming effect on the brain, sitting in the GABA receptors when taken at bedtime. The delicate balance between estrogen and progesterone in a woman’s body creates a hormonal symphony which lends itself to improved sleep patterns.
Low-dose naltrexone (LDN) is another newer modality for the enhancement of sleep patterns. Naltrexone has been marketed since the 1970’s for opioid addiction. Low-dose naltrexone, LDN, uses 10% of the normally prescribed dose. By blocking the opioid receptors in the brain, the body releases endorphins, which then enhances sleep patterns. It is a compounded medication. The dose is started at 1.5 mg, and titrated (increased) to 4.5 mg at bedtime. It has few side effects, a good safety profile and is not habit-forming. This product is also very useful for auto-immune patients who inherently have a high degree of inflammation in their bodies. When inflammation is tamped down, sleep quality improves.
Last but not least, peptides are extremely effective in enhancing sleep patterns. Peptides are signaling agents and are most effective in both men and women when hormones are optimized first. Hormones provide the fertile ground upon which the peptides can work effectively. There are different peptides for different purposes. The growth hormone releasing peptides have all but replaced the use of human growth hormone for enhancing sleep patterns. Human growth hormone introduced into the body from the outside provides a constant stimulus, can drive certain cancers and is not considered safe. However, pulsing human growth hormone NATURALLY from the anterior pituitary promotes quality sleep patterns. Peptides such as CJC1295/ipamorelin or tesamorelin/ipamorelin are examples of peptides used together for synergy that promote quality sleep patterns.
Improving sleep for patients has far-reaching implications. Sleep promotes emotional resilience, it is a buffer to handle stress effectively and provides an emotional reset. Getting good quality sleep promotes weight loss, enhances brain function and allows the body to do DNA repair and tissue recovery. When patients sleep better, health inherently improves. Sleep regulates longevity.