The previous posts outlined lifestyle modifications for improving sleep, as well as various nutraceutical and botanical treatments for attaining better sleep.

However, what if it’s been several weeks and none of these treatments seem to be helping? This is where the investigation begins. You doctor will perform a more detailed evaluation- often including lab testing and referrals- to help discern the cause of this hard-to-treat insomnia.


Laboratory Testing

Lab workup may start by analyzing your thyroid function, ruling out hyperthyroidism as a cause and/or blood sugar testing to determine if highs or lows are involved. Another test, unique to alternative medicine, provides a salivary 4-part cortisol measurement. This will help to identify if the insomnia occurs because of abnormal cortisol secretion. Another valuable test measures neurotransmitter levels (including serotonin, histamine, GABA and others) to identify and treat deficiencies or excesses.


Physical Exam

It is likely your doctor has already performed a full physical exam; however, they may choose to repeat it and pay special attention to heart function, neurological function, as well as oral and throat anatomy.


Other conditions that are important to rule out include restless leg syndrome and musculoskeletal pain or spasm.



If needed, your doctor may refer you to a sleep specialist to rule out sleep apnea. Physical therapy or orthopedic referrals can be useful to help treat chronic pain. Lastly, your doctor may choose to refer to a mental health practitioner for further evaluation; it is important to identify if sleep difficulties originate from mental or emotional causes.


Contact your doctor today if you suffer from sleep difficulties that do not respond to treatment. It is an important issue to address as poor sleep has negative health effects, both short and long term.



To a good night’s rest!



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