Natural treatments for insomnia are many and varied. Results are hit and miss because not all cases of insomnia have the same cause and because herbs and supplements are not drugs. Sometimes taking the time to understand why insomnia exists can make finding effective treatment easier.

Inflammation, Insomnia, CRP, and Poor Sleep

Name any chronic problem and you can safely say that, in most instances (nearly all), reducing inflammation will improve the situation. Insomnia is no different. CRP is a common lab test that shows inflammation. High CRP has been studied and found to be associated with insomnia and poor sleep [1]. Much of the research centers around the idea that poor sleep increases CRP. The question is: Can it work the other way? Can addressing inflammation improve sleep. Clinically, I have usually found this to be the case; just waiting for the research to catch up. There is some scientific evidence for my point of view, however; poor sleep can cause inflammation, but inflammation can also cause poor sleep [2,3].

Diet, Inflammation and Poor Sleep

Studies looking at inflammatory markers such as C-reactive protein (CRP) often conclude that poor sleep increases inflammation. They are less likely to ask the opposite question: Can reducing inflammation improve sleep? Dietary studies suggest that it can.

The Western diet is a major source of chronic inflammation. Sugar, refined starches, ultra-processed foods, and a lack of fiber and polyphenols all promote inflammation [5]. Improving the quality of the diet has been shown to improve both sleep quality and sleep duration [4].

One study found that eating a high-glycemic diet made it harder to fall asleep [6]. Other research suggests that the amount and quality of carbohydrates in the diet may also influence sleep [10].

Diet doesn’t just affect sleep directly—it also affects inflammation. In a 12-year study of nearly 2,000 adults, people under age 50 who ate the most inflammatory diets were significantly more likely to have elevated C-reactive protein (CRP), an important marker of inflammation [7].

Perhaps most importantly, researchers found that people who switched to a more anti-inflammatory diet slept better after three months. They spent less time awake during the night, and their sleep became more efficient, even though they did not sleep longer [11]. This suggests that reducing inflammation through diet may improve sleep quality without medication.

This raises another interesting question: Why would reducing inflammation improve sleep? Researchers are beginning to uncover several possible answers, including effects on serotonin, melatonin, GABA, cortisol, and the gut microbiome.

Inflammation, Neurotransmitters, and Insomnia

One reason we need to explore reducing inflammation as a way to improve sleep is because of the effect inflammation has on neurotransmitters. Serotonin is often called the “feel-good” neurotransmitter, but it also plays another important role—it is used to make melatonin, the hormone that helps regulate sleep.

Normally, the amino acid tryptophan is converted into serotonin. Chronic inflammation changes that. Inflammatory chemicals activate an enzyme called indoleamine 2,3-dioxygenase (IDO), which diverts tryptophan away from serotonin production and into a different chemical pathway called the kynurenine pathway.

As a result, the body may produce less serotonin. Since serotonin is the raw material used to make melatonin, chronic inflammation may also reduce the body’s natural melatonin production.

Instead of making serotonin, the kynurenine pathway produces several compounds that can affect the brain. One of these, quinolinic acid, can overstimulate nerve cells and has been linked to several neurological disorders [12-14].

This raises an interesting question. If melatonin supplements help you sleep, should you also ask why your body wasn’t making enough melatonin in the first place? Chronic inflammation may be one possible explanation.

Sleep/Depression, Depression/Sleep: A Perpetual Motion Machine of Misery

Depression can lead to poor sleep, and poor sleep makes depression worse [12]. Both increase inflammation, and inflammation makes both worse. It’s a feedback loop. Taking medication, or even supplements may mitigate the problem. It may, however, be better to start addressing inflammation. A good place to start is diet; the Roadmap to Health is a good place to start [click to download for free].

Insomnia Usually Has More Than One Cause

Inflammation is only one piece of the puzzle. Mitochondrial function, cortisol and the HPA axis, GABA, the gut microbiome, nutrient deficiencies, sleep apnea, medications, and even your bedroom environment can all affect sleep. The good news is that each problem you correct removes another “straw from the camel’s back,” bringing you one step closer to sleeping normally again.

Important: If you snore heavily, stop breathing during sleep, wake up choking, or are always tired despite sleeping enough hours, ask your healthcare provider about sleep apnea. Natural approaches may help many causes of insomnia, but sleep apnea should always be ruled out first.

 

Selected References:

  1. Dig Dis Sci. 2015 Feb 21;60(7):2136–2143. High C – reactive protein is Associated with Poor Sleep Quality Independent of Nocturnal Symptoms in Patients with Inflammatory Bowel Disease
  2. Sleep Med Clin. 2023 Jun;18(2):213-218 Sleep and Inflammation: Bidirectional Relationship
  3. Dig Dis Sci. 2015 Feb 21;60(7):2136–2143 High C – reactive protein is Associated with Poor Sleep Quality Independent of Nocturnal Symptoms in Patients with Inflammatory Bowel Disease
  4. Adv Nutr. 2016 Sep 15;7(5):938-49. Effects of Diet on Sleep Quality
  5. Public Health Nutr. 2013 Aug 14;17(8):1689–1696. Designing and developing a literature-derived, population-based dietary inflammatory index
  6. Am J Clin Nutr. 2007 Feb;85(2):426-30. High-glycemic-index carbohydrate meals shorten sleep onset
  7. Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample. Appetite. 2013;64:71–80.
  8. Long-term associations between inflammatory dietary scores in relation to long-term C-reactive protein status measured 12 years later: findings from the Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) cohort. Brit J Nutr. 2017;117(2):306–314. 
  9. 2020 May 14;43(11):zsaa093. Changes in dietary inflammatory potential predict changes in sleep quality metrics, but not sleep duration
  10. 2017 Feb 1;40(2):zsw057. Short Sleep Duration Is Associated With Eating More Carbohydrates and Less Dietary Fat in Mexican American Children
  11. Sleep, Volume 43, Issue 11, November 2020, zsaa093, Changes in dietary inflammatory potential predict changes in sleep quality metrics, but not sleep duration
  12. J Psychosom Res. 2017 May 22;99:1–7. Sleep Disturbance and Kynurenine Metabolism in Depression
  13. Sleep, Volume 40, Issue 11, November 2017, zsx141, Acute Kynurenine Challenge Disrupts Sleep–Wake Architecture and Impairs Contextual Memory in Adult Rats
  14. J Neurovirol. 2024 Mar 12;30(2):122–130. Tryptophan-Kynurenine Metabolic Pathway and Daytime Dysfunction in Women with HIV