Monthly Archives: March 2014

Insomnia: What’s your cause?

Typical types of insomnia include sleep initiation and early morning waking. I generally see early risers waking between 2-4am and struggling to fall back asleep. Prior to initiating sleep treatment I like to unravel the cause of the insomnia.

Difficulty Initiating Sleep:

Ideally you fall asleep within 20 minutes of head on the pillow and lights out. For some folks that can take upwards of 3 hours! What is going on here?

There are two major events I see regularly that affect sleep initiation:

–          too much caffeine

–          too much light exposure too close to bedtime

It’s surprising how a little too much caffeine or coffee too late in the day can wreak havoc on your ability to fall asleep. Try cutting down to 1 cup in the morning before 9am as a trial to see if that does the trick. I’ve had some patients be intolerant to ANY constant use of caffeine as well. It’s dependent upon your body’s metabolism and sensitivity.

It’s not so surprising with the increase in amazing serial TV shows how many people are watching a LOT of TV, often in their bedrooms. Or staying up late looking at their phones, iPads or computer screens. It can take up to 2 hours for some people after turning off the screens to fall asleep properly. Light stimulates circadian phase delay and melatonin suppression, the natural hormone that makes you sleepy.

Major events that cause early waking:

–          High stress causing adrenal overload

–          Anxiety or depression, neurotransmitter imbalances

Adrenal overproduction increases cortisol (and DHEA but that’s another story) to mitigate the damaging effects of stress in the body. Chronic high unrelenting stress can cause an early rise in cortisol levels around 2-4am instead of around 6am, leading to early waking. This feels like waking up and feeling wide awake and calm but knowing you are still tired and needing to sleep. Often times sleep is difficult or light after this point.

Mood disorders are more complicated but regularly affect sleep in a variety of ways. Typical experiences are a feeling of “monkey mind” or anxiety while lying awake. Excessive worry. Other times it’s alongside a landslide into a depressive episode or an extended phase that’s more manic or obsessive. Can you correlate your insomnia to mood shifts? This gives great insight into your sleep disturbances.

There are definitely other causes to sleep disturbances not covered here. A lot of people suffer through their insomnia and never think to look for answers or have no idea what to try. Please contact your naturopathic physician if you struggle with your sleeping, we have lots of tricks up our sleeves!

Breast Cancer Screening: Are Mammograms the way?

A recent study published in the British Medical Journal questions the utility of routine mammograms. The study suggests that mammograms routinely detect cancers that might not progress to more serious cancers if left alone and may be better left unfound. Although we feel this article does need to be acknowledged, we also wanted to recognize that there is lots of research on the benefits of routine mammograms, and no divisive evidence that it does more harm than good. At Emerald City Clinic we routinely recommend regular breast screening to patients, such as mammograms, breast thermography, and ultrasounds. However, it is the opinion of Emerald City Clinic that the best ongoing prevention is an awareness of your own body and discussing any concerns with your physician. This means doing regular breast self-examinations (BSE). The American Cancer Society has a good tutorial on BSE at:

While mammograms and other screening options may help detect cancers, they are not perfect and in no way replace the knowledge of your own body. Please talk with your Emerald City physician to discuss specific options and recommendations for breast screening.

We also have a comparison chart that you may peruse located on our website here:

Reference: BMJ 2014;348:g366 (Published 11 February 2014)

The Liquid Diet

For a sundry of reasons, you may be asked at some point before or after major medical intervention to be on a liquid diet. Don’t let yourself succumb to the choices of jello, pop, gummy bears, Popsicle, coffee, and peppermints (a diet recently recited to me by a family member!). Even “food” items with some slightly redeeming qualities such as chicken and vegetable bouillon cubes and something called “resource breeze” which is like an Ensure product, can be tempting but easily avoided. These will NOT encourage the preparation/healing process. This is the year 2014 when we have choices like miso soup, vegetable broth, kombucha, and fresh vegetable juices.  There are so many options for healthy clear liquid diets that could assist the healing process– make the right decisions!


Dr. Molly Niedermeyer