If you’re tired of waking up at 2 a.m. or 3 a.m. and struggling to fall back asleep, this episode is for you. Clinical Nutritionist JoAnn Clinton explains the science behind nighttime awakenings and what your body might be trying to tell you.
We’ll explore how blood sugar, cortisol, thyroid, liver function, menopause, and gut health all play a role in broken sleep and the specific labs (like fasting insulin, salivary cortisol mapping, thyroid panels, liver enzymes, and the DUTCH test) that reveal the root cause.
By the end, you’ll have a functional roadmap to start addressing your sleep at the source so you can move beyond quick fixes and finally sleep through the night.
Sources:
Blood Sugar:
Kinsella J, Giamila PF, Cryer PE. Nighttime hypoglycemia can trigger sympathetic nervous system activation and wakefulness. Diabetes Care. 2011;34(9):2023-2028. Accessed August 17, 2025. http://solanomd.com/uploads/3/4/1/7/34170332/nejm_mechanismdz_hypoglycemia.pdf.
Cortisol:
Buckley TM, Schatzberg AF. Aging and the role of the HPA axis and rhythm in sleep and memory-consolidation. Am J Geriatr Psychiatry. 2005 May;13(5):344-52. doi: 10.1176/appi.ajgp.13.5.344. PMID: 15879582.
Hypothyroidism:
Song L, Lei J, Jiang K, Lei Y, Tang Y, Zhu J, Li Z, Tang H. The Association Between Subclinical Hypothyroidism and Sleep Quality: A Population-Based Study. Risk Manag Healthc Policy. 2019 Dec 19:12:369-374. doi: 10.2147/RMHP.S234552. eCollection 2019.
Liver:
Wijarnpreecha K, Thongprayoon C, Panjawatanan P, Ungprasert P. Insomnia and risk of nonalcoholic fatty liver disease: A systematic review and meta-analysis. J Postgrad Med. 2017 Oct-Dec;63(4):226-231. doi: 10.4103/jpgm.JPGM_140_17. PMID: 28862239; PMCID: PMC5664866.
Systemic Inflammation:
Fernandez-Mendoza J, Baker JH, Vgontzas AN, Gaines J, Liao D, Bixler EO. Insomnia symptoms with objective short sleep duration are associated with systemic inflammation in adolescents. Brain Behav Immun. 2017 Mar;61:110-116. doi: 10.1016/j.bbi.2016.12.026. Epub 2016 Dec 30. PMID: 28041986; PMCID: PMC5316336.
Hormonal:
Kravitz HM, Ganz PA, Bromberger J, Powell LH, Sutton-Tyrrell K, Meyer PM. Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause. 2003 Jan-Feb;10(1):19-28. doi: 10.1097/00042192-200310010-00005. PMID: 12544673.
Gut:
Lin Z, Jiang T, Chen M, Ji X, Wang Y. Gut microbiota and sleep: Interaction mechanisms and therapeutic prospects. Open Life Sci. 2024 Jul 18;19(1):20220910. doi: 10.1515/biol-2022-0910. PMID: 39035457; PMCID: PMC11260001.
Zhang Q, Yun Y, An H, Zhao W, Ma T, Wang Z, Yang F. Gut Microbiome Composition Associated With Major Depressive Disorder and Sleep Quality. Front Psychiatry. 2021;12:645045. doi:10.3389/fpsyt.2021.645045