Sleep onset is a melatonin and GABA problem. Sleep maintenance, staying asleep, especially the 2-4 AM wake, is mostly cortisol, blood sugar, progesterone, and GH-axis. The pattern of when you wake tells you which.
If you wake at 2-4 AM alert and can't fall back asleep, that's classic dysregulated cortisol. Often comes from chronic stress, late caffeine, or HPA exhaustion.
Progesterone is GABAergic, it deepens sleep. As it drops, sleep gets fragmented and night sweats appear.
If you wake hungry or shaky, you're dropping into hypoglycemia overnight. Common with skipped dinner or heavy alcohol.
GH pulses during slow-wave sleep. Low GH-axis output is associated with poor restorative sleep, slow recovery, and poor skin turnover.
Often missed in lean women. Untreated apnea destroys sleep architecture and crushes hormones.
Both directly support deep sleep architecture. Restoring either improves sleep quality.
If perimenopausal, progesterone alone or full HRT restores sleep depth. Often the most dramatic single change a patient reports.
See full details →GHRH analog that restores GH pulsing during sleep. Often noticeable within weeks for slow-wave sleep depth.
See full details →Restoring T improves sleep architecture and resolves the “tired but wired” pattern.
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