Sleep Test 101

The body's alternating cycle of sleep and waking is directly related to the levels of two key hormones: melatonin and cortisol. Understanding the fluctuations of these biomarkers throughout the day and how they relate to each other is important for determining why you may be experiencing sleeping difficulty. Sixty million Americans are estimated to persistently suffer from sleep deprivation. And 70 percent of adults experience daily stress to the point where it disrupts their nightly sleep.

Melatonin

Melatonin is a hormone that helps regulate the body's internal biological clock. Melatonin is produced in the pineal gland, a pea-sized gland located in your brain. During the day, the pineal gland is inactive. When the sun goes down and darkness occurs, the pineal is activated and begins to produce melatonin. Typically, melatonin levels peak around bedtime, stay elevated throughout the night, and then fall back to daytime levels in the morning.

Melatonin is known as the "Dracula of hormones" because your body naturally produces melatonin in response to darkness, and production is "shut off" by bright light. The feedback between the body and the environment is the primary way your body knows when it should be asleep or awake. In other words, melatonin levels directly impact your sleep cycle by helping to induce and maintain normal sleep.

If melatonin never rises properly at night or if production is disrupted by light or other factors, you may experience symptoms of sleep deprivation.

Low levels of melatonin in the evening/night are related to the following symptoms: difficulty falling asleep at night, waking up during the night, waking up too early, fatigue, not feeling rested, and daytime tiredness or sleepiness.

On the other hand, if your levels of melatonin are higher than the normal range in the morning/daytime, you may experience fatigue, grogginess, or reduced core body temperature.

Many things can disrupt this cycle, including stress, dietary factors, medications, your environment, your work schedule, and the amount or timing of light exposure.

Collection Timing

To determine melatonin levels, the Thorne Sleep Test actually measures MT6s, a stable metabolite of melatonin that can be found in urine. When looking at the graph of your melatonin results throughout the day, it is important to note that your urine sample reflects your body's melatonin levels earlier in the day. For example, your first urine sample taken as soon as you wake up in the morning indicates the level of melatonin in your body during the nighttime.

Collection

Reflects Melatonin Levels During

1st

Nighttime

2nd

Morning

3rd

Daytime

4th

Evening

Cortisol

Balancing melatonin is a key hormone from the adrenal gland ‐ cortisol. Cortisol's level should be highest shortly after waking and should fall throughout the day. When this hormone does not follow its normal cycle, sleep and health can be affected.

This stress hormone plays many roles in the body, but it has a special relationship to sleep. Cortisol follows a cycle that is opposite of melatonin's and, in this role, is responsible for signaling the body to be awake and responsive. Cortisol should be lowest late at night (when melatonin levels are high) and should have a peak shortly after waking in the morning.

The morning peak of cortisol is thought to "prepare you for the day" by:

• Raising your blood sugar, giving you energy, and probably also making you hungry for breakfast soon after
• Increasing your metabolism and getting you ready to be active
• Preparing you for the upcoming stressors of the day

The cortisol rhythm can become unbalanced from chronic stress related to emotions, lifestyle, diet, health issues, overtraining, and other causes. We can see more than one kind of abnormal pattern, but the most common abnormal patterns for cortisol are explained below.

When Cortisol is Too High

It is important for health that your adrenal glands secrete cortisol in response to stress. However, it is equally as important that your cortisol levels return to normal following a stressful event. If the stress response is activated too often, then your body doesn't have a chance to return to normal. When cortisol levels are too high, then your body feels "on" all the time. You may have disturbed sleep, excessive hunger, weight gain, and anxious mood. Elevated levels of stress hormones can impair your body's ability to absorb nutrients from your food because cortisol tells your body to stop producing the enzymes needed for digestion.

When Cortisol is Too Low

Cortisol levels that are too low could indicate that your adrenal glands are persistently depleted and unable to meet the demands that your body puts on them. As a result, you can feel fatigued all the time, have low mood, get sick more frequently, have challenges with pain and inflammation, and have a hard time responding to normal stress.

If your cortisol levels are abnormally low persistently, it may be a sign of a medical condition that should be should be managed by an endocrinologist.

Collection Timing

When looking at the graph of your results, it is important to note that your urine sample reflects your body's cortisol levels from earlier times during the day. For example, your first urine sample taken when you wake up in the morning indicates the level of cortisol in your body the night before.

Collection

Reflects Cortisol Levels During

1st

Nighttime

2nd

Morning

3rd

Daytime

4th

Evening

Test taker must be 18+ and reside in the U.S.

You should take this test if you

• Have trouble falling asleep
• Wake up during the night
• Wake up too early
• Don’t feel rested after sleeping
• Feel tired but wired
• Experience mid-day energy dip

At home tests are not permitted for use in:

• Armed Forces Americas
• Armed Forces Europe
• Armed Forces Pacific
• American Samoa
• Maryland
• Northern Mariana Islands
• New Jersey
• New York
• Rhode Island
• United States Minor Outlying Islands

Sleep is a complex health concern and can be impacted by several factors.  While this test is an important tool that gives you personalized insight into key hormones that impact sleep, there may also be other factors that are contributing to sleep problems.  Therefore, we always encourage you to consult a health-care practitioner if you suspect a problem or concern with your sleeping habits.