Sleep — The Pillar That Runs Everything Else

Your supplement stack is worthless if you're not sleeping.

I don't care how clean your diet is. I don't care if you're taking the perfect combination of magnesium, adaptogens, and B vitamins. If you're sleeping five hours a night, you're wasting your time and your money.

Sleep isn't a pillar of health because it sounds good on a poster. It's a pillar because it's the foundation that everything else sits on. Your metabolism. Your hormones. Your immune function. Your mental health. All of it runs through sleep.

And yet patients tell me constantly in my Central Texas practice: "I know I should sleep more, but I'm just a light sleeper." Or "I've always run on six hours." Or "I'll catch up on the weekend."

You're not catching up. You're accumulating damage. And that damage shows up in labs — elevated fasting insulin, inverted cortisol curves, tanking testosterone — long before you connect the dots.

What Bad Sleep Actually Does

This isn't just "you'll feel tired." The downstream effects are staggering, and most people have no idea how far they reach.

Restricting healthy young adults to four hours of sleep for just six nights produces insulin resistance comparable to pre-diabetes. Six nights. In otherwise healthy people. Let that sink in. You can eat perfectly clean and still tank your metabolic health by not sleeping.

Sleep deprivation jacks up cortisol — particularly in the evening, when cortisol should be at its lowest. That elevated nighttime cortisol then makes it harder to fall asleep, which raises cortisol further. It's a vicious cycle, and it's one of the most common patterns I see in my practice. This is HPA axis dysfunction at its finest — your stress response system getting stuck in a feedback loop that nobody's addressing.

Short sleep also hijacks your appetite. Ghrelin — your hunger hormone — goes up. Leptin — your satiety hormone — goes down. And the cravings shift toward carb-dense foods specifically. So no, you're not weak-willed for craving garbage after a bad night. Your hormones are literally steering you there.

And the immune piece — even modest sleep restriction reduces natural killer cell activity significantly. These are the cells your body uses to surveil for cancer and fight viral infections. From one bad night.

In these cases, the labs tell the story. Fasting insulin is elevated, cortisol curve is inverted, testosterone is tanking. They think it's age. It's sleep.

The Cortisol-Sleep Death Spiral

I need to go deeper on the HPA axis for a minute because it's central to almost everything I see.

Your cortisol should follow a rhythm: high in the morning — that's what wakes you up — gradually declining through the day, hitting its lowest point around midnight. When that rhythm gets disrupted from chronic stress, blood sugar instability, gut inflammation, whatever the driver is, you end up with a flattened or inverted cortisol curve. High at night, low in the morning. Wired at bedtime, can't drag yourself up at 7 AM.

This is a tier one issue in my framework. When I evaluate patients, I think in tiers: tier one is the foundational stuff — gut health, metabolic function, and HPA axis regulation. Tier two gets into toxins, hormones, food sensitivities. Tier three is genetics and structural issues. You'd be amazed how many tier two and tier three problems resolve when you fix the foundations. And sleep — specifically the cortisol-sleep relationship — is ground zero for tier one.

If your cortisol is elevated at night, no amount of melatonin is going to override that. Which brings me to something I talk about constantly.

Melatonin Is Not What You Think It Is

Melatonin is not a sedative. It's a circadian signal. It tells your brain that it's dark outside and it's time to prepare for sleep. That's it. It doesn't make you sleep.

And yet people are popping 5, 10, even 20 milligrams like it's Benadryl.

Your body's natural melatonin production is very low. So when you take high doses, you're flooding your receptors with far more than the normal signal. Over time, this can downregulate your receptors and actually make your sleep worse. Plus, melatonin at those doses can suppress reproductive hormones — not something most people are thinking about when they grab it off the shelf.

If you're going to use melatonin, use it correctly: low dose, taken 30 to 60 minutes before your target bedtime, primarily to shift your circadian phase. It's a timing tool, not a knockout drug.

The Stuff Nobody's Looking For

When someone comes to me with sleep problems, I'm not just asking about screen time and caffeine — though those matter. I'm looking at the whole system.

​Blood sugar crashes at night. This is huge and wildly under-recognized. If your blood sugar drops too low at 2 AM, your body releases cortisol and adrenaline to mobilize glucose. That's what wakes you up at 2 or 3 in the morning with your heart pounding. It's not anxiety — it's a hypoglycemic stress response. I see this constantly, and it's fixable. A small protein-and-fat snack before bed, better blood sugar management during the day, and sometimes targeted support for insulin sensitivity.

​Undiagnosed sleep apnea. A good chunk of my patients — especially men over 40, but women too, particularly post-menopause — have obstructive sleep apnea and don't know it. They're not all overweight. They're not all snoring. But they're desaturating oxygen all night, triggering sympathetic nervous system activation, and waking up feeling like they got hit by a truck. If you're doing everything right and still sleeping poorly, get a real sleep study. Not the ring on your finger — an actual polysomnography or a validated home test.

​Environmental exposures. Mold exposure can cause neuroinflammation that directly disrupts sleep architecture. I've had patients with insomnia that wouldn't budge until we identified and addressed significant mycotoxin exposure. Heavy metals — lead, mercury — both interfere with neurotransmitter metabolism, including the serotonin-to-melatonin conversion pathway. This is tier two workup territory, and it's the kind of thing that gets completely missed in conventional settings.

​Gut dysfunction. Your gut microbiome has its own circadian rhythm. Disrupting your sleep-wake cycle disrupts microbial rhythms, leading to dysbiosis. And a disrupted microbiome impairs sleep. It's bidirectional. Your gut produces over 90% of your body's serotonin, which is the precursor to melatonin. If your gut is inflamed or dysbiotic, your ability to produce adequate melatonin naturally is compromised. This is why sleep and gut health live in the same tier.

What I Actually Do

My approach is layered because — surprise — there's no single magic bullet.

​Layer one: sleep hygiene that actually matters. I know you've heard it before. But you probably aren't doing it. Consistent bed and wake times — yes, weekends too. Room temperature around 65 to 68 degrees. Pitch dark. No screens for 60 minutes before bed, or at minimum blue-light blocking glasses — the real ones, not the fashion lenses. Blue light suppresses melatonin production, and even brief evening exposure can delay your circadian phase significantly.

You cannot out-supplement bad sleep hygiene. I say this to patients constantly. If you're scrolling your phone in bed at 11 PM and then taking four supplements to try to sleep, you're fighting yourself.

​Layer two: cortisol management. If cortisol is elevated at night — and I measure this with specialized testing — we address it directly. Certain supplements have good evidence for blunting nighttime cortisol spikes. Adaptogenic herbs have been shown to reduce cortisol significantly in chronically stressed adults. These aren't band-aids. They're supporting your physiology while we address the root causes of the HPA axis dysfunction.

​Layer three: blood sugar stability. A small snack with protein and fat before bed if you're a 2 AM waker. Think a tablespoon of almond butter, half an avocado, or a small handful of nuts. We're keeping glucose stable so your adrenals don't have to rescue you at 3 AM.

​Layer four: targeted supplements. Magnesium supplementation, chosen based on the specific form your body needs — different forms have different effects on the nervous system. Certain amino acids promote calm brain wave activity that transitions into sleep. Most Americans are deficient in key nutrients anyway, so this is often correcting an underlying insufficiency, not just managing symptoms.

What This Looks Like in Practice

In these cases, we start with baseline labs — metabolic markers and expanded thyroid. Fasting insulin is typically elevated, cortisol curve is inverted, free T3 is on the low end. Three tier one problems, all feeding into each other, all manifesting as terrible sleep and everything that comes with it.

We address blood sugar first — dietary changes, a protein-fat snack before bed. Add targeted supplementation based on testing results. Strict sleep-wake schedule.

Within three weeks, they're usually sleeping six and a half to seven hours consistently. Within two months, fasting insulin has dropped, cortisol curve is normalizing, and they've lost 10-15 pounds without changing their exercise routine.

When sleep is bad for long enough, you forget what normal feels like. That's why fixing it feels like a revelation.

The Bottom Line

Sleep is not a nice-to-have. It's not something you'll "get to" after you figure out your diet and exercise. It's the foundation that everything else sits on. Your metabolism, your hormones, your immune function, your mental health — all of it runs through sleep.

And if you've been struggling with sleep and haven't gotten real answers — if you've been told to "practice better sleep hygiene" without anyone actually investigating why you can't sleep — that's exactly what we dig into at Rooted Health.

We figure out the why. And then we fix it.

Give us a call at 254-780-0023 or visit rootedhealthclinic.com to schedule a consultation.

Rooted Health Clinic — Salado, Texas