The inability to achieve a refreshing night’s sleep is often one of the chief complaints of someone with an autoimmune disease. No matter how fatigued you become, it just seems as if your body has lost its ability to drift off into a peaceful and restorative nights rest.
Sound refreshing sleep depends on your body’s ability to digest proteins and release essential amino acids. One of the major regulators of the sleep-wake cycle is the hormone melatonin. Melatonin is derived from the essential amino acid tryptophan.
Symptoms of low melatonin include:
• Difficulty getting to sleep
• Difficulty falling back to sleep when awakened during the night
• Light sleeper/easy waking during the night
• Early morning awakening
• Un-refreshing sleep
In a previous study posted we showed that lupus patients lack all of the essential amino acids, including tryptophan. A lack of tryptophan would then lead to low melatonin.
In the following study the researchers found that patients with lupus had significantly lower levels of melatonin in comparison to healthy women.
Decreased daily melatonin levels in women with systemic lupus erythematosus- A short report
Dobromir Tanev2, Georgi Kirilov1
“SLE patient showed significantly lower daily melatonin levels in comparison to healthy controls…”
Multiple sclerosis patients also lack the essential amino acid tryptophan. The lack of tryptophan would then lead to a lack of melatonin. Researchers in the following study found that patients with multiple sclerosis had “significantly” decreased levels of melatonin (6-SMT).
Melatonin dysregulation, sleep disturbances and fatigue in multiple sclerosis.
Melamud, L., D. Golan, R. Luboshitzky, I. Lavi, A. Miller. 2012. J Neurol Sci. 2012 Mar 15;314(1-2):37-40. doi: 10.1016/j.jns.2011.11.003. Epub 2011 Dec 1.
“Sleep disruption and fatigue are common in Multiple Sclerosis (MS). Melatonin is one of the major regulators of sleep-wake cycle…MS patients demonstrated significantly decreased levels of 6-SMT… Sleep Efficiency was significantly lower in the MS group compared to controls.
Research has found that patients with fibromyalgia also lack the enzymes necessary to digest proteins (protease). Therefore, fibromyalgia patients also lack essential amino acids. For instance, in the following study published in the Journal of Rheumatology the researchers found that patients with fibromyalgia lacked the essential amino acids tryptophan and histidine.
Plasma tryptophan and other amino acids in primary fibromyalgia: a controlled study.
Yunus M.B., J.W. Dailey, J.C. Aldag, A.T. Masi, P.C. Jobe. 1992. J Rheumatol Jan;19(1):90-4.
”…Transport ratio of tryptophan was found to be significantly decreased in PF compared with the control group…Plasma tryptophan level was lower in PF…than in healthy controls… Additionally, plasma histidine…levels were found to be significantly…lower in patients with PF than in controls.”
The lack of tryptophan will then lead to a lack of melatonin in patients with fibromyalgia. In the following study the researchers found that fibromyalgia patients had a 31% lower nocturnal melatonin (MT) secretion than healthy subjects.
Fibromyalgia—a syndrome associated with decreased nocturnal melatonin secretion.
Wikner, J., U. Hirsch, L. Wetterberg, S. Röjdmark. 1998. Clin Endocrinol (Oxf). 49(2):179-83.
“The FMS patients had a 31% lower MT secretion than healthy subjects during the hours of darkness.”
Research has discovered that patients with rheumatoid arthritis also have difficulty falling asleep and wake frequently once they do get to sleep.
The essential amino acid tryptophan is also lacking in rheumatoid arthritis patients, as the following study confirms.
Rheumatol Rehabil. 1978 Nov;17(4):227-232.
Metabolic abnormalities of tryptophan and nicotinic acid in patients with rheumatoid arthritis.
Labadarios D, McKenzie DY, Dickerson JW, Parke DV.
“…The mean plasma total tryptophan concentration of 13 long-standing rheumatoid arthritis patients was found to be lower than that of seven nonrheumatoid control subjects, but the plasma nicotinic acid concentration was unchanged…”
And finally, following is a link to information on the association research has recently made to diabetes and low melatonin.
Take Home Message:
The essential amino acid tryptophan is lacking in patients with autoimmune disease. Tryptophan is needed to produce the hormone melatonin. Melatonin is one of the major regulators of the sleep-wake cycle. The lack of melatonin in patients with autoimmune disease would explain the inability of autoimmune disease patients to achieve sound refreshing sleep.