Keto Insomnia: Duration, Symptoms, and How to Get Rid of It

Keto insomnia is one of the common drawbacks during the adaptation phase of the keto diet. While this decreases over time, it’s important to understand the science behind it to prevent complications. 

This comprehensive article will cover the causes, symptoms, onset and duration, possible complications, and ways to prevent or decrease keto insomnia.

Key Takeaways:

• Stress, electrolyte imbalance, caffeine, medical conditions, increased urination, hunger, and low blood sugar during fat-adaption can cause keto insomnia.
• It typically starts in the first week when your body starts transitioning to burning fat for energy.
• Keto insomnia can last up to 5 weeks after starting keto.
• Difficulty falling asleep, frequent waking, daytime sleepiness, fatigue, disrupted sleep, and heightened stress levels at night are symptoms of keto insomnia.
• Electrolytes, nutrient-dense foods, supplements, proper carbohydrate and caffeine intake timing, sleep hygiene, exercise, and meditation can manage keto insomnia.

Table of Contents:

• What Is Keto Insomnia?
• The Science Behind Keto and Sleep
• When Does Keto Insomnia Start?
• How Long Does Keto Insomnia Last?
• Symptoms of Keto Insomnia
• Potential Complications of Keto Insomnia
• How to Prevent and Manage Keto Insomnia
• The Bottom Line

What Is Keto Insomnia?

Keto insomnia, characterized by difficulty falling asleep or having sleep disturbances,¹ is a temporary side effect of keto, especially during the adaptation phase.

Keto insomnia often appears with other keto flu symptoms, making adherence to the keto diet more challenging. 

However, it’s important to note that keto insomnia is not universal, and numerous studies support its benefit in improving sleep quality.² 

The Science Behind Keto and Sleep

1. Low Blood Sugar

Ketogenic diets drastically reduce carbohydrate intake, inducing ketosis, where the body relies on fats for energy.³ During this transition, blood sugar levels drop, possibly leading to hypoglycemia.⁴ 

Without sufficient glucose, the brain struggles to maintain a steady energy supply, causing disruptions in the sleep-wake cycle.

These symptoms due to transitioning to burning fat for energy are also known as the keto flu.

This hypoglycemic state can trigger the release of stress hormones like adrenaline,⁵ contributing to arousal and sleep difficulties.

2. Electrolyte Imbalance

Keto’s ability to induce dehydration causes electrolyte imbalance. Electrolytes are crucial in nerve conduction and muscle relaxation, including those involved in initiating and maintaining sleep. 

Insufficient magnesium, for example, can hinder the function of GABA receptors,⁶ affecting the calming signals in the brain. Low sodium levels also increase the intensity of sleep bruxism⁷ or teeth grinding. 

3. Stress

The restrictive nature of keto may affect one’s mental health, elevating stress. Often, people starting on their keto diet feel social isolation. 

Moreover, the drastic decrease in carbohydrate intake affects one’s hormones, often increasing stress. 

4. Nocturia

The decreased glycogen stores and increased ketones have a diuretic effect, often cousin nocturia, or increased urination at night, often resulting in sleep disturbances. 

5. Increased Hunger

Ketogenic diets often result in a caloric deficit, leading to increased hunger, particularly in the initial stages. 

As evidenced in keto diets, weight loss affects appetite hormones, including ghrelin and leptin. Some studies show that weight loss increases the hunger hormone ghrelin,⁸ possibly affecting sleep quality.⁹  

However, higher fat and lower carb intake reduces hunger and elevates satiety hormones in the long run.

6. Too Much Caffeine

Drinking coffee and tea is shared among keto enjoyers to boost energy levels. Caffeine is a stimulant that blocks adenosine receptors,¹⁰ hindering the natural sleep-inducing signals in the brain.

Caffeine half-life ranges from 1.5 to 9.5 hours,¹¹ varying per individual, making caffeine intake timing crucial for sleep quality.  

7. Underlying Medical Conditions

Individuals with pre-existing medical conditions may be more susceptible to sleep disturbances when transitioning to a ketogenic diet.

Medical conditions that may affect sleep¹² include mental health disorders, diabetes, gastroesophageal reflux disease, chronic pain, thyroid problems, hypertension, neurodegenerative disorders, and cancer. 

When Does Keto Insomnia Start?

Keto insomnia often starts within the first week of getting into the keto diet. However, it’s important to note that individuals adjust differently, and keto insomnia is not universal.

It’s also important to note that the frequency of keto insomnia should decrease as you go along the diet. If it remains persistent even after weeks of doing the keto diet and applying the ways to prevent it, you may need to seek medical evaluation.

How Long Does Keto Insomnia Last?

Keto insomnia, along with other keto flu symptoms, usually lasts about 4-5 weeks from the onset of the keto diet. 

However, it could be possible for some people to experience it for shorter or longer periods, depending on how fast they adapt to the metabolic changes. When addressed properly, keto insomnia should resolve earlier than expected. 

Symptoms of Keto Insomnia

Keto insomnia may present differently per individual, but common symptoms include:

• Difficulty falling asleep
• Frequent waking during the night
• Daytime sleepiness and fatigue
• Restlessness in bed
• Sleep onset latency (extended time to fall asleep)
• Shallow or disrupted sleep
• Heightened stress levels at night

Once you notice these symptoms, it’s important to make adjustments to address them, prevent complications, and better adhere to the keto diet. 

Potential Complications of Keto Insomnia

Having quality sleep is essential for overall health. When left unattended, acute insomnia may progress and lead to several complications, as discussed below.

1. Chronic Insomnia

Prolonged and untreated keto insomnia can evolve into chronic insomnia,¹² characterized by persistent difficulties falling or staying asleep at least 3 nights a week for 3 months or more. 

Chronic insomnia may need medical evaluation and involve tests like thyroid function tests, glycosylated hemoglobin tests, complete blood count tests, serum iron studies, liver function tests, and renal function tests. 

2. Decreased Concentration

Insufficient and disrupted sleep impairs cognitive functions,¹³ such as attention, memory, and problem-solving. This may affect your academic output, increase the risk of motor vehicle accidents, and decrease productivity at work. 

3. Increased Anxiety and Stress

Stress induces insomnia, and insomnia increases stress.¹⁴ Persistent keto insomnia disrupts hormonal balance, leading to elevated stress levels and increased susceptibility to anxiety.

4. Weakened Immune System

Sleep deprivation may result in modifications in innate and adaptive immune responses,¹⁵ resulting in a chronic inflammatory state and an increased risk for infectious/inflammatory pathologies such as cardiometabolic, neoplastic, autoimmune, and neurological illnesses.

5. Fatigue

Fatigue is often the core symptom of insomnia.¹⁶ The primary function of sleep is to restore and rejuvenate the body, and insomnia disrupts this restoration process, resulting in persistent fatigue.  

6. Increased Blood Pressure

Increased blood pressure causes insomnia,¹⁷ but insomnia, particularly when accompanied by stress and elevated cortisol levels, can contribute to increased blood pressure.¹⁸ Prolonged hypertension poses significant risks to heart health and overall well-being.

7. Reduced Quality of Life

The cumulative impact of chronic keto insomnia on various aspects of health contributes to a reduced quality of life. Insomnia compromises physical and mental well-being, interpersonal relationships, and overall life satisfaction.

How to Prevent and Manage Keto Insomnia

1. Gradual Decrease of Carbohydrate Intake

To prevent hormonal changes that may lead to keto insomnia, initiate the ketogenic diet with a gradual reduction in carbohydrate intake. You can start by decreasing your carbohydrates to 40% in the first week, 25% in the second week, and 10-15% in the third week.

This approach allows the body to adapt to a low-carb state without experiencing abrupt changes in blood sugar levels, potentially minimizing disruptions to sleep. 

2. Proper Carbohydrate Intake Timing

To avoid hypoglycemia at night, you can have your carbohydrates during dinner. This allows your blood sugar to stay within normal levels by the time you get to bed, preventing hunger. 

3. Focus on Nutrient-dense Foods

Prioritizing nutrient-dense foods is fundamental in preventing nutritional deficiencies contributing to keto insomnia.

Keep your keto macros, but focus on natural fat sources and nutrient-dense low-carb vegetables. These foods will promote satiety and regulate hormones, promoting better sleep quality. 

In the same way, avoid highly processed, spicy, or highly acidic foods and foods with high glycemic index.

4. Proper Sleep Hygiene

Maintaining proper sleep hygiene is the most crucial part of addressing keto insomnia. To do this, stick to the following rules:

1. Consistent Sleep Schedule: Maintain a regular sleep routine by going to bed and waking up at the same time daily. This stabilizes your circadian rhythm, enhancing overall sleep quality.
2. Create a Comfortable Sleep Environment: Optimize your sleep space by keeping it dark, quiet, and cool. Invest in a comfortable mattress and pillows, eliminating disturbances for a restful night.
3. Limit Screen Time Before Bed: Minimize exposure to screens before bedtime to avoid disruptions in melatonin production. Consider using blue light filters on electronic devices.
4. Wind Down Before Bed: Establish a pre-sleep routine with calming activities like reading or relaxation exercises, signaling your body that it’s time to unwind.
5. Limit Naps: Keep daytime naps short and avoid them close to bedtime to prevent interference with nighttime sleep.
6. Evaluate Your Sleep Environment: Regularly assess and optimize your sleep environment, ensuring your mattress and pillows offer adequate support. Address any issues with noise, light, or temperature.

5. Increase Electrolyte Intake

Ensuring an adequate intake of essential electrolytes, particularly magnesium, sodium, and potassium, is vital for addressing potential contributors to keto insomnia. Studies suggest that magnesium supplementation enhances sleep quality.¹⁹ 

6. Incorporate Sleep-inducing Supplements

Consult your healthcare provider for supplements that induce sleep. Some options include magnesium, valerian root, chamomile, lavender, theanine, glycine, GABA, vitamin D, and B vitamins. 

7. Regular Exercise

Exercise has been linked to improvements in relaxation, leading to better sleep patterns and overall well-being. Experiment on what timing works best for you, as some may benefit from doing it in the mornings while others prefer it at night to help them fall asleep faster. 

Cardio exercises, including aerobics, walking, swimming, cycling, jogging, yoga, and stretching, are the best for better sleep. 

8. Follow Relaxation Techniques and Meditate

Relaxation techniques and meditation are beneficial for mitigating the physiological stress response associated with keto insomnia. 

You can follow guided meditations you can find online, read books before sleeping, practice deep breathing exercises, and follow progressive muscle relaxation techniques to relieve stress. 

9. Avoid Longer Fasting Periods

Avoid extended fasting periods to prevent nocturnal hunger and potential disruptions to sleep. If you’re doing intermittent fasting and keto simultaneously, have your last meal within 4 hours of bedtime to prevent excessive hunger. 

10. Proper Caffeine Timing

Caffeine offers energy boost but proper timing is crucial to avoid disrupting your sleep cycle. As a rule of thumb, you should not have caffeine 6 hours before bedtime, which means your last cup of coffee or tea should be around 2-3 PM. 

Moreover, limit your caffeine intake to less than 400 mg daily, which translates to 4-5 cups of coffee or tea, depending on the concentration. 

The Bottom Line

Keto insomnia is a common keto symptom, although not universal. Hormonal changes, stress, hunger, electrolyte imbalance, and too much caffeine are the common causes. 

It’s easy to manage and address keto insomnia once you identify the symptoms. Keto insomnia often resolves along with other symptoms in the adaptation phase, and you should consult your healthcare provider for persistent symptoms. 

Frequently Asked Questions (FAQ)

References

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