Sleep Disturbances, Cortisol and Adrenal Function

Posted on October 23, 2009 by Dr. Wilson's Adrenal Fatigue Team

Sleep Disturbances, Cortisol and Adrenal Function

People are becoming more aware of the ravages of stress and how it leaks into every corner of their lives. Of course, increased stress means increased sleep disturbances for many. Less sleep means they experience more stress the day after. This pattern continues in a vicious cycle, making stress and sleep loss in terms of hours and quality intimately interconnected.

If stress has somewhat depleted the adrenal glands, which is often the case, people under stress do not wake feeling rested. Cortisol, an adrenal hormone, is needed to allow that person to wake feeling refreshed and bouncing out of bed in the morning. It is also important to induce an alpha wave, a requirement for the first phase of sleep. If cortisol is low, falling asleep is difficult. Cortisol is also necessary to maintain good blood sugar levels throughout the day and night. If cortisol is low during the day people wake feeling tired and often need coffee, cola and other caffeinated beverages to get going and to keep going during the day. This over consumption of caffeine not only causes blood sugar to rapidly rise and then precipitously fall an hour and a half later, but also tends to interfere with sleep that night. The resulting lack restful sleep creates more stress the next morning and perpetuates the cycle of low cortisol and difficulty sleeping. This low adrenal function is a frequent occurrence in both sleep disturbance and inadequate response to stress. During adrenal fatigue, a condition where the adrenal glands are not able to keep up with the demands placed on them, people often have problems managing their stress and sleeping well.

The Connection Between Poor Sleep and Adrenal Function

There can be several reasons for sleeplessness with adrenal fatigue. If you are waking between 1:00 and 3:00 AM, your liver may be lacking the glycogen reserves needed for conversion by the adrenals to keep the blood glucose levels high enough during the night. Blood sugar is normally low during the early morning hours but, if you are experiencing adrenal fatigue, your blood glucose levels may sometimes fall so low that hypoglycemic (low blood sugar) symptoms wake you during the night. This is often the case if you have panic or anxiety attacks, nightmares, or sleep fitfully between 1:00 and 4:00 AM. To help counteract this, have one or two bites of a snack that contains protein, unrefined carbohydrate, and high quality fat before going to bed, such as half a slice of whole grain toast with peanut butter or a slice of cheese on a whole grain cracker.

Both too high and too low nighttime cortisol levels can cause sleep disturbances. To determine if this is a problem for you, simply do a saliva cortisol test at night and compare your night sample levels with your own daytime levels and with the test standards for those times. To do the night test, take a saliva sample at bedtime, another if you wake up during the night and a third when you wake up in the morning. Write the time each sample was taken on the vial and in your notebook on a separate sheet of paper. If cortisol is the culprit, your cortisol levels will be significantly higher or lower than normal for those times. If your nighttime cortisol levels are too low, you may sleep better when you exercise in the evening, before going to bed because exercise tends to raise cortisol levels. If your nighttime cortisol levels are too high, try doing one of the relaxation or meditation exercises to calm you down before going to bed. The specific yoga posture called the alternate leg-pull can be quite helpful in getting to sleep or returning to sleep. This is a basic yoga posture that almost any yoga book or video will describe but an instructor is preferable because there is some subtlety to doing this posture.

Things You Can Do to Improve Your Quality of Sleep:

• Above all, go to bed before 10:30 PM and stay in bed until 9:00AM as often as possible, even if it is just on the weekends. It is amazing how restorative sleeping until 9:00 AM is for the adrenals.

• Be sure to get enough physical exercise during the day. Try varying the kinds of exercise you do, their intensity or when you exercise. Many people have told me swimming at night helps them sleep.

• Certain postures in yoga, tai chi and qi gong can also be helpful. Check with a teacher of these disciplines to find out which postures or exercises would specifically help you.

• Avoid coffee, caffeine containing beverages and chocolate because they act as stimulants. These can interrupt sleep patterns and increase morning lows. Even if they are consumed early in the day, they can disrupt sleep and make the next morning harder to negotiate.

• Some people are photosensitive and watching television or looking at a computer screen keeps their melatonin from rising and inducing sleep. If you are having difficulty going to sleep and usually are staring at a TV or computer screen late at night, try having an 8:00 PM limit on these visual stimuli.

• If your cortisol levels are low late at night, try exercising in the evening, as exercise raises cortisol levels and may afford you a sound night’s sleep.

• There are particular nutritional supplements that can be beneficial. Often melatonin (0.3-1.3 mg) taken 30 minutes before bedtime helps establish normal sleep patterns. Calcium citrate (500mg) taken with 50 mg of 5-hydroxytriptophan (5HTP) at night before retiring is also relaxing and helps many people sleep throughout the night. Trace mineral tablets taken at the evening meal also help relax the body. Adrenal extracts taken ½ hour before bedtime often help those with adrenal fatigue fall asleep and remain asleep. If your adrenal fatigue is moderate or severe, try this one first.

• The hypothalamus is very important in regulating sleep. Although accurately testing hypothalamic function is complicated, a simple test you can do yourself is to try taking one to four tablets of hypothalamus extract and 10-40mg of manganese before bedtime and see if your sleep improves. Sometimes the hypothalamus tablets need to be combined with the adrenal extracts to normalize sleep.

• There are also several herbs commonly used to promote better sleep such as hops (whole plant), catnip (leaves), valerian (root) and licorice (root). Although not known as a sedative, the herb ashwagandha can help indirectly through its ability to normalize cortisol and sex hormones, both of which can produce sleep disturbances.

• During the day, you will probably notice that you have particular times when you feel more lethargic, cloudy headed, tired or have other symptoms of adrenal fatigue. Try to schedule your breaks so that when these occur, you can physically lie down for 15-30 minutes. Lying down is much more restorative than sitting for the person with adrenal fatigue.

If none of these help and your life is being deleteriously affected by lack of or interrupted sleep, check your local area for the location of the nearest sleep center. Several cities around the country have these centers that specialize in helping individuals determine the cause of their sleep disturbances.