Sleep is one of the most important aspects to our health, yet it is one we don’t get enough of. When we have difficulty falling asleep or maintaining sleep it is known as insomnia. There are many individuals that suffer from this. There are many things that can affect your ability to sleep such as stress, anxiety, blood sugar, inflammation, brain dysfunction and cortisol dysfunction. These all have the ability to impact each other and can make obtaining sleep hygiene more difficult if all issues aren’t addressed. Chronic insomnia has been shown to affect emotions, memory, and cognitive function in addition to impacting energy levels and leading to chronic fatigue. We will cover how stress, anxiety, blood sugar, inflammation, brain dysfunction and cortisol dysfunction are tied together to affect sleep as well what you can do about it.
Many people have heard of “fight or flight” and “rest and digest”. These are the two parts of your autonomic nervous system known as sympathetic and parasympathetic. Sympathetics are very important in times of stress, physical activity, and life threatening activities. It allows for blood flow and energy to be shifted to the specific functions that are vital for performance. Parasympathetic on the other hand is important in times of rest, digestion, and recovery. There needs to be an appropriate balance between these two. When we have stress, anxiety, inflammation, blood sugar imbalance and brain imbalance it leads to excitation of the sympathetics. When we shift into a sympathetic response we produce more adrenaline. One of the other things that increases is cortisol. Cortisol has the ability to impact our sleep in two ways. We can have normal amounts of production, but altered levels at different times of day. This would be known as an altered cortisol rhythm. The other possibility is excess cortisol production. Cortisol is used to break down stored glucose to be used for energy. It is a normal response for cortisol levels to rise during activity, but they should decrease during times of rest as long as we are getting enough nutrients. The time it increases the most is during the night when we sleep. This is because our body and brain still need glucose to perform necessary functions, but we are not obtaining any nutrients from food as we are sleeping. When we wake up in the morning this will result in the highest level of cortisol seen throughout the day. If appropriate nutrients aren’t obtained before going to sleep; this will result in waking up during the night as cortisol will spike to allow for glucose levels to increase. When our cortisol is high before bedtime this will make it more difficult to go to sleep. Many individuals will complain of being tired, but their mind is racing and they don’t have the ability to shut it off. This results in them having difficulty going to sleep in a timely manner. The opposite is true in the morning if cortisol levels don’t increase to the level they need to. Individuals will find it very difficult to get out of bed as they will have no energy. When this pattern continues for too long these individuals will need stimulants such as coffee, energy drinks, or other caffeinated beverages to give them the ability to function throughout the day. It is important to address any sleep issues as early as possible as chronic sleep disturbances will lead to anxiety, stress, depression, and altered cognitive function.
What can you do?
1. Eat appropriate diet and don’t skip meals
2. Decrease inflammation
3. Obtain a functional neurological exam to identify function of sympathetics and parasympathetics
4. Comprehensive lab work that includes blood sugar and salivary cortisol levels
5. Decrease stress and anxiety utilizing techniques and therapy such as meditation, neurofeedback, and deep breathing
Riemann, D., Kloepfer, C., & Berger, M. (2009). Functional and structural brain alterations in insomnia: Implications for pathophysiology. The European Journal of Neuroscience,29(9), 1754-1760. doi:10.1111/j.1460-9568.2009.06721.x
Roth, T., Roehrs, T., & Pies, R. (2007). Insomnia: Pathophysiology and implications for treatment. Sleep Medicine Reviews, 11(1), 71-79. doi:10.1016/j.smrv.2006.06.002