Stress & Sleep: What's the link?

Have you ever been exhausted but can't sleep? Perhaps not only experiencing sleepless nights and insomnia, but being in a pattern of ‘wired and tired’ for continual weeks at a time?

Sleep is a vital human function which allows our brains to recharge and our bodies to rest and we need lots of it to function effectively day to day but also to maintain our wellbeing into the future.

How much sleep do we need and why is it important?

Research shows that adults should be getting an average of 8 hours sleep per night.

If our sleep quantity or quality is impacted, our bodies do not reap the amazing benefits such as:

- Muscle repair

- Memory consolidation

- Regulating energy metabolism

- Controlling appetite

- Improving glucose uptake (important if you have insulin resistance or PCOS).

Also, when we don't get enough sleep our body produces more cortisol, aka the stress hormone which can cause:

- Mood swings

- Memory loss

- Altered judgement

In addition, chronic sleep deprivation can contribute to health problems, such as obesity, via its impact on hunger signals, diabetes, immunity, gastrointestinal upset, mood disorders, and high blood pressure. Wild right?!

How does stress affect your sleep?

Well, there is a circadian pattern of cortisol secretion by the adrenal glands, where circulating cortisol rises and falls throughout the 24-hour daily cycle, typically being highest at around 8am and lowest between midnight and 4am.

Both high and low night-time cortisol levels can interrupt sleep.

The stress surge of hormones such as adrenaline and cortisol increase alertness, making it harder to fall asleep, and can cause night-time wakefulness when they remain high or rise and fall in irregular patterns during the night. Frequent or constant stress can chronically elevate these hormone levels, resulting in a hyper-alert state that is simply incompatible with restorative sleep.

The fact that inadequate sleep causes a rise in cortisol, means we get stuck in a loop of stress hormone imbalance. Eventually, after long periods of high stress and high cortisol, the system becomes overwhelmed, and the body is unable to maintain the hormonal response to stress. The end result? Exhaustion.

In addition to insomnia, signs of chronic high stress (and potentially HPA axis dysregulation) may include fatigue, brain fog, anxiety, depression, low libido, poor ability to handle stress, low exercise tolerance, and decreased immunity.

Better understanding the stress response

The hypothalamic-pituitary-adrenal axis (HPA) is the main stress response system, and is the link between perceived stress and our physical reactions to stress. A hormone cascade begins every time we perceive stress, whether it be a physical danger, reading a bad email, being stuck in traffic, or persistent mental worry.

The end results of the stress response is equipping us to run from danger.

The heart beats faster, pushing blood to the muscles, heart, and other vital organs. Pulse rate and blood pressure increase. Breath becomes more rapid. Small airways in the lungs expand, allowing as much oxygen as possible with each breath. Additional oxygen is sent to the brain, which increases alertness. Sight, hearing, and other senses become sharper. Meanwhile, adrenaline triggers the release of glucose and fats from storage in the body. These nutrients flood into the bloodstream, supplying the body with energy.

After the initial surge of adrenaline eases, the hypothalamus activates the second part of the stress response system. If the brain continues to perceive danger, it wants the sympathetic nervous system (responsible for fight or flight) to stay charged. It does this via hormones which trigger a release of cortisol. This enables the body to stay revved up and on high alert for long periods of time.

The issue is that we are not designed to stay stressed for long periods of time, and chronically high cortisol causes a flow-on effect in the body.

Here are six ways that can help reduce stress & support a restful sleep:

1. Ensure good sleep hygiene

• Create a cool, dark & quiet room for sleep.

• Practice the same bed-time & rise-time, we recommend 10-11pm - 6-7am.

• Expose yourself to natural light first thing on waking: this will help establish your circadian rhythm.

• Don't exercise past 6pm as this can raise cortisol levels, which may be too stimulating and inhibit your ability to get to sleep.

• Turn off all screens at least 1 hour before bed: the lights can interrupt circadian rhythm. This is an ideal time to try some reading or relaxation exercises listed below.

• Add calming essential oils to a diffuser: to help to promote relaxation and sleep.

2. Complete relaxing activities prior to bedtime (and at stressful intervals during the day)

• Practice 10 minutes of breathing before bed: exercises such as box breathing

• Enjoy 20-30 minutes of yin yoga before bed

• Tap into 10-15 minutes of meditation, guided, music or otherwise. We recommend Insight Timer.

• Read a book, go old school and read a physical book

• Take a look at our full top 100 list of relaxation ideas here

3. Include herbal medicine & tea in your daily routine

• Include adaptogens & adrenal tonics during the day: they are excellent supports to help adapt the body to stress and promote healthy adrenal function. They include herbs such as withania, rhodiola, siberian ginseng, rehmannia, and licorice.

• Take sedatives & hypnotics before bed: they can directly support sleep onset and maintenance. We recommend herbs such as passionflower, zizyphus, skullcap, kava, hops, lemon balm, and chamomile.

• Reduce anxiety with anxiolytics & nervines: they help to reduce anxiety and calm the stress response. We recommend herbs such as oats, motherwort, skullcap, vervain, kava, lavender, and passionflower.

• Drink 2-3 cups of our hand blended soothing organic After Hours tea daily: made with withania, passionflower, lemon balm, chamomile & cinnamon

4. Supplement with these nutrients:

• Magnesium: is my number one nutrient for sleep difficulties. It works as a relaxant, plus we go through stores of magnesium faster during times of stress. Source a good quality magnesium bisglycinate and take 300mg one hour before bed.

• Vitamin B6: or preferably an activated B complex which is beneficial during times of stress. Take either 50mg of Vitamin B6 or one capsule of an activated B complex in the mornings.

• Vitamin D: due to its role in regulating serotonin. Serotonin is largely responsible for establishing a fixed sleeping and waking cycle. Vitamin D is recommended if you are found to have low levels via pathology. Take 1000 IU per day.

5. Follow these dietary tips:

• Avoid alcohol in the evenings. although alcohol may help promote sleep onset, after a few hours it acts as a stimulant, increasing the number of times you wake and decreasing the quality of sleep.

• Limit caffeine to 1 shot no later than 11am: A well known stimulant its best to avoid this altogether when in a chronic stress cycle.

• Eat tryptophan rich foods: theoretically may help to promote sleep, due to tryptophan's role in melatonin production. This includes chicken, turkey, eggs, pumpkin seeds, and soy.

• Eat dinner at least 3 hours before bed: this gives your body a chance to process the food, so you are less likely to feel uncomfortable with a full stomach and be interrupted by reflux.

6. Stress Management:

• Keep a journal: so you are able to get your worries out of your head and onto a page.

• Exercise daily in the morning: even if all you can manage is a walk around the block.

• Deal with your stressors head on: Although it may seem unavoidable, it's worth analysing what areas in your life are contributing to stress. If the situation cannot be changed, perhaps the way you view it can be adjusted so it seems more manageable.

As always, we are here to support you. If you would like individualised treatment for insomnia, stress, HPA axis dysregulation, or fatigue, please get in touch here.

References
http://healthysleep.med.harvard.edu/healthy/matters/benefits-of-sleep/why-do-we-sleep
http://healthysleep.med.harvard.edu/healthy/matters/consequences
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/
https://www.sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/
https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902103/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057754/
Hechtman, L (2019). Clinical Naturopathic Medicine: second Edition.
Walker, M (2018). Why We Sleep: The new science of sleep and dreams.