Dr. Doni, author of The Stress Remedy, discusses how stress and our cortisol levels can disrupt our sleep and offers advice on how to keep things balanced.
In the introduction to this series of articles I gave an overview of 12 things that can disrupt our sleep. These are:
- Waking to use the bathroom
- Blood sugar imbalance
- Elevated cortisol (this post)
- Weight gain
- Inflammation and pain
- Food sensitivities
- Imbalanced neurotransmitters
- Hormonal changes
- Low melatonin
Over the past few weeks, I have examined the first four reasons why sleep can be disrupted and given tips on how to address them. This week, as we enter the often stressful holiday season, it’s time to consider how an increase in your cortisol, the main stress hormone, can throw off your sleep cycle.
To help explain how cortisol becomes elevated and why it can disrupt your sleep, I’m going to share a few excerpts from my newly released ebook, called Stress Remedies, a companion guide to my book The Stress Remedy.
What should my cortisol levels be doing?
We don’t want our cortisol to be low all day long; just at night when we sleep. In the morning we want cortisol levels to be high, waking us up and giving us the energy to get through the day. Cortisol production should gradually decrease through the day, until it reaches its lowest levels late in the evening, when you are ready for bed.
However, if your cortisol levels do not decrease in the evening, because the stress response is triggered and doesn’t shut off cortisol production, it can lead to real issues.
EXCERPT FROM STRESS REMEDIES:
In a healthy body, the stress response turns on…and then off, allowing the relaxation response to take over. You work hard during the day, and then you rest in the evening. You gear up for a sudden challenge, and then you let go of the tension and return to a relaxed state.
In this balanced state, stress is tolerable, even enjoyable. At worst, life is full of manageable crises that are laid to rest at the end of each day. At best, life is full of exhilarating challenges that bring out your best, leaving you satisfied and fulfilled.
For many of us, though, the balance has tipped. We can begin to feel as though our stress response is permanently on, with not nearly enough relaxation to balance things out.
In this situation (when cortisol remains elevated), your body receives an energizing signal that makes it difficult to relax and nod off to dreamland. Instead, you are likely to find yourself buzzing around your home getting lots done until you start to realize that morning is growing nearer.
Sometimes you’ll be aware that you’re stressed and your cortisol is elevated, such as prior to a big event (weddings seem to really have this effect) or when you have lots to do (wrapping presents, anyone?). Other times, you might not be able to tell that your body is stressed, perhaps in response to a past stress or from a physical source of stress within your body (such as leaky gut or inflammation), and is simply not able to turn off the cortisol stress response. When our stress response is triggered too frequently, it is less able to turn off and is therefore more likely to get stuck in an imbalanced state.
It’s one thing to understand that a stress response and elevated cortisol could be keeping you awake, but I want to take it a step further. Here, in the next excerpt, is the key to understanding why elevated cortisol and disrupted sleep lead to a vicious cycle of sleep issues and health concerns.
Why is high cortisol such a problem?
EXCERPT FROM STRESS REMEDIES:
Cortisol is so tremendously important in our health and well-being that I consider it the “x factor” underlying just about every health problem we face. When our cortisol levels are optimal, we feel terrific. When our cortisol levels are off, we feel anxious and unsettled; fatigued and unmotivated; or, sometimes, both.
After all, stress is the primary condition of life. And cortisol is how we experience stress. Whether we feel exhilarated, thrilled, and energized, or listless, jumpy, and depressed, cortisol is likely at the root of our experience.
Cortisol has a profound effect on our entire biology. It affects our endocrine system, which produces all our hormones, including thyroid hormone (which regulates metabolism), insulin (which regulates blood sugar), and our sex hormones (estrogen, progesterone, and testosterone, which regulate sexual function, menstrual cycles, and menopause). Cortisol has a profound effect on our digestion and on our immune system. It also affects our neurotransmitters, the brain chemicals that determine energy, mood, mental clarity, focus, and sleep.
Cortisol cues our body to hold onto body fat, so it plays a huge role in weight gain. It is a major contributor to anxiety and depression. When our cortisol levels are optimal, we feel mentally sharp, clear, and motivated. When our cortisol levels are off, we tend to feel foggy, listless, and fatigued. Cortisol also affects our blood pressure and circulation; our lungs, muscles, and bones; and even our skin and hair.
As a practitioner, my first step in almost every situation is to measure my patient’s cortisol levels. Almost always, if someone is having health problems, their cortisol levels are out of balance. Until we can restore optimal cortisol levels, my patient’s health problems will continue. And when cortisol levels return to optimal, good health will surely follow.
You see, once cortisol is elevated, sleep deprivation is the least of your concerns because the more nights that go by with cortisol high instead of low, the more likely you are to develop digestive issues, hormone imbalances, mood changes, and/or issues related to your immune system (allergies, autoimmunity, infections, and/or cancer).
This is why keeping your cortisol on track is so important! And sleeping well is one way to know that your cortisol is likely to be at an optimal level.
Now if you are not sleeping well, and/or if you recently experienced a stressful time in your life that could have thrown off your healthy cortisol curve, then I encourage you to have your cortisol levels checked. Not just in a morning blood draw—which would only show your cortisol level at that time of day. We need to see at least four cortisol levels, starting from the morning, through mid-day, evening and bedtime. And if you are waking in the night, let’s check your cortisol then as well. The most effective way to do this is by collecting your saliva at each of these times. Then we can make a graph to show exactly what your cortisol is up to. Is it high in the morning and low at night? Spiking in the middle of the night and waking you up?
What can you do about it?
If you’d like to get started by having your cortisol levels tested, you can ask your naturopathic doctor to run the test for you (note that most medical doctors are not likely to order this test), or feel free to schedule a time to meet with me and I can take care of it for you. Then, when the results come in, you’ll find out if your cortisol needs to be addressed. Better to do the test than to guess, because that way you can be most efficient with choosing the right herbs and nutrients and the right time of day for you to take them.
I also want to remind you that cortisol affects your blood sugar levels, so when your cortisol is elevated, it makes it more likely that your blood sugar will be up too. We may need to address them both in order to get the best results. The same with food sensitivities; if you are sensitive to gluten, and still eating gluten, you are likely to trigger a cortisol response, and that elevated cortisol can disrupt your sleep as well as your digestion, furthering the vicious cycle of unwellness.
This excerpt describes four things you can do to help yourself whether your cortisol levels are imbalanced or not.
EXCERPT FROM STRESS REMEDIES:
There are several ways to ensure that stress plays a positive, energizing role in your life, rather than allowing it to become a source of ill health. One key way to prevent stress from derailing your health is to eat, drink, sleep, and exercise in the ways that best support your body:
Eat according to your physiology. A key aspect of minimizing the stress on your system is to eat in a way that fits your physiology. The least stressful and most supportive way to nourish yourself is to eat six small “half-meals” each day, with each small meal including the correct balance of proteins (40%-45%), carbs (40%-45%), and healthy fats (10%-20%).
Drink plenty of filtered water. To find the amount you need, divide your body weight in half. That’s how many ounces of water you need to drink throughout the day, even if you don’t “feel thirsty,” and you need even more if you are drinking caffeinated beverages, if you are engaged in vigorous physical activity, or if you are in a hot climate. Your thirst monitors don’t really reflect your body’s need for water, yet when your body becomes even slightly dehydrated, your stress response begins.
Get 7.5-9 hours of refreshing sleep each night. We all need sleep—and we need it even more if our waking hours have been full of stressful challenges. Even when we experience these challenges as positive—a new romantic interest, an exciting project at work, a vacation full of thrilling adventures—our body needs time to relax and recover from the demands of the day.
Exercise at least 15 minutes a day, three to five days a week. Your body was born to move, and when it doesn’t get that opportunity, you will find it very difficult to maintain optimal health. Of course, exercise itself is a form of stress—a physical challenge to your body—but paradoxically, it also helps to release stress. A number of studies have shown that regular exercise is associated with decreased anxiety and depression, as well as heart disease, diabetes, and cancer.
One of the best things you can do for your health and well-being is to rebalance your stress response and cortisol levels. That is because an optimal cortisol level means you’ll probably sleep better. As we’ve learned so far in this series about sleep, getting 7.5 to 9 hours of shut-eye each night makes a world of difference in terms of preventing heart disease, cancer, and diabetes.
Let’s get this turned around for you! The more you understand about how your body responds, the better. These are the tools that I find help patients recover and get back to sleeping. You might begin by downloading my new ebook at Kindle – Stress Remedies: How Your Can Reduce Your Stress and Boost Your Health in Just 15 Minutes a Day—it’s only 99 cents and includes a quick and easy quiz to help you get to understand how your body has been affected by stress. It also includes a whole section on activities you can choose—cost-free, supplement-free things you can do—to rebalance your cortisol and stress response. Those are the “stress remedies” the book is named after – read all about them in the ebook and choose the ones that work best in your life.
Or, for all the details about what I recommend, from which foods to eat and not eat, to how to exercise and decrease exposure to toxins, you can get your hands on a copy of my 340-page book, The Stress Remedy. It includes a 3-week menu plan, recipes, and resources to help you successfully manage stress.
Next time, we’ll be talking about how weight gain can affect your sleep. If you’d like to learn more, please be sure to either subscribe to my blog or sign up to receive my newsletter below. Please share your thoughts and questions about cortisol levels and sleep in the comments box below.
11th December 2014
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