Tag Archives: cortisol

Natural Approaches for Insomnia

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One of the most common problems my patients report is difficulty with sleep. Whether they have trouble getting to sleep, staying asleep, or waking frequently, not getting the rest our bodies need is frustrating and significantly impacts the severity of other ailments. Poor sleep or insufficient is linked to weight gain, cardiovascular disease, decreased immunity and poor healing. The reasons for insomnia are varied, so natural treatments need to address whatever it is that is out of balance. When thinking about insomnia, we have to make sure that three different systems are ready for sleep; the hormones, the nervous system, and the muscles. Having good bedtime habits such as stopping screen time one hour before bed, stretching, yoga, or meditation before bed, and a cup of herbal tea are all great first steps, but if sleep remains a problem, the primary places I look to regain balance are Hormones, Neurotransmitters, Blood sugar, Muscle tension, and pain. Here is how I approach this issue:
Hormones
In my practice, the most common reason I see for persistent insomnia is an imbalance in the hormones. There are several hormones that can be out of balance that will contribute to poor sleep. Often we will have to test to see which of these is the culprit:
Estrogen/Progesterone: Especially after childbirth and during menopause, when these reproductive hormones are not produced in balance with each other, sleep can be effected. Most commonly, this imbalance is accompanied by hot flashes and night sweats.
Thyroid: When thyroid function gets too low or too high it can impact the sleep. If thyroid levels are too high, often there are heart palpitations or agitation along with the insomnia. When thyroid is too low, people often will wake feeling insufficiently rested no matter how long they have slept.
Cortisol: This is our primary hormone that tells us we are awake. It is a stress hormone that helps the body to mobilize blood sugar for fight or flight situations (aka, so we can run from a bear). If we have too much stress over a prolonged period of time, though, the body will sometimes start making cortisol in the middle of the night–when this is the culprit people often will wake at 3-4am and won’t be able to go back to sleep.
Neurotransmitters
Neurotransmitters are amino-acid based chemicals produced by our nervous system that tell our brain and nerves how we feel–sleepy, awake, excited,happy, sad, etc. The three neurotransmitters that are most associated with deep, relaxing sleep are melatonin, serotonin, and GABA. GABA is derived from the amino acids glutamine or glutamate, and serotonin and melatonin are made from tryptophan. For people who are experiencing persistent or severe sleep difficulties, we can test to see what your levels are and if the more excitatory neurotransmitters are too high to allow your brain to calm down. Many of our best natural sleep aids are made from these neurotransmitters or contain precursors to them.

Blood Sugar
This category is directly related to the discussion on cortisol, above. For people who have difficulty keeping their blood sugar stable (either from hypoglycemia, metabolic syndrome, or diabetes), and especially for people who do not eat regularly, eat dinner very early, or eat sweets after dinner, this can impact sleep. For instance, if you eat dinner at 6pm, by 3am it has been 9 hours since you last ate. Although cortisol is primarily a stress hormone, its other function is to mobilize glucose from storage when the blood sugar gets too low. When cortisol spikes at 3am, then the brain wakes up and it becomes difficult to go back to sleep. In this case, a light protein snack right before bed such as an apple with peanut butter will greatly improve sleep.

Muscle tension and Pain
For people with chronic pain, it isn’t sleep itself that is the problem, but the pain that keeps them up. If there is chronic pain we have to get to the root of it and fix this issue. Often, however, there can be muscle tension that causes pain or headaches and leads to poor sleep. Tight muscles also may just keep the body so tense that sleep is difficult regardless of pain. The simplest options for helping the muscles relax before bed are stretching, deep breathing, hot baths and hydrating during the day (not so it keeps you up having to use the restroom). Other very effective options are taking some minerals such as Calcium or magnesium or drinking coconut water which is high in potassium before bed.

Insomnia can be a brief, transitory concern that is related to a specific event or a problem that can last many years. Persistent insomnia can lead to or exacerbate a host of other health concerns. By narrowing down the causes, we can individualize a plan to help put you back to sleep!

Cortisol, Blood Sugar, and Adrenal Health

One of the primary goals for our seasonal eating during the winter is to keep the blood sugar balanced. Especially during the winter months, it is crucial to work on preserving and increasing the health of the adrenals; controlling blood sugar is one very important way to do this.
During this time of the year, because we are not getting much energy from the sun and fresh foods, we must rely more heavily on our body’s own methods of energy production from the hormone, or endocrine system. One of the primary organs we want to support during this time are the adrenal glands, as they are responsible for producing many of the hormones that help us feel energetic.

The hormone we associate most with our ability to feel “awake” is cortisol. Cortisol is a sugar-mobilizing hormone we produce for two primary reasons: as a response to stress and when our blood sugar drops too low. Historically, stress for humans has meant “fight or flight” or as I like to put it “I have to run from the bear.” During stress, our body makes adrenaline which helps prepare us for running: our heart pumps faster and lungs open wide to help provide more blood to our brain and muscles. At the same time we are producing adrenaline, we also produce cortisol, which mobilizes sugar from storage so the brain and muscles can work extra hard, run fast, and climb that tree.

When blood sugar drops low and we start to feel fatigued and foggy, our body will also make cortisol so we can boost the blood sugar and feel clear and awake again. A diet high in refined starch and sugars has the tendency to spike blood sugar. When the blood sugar spikes, the pancreas will produce a lot of insulin which will put that sugar into our cells very quickly, which in turn will drop the blood sugar very low. Some of us know this feeling of hypoglycemia which can produce groggyness, crankiness, headache, and a desire to nap. When the body becomes hypoglycemic, the adrenals will produce cortisol to try to manage the low blood sugar.

The problem with this pattern is that, over time, the adrenals can become accustomed to producing more cortisol than is healthy for them. The combination of a stressful lifestyle and chronic hypoglycemia can fatigue the adrenals which compromises their ability to function properly. This can lead to insomnia, weight gain, extreme fatigue, and can even contribute to heart disease.

The wintertime is the ideal time to replenish our adrenals. The dark, cold weather helps us to bring our focus inward and take the time to rejuvenate our own sources of energy production. The simplest ways to do this are adequate sleep, managing stress properly, and keeping the blood sugar well regulated. The rules of keeping the blood sugar stable are:regular meals, avoiding refined starches and sugars, and focusing more on eating proteins, high fiber, and fats.