Wired & Tired: Impacts of Chronic Stress on Sleep

Sleep is critical for health. A solid stretch of sleep helps the brain commit new info to memory, influences how the body processes and stores carbs, alters levels of hormones that affect appetite, and makes us less prone to mistakes and falls. Regular solid sleep is needed for healthy cardiovascular and immune function including blood pressure and heart rate regulation and NK cell activity. (NK or natural killer cells are best known for killing virally infected cells, and detecting and controlling early signs of cancer!)

In my clinic we talk a lot about sleep because sleeplessness and insomnia show up differently. Triggers and causes of sleepless nights vary from person to person - and while some are situational, others are deeply ingrained. In our constant go-go-go culture, especially here in the TriState area where we are so close to the "city that never sleeps" it is not unusual for many of us to sacrifice and skimp on sleep. The motto "sleep when you're dead" is dead wrong - but even when we recognize the need we have for deeper, better, or more consistent sleep - many of us struggle to get there. 

The top causes of insomnia I see in clinical practice are:
1. Cortisol Excess
2. Serotonin/Melatonin Deficiency
3. GABA Exhaustion

A number of things can raise nighttime levels of the hormone cortisol temporarily: alcohol or caffeine use, an argument with a spouse, and evening exercise among them.  Chronic stress, the type that is due to such things as long-standing pain, trauma, or financial, legal, or relationship problems, can lead to a permanent hypercortisol state — even long after the precipitating events have resolved. When a hypercortisol state occurs at night, when cortisol levels should be at their lowest, the type of insomnia that develops is typically an alert “ready to work” one or an agitated and hyper-vigilant state. One might also experience sudden night time awakenings associated with startled sensations and a racing heart, as if waking from a nightmare.

Because, chronically elevated cortisol suppresses serotonin and exhausts GABA, there is cross over into other types of insomnia. 

For those that struggle to fall asleep, a subnormal level of serotonin may be to blame. Serotonin is converted into melatonin inside the brain (specifically the pineal gland inside the brain). If there is not enough serotonin (or too much blue light - more on this at a later date), the result is lower than normal levels of melatonin. This equates to difficulty falling asleep, and for some additional difficulty staying asleep. This is the insomnia of the worried mind, the one that is filled with what-ifs and loops of thought.

Do you have difficulty winding down at night and feel like you are unable to relax? Do you carry all your stress in your neck, shoulders, or back? Do you have panic attacks? Gamma amino butyric acid is one of the brainʼs primary inhibitory (i.e. calming) neurotransmitters, and neutralizing adrenaline is its primary function. If feelings of overwhelm, muscle tension and/or panic are leaving you restless and unable to sleep low levels of GABA may be behind it all.

So what do we do about it? Everyone has that friend or relative that touts a melatonin supplement as a gift from the gods - but you tried it (and tried it again) and still NOTHING. Some of us turn to other over the counter products like anti-histamines which might do the trick knocking us out but at what cost? (Read more here: Antihistamine Use & the Development of Dementia) Hypnotic medications and benzodiazepines come with the very real and devastating risks of addiction and cognitive impairment (read more here). 

Naturopathic medicine reaches far beyond just another pill for your ill - i.e. in clinical practice I don't just replace your over the counter sleep med with a "healthy and more natural" dose of melatonin. If that was the case, my job would be a piece of cake. Instead what I do as a naturopathic physician is work with you to identify your unique triggers and personalize solutions to YOU. While there may be a few general guidelines, there is no protocol, no one-size-fits-all approach. Sleep deprivation is no joke. The human brain is a mighty organ, but even it too needs time to close the door and shut off the lights. 

Wondering how naturopathic medicine can help you sleep better? Schedule a visit with Dr. Kellyn Misset at Clarity Integrative Medicine to get started on the path to consistent, solid, restful sleep.