One of the most common complaints brought to health care practitioners these days is insomnia.
What Factors Contribute to Insomnia?
Not getting to sleep or not staying asleep throughout the night – or both, can interfere with your ability to manage your health—and your life! It can contribute to memory loss/dementia, higher blood sugars (leading to Type II diabetes), fatigue, inflammation and increased obesity.,
In seeking solutions to insomnia, we often find a common cause—an adrenal hormone called cortisol that rises when we feel stressed.
Cortisol and Insomnia
Cortisol is normally released in a circadian rhythm throughout the day, with highest levels in the morning and lowest levels at around midnight.
During stressful times, cortisol rises higher and may not drop when it should toward the end of the day. Your HPA axis (your Hypothalamus-Pituitary-Adrenal system) is turned on. This activation increases heart rate and blood pressure, releases energy stores, and sharpens the senses.
All of these functions are imperative during times of danger to initiate the “fight or flight” response.
Today, however, we are often exposed to too much chronic stress – the unrelenting kind. Day in and day out, we often meet multiple stressors. The adrenal glands are forced to be always on alert – constantly producing extra cortisol to meet those stressors. This can severely interfere with sleep.
Night Owl? Early Riser?
If cortisol does not fall, as it should, in the evening, you become a night owl. Sleep eludes you and you sit at the computer till the wee hours of the night. Or maybe cortisol falls properly in the evening but rises too early in the morning, awakening you at 3:00 or 4:00 a.m. Your mind kicks in and gets busy planning your day or worrying over some issue. You lose sleep.
If the cortisol level is high during the night, you will have disrupted rapid eye movement (REM) sleep and will wake up non-refreshed, no matter how many hours of sleep you appear to have. REM-disrupted sleep may be one of the reasons that some individuals can have a full eight hours or more of rest and but still wake up exhausted.
Cortisol Levels and Food Intake (Glycemic Index)
According to Dr. Pauline Harding, MD, cortisol levels are also rapidly responsive to our food intake during the day.
She explains that the glycemic index of a meal affects the cortisol level for approximately five hours. Worse than having a high glycemic meal is having no meal at all. Any time during the day that one does not eat within five hours of the previous meal or snack, the cortisol level tends to rise. A rise above the normal range during the day almost guarantees that the nighttime cortisol will be high and thus disrupt REM sleep.
The bottom line here is to minimize your carbohydrate intake, avoid high-glycemic carbs altogether and eat 3 meals a day which all include a good protein food (best is animal-source protein) at each meal. This sort of eating will stabilize blood sugar and help minimize cortisol excess.
Salivary Adrenal Testing for Cortisol
To evaluate a patient’s cortisol levels, salivary adrenal testing is useful.
NeuroLab’s AH profile (which also included in HPA profile) consists of 4 cortisol readings and 2 of DHEA, spread over the day.
Salivary testing has been shown to accurately correlate with plasma levels of free cortisol and free DHEA. If you know where your cortisol levels are imbalanced, you can then intervene to balance them out – restoring healthy sleep.
Other Natural and Lifestyle Remedies for Regulating Cortisol Production
Meanwhile, for night-owls, you can experiment with timed-release melatonin or phosphorylated serine after dinner to help you get to sleep and stay asleep. Use L-theanine to calm the mind, and institute stress-reduction practices such as exercise earlier in the day and meditation later. Sleeping deeply for 7 – 9 hours can restore everything about you – enhancing your life experience and making you smile!
 McEwen BS. (2006). Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and allostatic load. Metabolism. Oct;55(10 Suppl 2):S20-3.
 McEwen BS, Karatsoreos IN. (2015). Sleep Deprivation and Circadian Disruption: Stress, Allostasis, and Allostatic Load. Sleep Med Clin. Mar;10(1):1-10. doi: 10.1016/j.jsmc.2014.11.007.
 Gemignani A, Piarulli A, Menicucci D, et al. (2014). How stressful are 105 days of isolation? Sleep EEG patterns and tonic cortisol in healthy volunteers simulating manned flight to Mars. Int J Psychophysiol. Aug;93(2):211-9.
 Harding Pauline. (2005). Eat your Way to Better Sleep. Nutrition Digest, 38:1. Retrieved from http://americannutritionassociation.org/newsletter/eat-your-way-better-sleep
[starbox id = “Ramona Richard NC MS”]