Stress and Insomnia (aka 3am hell!)

Compared with good sleepers, people with insomnia secrete more cortisol in the evening before bedtime and in the first half of their sleep; they also have more fast brain-wave activity in non-rapid eye movement (NREM) sleep, both indicators of arousal. Stress is the principal cause of the insomnia that plagues so many millions of Americans.

How does stress cause insomnia? To understand that, we must first know a little bit about the physical processes that occur when we fall asleep. Falling asleep is a natural process that involves a distinct sequence of events in the body. As we approach sleep, there is a gradual lowering of metabolism. Our heart rate slows and our blood pressure declines. Our breathing becomes more regular, and we consume less oxygen. At the same time, there are changes in the processing activity of the brain. The activity of neurons in the cerebral cortex becomes first slower, and then more synchronized, indicating a shift away from the complex, activated patterns of waking consciousness and toward a homogenous, deactivated state. As a result, we cease to process the sensory messages coming in from the outside world, and we slip into quiet sleep.

The adrenal hormone cortisol is a trigger of the stress response. That's not cortisol's only job, however. In addition to the sharp transitory peaks of cortisol secretion that characterize the stress response, there is also a daily, cyclical rise and fall of cortisol levels that govern our level of wakefulness throughout the day and night. Cortisol is excitatory; it arouses us and wakes us up. Blood levels of cortisol have been shown to increase between 50 and 160 percent within thirty minutes of waking; that produces the powerful jolt of arousal needed to wake us up and get us moving in the morning. Then, cortisol levels should decline as the day wears on and reach their lowest point in the evening, allowing us to rest, relax, and sleep.

But, as we know, cortisol levels can also be affected by the conditions of our daily existence. Dangerous, demanding, or threatening events--stressors--cause us to temporarily secrete higher levels of cortisol. That's a good thing, because we need to be aroused in order to answer the challenges that arise in the course of our lives. But when, as a result of prolonged or unremitting stress, whether real or perceived, our cortisol levels get stuck at a chronically higher level, that's bad news for our bodies and minds, and especially bad news for our ability to sleep and rest. Chronic over-secretion of cortisol leaves us chronically hyperaroused. Numerous studies indicate that insomnia is accompanied by excessive activation of the stress-response system not only during waking hours but during sleep as well. Furthermore, chronically elevated levels of cortisol and its precursor, adrenocorticotropic hormone (ACTH), can make sleep shallow, fragmented, and unrestful; delay the onset of sleep; and produce more frequent nocturnal awakenings.

Stress is the principal cause of insomnia. Stress hormones are excitatory. When stress becomes chronic, we become chronically excited, or hyperaroused. When we're chronically hyperaroused, we can't sleep, and the sleep we do get is not as restful.

Your Car Can't Run Without Gas and Neither Can You

A simple sugar called glucose is the primary fuel for every cell in your body. Carbohydrates that you eat break down into glucose that is then delivered to all of your cells via the blood stream. Without adequate levels of glucose in your blood your cells can not perform their functions normally. Your brain, although only about 1-2% of your body mass, uses about 25% of available glucose. Not surprisingly, many symptoms of hypoglycemia (lower than normal blood sugar) are your brain telling your body that it is in desperate need of glucose such as: craving sweets, mood swings, migraine headaches, dizziness, irritability, shaking, being jittery, blurred vision, agitation, light-headedness, and forgetfulness.  It is my clinical experience that hypoglycemia is an underlying mechanism in over 50% of cases of migraine headaches.

Functional hypoglycemia has reached epidemic proportions in this county in the past two decades due primarily to, what I like to call, the SAD SAL—the Standard American Diet, consisting of ever increasing amounts of refined carbohydrates (soda, sugary snacks, breakfast cereals, many coffee drinks) and the Standard American Lifestyle of skipping breakfast, grabbing unhealthy food on the run, high amounts of caffeine, too much alcohol, high stress and not enough sleep.

Hypoglycemia also has devastating effects on the gastrointestinal system, typically by causing low stomach acid and therefore poor digestion, and on the entire endocrine system—all of the glands in your body such as the pituitary, thyroid, gonads, and adrenal glands, that regulate many bodily functions. Many hypoglycemics have significantly suppressed adrenal function leading to symptoms of: sleep disturbance/insomnia, morning sluggishness  afternoon fatigue, dizziness when standing up quickly, salt cravings and weak nails.

Supporting Hypoglycemia--What You Can Do

Diet & Lifestyle

There are many books and websites with information about hypoglycemia. These supportive recommendations are by no means exhaustive, but are a concise summary of necessary diet and lifestyle changes to support hypoglycemia.

1. You must have breakfast every morning within 30-45 minutes of waking. Breakfast must not be heavy on carbohydrates and have both a good fat and protein source. Breakfast could look something like one or two hard boiled eggs and some low-fat yogurt or a protein shake blended with almond milk and some fruit.
2. You must have a small snack 2 to 2 ½ hours after breakfast and after lunch. Your snack should be fat amd protein based such as a small handful of raw almonds, cashews or sunflower seeds or a stalk of celery with some almond butter.
3. Lunch and dinner should include fiber, veggies, and a lean protein. A mixed green salad with steamed veggies and a piece of grilled chicken, fish or lean red meat would be a good option.
4. You need to establish routines around meals and snacks so that none are ever missed or pushed back an hour or two. Appropriate snacks like trail mix, nuts, seeds or well balanced protein bars must be kept handy in your vehicle and at work.
5. You must establish good bedtime and wake-up routines. Go to bed and, most importantly, get up at the same time every day. Get at least 6 ½ hours of sleep nightly.

Supplementation

To support all of physiological mechanisms associated with hypoglycemia we suggest supplementing with a broad spectrum of vitamins, minerals, and glandulars to improve nutritive and biological conditions and support healthy blood sugar levels. Antioxidants are also important to support cells during high oxidative stress especially when caused by oxidized blood glucose. Key factors include: thiamin, riboflavin, niacin, B6, Folate, B12, and pantothenate, manganese, chromium, inositol, and l-carnitine, omega-3 fatty acids, and adaptogenic herbs. I often recommend two products from Apex Energetics called Proglyco-SP and Adaptocrine to support functional hypoglycemia both of which have produced outstanding results.  A high quality omega-3 supplement containing EPA and DHA is also of great benefit.  

To find out if hypoglycemia is an underlying cause of your dis-ease, fill-out the free survey at www.helpmebewell.com. Help Me Be Well will give you a thorough, free report about your potential health pitfalls.

Fuel your system well.

Yours in Health,

Dr. James Turnbull D.C., C.C.S.T., F.I.A.M.A.

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