No one wants to be the Christmas Grinch!

Written December 2016 by Phoebe Wynne-Lewis, BHSc, Dip Nat Med, Dip Herb Med – FxMed Technical Support

Avoid the Festive Fallout by Reducing Stress & Getting Enough Sleep.

Christmas is that special time of year where we get to eat plenty of delicious food, enjoy spending time with relatives, (or pretend to), go Christmas caroling, watch the children dress up like turkeys and pilgrims at their school plays, put up the Christmas tree, clean the house, do this, do that, do those other things, go to office parties, do more, go present shopping, do more, more, more….Heeeeelp!!

With all that we need to accomplish in preparation for the Festive Season, it’s no wonder that our stress levels soar and we become sleep deprived leading up to Christmas and New Year. Those lines from “Twas the Night before Christmas” about children being nestled snug in bed dreaming about candy and how nothing in the house was stirring (including the mice in the roof) are very misleading. Maybe the children and mice are getting plenty of sleep, but most adults are running themselves ragged, trying to cram so much holiday cheer into each day that they often don’t get a full nights sleep, causing them to be less Christmas cheery and more Christmas grinchy!

HPA Axis — Stress & Sleep

The Hypothalamic-Pituitary-Adrenal axis (HPA axis) is a complex set of direct influences and feedback interactions among three endocrine glands: the hypothalamus, the pituitary gland and the adrenal glands. These organs and their interactions constitute the HPA axis, a major neuroendocrine system that controls reactions to stress and regulates many body processes.

In response to stress, the hypothalamus secretes Corticotropin-Releasing Hormone (CRH) that then stimulates the pituitary gland to secrete Adrenocorticotropic Hormone (ACTH). ACTH then reaches the adrenal cortex and cortisol is synthesized and secreted into the bloodstream. Cortisol acts as both mediator and inhibitor of the stress response. The HPA axis is under negative feedback control from cortisol. Cortisol then is the primary regulator of the HPA axis with negative feedback on ACTH and CRH, exerting its control on both the hypothalamus and the pituitary gland. Under prolonged stress the HPA axis no longer responds to this negative feedback. This prolonged stress response can then cause continuous cortisol synthesis and chronically elevated cortisol levels are linked to many disorders including insomnia.

The initiation of sleep occurs concurrently with a low HPA axis activation. Therefore HPA axis hyperactivity can lead to fragmentation of sleep, decreased slow-wave sleep and a shortened sleep time. While a dysfunction of the HPA axis can play a role in some sleep disorders, in other cases, the HPA axis dysfunction may be a result of a sleep disorder, as with obstructive sleep apnea and insomnia, worsening the cycle.

In summary, HPA axis hyperactivity can have a negative impact on sleep. In turn, sleep problems including insomnia and obstructive sleep apnea can worsen HPA axis dysfunction.

Interventions to normalize HPA axis abnormalities, decrease nocturnal CRH hyperactivity and decrease cortisol may be beneficial in treating insomnia and other sleep disorders.

Adrenal Function in Sleep Patterns

Stress and adrenal function affect sleep, particularly the circadian pattern of cortisol secretion by the adrenal glands. Circulating cortisol normally rises and falls throughout the 24-hour daily cycle, and is typically highest at around 8 AM and lowest between midnight and 4 AM. Both high and low night time cortisol levels can interrupt sound sleep. The surge in adrenal hormones adrenaline and cortisol, released by stress makes it more difficult to relax into sound sleep – especially when they remain high or rise and fall irregularly through the night. Frequent or constant stress can chronically elevate these hormone levels, resulting in a hyper-vigilant state incompatible with restful sleep. If this is the reason for poor sleep, anything that reduces stress and enhances the ability to handle stress may improve sleep. This can include relaxation, yoga, breathing and/or meditation techniques. Refraining from vigorous exercise in the evening and taking time to consciously relax before going to bed may calm the adrenals and help lower cortisol and adrenaline levels.

An abnormally flattened circadian cortisol cycle has been linked with insomnia, and may lead to another possible source of night time sleep disruption – low blood sugar. Cortisol plays an important role in maintaining blood glucose levels around the clock. Although blood glucose is normally low by the early morning hours, low cortisol levels may not be sufficient to adequately sustain blood glucose. Low glucose signals an internal alarm (glucose is the main fuel for all cells, including brain cells) that disrupts sleep so the person can wake up and refuel. Low night time blood glucose can also result from inadequate glycogen reserves in the liver. Cortisol causes these reserves to be broken down into glucose that is then available to the cells. When low cortisol and low glycogen reserves coincide, blood glucose will most likely drop, disrupting sleep. Waking between 1–3 AM may indicate low blood sugar resulting from inadequate glycogen reserves in the liver, HPA Axis dysregulation and/or disrupted cortisol rhythm. This is often the culprit when panic or anxiety attacks, nightmares or fitful, restless sleep occur between 1 and 4 AM. If low blood sugar is disrupting sound sleep, supporting healthy cortisol adrenal function via the HPA Axis may contribute long term to sound sleep. Also having a healthy snack before bed can help fortify the body’s night time energy reserves.

Therapeutic Strategies

There’s no reason to let the holidays rob you of that deep slumber you not only crave, but need to
make it through the Festive Season.

  • Take a relaxing bath.
  • Listen to some soothing music.
  • Meditation – some forms have been proven to lower cortisol levels.
  • Try Acupuncture or Acupressure.
  • Take relaxation breaks during the day.
  • Avoid bright screens leading up to bed time.
  • Don’t work or study in bed.
  • Avoid eating late at night.
  • Breathe deeply – using the diaphragm and breathing deeply activates the vagus nerve, helping to
    override the stress response.
  • Smile and laugh throughout the day – this will also actively change our biochemistry and calm down
    the production of stress hormones.