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Patients with Adrenal Fatigue are a cut above the rest. By way of more than 300,000 patient interactions, we at Clymer have learned a great deal about our patients with Adrenal Fatigue. My patients have educated themselves about their health challenges. You probably have, too. That’s why you’ve landed on this page.
There is an inextricable connection between insomnia and Adrenal Fatigue. Quite often, well-meaning doctors treat the symptom of insomnia and sleep disturbance without addressing the underlying cause. They prescribe sleep aids and anxiety meds without assessing the adrenal function.
#1 I know what you’re going through.
I have endured my own personal battle with Adrenal Fatigue.
I’ve been there, and it’s what brought me here. Like all of my patients, I suffered from many symptoms of Adrenal Fatigue, both in college and before. In the early evening, I was exhausted, and then I was wide awake by 10 p.m. If I did manage to fall asleep, then I woke several times at night … sometimes to stare at the ceiling until I had to get up for class.
I had always found myself drawn to the study of natural medicine, and I decided to switch majors from finance to that of Naturopathic Medicine. I went on to study at Bastyr University School of Naturopath Medicine, and it was only by chance that I discovered my insomnia and sleep disturbance were symptoms of something bigger. I happened upon a book, Chronic Fatigue Unmasked, and it opened my eyes.
I had Adrenal Fatigue.
All my symptoms were there: profound fatigue, insomnia, gastrointestinal issues, chronic illness. The list went on.
From that discovery, I graduated from Bastyr and made my way to Clymer Healing Center. I sought out Dr. Gerald Poesnecker, the author of Chronic Fatigue Unmasked and a pioneer in the field of Adrenal Dysfunction. He became my mentor as I completed my residence with him. After his passing, I refined and built upon Dr. Poesnecker’ s proven methods.
In the video at the bottom of this article, I share my journey with Adrenal Fatigue … and ridding myself of insomnia for good.
#2 Can you relate?
- “I get tired too early in the evening.”
- “As soon as I try to go to sleep, I’m wide awake for hours.”
- “If I do get to sleep, I never feel like I’ve slept. I am never refreshed in the morning.”
- “I can barely function at all in the morning, but I perk up in the evening and feel better. At night, I can do work, I can actually think.”
- “I can usually fall asleep okay, but I wake up like clockwork every few hours.”
- “A couple of hours after I go to sleep, I’ll wake up. I’ll feel both exhausted and wide awake as if I’ve had three cups of coffee.”
These are comments I hear on a daily basis in my practice treating Adrenal Fatigue. Any sound familiar?
Insomnia is a hallmark of an overworked stress response and Adrenal Fatigue.
Whether it is difficulty falling asleep, difficulty staying asleep, circadian rhythm imbalance, or simply a lack of deep sleep, it’s all insomnia. And it’s all related to Adrenal Fatigue.
It is rare for me to have a patient with Adrenal Fatigue that sleeps well. As you would expect, this is a hindrance to recovery.
To understand how to fix the sleep issues for those with Adrenal Fatigue, it helps first to know why sleep is important in the first place and what “normal” sleep is.
# 3 The surprising power of sleep
Sleep is vital to optimal health and well-being, but strangely enough, despite much research, we’re still not sure why. Sounds strange, doesn’t it?
Much of the research out there points toward sleep establishing metabolic homeostasis (balance). This homeostasis can be summed in three functions: recovery, regeneration, and realignment. During sleep (more precisely, deep or slow wave sleep) our body does all of its metabolic maintenance. It heals from the activities of the prior day. Sleep is essential.
Now imagine that a person is under chronic stress, perpetually running from a proverbial tiger, putting increased demands on their metabolism. The need for sleep is even more profound in these people!
Add to this that those with Adrenal Fatigue have numerous biochemical and behavioral reasons that decrease sleep quality. The primary one is elevated cortisol in the evening. You can see how a vicious cycle of dysfunction will occur.
Insomnia develops out of Adrenal Fatigue then exacerbates the dysfunction because our repair processes are compromised. The subsequent lack of repair further depletes our system, worsens the adrenal issues, and hence worsens the sleep. It’s cyclical, and the cycle must be broken by healing the adrenals.
#4 How cortisol throws your circadian rhythm off beat
Our normal circadian rhythm (daily energy) is ultimately defined by the levels of the adrenal hormone cortisol. Cortisol levels are defined by the hypothalamus and pituitary glands in the brain that are components of the H-P-A axis (aka your stress response).
Normally, cortisol levels should rise in the early morning, giving us the energy to wake and tackle our day. Cortisol levels will then gradually decline throughout the day, ending at their lowest levels late in the evening when we’re ready to ease into bed, go to sleep, and recover.
This is how our circadian rhythm should work.
When there is an imbalance in cortisol levels, as there is in Adrenal Fatigue, our circadian rhythm shifts so that we have daytime cortisol levels at night and nighttime cortisol levels during the day. This is what contributes to the pattern of sluggish morning energy and the excessive evening energy.
#5 The sleep cycle uncovered
The brain never actually “sleeps” or shuts down. It’s active throughout the night.
Normal sleep occurs in cycles of approximately 90 minutes. Most of us go through four to five of these cycles per night. We drop into sleep, passing through sleep cycles one through four, during which our brain-wave patterns change.
The first phase of sleep is the deepest, and each subsequent 90-minute phase (45 minutes down and 45 minutes up) is not quite as deep. The phase of sleep in which we dream is called REM or “rapid eye movement” sleep.
Many people think that if they dream at night, they must be sleeping deeply; however, this is not necessarily the case. REM sleep occurs during stage-one sleep—or light sleep—and this is the phase we pass through on our way down into deeper stages of sleep. Since we go through four to five phases of the sleep cycle, we will enter into four to five episodes of REM sleep during a typical night.
It is these phases and brain-wave patterns that encourage various healing processes in the body, including the release of repair hormones, especially growth hormone.
#6 Nightowl vs. early bird
Many experts feel (myself included)–and research supports the idea–that the time of night in which the first phase of sleep occurs is important. This may be a result of optimal melatonin secretion, growth-hormone production, or the result of some not yet discovered process.
We do know that only one-third of sleep-related genes are triggered during daytime sleep versus those of nighttime sleep. This research suggests that daytime sleep is not as efficient for our bodies as is nighttime sleep and possibly explains the many health problems that shift workers (nurses, firefighters, police, cleaning services) experience.
Research suggests that the first phase of sleep should occur before 11 p.m. and as close to 9 to10 p.m. as possible.
After working with thousands of patients, I am well aware of the challenges, frustration, and even disbelief that this causes in patients.
“But I’m just a night owl.”
“I’ve been this way since I was a kid.”
“But nighttime is the only time I can function, the only time I can think and get anything done.”
You may think you’re a night owl, but I assure you, your body doesn’t want to play by those rules. It simply does not function that way properly.
#7 Obey the laws of nature
Naturopathic philosophy tells us that all humans come from and are strongly connected to Mother Nature and the earth. As such, like it or not, we are inherently tethered to the cycles of the sun and the moon. This means that many thousands of years ago we were designed to rise when the sun rises and to sleep when the sun sets.
While some animal species are truly nocturnal, humans are not one of them!
If we were to ignore the law of gravity by leaping off a cliff, for instance, the detrimental results become apparent very quickly. When we defy the law of our sleep-wake cycle, it takes longer to demonstrate the devastating consequences, but the consequences will prevail.
We have many ways of cheating this indelible law of nature; blame it on Edison, Tesla, Franklin, Facebook, you name it. Just think about the technological advances in the past 100 years alone. Although technological change has progressed quickly, our bodies take far longer to evolve. We have not yet adapted to the technological change that allows us to defy the law of our sleep-wake cycle.
I realize that this is a tough pill to swallow for most of us. Ultimately, however, the more thoroughly we accept this and the more quickly we move in the direction of obeying this law, the healthier we all will be.
#8 Don’t get caught in the vicious circle
Studies show that one can even induce syndromes such as Fibromyalgia and Chronic Fatigue Syndrome (each has Adrenal Fatigue at its core) by disrupting the sleep cycle over time.
Despite the studies, the question still arises: Is the lack of sleep causing the symptoms and Adrenal Fatigue or is the Adrenal Fatigue causing the lack of sleep? The answer to this “chicken or the egg” question is … both.
Yes, we must address both. In the majority of cases, it is the chronic stress, which overloads the adrenal stress capacity, that leads to the reduced sleep quality first. This then sets people up for a downward spiral of stress, causing sleep deprivation, reducing tolerance to stress, leading to more stress, causing more sleep deprivation, and so on.
The only way to conquer this is to heal the Adrenal Fatigue first.
#9 Has your bucket runneth over?
I use a metaphor to help my patients understand Adrenal Fatigue.
Our genetic capacity for stress is developed at conception and shaped throughout life, half from mom, half from dad. In utero, our adrenals get an idea of how stressful the outside world is through a shared circulation between mom and baby.
Each of us comes into the world with a certain sized “bucket,” which represents our tolerance for stress, any stress. Each of us has only one bucket old all kinds of stress; there is no separation of various stressors from one another.
Whether it be an injury, a chemical toxin, an annoying text message from your brother, or fear of debt, all stressors go into the same bucket, although some may be weighted more than others.
Your bucket–large or small–holds everything! Until it can’t.
By design, this bucket was meant for extreme, acute stressors, such as a plague, famine, or a predator. If a tiger were to lunge at you, your bucket would immediately and completely fill with “stress.”
If you lived through the experience with the tiger, then your bucket would empty again and be ready for the next time.
The problem with living in our present society is that we now use our stress response bucket quite differently from its designed purpose.
Chronic, low-level stress comprises our world. We no longer have to fear for our safety from predators, no longer have to worry about starvation (most of us at least), and no longer deal with deadly plagues. However, we do fill our bucket with multiple chronic, perpetual stressors.
The list of chronic stressors is long and ever-changing, and you likely know your list better than I do. We are bombarded by so much constant stress these days that we don’t think twice about it, just as you wouldn’t notice a watch on your wrist after only a few minutes of wearing it.
When you remain in this stress response too often—whether your mortgage is past due or you’ve got some tigers in your neighborhood that I don’t know about—your body compensates. But when it compensates for too long, this over-activates the organs of stress and shuts down the organs of relaxation (such as those in your immune system and digestive systems and those of reproductive and thyroid function).
This is Adrenal Fatigue.
# 10 “Just help me sleep, Doc.”
My patients tell me regularly that if they could just sleep that they feel they would heal. In part, this is true.
There is a difference, however, between knocking someone out with prescription drugs and balancing the inherent sleep-wake cycle by healing the Adrenal Fatigue.
The prescription drugs may put you to sleep, sure, but you wouldn’t reap the healing benefits of deep sleep.
The only way to help you to sleep deeply and naturally, to help you get the true benefits of sleep, is by balancing the adrenal hormones and healing the underlying Adrenal Fatigue. Sleep is essential to recovery, but it has to be done the right way.
Assess and fix the adrenals, and the normal sleep/wake cycle fall into place. Once your sleep/wake cycle is corrected, your whole body begins to heal.
#11 The pharmaceutical fraud of artificial sleep
There are numerous over the counter (OTC) and pharmaceutical sleep remedies. This is a multi-million-dollar segment of the Big Pharma industry. Advertisements from pharmaceutical companies geared at targeting those of us with insomnia are everywhere. There is an implied promise of butterflies, sunshine, and beautiful music upon waking.
Some of these aids work to help us to sleep temporarily, but they all miss the target, which is to treat the cause. Because they miss the target, the effects of these remedies are temporary at best, merely a Band-Aid … if they work at all.
The real downside—the warning that rarely gets to the consumer/patient is that some of these remedies—both OTC and prescribed remedies worsen the problem over time by inhibiting deep sleep and causing dependence.
Some patients with Adrenal Fatigue report that they can sleep; however, it is likely that the sleep quality is compromised due to hormone dysregulation. Even if someone does manage to sleep under these circumstances (on her own or through pharmaceutical means), the elevated cortisol at night is still present, which causes a biochemical disturbance. This prevents all of the necessary healing and bodily maintenance during the night.
Many of the medications used for insomnia disrupt the normal sleep-wake cycle. The benzodiazepines (most famously Valium, Xanax, Klonopin, Ativan, etc.) are a good example of this problem. Research shows that benzodiazepines shorten the time spent in bed before falling asleep, prolong the sleep time, and, in general, reduce wakefulness. However, the research also shows that these drugs worsen sleep quality by increasing light sleep and decreasing deep sleep.
For this reason, benzodiazepines inhibit the health promoting growth, repair, and other healing processes that will only occur during deep sleep. The same can be said for many of the other drugs used for sleep dysfunction. You’ll feel like you’re sleeping, but it won’t be a deep sleep. Not only won’t it help you heal over the long-term, but it will also actually prolong the condition.
#12 Supplement cover-up
If you’re reading this, chances are that you’re familiar with drugs and their efficacy or lack thereof. You’re most likely aware of the numerous natural remedies used to address insomnia, as well. Many of my colleagues treat insomnia; however, they merely use a process that I refer to as “green allopathy” to do so.
Green allopathy is simply using the same conventional medical philosophy: giving one drug for one symptom. The only difference between their approach and that of conventional medicine is that they use a remedy that is gentler.
Examples of this type of treatment? Melatonin, l-Tryptophan, 5-HTP, chamomile, valerian, GABA, etc. One may or may not have had any success with these remedies, but the issue remains the same: These remedies don’t target the underlying problem that creates insomnia. They will only be temporarily beneficial … if they work at all.
The most successful way to treat insomnia is to address the underlying biochemical cause. This invariably leads us back to the Adrenal Fatigue.
Successful treatment involves modulation of cortisol levels and HPA axis control. Sometimes treating this way isn’t quick or easy, and it may involve multifactorial control points. Once you do fix the problem, however, you fix the problem for good.
#13 The ten-marker test
It makes sense that if you have daytime cortisol levels at night—cortisol that is two, three, or four times as much as you should—you will have “daytime” energy and stimulation at night. This means you’ll have some trouble sleeping.
The ability to enter REM sleep cycles and experience regenerative sleep is interrupted by high cortisol values at night and in the morning. Chronic lack of REM sleep can reduce a person’s mental vitality and vigor and induce depression.
It’s interesting to note that you can also have trouble sleeping during the later stages of Adrenal Fatigue when your cortisol levels are low. Cortisol that is too low at night can cause as much insomnia as high nighttime cortisol. The treatment of these two very different situations is, of course, very different.
Proper assessment of adrenal hormones and astute interpretation of that assessment is crucial. A Chronobiologic Salivary Cortisol test from a reputable lab and interpretation by an experienced professional is by far the most accurate and sensitive way to accomplish this goal.
The majority of labs out there test for only four samples of cortisol (although a few will also test for DHEA). There are several other values (a total of 10 individual test results) included in the test I use. Each of these values is invaluable to me in determining the exact Adrenal Fatigue staging, and hence in developing an appropriate, individualized treatment plan for each patient.
The comprehensive, accurate, and sensitive nature of this simple test makes it an invaluable tool in my clinician’s toolkit.
#14 Healing from the ground up
These are the key points to remember when we seek overall healing:
- Reviewing testing with a more discerning eye, an eye towards trends and dysfunction.
- Paying close attention to the subtle changes in blood work.
- Addressing dysfunction before it leads to full-fledged disease.
- Controlling symptoms while focusing on healing the dysfunction at its root.
- Identifying and treating disease while looking for trends of dysfunction.
The most important points to remember concerning adrenal and sleep functions:
- Adrenal hormones (aka stress hormones) define your circadian rhythm of daily energy.
- Stress hormones released at the wrong time of the day disrupt this rhythm contributing to insomnia.
- Stress hormones also suppress melatonin and growth hormone production, thus inhibiting deep sleep and the overnight repair process.
- Assessment is key; both high and low cortisol can cause insomnia.
- If you fix the stress hormone problem (aka Adrenal Fatigue), you can fix insomnia.
- As you fix insomnia (fix, not mask!), you make it easier to fix the Adrenal Fatigue.
#15 How regular sleep function returns
Adrenal Fatigue is commonly hallmarked by fatigue combined with insomnia. This irony of being tired yet not being able to sleep is quite specific to this condition.
It is imperative that patients with these conditions do everything in their power to improve the quality of their sleep. Once patients are sleeping consistently, they will eventually reap the benefits of good quality deep sleep.
Once deep sleep begins, the body begins to heal on a cellular level, but this is difficult to feel. Once the cells heal, then the tissue begins to heal. Once the tissue heals, the organs begin to heal.
As the organs heal, there will be decreased overall pain, improved wound repair, more rapid recovery from injury, less brain fog, and increased vitality. Eventually, patients experience the consistent, smooth energy that is optimal and healthy.
I tell patients not to be disappointed if they do not wake refreshed after a few good nights’ sleep. There is often a large deficit to repay. Their adrenal bank account has been drained! They’ve been borrowing energy from tomorrow to pay for today. This is akin to overspending, eating away at savings, blowing through the emergency fund, and then living on credit cards.
Your money is analogous to your energy.
If you were to fix your financial problem, you would first have to curtail spending. Next, you would have to start paying back those credit cards. While this is an important step to recovering your finances, you’re in the position of having to pay off your debt without seeing your bank account grow once more.
You must pay off your debt and eventually build up your savings. Then, you will have some cushion and some money with which to live.
The same is true with Adrenal Fatigue. It can take a while to pay off your debts, to build up a reserve, to have an account of energy that you can rely on. This is when normal sleeping patterns begin to return.
You will feel the benefits of sleeping better in time; you just have to be patient.
#16 The bottom line…
In over a decade of seeing thousands of patients both in my office and via telephone or Skype, I have discovered that once someone has Adrenal Fatigue, the physiologic shift that occurs affects their sleeping patterns.
Many well-educated and well-intentioned doctors will focus on insomnia as a “condition” without paying attention to it cause.
But it’s time get to the bottom of things, to tie it all together. It is a mistake for doctors, both conventional and alternative, to focus on only one part of this dysfunctional process.
The primary goal must always be to treat the underlying Adrenal Fatigue and chronic activation of the stress response. Failure to do so wastes your precious resources of time, money, and most important, energy.
Once the underlying Adrenal Fatigue is properly assessed and treated, it’s as if the all the other systems of the body can come to life again. And this is when insomnia will dissipate.
In the video below, I share my journey with Adrenal Fatigue. To reach out to us here at the Clymer Healing Center simply fill out this short application form.