What is Insomnia?
Insomnia is a general term referring to any difficulty in falling asleep or staying asleep. Left untreated, it may lead to irritability, memory problems, depression, anxiety, and, in the longer term, to an increased risk of accidents, heart disease, hypertension, diabetes, immune system problems, etc. Insomnia is the most commonly diagnosed sleep disorder – affecting some 30% to 50% of the general population with about 10% of the population suffering from long-standing or chronic insomnia.
Insomnia is often a symptom or side-effect of another disease or complaint (such as hyperthyroidism, congestive heart failure, chronic obstructive pulmonary disease, dementia, pain-related conditions, or other underlying sleep disorders) rather than a disorder in itself, in which case it is known as secondary insomnia. However, where the insomnia symptoms are not due to any specific physical or mental imbalance and have no obvious other cause, it is referred to as primary insomnia.
Insomnia may also be classed depending on its regularity and persistence: transient insomnia (insomnia that persists for just a few days, usually following a stressful event or excessive use of stimulants like caffeine or nicotine); episodic (short-term) insomnia (insomnia symptoms that last up to three weeks, interspersed with periods or more or less normal sleep); or chronic (persistent) insomnia (ongoing insomnia symptoms that recur at least two days a week for at least a month).
Insomnia may have one or more of several causes, including stress, heartburn or acid reflux, bed-wetting, a poor sleep environment, aches and pains from injuries or illnesses, an inconsistent sleep schedule, excessive exercise or food just before bedtime, or the effects of medications, alcohol, tobacco, caffeine, etc. It is often not understood that caffeine, for example, has a “half-life” of about five hours, so that, even five hours after a cup of coffee or a cola, half of the caffeine still remains active in the body, and as much as a quarter is still there even ten hours later.
The number one cause of insomnia is stress and anxiety, whether from school- or job-related pressures, family or marriage problems, serious illness or death in the family, etc. Middle-aged men in particular have been shown to exhibit increased sensitivity to arousal-producing stress hormones, such as cortisol. But, if short-term insomnia is not managed properly, it can become a long-term problem, persisting long after the original stress has passed. Most insomniacs tend to be anxiety-prone by nature, and this may predispose them to worry more about sleep. Stress and anxiety about difficulties in sleeping may in itself be enough to perpetuate the insomnia, in a kind of vicious circle (sometimes referred to as conditioned insomnia).
Adrenal Fatigue can cause Insomnia
Difficulty falling asleep is called sleep onset insomnia (SOI). It is important that cortisol is at its highest level in the morning and at its lowest level at night for normal sleep to occur, along with waking up refreshed and energized. When the cortisol balance is off, sleep patterns can be affected. High cortisol levels are typical of people suffering from Adrenal Fatigue, especially in the early stages. This happens when the adrenals are on over-drive, putting out excessive cortisol throughout the day in order to deal with the constant stress. Some of the excess cortisol even carries into the night and this will affect the ability to fall asleep, leading to insomnia. At the same time, stress triggers the adrenal medulla, which then produces excessive amounts of adrenaline (a hormone responsible for the fight or flight response). A high adrenaline level can independently disturb sleep patterns as the body is on full alert. This state is commonly called being wired. High cortisol and high adrenaline can occur simultaneously and this is common for those who suffer from Adrenal Fatigue.
For more information on Adrenal Fatigue, click here to visit our Adrenal-Fast page.
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The Circadian Rhythym
Your circadian rhythm is basically a 24-hour internal clock that is running in the background of your brain and cycles between sleepiness and alertness at regular intervals. It's also known as your sleep/wake cycle. The body’s built-in circadian clock, which is centred in the hypothalamus in the brain, is the main mechanism that controls the timing of sleep, and is independent of the amount of preceding sleep or wakefulness. This internal clock is coordinated with the day-night / light-dark cycle over a 24-hour period, and regulates the body’s sleep patterns, feeding patterns, core body temperature, brain wave activity, cell regeneration, hormone production, and other biological activities. Even a long sleep might be ineffective (or at least inefficient) if it occurs at the “wrong” time of the circadian cycle. Growth hormone, essential to the repair and restoration processes of the body, is also secreted during sleep, particularly during deep sleep, as are other hormones like testosterone.
Although the hypothalamus controls the circadian rhythm, outside factors like lightness and darkness can also impact it. When it’s dark at night, the eyes send a signal to the hypothalamus that it’s time to feel tired. The brain, in turn, sends a signal to the body to release melatonin, which makes the body tired. That’s why the circadian rhythm tends to coincide with the cycle of daytime and nighttime.
The circadian rhythm works best when a person has regular sleep habits, like going to bed at night and waking up in the morning around the same times from day to day (including weekends). When things get in the way, like jet lag, daylight savings time, or a compelling sporting event on TV that keeps a person up into the early hours of the morning, it can disrupt the circadian rhythm, which makes it harder to pay attention . The circadian rhythm changes as a person gets older. Most people do not have the same sleep/wake cycle as their partner, child or parents.
Blue light emitted from cellphones, laptops and other digital devices could also be the reason you cannot fall asleep at night. For more information, please go to our Ocu-Fast page.
How the liver can affect sleep patterns.
Studies have revealed that a correlation exists between the liver and sleep patterns, with those suffering from liver problems such as cirrhosis and fatty liver disease often exhibiting disturbed or upset sleep patterns.
Liver disease such as cirrhosis, can cause a whole plethora of symptoms. However, your liver doesn’t need to be that badly damaged to impact on sleep patterns. Sleep disturbances between 1-3am are often linked to the liver.
The liver is responsible for deactivating hormones
The liver plays a critical role when it comes to hormones. The liver isn’t responsible for secreting or producing hormones (numerous endocrine glands located around the body as well as organs such as the ovaries produce these) – but does deal with these hormones once they have served their purpose. Once the hormones circulating in the system have accomplished their task, whether it be triggering a stress reaction or getting a person ready for ovulation, they report to the liver, where they are broken down and deactivated – this prevents a hormonal imbalance from occurring.
When it comes to sleep patterns, many different hormones can have an effect but let’s look at the two main hormones that govern the sleep-wake cycle – cortisol and melatonin.
Cortisol is a stress hormone that is usually secreted just before you wake up in the morning so you feel refreshed and energised for the day ahead. Melatonin, on the other hand, is produced as natural light fades, helping you to feel relaxed and sleepy in preparation for bedtime.
The liver can influence these hormones in a couple of ways. People prone to stress or anxiety have elevated blood levels of cortisol, thereby increasing the liver’s workload when it comes to deactivating this particular hormone. In cases of chronic stress, the liver may become overwhelmed, meaning that excess cortisol may remain in the system for longer which not ideal for melatonin levels or sleep patterns!
Is it possible for excess melatonin to remain in the system like cortisol? Yes, but since cortisol is released as part of a stress reaction, higher levels of blood cortisol are more common. However, if a person is suffering from a troubled liver, it is possible that the liver may struggle to breakdown melatonin. This may result in increased bouts of daytime fatigue followed by night-time alertness when the liver finally gets around to deactivating the melatonin still circulating in the system.
The liver stores and produces glycogen
Glycogen is produced in the liver using leftover glucose (sugar) and is stored as an energy source that can be used by the body. For example, when your blood glucose levels start to fall, your liver can break glycogen down to release glucose into the bloodstream to help give your body some fuel.
Under normal circumstances, this system works well, however problems can arise. Stress can really take a toll on the liver because it depletes the liver’s stores of glycogen, which is used to produce stress hormones like adrenaline. Eventually, the liver will become fatigued from producing more and more glycogen, which will cause the blood sugar levels to become very high, upsetting sleep patterns. When blood glucose levels are high, the body secretes more insulin. When insulin levels are high, the liver produces more fat and cholesterol, which increases risk of developing NFLD.