One of the most confusing symptoms that my patients encounter is the feeling of draining fatigue that worsens through the day (inevitably resulting in a 3 o’clock caffeine and sugar hit), followed by an inability to actually fall asleep when their head hits the pillow at night.
What the??
Shouldn’t increasing fatigue through the day result in a rapid onset of deep and restorative sleep, to wake the next day feeling refreshed and full of life? For many, this is not the case.
The reason behind this is adrenal dysfunction. Basically what happens is a release of the hormone cortisol (think of this as your rev up energy booster) from the adrenal glands at inappropriate times of the day (e.g late in the evening when you should be going to bed). Cortisol is the arch nemesis of another hormone called melatonin which helps to initiate and maintain sleep. So when you cortisol lifts in the evening, the release of melatonin is suppressed. The result is a feeling of being ‘tired but wired’ – wanting to go to sleep but being unable to do so.
The flip side of this is waking with fatigue and grogginess. Due to an insufficient release of melatonin during the night (thanks a lot cortisol!), there is a lack of deep restorative sleep. In it’s place is typically a lot of active REM sleep with vivid dreaming and physical responsiveness (increased heart rate, rapid breathing etc).
If this is something you struggle with, there are a few simple strategies that can help:
- Avoid caffeine after lunch time
- Try to avoid stimulating activities in the afternoon and evening e.g. no gym or other strenuous exercise
- Eat dinner early in the evening
- Avoid exposure to intense artificial light in the evening, especially blue light from phone and tablet devices
- Make your bedroom as dark as possible
If these strategies don’t work, you may need to consider some herbal and nutrient therapy to reset your adrenal response, however I would strongly suggest testing your pattern of cortisol release with a salivary cortisol profile first. Your best results will come from working with a naturopath or integrative doctor who understands adrenal dysfunction.
In wellness,
James
