Dr Abshire on Sleep and Stress Hormones


If you do not get adequate sleep your body will be inflamed, a root cause of disease in the body and mind. In addition, your insulin receptors will be more resistant to the messages of the hormone, insulin, causing some degree of metabolic syndrome. A goal is 7.5 to 9 hours per night for most people. Although there are individual differences, and there is some evidence that a subset of people seem to do fine with less. Do not assume you are one of these people.


The adrenals, which serve the rest of the body, can be overstimulated and may get drained by chronic high mental stress, chronic roller coaster blood sugar, chronic lack of sleep, or all of the above. If you are stressed enough to show an abnormal pattern of either too high or too low cortisol on lab testing performed over the course of the day, you will not feel well. You may be able to determine by symptoms and timing of onset what you likely have and do not need to test. You may feel wired and tired. It may be that you are shaky and get so tired you cannot get to sleep easily. You might wake up during the night or too early. In either case of too high or too low cortisol you probable have low serotonin and high norepinephrine. The catecholamine norepinephrine leaves you feeling irritable, jumpy and hypervigilent, always on alert. Norepinephrine is a major messenger for inflammation, so this really needs to be corrected. If you do not have the inhibitory neurotransmitters serotonin and GABA to counter stimulation, you will feel overwhelmed. If extreme you will not be able to prioritize all the pressures weighing on you, and will not know where to start, feeling paralyzed. You will feel depressed. You will likely crave carbs, especially chocolate, and may not feel satisfied when you eat, thereby grazing on a series of various foods to chase satiety. You will also have low melatonin, as melatonin is made from serotonin, and may not be able to get to sleep or stay asleep.

You need to practice stress reduction practices, however I believe that the only thing that can fix the adrenals is catching up on sleep and continuing to get enough sleep. All attempts to medicate with low dose steroids only delay the problem and do not fix it. I believe you should maximize nutrition, correcting any deficiency that could be linked to insomnia and help with inflammation. Deficiencies of the B vitamins are linked to insomnia, but can stimulate so should be taken before noon with food. Omega 3's are anti-inflammatory and help the brain, so they too should be part of your program.

Sleep hygiene is very import and may be all you need to fix the problem. However, if you need absolute total black out, because a sliver of light or slight noise wakes you up that is a sign that your brain chemistry and stress hormones could stand some improving. It may be helpful to take brain neurotransmitter targeted nutritional supplements, in the beginning and then as needed, but they are not the whole answer. Use ear plugs, the wax variety are great and an eye black out mask if you cannot make your room quiet or dark enough.

Sometimes Bio-identical hormones are indicated during peri-menopause and early menopause if sleep is disturbed by hot flashes, and if there are no contraindications. Estrogen boosts serotonin and Progesterone can boost GABA. Testosterone boosts both dopamine and serotonin.

Occasionally, pharmaceutical sleep aid intervention is needed temporarily. The most extreme case I remember is when a pregnant woman and her infant were in danger when she might have had to deliver after 3 days of no sleep due to false labor pains. She was hospitalized and placed under a morphine sleep which saved them.