It is not uncommon in mid-life to all of a sudden wake up (literally) and realize you can’t sleep like you used to. If you are not sleeping well, it can affect so many aspects of life.
Sleep is the time we need to consolidate information, rest our bodies so they can heal from the micro-damage we cause during the day and to give our digestive systems a rest so our blood sugar can be balanced. Sleep deprivation can have a serious impact on your mental health long term. Prioritizing sleep is crucial for long term health.
But it’s not always that easy…
Eight of the above reasons are likely related to your hormones.
Stress, anxiety, and elevated cortisol all cause the same shift in hormones that can impact sleep. Stress and anxiety cause an increase in cortisol and if cortisol doesn’t come down, this will cause insomnia. Elevated cortisol can result in both sleep initiation insomnia (inability to fall asleep) and sleep maintenance insomnia (inability to stay asleep). The main reason getting to sleep can be a problem is because when cortisol is high, your body won’t produce melatonin.
Melatonin is the ‘sleepy’ hormone and we need it to start being produced before bedtime and throughout the night to get a good night’s sleep. High cortisol also means our body is on edge, we are ready for fight or flight, and often the mind can race and prevent sleep.
Melatonin can be impacted by high cortisol but its production can also be stunted by other factors. Having a regular bedtime routine that does not involve screens is important to stimulate appropriate melatonin production. The blue light from screens tells the body it is not night time and not to make melatonin.
The reason elevated cortisol can cause sleep maintenance insomnia is that it will cause your progesterone levels to decline. When your body is stressed it doesn’t know the nature of the stress and it thinks it could be running from a bear. Body functions other than those related to fight or flight get ignored. Your body really doesn’t care about sleep when it is focused on survival mode. Progesterone is another ‘sleepy’, ‘happy’ hormone and when your body ignores it’s production because it thinks it is constantly running from bears, its levels decline and sleep suffers.
Progesterone can also be decreased by other means. It naturally declines as we age but for some of us it declines more than others. If we are having cycles where we aren’t ovulating or we have poor quality eggs ovulating (both of which are very common in mid-life), progesterone can be especially low. In addition, if estrogen is really high compared to progesterone, we can get a relative low progesterone in the body and this can cause the same symptoms.
When we are sitting with a patient with insomnia, we evaluate all the possible reasons and then treat appropriately. This almost always involves doing functional lab testing of cortisol, estrogen, progesterone and melatonin.
If you want to learn more about how we help with insomnia at Hormone Health Associates, click here to book a free 20-minute discovery call.