This is the third article in an ongoing series. Make sure to check out the other articles when you’re finished with this one:
- What Causes Adrenal Fatigue? (Part I): An Introduction
- What Causes Adrenal Fatigue? (Part II): Blood Sugar
- What Causes Adrenal Fatigue? (Part III): Sleep
- What Causes Adrenal Fatigue? (Part IV): Inflammation
- What Causes Adrenal Fatigue? (Part V): Stress
- What Causes Adrenal Fatigue? (Part IV): Treatment
We underestimate just how important sleep is in the maintenance of health. It’s so significant that when altered, sleep challenges can be the sole cause of adrenal fatigue.
Our circadian rhythm (the sleep-wake cycle we all follow) is intertwined with our hypothalamic-pituitary-adrenal (HPA) axis. Meaning, if our sleep is suffering, we have a high probability of developing adrenal fatigue. (1)
All of us living on Earth abide under the influence of day-night cycles. Some activities, like sleep, are done at night. While others, like eating, are done in the day. When the light-dark cycle changes with a season, organisms sense these changes and synchronize their activities to be aligned with the new season’s rhythms.(2)
The body system in charge of regulating our sleep-wake cycle is known as the CLOCK system. The CLOCK and stress systems (adrenals or HPA axis) are both fundamental for survival. Therefore, they regularly communicate with each other.
The constant communication between the stress system and CLOCK system ensures our body’s energy expenditures are always in balance with its available resources. This is why we have low energy after staying up all night. The stress caused by a lack of sleep creates a state where we don’t have the resources to expend a lot of energy. (4)
The largest stressors to our body in regards to our circadian rhythm include:
- Working night shift
- Sleep deprivation
- Using electronic media before bed
- Air travel/jet lag
- Working indoors with minimal daytime light exposure
Sleep deprivation is likely the most significant issue for most of us. According to the World Sleep Society, the average Canadian sleeps only 6.4 hours each night. (4) Even though an overwhelming amount of evidence suggests that 7-8 hours of sleep each night is needed.
According to the Tulane Center for Aging and Circadianbiology:
Healthy aging is the ability to maintain the most consistent light/dark entrainable rhymicity and coordination at the molecular, cellular, and systemic levels throughout the lifespan, originating in the genetically programmed resistance to environmental cues and stress cabable of disrupting this balanced progression. (5)
Did you catch that?
They have found that the key to healthy aging is to maintain a consistent sleep schedule that is aligned with the natural light-dark cycle of where you live.
With the above in mind, there are two factors essential to addressing adrenal fatigue in the context of the sleep/wake cycle or circadian rhythm:
- Sleep quantity and quality
- Circadian disruption
Sleep loss (both acute and chronic) triggers an immune system response to inflammatory processes; specifically, an increase in cortisol levels. If this occurs over a long period of time, our body will eventually down-regulate (or suppress) cortisol production.
If you remember from my previous post, cortisol is an incredibly powerful anti-inflammatory hormone. When our body down-regulates cortisol production, it is no longer able to sufficiently stop inflammation. This leads to greater levels of inflammation. It takes only two consecutive nights of shortened sleep to generate large changes in the circadian production of cortisol. (6)
To summarize, if you are suffering from adrenal fatigue, it is imperative that you allocate (at minimum) 7.5 hours for sleep each and every night. For those working night shifts or some other rotation that alters your sleep/wake cycle, it is recommended to change shifts (if possible) while healing from adrenal fatigue.
Circadian disruptors are factors that create shifts in our body’s circadian rhythm. Think jet lag and shift work. Shift work, in particular, has been linked to multiple chronic diseases including: (7)
- Autoimmune disease
- Metabolic disease (diabetes, obesity)
- Mood disorders
While it may take one night shift to initially alter cortisol levels, you likely won’t notice any immediate symptoms. These effects will often go unnoticed for years. Developing adrenal fatigue is not an overnight occurrence. It develops due to a consistent, unrelenting stress to the body. Often, it takes years to develop.
The more robust your immune system, the longer you’ll be able to endure disruption to your circadian rhythm. So, if shift work is unavoidable, it is imperative that your nutrition, stress reduction techniques, and exercise habits are all functioning at one hundred percent.
Use of prescription sleep aids and caffeine are not recommended. These contribute to further degradation of your body’s natural sleep-wake cycle.
How to treat adrenal fatigue caused by circadian disruption
There are three specific techniques we recommend for treating adrenal fatigue caused by circadian disruption:
- Sleep entrainment
- Access to morning sunlight
- Avoid the use of electronics before bed
The most obvious (and often underutilized) is to regulate your sleep-wake cycle with that of your location’s natural sunrise and sunsets. You should aim to be asleep when it is dark out and awake during the daylight hours. This is the rhythm our bodies have adapted to over thousands of years.
In our culture of high performance, sleep is often regarded as an inconvenience. Therefore, in order to ensure you are getting 7-8 hours each night, this duration of time needs to be scheduled. It is unlikely that you will be able to alter the time in which you wake due to your work commitments. Therefore, the time that you have control over is the time in which you go to bed.
You need to consciously make the effort to put yourself in bed so that you have 7-8 hours before your alarm goes off.
Access to morning sunlight
One of the first things our body needs upon waking is a large dose of sunshine. Exposure to sunlight ensures a large release of cortisol. This is called the cortisol awakening response – for more information refer to my initial post in the series.
For those of us residing in the northern hemisphere, access to sunlight before work may not be plausible during the winter months. In this circumstances, I recommend purchasing a light-therapy device. After rising, spend 10-15 minutes in front of this device.
Exposure to light in the morning will entrain your body to a light-dark cycle that is aligned with your work schedule. During lunch, ensure that your body is again exposed to sunlight – a brief walk outdoors is all that is required.
Melatonin is a hormone our body produces at night to assist with falling asleep. A multitude of studies have shown melatonin to assist with bringing our body to rest. This is especially true in older patients who typically have decreased melatonin production. Always begin melatonin supplementation at the lowest possible dose that helps maintain proper sleep pattern.
Typical doses are 1-3mg and should be taken as close to bedtime as possible.
Avoid the use of electronics before bed
The brightness from your device’s screen is from the blue color spectrum. The retinal ganglion cells in your eyes are very sensitive to the blue and green light. So sensitive, in fact, that our bodies confuse the light from our screen with that of the sun. (2)
When your body should be sensing darkness and increasing melatonin production in order to prepare for sleep, the light from your device is suppressing melatonin by telling your body that it is still daytime.
Apps like F.Lux can be used to block blue light from being emitted from your device. Whether you have adrenal fatigue or not, I would recommend installing f.lux. The use of this app can reduce the stress on your body caused by a decrease in melatonin production.
Ok, now I want to hear from you.
How have you created a regular sleep schedule?
Also published on Medium.