Cortisol is an intrinsic hormone we all have. It is secreted by the adrenal glands on a regular daily basis.  There is a daily fluctuation in levels, called it’s circadian rhythm.  Cortisol should be low at night while we sleep.  It rapidly rises in the early morning, helping us have the energy to start our day.  Cortisol also can increase due to acute stress, such as an auto accident, or can be chronically elevated due to a chronic stressor.  It is thought that after long periods of chronic stress the adrenal glands get fatigued, so that cortisol is abnormally low.  Cortisol is typically elevated in depression, and low in Chronic Fatigue Syndrome (CFS).

So how does our cortisol levels affect our sleep? 

Cortisol is a wake-promoting hormone, so it can contribute to insomnia when it is high.  In my naturopathic sleep medicine practice we evaluate cortisol when the patient reports high stress levels and difficulty sleeping in the middle of the night.  Salivary cortisol levels are typically tested at four time points throughout a day – 7am, noon, 4pm and midnight.  The patients results are then compared to the normal profile. 

What will help normalize cortisol levels?

Many nutrients are needed by the adrenal glands to function well.  These include vitamins C, B6, and zinc and magnesium.  Some botanical medicines will also support adrenal function.  When the 24 hour cortisol profile is abnormal, supplements are typically recommended for 3 months, then levels are re-tested.  As always, it is equally (or more) important to address the underlying reason that the cortisol has gotten out of balance.  Behavioral approaches to decreasing stress include deep breathing, progressive muscle relaxation, good diet with avoidance of caffeine and alcohol, and good relationships.  If you suspect your cortisol levels may be affecting your ability to sleep consult with a physician for evaluation and treatment if necessary.

For more information about Naturopathic Sleep Medicine go to https://naturalsleepmedicine.net.