This is part two of a series on sleep. You can read the first post here.
In the last post I wrote about the circadian hormones melatonin and cortisol. I continue in this post, and get specific about regulating cortisol to restore optimal circadian rhythms.
It’s certainly helpful to take the Dutch adrenal hormone test to find out your circadian hormone levels and see your diurnal (daily) cortisol curve, so you can intervene precisely. However, there’s lots you can do with lifestyle factors alone. In fact, lifestyle factors are the most important key to restorative sleep.*
Circadian Hormone Review
Melatonin is the hormone that is secreted from your pituitary gland, in your brain. It tends to do its job if you let it. Cortisol is produced by your adrenal glands, after signaling from your brain. Cortisol is trickier because it can easily get out of hand. It can be too low or too high overall, or at the wrong times.
Cortisol has gotten a bad reputation in recent years. You may have heard it’s associated with stress, inflammation, or abdominal fat. Those connections are true, in cases of chronically high cortisol. However, cortisol is not a bad hormone at all. We need it, to help us wake up in the morning, and effectively deal with inflammation, infections, low blood sugar, and stress throughout the day.
We want cortisol. But we want it at the right times, and in the right amounts. At least 50% of our cortisol output ideally should take place during the first 30 minutes we are awake. This is called the Cortisol Awakening Response (CAR). The remaining amount is secreted throughout the day and should lower in the evening, and be very low during the night.
Cortisol is signaled by light, blue light in particular, and by stress. The full-spectrum light of the outdoors stimulates your CAR. Full-spectrum light includes blue light. Unfortunately, our electronic devices we tend to use at night emit a lot of blue light. This includes TVs, tablets, phones – screens in general. Many people are aware of this and either use amber glasses to block the blue light during the evening, or built-in software that removes blue light. One example of this is F.lux®. You can also program your smart phones to dim in the evening.
Set your Cortisol Awakening Response in the morning
You can intentionally stimulate cortisol in the morning by getting up at a regular time, and exposing yourself to full-spectrum outdoor light, and movement. You can exercise outdoors. Or, you can simply go outside and jump rope for a few minutes, jump on a mini trampoline, or walk around the block briskly.
What if you get up while it’s still dark? You can get a blue light box, which omits only blue light. Do some movement indoors in the same room as the blue light box. You don’t need to stare at it, just have it on. Blue light boxes have been shown to work for depression as well. When you get your CAR going in the morning, it sets your cortisol diurnal rhythm.
My most difficult cases of insomnia have responded the best by working with their morning CAR.
Get up at the same time every day
Wake at the same time every morning. Don’t sleep later on a weekend, or after a bad night’s sleep. If you have sleep problems, morning regularity is crucial. If you don’t go with your CAR, and instead sleep through it, you may easily mess up your day and your next night’s sleep. While you train your circadian rhythms to work again, you may force yourself to get up, and you may be tired for a few days. But if you’re not sleeping well, you are probably tired anyway!
If you’re not sleeping, lose the caffeine. It’s a no brainer
If you use caffeine in the morning, time it with your CAR. If you have sleep problems, the caffeine needs to go. Yes, you may be tired or have headaches while withdrawing. However, since the effects of caffeine can raise your cortisol for hours, it affects your 24 hour circadian rhythms. If you need medication (pharmaceutical or natural) to sleep at night, and you use caffeine, first lose the caffeine. You can wean down slowly, or switch to green tea. You WILL adjust. It won’t take long. There are other rituals you can do in the morning to replace it.
Regulating cortisol throughout your day
Resetting your CAR is the easy part. The difficult part is taming your cortisol throughout the day. We want cortisol available for when we need it. However, certain situations keep your cortisol too high. The biggest one is chronic stress. This mechanism is described here.
It’s not just your perception of external stress; internal biological processes can also cause chronic stress. This may be the kind of stress that you don’t feel. These processes include infections, inflammation, high or low blood sugar, and excess weight. These biological stressors are best addressed with professional help. But the biggest source of stress, your perception of stress, you can change, by yourself. There are many means to do this, described here and here.
Biofeedback and meditation practices are the most researched and effective. Some people get stuck in stressful thought patterns they cannot get out of. Short term cognitive behavior therapy, EMDR, and hypnotherapy, all with a skilled therapist, can be highly effective for breaking these thought habits.
Getting fresh outdoor air is conducive to sleeping well at night. Exercise and movement throughout the day also contributes to good sleep.
How you spend your evening
Back to cortisol. Cortisol should be dropping way low in the evening. The lowering of cortisol and light allows melatonin to come out. You are not going to produce melatonin if cortisol is high and lights are on. The telltale sign of elevated cortisol at night is that second wind that you may have late at night.
How to encourage cortisol to lower at night?
Make a point of devoting your evening to relaxing and calm. Don’t yell at your kids or fight with family members. If you use screens for entertainment, watch comedies instead of news or thrillers. Obviously some people need to take this more seriously than others. But everyone has a certain time they need to wind down the drama and stimulation. The news these days can certainly raise cortisol. It may be better to catch up on it during earlier hours. Thrilling, dramatic, and addictive media (including books!) can keep cortisol up. If you have to bring work home at night, it’s fine if it isn’t stressful. If it is, complete it before the last two hours of your evening.
Winding down with bedtime rituals
Besides avoiding the stress at night, there’s the winding down part. For people with sleep problems, one to two hours off screens, and off blue light is best. Winding down your cortisol can include any activities that are truly relaxing – think about what could elicit “feed and breed” hormones, or “rest and digest” hormones. This means evoking the parasympathetic nervous system, read more about ways to do that here.
Develop before-bed rituals so your mind and body learn to associate them with sleep. Relax with family, read something light, do yoga or Feldenkrais, meditate, listen to relaxing music, do biofeedback such as HeartMath, or take a bath.
Go to bed in time to get at least eight hours of sleep. Some people need closer to nine. Few are okay with seven. Every minute before midnight is precious. Go to bed at the same time every night. Your body loves these rhythms.
Avoid the liver-taxing toxins
Lastly, if you have sleep problems, you may not restore optimal sleep if you drink alcohol or use recreational drugs at night (for some people this includes THC and CBD from marijuana). If you find yourself waking up around 2 AM and having difficulty getting back to sleep, cut out these habits. This is around the time your liver is processing those substances, and keeping you awake.
Now we get to night time
The sleep hygiene tips hold up. Regularity. Every minute before midnight is precious. Dark room – no street lights or electronics or night lights. Your pineal gland is very sensitive. It picks up even red lights from clocks. Use blackout curtains if there are street lights. If you live rurally, natural light from the moon and stars can be fine. Some people love using a mask that filters light. Others love using earplugs that filter sound.
When you get in bed you should be warm enough to go to sleep, but during the night you want the air to be a cooler temperature. Around 65º is optimal, or a bit higher or lower.
If you wake up during the night, don’t look at your phone or another screen. Don’t work. If you get up, use yellow light and read boring nonfiction. Or, stay in bed and use techniques to get back to sleep. Two excellent ones are Sleep Salon and the Sounder Sleep System.
- Get up at the same time, move outdoors, or indoors with a blue light box, even for 2 minutes, to stimulate your CAR (Cortisol Awakening Response). This is the time for caffeine, but only if you don’t have sleep problems.
- Use biofeedback and/or meditation to change your response to perceived stress throughout the day.
- Exercise appropriately.
- Get fresh air.
- Calm and relax in the evening.
- Bedtime rituals.
- Go to bed in time to get at least 8 hours of sleep.
- Keep your room cool and dark – no lights from the outside, or from clocks or electronics.
*If you have a medical condition that alters your sleep, such as sleep apnea, please consult your doctor!