Sleep Debt: The Truth About Sleep Quality and Stress

You don’t just want coffee in the morning – you need it.

You can’t remember the last time you had a good night’s sleep.

You struggle to concentrate in a meeting – or worse, when you’re watching your kid’s big game.

And the mood swings and food cravings are something else.

Sound familiar? You could be dealing with sleep debt.

Sleep debt is what happens when you struggle with a cumulative loss of sleep – maybe only getting 5 hours a night when you once had 7 or 8– or simply not getting enough deep sleep. Alleviating long term sleep debt is not as simple as sleeping in at the weekend – not that many of us get the chance these days! But if you find yourself stressed and tired from not sleeping enough, there are ways around this issue – and you’ll be able to rest more fruitfully!

The Relationship Between Cortisol and Melatonin – and What It Means for Your Sleep

You may have heard of cortisol before – it’s colloquially known as your ‘stress hormone’, even though your fight or flight reflex is instigated more by adrenaline and related hormones in an acute situation. But your body does produce a lot more cortisol whenever you’re stressed. Think about all the times in the day when you feel stressed – maybe at work, in traffic, on the phone to customer services – whatever the source of your stress, your cortisol levels increase whenever your brain senses “danger!”

The role of cortisol is to ready your body to cope with threats, often putting on hold those body functions that are considered “non-essential” in times of danger. These processes include immune system, blood pressure, hormone production and blood sugar maintenance – and of course, the ability of sleep.

Normally, your cortisol levels are highest in the morning – to help you wake up – reducing throughout the day and hitting the lowest point around the time you’re ready to sleep.

Melatonin is a hormone strongly associated with sleep, as darkness stimulates your brain into making it, to signal that it’s time to sleep. Melatonin is essential to synchronize your sleep/wake cycle, or circadian rhythm – your internal clock that helps you move from being asleep to being awake, and vice versa. While you can sleep without raised melatonin, the hormone does trigger a much deeper, more restful sleep. Ideally, your melatonin levels should be highest between just before bedtime and the early hours of the morning, before tapering off in preparation for waking up and the rest of the day.

So – low melatonin can affect the quality of your sleep, or if you have a delayed circadian clock, it may only kick in during the early hours of the morning – long after your partner and family have gone off to sleep. Also, high levels of cortisol can impede sleep, as your body is in a state of stress-related alert, and the last thing it wants to do is lower your guard. Both hormone issues have a less than desirable effect on your health.

The Health Effects of Poor Sleep

The effects of continued poor sleep are much more serious than simply needing an extra cup of coffee in the morning. Not getting enough rest can impact your health and impede day to day functions. Your sleep debt can even affect your performance, cognitive function, and personal relationships.

Sleep deprivation can contribute in the long term to:

1. Alzheimer’s disease – If you carry the genetic marker APOE4 and have trouble sleeping, this increases your risk of developing Alzheimer’s. Your body can only clean and maintain your brain through the glymphatic system while you’re deeply asleep, so disrupted sleep can affect the efficiency of this process, and create a larger risk factor for cognitive degeneration.
2. Learning difficulties – Insufficient deep REM sleep may affect your ability to learn new things – both knowledge and skills. REM sleep is crucial for learning new languages and retaining new information.
3. Diabetes – Sleep deprivation is a known risk factor for type 2 diabetes, as it affects insulin sensitivity.
4. Cardiovascular disease – Poor sleep can lead to an increased risk of heart attacks and stroke, caused by increased levels of cortisol and decreased levels of melatonin.
5. Cancer – Sleep deprivation and disruption of the circadian rhythm can accelerate tumor formation.
6. Depression – poor sleep and depression have a bidirectional relationship, meaning that they can feed into each other.
7. Obesity – insufficient sleep can increase appetite, as it causes changes in the brain, and in the timing of the release of hormones responsible for appetite stimulation and suppression.
8. Anxiety – poor sleep can result in low grade neuroinflammation, which can result in poor cognitive function and anxiety.

Although the immediate effects of not getting enough sleep can be frustrating, it’s clear that the long-term risks are far worse. Fortunately there are a number of ways to improve your sleep hygiene and find a way to pay off some of that sleep debt!

5 Ways to Manage Cortisol and Achieve Better Sleep

When patients ask me how to reduce cortisol levels or increase melatonin, I point out that everything in their body is connected, and it’s not a case of simply fixing one thing! You have to heal your body as a whole.

Here are my top 5 ways to manage these hormones and aid your sleep:

1. Eat regular meals with an emphasis on protein, and reduce your intake of sugar, processed carbohydrates, and coffee. While the coffee and donuts may make you feel momentarily better during the day, they’re playing further havoc with your blood glucose and brain stimulation. Avoid caffeine after 2pm especially.  Eating healthier helps you reset your sleep. Drink plenty of water.
2. Alleviate your stress, by meeting your problems head on, reducing your load (if you feel like you’re doing too much – you probably are!), and learning coping techniques. I like to use a meditation, deep breathing, yoga, and being in nature.
3. Exercise! While it’s hard to keep moving when you feel you need matchsticks to keep your eyes open, exercise can help to reduce your cortisol levels, making it easier to be more relaxed at night. I don’t recommend exercising in the evening, as the adrenaline may interfere with sleep, but some strength training or low-to-moderate exercise of any kind during the day is ideal.
4. Make sure your bedroom is dark and cool, and electronic-free as much as possible.  Many screens emit light that can disrupt your circadian rhythm – and social media can be pretty addictive!
5. Aim for 7-8 hours of sleep per night, and maintain a bedtime routine, always going to bed and waking up around the same time every day. Routine may help your circadian rhythm reset, and the resulting self-care can only help reduce your cortisol levels.

At Arizona Wellness Medicine, you can work with a health coach and doctor to heal your body and improve your sleep. If you’re interested in tackling your sleep issues in Arizona, call to book an appointment on 602 892-4727 or fill out our contact form.