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The Importance of Sleep with Adrenal Fatigue

Posted Feb 08, 2019

Along with diet and regular exercise, getting a healthy night’s sleep is an essential component of living a healthy life. Lack of sleep is a common sign of adrenal fatigue and can also have a significant impact on your patients. Chronic lack of sleep is now regarded as a health hazard and has been associated with several health conditions, including decreased immunity with increased susceptibility to infections, impaired glucose tolerance and decreased morning cortisol levels that cause cravings for carbohydrates even when enough calories have been consumed.

Not getting enough sleep can also increase circulating estrogen levels, upsetting hormonal balance. This is in addition to the decreased alertness and concentration that most people experience when not getting the proper amount of rest.

There can be several reasons for sleeplessness with adrenal fatigue. Both too high and too low nighttime cortisol levels can cause sleep disturbances. To determine if this is a problem for your patients, administer a saliva cortisol test at night and compare their night sample levels with their daytime levels along with the test standards for those times.

To do the night test, have them give a saliva sample at bedtime, another if they wake up during the night and a third when they wake up in the morning. Have them write the time each sample was taken on the vial and in a notebook on a separate sheet of paper. If cortisol is the culprit, their cortisol levels will be significantly higher or lower than normal for those times.

If your patients are waking between 1:00 and 3:00 AM, their liver may be lacking the glycogen reserves needed for conversion by the adrenals to keep blood glucose levels high enough during the night. Blood sugar is normally low during the early morning hours, but in those with adrenal fatigue and low cortisol, the blood glucose levels may sometimes fall so low that low blood sugar symptoms wake them during the night.

This is often the case if they experience panic or anxiety attacks, nightmares, or sleep fitfully between 1:00 and 4:00 AM. If their night time cortisol levels are too low, they may sleep better when they exercise in the evening, as exercise tends to raise cortisol levels.

If their nighttime cortisol levels are too high, have them try a relaxation or meditation exercise to calm them down before going to bed. The yoga pose called the alternate leg pull can be quite helpful in getting to sleep or returning to sleep. This is a basic yoga posture that almost any yoga book or video will describe, but an instructor is preferable as there is some subtlety to doing this posture.

For people with adrenal fatigue, it’s important to be in bed and asleep before their second wind hits at about 11:00 PM. Riding the second wind and staying up until 1:00 or 2:00 in the morning will further exhaust the adrenals. Though they may feel more energetic during that time than they have felt all day, these few hours of energy will cost them the following day when they feel lethargic and tired. In order to avoid this pitfall, advise them to be in bed and on their way to sleep before 10:30 PM, so that their adrenal glands do not have a chance to kick into overdrive for that second wind.

A common stumbling block for adrenal fatigue sufferers is that morning cup of coffee. Caffeine temporarily drives the adrenal glands, which further depletes adrenal reserves. As a result, they experience repeated sugar and caffeine cravings throughout the day to jack up their flagging energy, causing a roller coaster blood sugar effect.

By mid-afternoon or the end of the day, they’ll end up completely exhausted and in need of sleep. Your patients will therefore do better and sleep better by eliminating caffeine and instead try drinking water salted to taste (approximately 1/8-1/4 tsp. of sea or Celtic salt in a glass of water). Of course they should also greatly limit sweet and sugary foods and support adrenal function and steady blood sugar with frequent small snacks and meals containing protein, complex carbs and good quality fats (see Eating for Stress).

Sleep is extremely important to full adrenal recovery, but the twist is that sleeplessness is sometimes one of the signs of adrenal fatigue. These tips can help address common sleep problems patients with adrenal fatigue experience and enhance their adrenal replenishment. Insuring they’re getting the recommending 8-9 hours of sleep daily can greatly improve their attitude, energy levels, and overall health!


Wilson, James L. Adrenal Fatigue: The 21st Century Stress Syndrome. Petaluma: Smart Publications, 2001. Print.