RT3-Adrenals sleep

Sleep/wake patterns

When suffering from adrenal issues, bedtime should be no later than

10 p.m. and wake time no later than 8 a.m. This follows the normal

diurnal pattern of cortisol. For someone who has a later bedtime,

working toward a 10 p.m. bedtime in small increments, such as ten or

fifteen minutes earlier each week, may be helpful.

Good sleep hygiene

It may be helpful to be in a room with subdued light for an hour before

lights out. Melatonin, the rise of which signals cortisol to be lowered,

increases in response to darkness. Avoid computers late in the

evening. It may also be helpful to get into natural light when waking in

the morning.

Nighttime cortisol and sleep

Trouble falling asleep is common with adrenal fatigue. Low cortisol in

the morning results in too much being produced at night. Treating high

nighttime cortisol with strong cortisol lowering supplements such as

phosphatidyl serine does not address the underlying problem of low

daytime cortisol. Ideally, high nighttime production of cortisol needs to

be pushed toward morning, not eliminated.

Safe sleep aids

• 1 to 3 mgs over-the-counter instant release melatonin

• about 30 minutes before lights out

• use lowest dose that is effective

• trial a dose for three days before increasing

• too high dose may cause grogginess or difficulty waking the

following morning

• Over-the-counter antihistamine (such as benedryl)

• not non-drowsy

• about 30 minutes before lights out

• Vitamin B12

Studies wth teenagers have indicated that in some people the

sleep/wake cycle can be corrected with 3 milligrams a day of B12. It

appears to affect the release of melatonin at night and the response

to sun in the morning and help reset the sleep-wake cycle in four to

six weeks.

Prescription sleep aids

• Affect the HPA axis

• Can cause addiction

• Need to be weaned gradually

Insomnia with bedtime dose of hydrocortisone

• May indicate insufficient daytime dosing

• Trial increased daytime dosing

• Replace other sleep aids with melatonin; antihistamine

• Grogginess in the morning indicates time to replace the melatonin

with bedtime dose of HC

Waking during the night

• Waking in the middle of the night can be caused by very low overnight

cortisol and/or dysfunctional insulin secretion causing a hypoglycemic

state. When this occurs, the body tries to activate the adrenal glands to

put out more cortisol to stimulate the liver to raise blood glucose to its

normal level. This can be hard for fatigued adrenals to do and the body

may produce adrenaline instead. A high fat, high protein snack at

bedtime may help.

• Repeated waking to urinate can be from low aldosterone, high

potassium or possibly from potassium supplements taken late in the

day.

Waking early

Waking early can be from high cortisol or from adrenaline due to low

cortisol or low blood sugar.

Difficulty waking

For someone taking T3 thyroid medication, a bedtime dose will

generally help with waking easily in the morning.

Sleep issues