Chronic Tiredness and Insomnia in Adrenal Fatigue

By: Michael Lam, MD, MPH; Dorine Lam, RDN, MS, MPH

Chronic Tiredness is a common symptom of Adrenal FatigueA common cause of insomnia is the malfunction of the Hypothalamus-Pituitary-Adrenal (HPA) axis. Adrenal glands are an integral part of this axis. Insomnia leading to chronic tiredness is therefore a classic sign of Adrenal Fatigue.

The main complaints for insomnia include: difficulty falling asleep (sleep onset insomnia), disturbed sleep, being easily woken up at night, difficulty falling back to sleep (sleep maintenance insomnia), feelings of not being rested, leading to chronic tiredness in the morning, starting slower in the morning, and feeling fatigued during the day.

Sleep Onset Insomnia (SOI)

Difficulty falling asleep is called sleep onset insomnia (SOI). It is important that cortisol is at its highest level in the morning and at its lowest level at night for normal sleep to occur, along with waking up refreshed and energized. When the cortisol balance is off, sleep patterns can be affected. High cortisol levels are typical of people suffering from Adrenal Fatigue, especially in the early stages. This happens when the adrenals are on over-drive, putting out excessive cortisol throughout the day in order to deal with the constant stress. Some of the excess cortisol even carries into the night and this will affect the ability to fall asleep, leading to SOI. At the same time, stress triggers the adrenal medulla, which then produces excessive amounts of adrenaline (a hormone responsible for the fight or flight response). A high adrenaline level can independently disturb sleep patterns as the body is on full alert. This state is commonly called being wired. High cortisol and high adrenaline can occur simultaneously and this is common for those who suffer from Adrenal Fatigue.

Tips to Sleep Better and Avoid Chronic Tiredness

  • Sleep in a completely cool, quiet, and dark room. This will enhance melatonin production, an important sleep-regulating hormone. Try to draw and close all the shades and curtains. Even a small amount of light can reduce melatonin output from our brains.
  • Going to bed at the same time is important for people who suffer from Chronic TirednessGo to bed and get up at about the same time every day, even on the weekends. Sticking to a schedule helps reinforce your body’s sleep-wake cycle and can help you fall asleep more easily at night. Do the same things each night to tell your body it’s time to wind down. This may include taking a warm bath or shower, reading a book, or listening to soothing music. Relaxing activities done with lowered lights can help ease the transition between wakefulness and sleepiness.
  • Remove all electrical appliances, such as night-lights and alarms and put them at least 10 feet away from the bed to reduce EMF emissions, which can alter sleep patterns.
  • Do not do strenuous aerobics exercise or power yoga after dinner to avoid overstimulation of the sympathetic nervous system (SNS), which is frequently on overdrive in people who already suffer from Adrenal Fatigue.
  • Turn off your computer, TV, loud music, excitatory video games, and other devices that may trigger an adrenaline rush after 6 p.m. Try reading books in a quiet environment during the evening. If you do have to watch TV, refrain from channel surfing and violence oriented shows.
  • Avoid adrenal stimulators. It is very important to avoid certain foods and chemicals in order to avoid excessive stress on the adrenal glands. Sugary foods, caffeine and decaffeinated drinks of all kinds are to be avoided. Nicotine, alcohol, allergic foods (histamine is an adrenal stimulant), green tea, and chocolates are common offenders. Herbs and glandular products, unless approved by your health care professional, should also be avoided. Avoid partially hydrogenated fats such as deep fried foods and shortenings as they inhibit steroid hormone synthesis. Also avoid artificial sweeteners, which block the conversion of phenylalanine to tyrosine, needed to synthesize catecholamines in the adrenal medulla. Herbal tea, such as chamomile, is permitted.
  • Do gentle Adrenal Restorative Exercise, Adrenal Stretching, and Adrenal Rebuilding exercises in the late afternoon to transition the body at the end of a workday to evening. Do not do them in the evening. Low aerobics like long, slow walks should be done in the morning or late in the afternoon. Taking a short walk after dinner is an exception provided the body does not feel drained immediately afterward.
  • Always go to sleep before 10 p.m. at the latest. If you are tired, go to sleep earlier. Do the Adrenal Breathing Exercises just before bedtime and not at any other time in the evening. This will help with the transition to sleep. You should do this as part of your relaxing bedtime routine.
  • A small snack of protein and fat (a handful of nuts or cottage cheese) before sleep is good. A light snack before bed can help promote sleep. When you pair foods containing tryptophan with carbohydrates, this will help to calm the brain down and allows the body to sleep better.
  • Try not to worry at bed time with Chronic TirednessIf you don’t fall asleep, get up and do something else like Adrenal Restorative Exercises or Adrenal Breathing Exercises. Go back to bed when you’re tired. Don’t agonize over falling asleep. The stress will only prevent sleep and lead to chronic tiredness. It is common for many people with Adrenal Fatigue to feel wired and tired at the same time. If your mind is running and cannot stop, use the energy to think positive thoughts. Set aside worries and any negative thoughts, get into the habit of positive thinking at bedtime, and occupy your mind with images of relaxing places or happy events.
  • A good bed is subjective and different for each person. Make sure you have a bed that is comfortable and offers orthopedic support. If you share your bed, make sure there’s enough room for two. Children and pets are often disruptive, so you may need to set limits on how often they can sleep in your bed with you.
  • Take a natural sleep aid as directed by your health care professional. There are many available, each with its own special characteristics. It’s common to use multiple sleep aids when dealing with chronic tiredness and insomnia, but some trial and error is needed to arrive at the right combination for you.

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© Copyright 2014 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Questions

You may want to find out what is the underlying issues that cause you to have the vivid dream.

Seriphos may help balance or lower cortisol for some that have high cortisol level with AFS. Some people, however, can have paradoxical reactions, with the opposite outcome.

Chronic Tiredness is a common symptom of Adrenal Fatigue
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There is a wealth of information on this website regarding adrenal fatigue. I have always wondered why I would wake up in the middle of night and could not go back to sleep. I have fought this for years. Now I know this is called sleep maintenance insomia.