Stress Less and Sleep Better
To begin with, it is essential to differentiate between acute stress and chronic stress. Short-term stress may be beneficial or protective; it is merely like ringing the alarm bell in response to a specific threat. Acute stress is also called “fight or flight response.” It provides a short burst of energy, helping ward off the danger. The short-term adrenalin rush mainly characterizes such an acute reaction.
However, chronic stress is altogether a different thing; it is like keeping the alarm button pressed continually, and in many cases for no apparent reason, just due to a perceived threat. The human body is not created to remain in a state of psychological and physiological alarm continually.
Chronic stress is a complex reaction changing the body’s biology, resulting in altered emotional and physiological responses. The neuroendocrine mechanism of chronic stress differs a lot from the acute stress response, affecting almost every bodily function. Central to all these changes is the altered activity of the hypothalamic-pituitary-adrenal (HPA) axis.
Chronic stress is characterized by higher brain activity, higher levels of catecholamines. Higher HPA activation results in a high level of cortisol, thus resulting in complex metabolic changes in the body. Further, stress results in certain behavior changes.
Humans need to sleep for about one-third of the time to stay healthy. It is essential for both the regeneration of the body and psychological health. Stress and sleep have a dual-sided connection, meaning higher stress disturbs sleep, and a lower amount of sleep increases the risk of stress and anxiety.
The human body can tolerate sleep deficiency to some extent. However, continual sleep deprivation results in the activation of various defensive mechanisms, necessary to maintain homeostasis. If these mechanisms fail, insomnia may happen.
HPA axis becomes suppressed in the evening to promote the beginning of sleep. As the rest progresses, the HPA axis slowly becomes more active. It has a two-way relationship with circadian rhythm. HPA axis keeps changing during the night according to various phases of sleep. It is suppressed during deep sleep and is more active in the dream state. HPA axis is more active in the morning, resulting in higher levels of adrenocorticotrophic hormone (ACTH) and higher activity of the sympathetic nervous system.
The immune system also seems to play a role in sleep regulation. Chronic stress results in changes in immune regulation. There is a known link between cytokines and sleep regulation. Cytokines like interleukin, tumor necrosis factor, interferon, also participate in sleep regulation and are part of HPA regulation.
Fortunately, most sleep-related issues are transient. In most people, insomnia would not last for more than a few days. However, things become complex if insomnia continues to persist for a more extended period. Stress is undoubtedly among the most important factors involved in chronic insomnia.
Understanding Sleep Architecture and Mechanism
During sleep, humans go through several cycles of NREM (non-rapid eye movement) and REM (rapid eye movement) sleep. NREM is further divided into three or four phases based on the changes seen on an electroencephalogram. Sleep starts with drowsiness, progresses into a deep sleep (NREM), followed by a dreamy state (REM).
During the night, several cycles of NREM and REM are repeated. Usually, a single period of NREM and REM lasts 70 to 100 minutes, though later NREM and REM cycles may be more prolonged. Maintenance of NREM and REM cycles is important for maintaining the quality of sleep.
Stress may affect not only sleep duration but may also negatively impact on the quality of sleep. Nightmares related to PTSD is an example of how it may change sleep architecture leading to disturbed sleep pattern.
While sleeping, numerous changes occur in the body functions. These changes occur to promote sleep and regeneration. However, psychological stress may alter these body responses, thus worsening the quality of sleep. Some of the changes that occur in the body are:
- Cardiovascular: sleep causes a reduction in heart rate and output, reduced blood pressure, and thus reduces stress on the cardiovascular system. This occurs due to increased activity of the parasympathetic nervous system. During REM cycles, there could be a small increase in cardiovascular activity. Higher stress-related sleep disturbances in sleep may reduce the resting time for the cardiovascular system, thus increasing the risk of various diseases. In the morning, there is again a sharp rise in blood pressure and cardiovascular activity, and it explains why heart attacks occur in the morning.
- Autonomic nervous system: As sleep deepens, sympathetic activity slows down, the night is dominated by higher activity of the parasympathetic system. This plays an important role in slowing down all the body functions from the heart to the intestine, giving rest and recovery time to all the organs. It also results in a fall in body temperature during the night.
- Respiration: sleep also causes a slowdown in breathing and a reduced supply of oxygen. During sleep, the body is more resistant to various reflexes.
- Brain blood flow: it is considerably reduced during NREM, resulting in a lower level of metabolic activity. However, during the REM stage blood flow to the brain is comparable to wakefulness, but with a difference. In the REM state, certain areas of the brain like the limbic system get more blood.
- Renal: complex changes occur while sleeping like reduced production of urine, less secretion of minerals, changes in hormone secretion.
- Endocrine: There are considerable changes in the levels of various hormones, like higher levels of growth hormone, especially during the first few hours of sleep onset, and so on.
Circadian Rhythm and Sleep
Circadian rhythm is a collective name for the various processes that occur during the 24 hours. It means that a person may feel sleepy at a fixed time daily. However, external stimuli can alter the circadian rhythm. Stress factors can change it, resulting in a longer circadian rhythm, or even shortened.
One of the brain regions that play an important role in this daily rhythm is the suprachiasmatic nucleus (SCN), also called the “master clock” of the body. It has a relation to the stimulation of the brain through light. Reduced light increases the production of melatonin, one of the critical hormones in sleep cycles. Bright light may inhibit melatonin production. This explains why light therapy has a role in the treatment of insomnia, anxiety, depression, and stress. Changes in melatonin may affect the secretion of various other hormones.
This daily rhythm also controls the core body temperature. Fall in body temperature promotes sleep, and sleep reduces the body’s temperature.
HPA axis activity also demonstrates rhythmic characteristics. Its activity level is at its lowest in the evening, resulting in lower levels of cortisol, whereas the HPA axis is more active in the morning. Stress-related changes in the cortisol levels are central to changes in the sleep pattern.
Stress and Insomnia
Post-traumatic stress disorder (PTSD) frequently leads to sleep disturbances. It is an extreme cause of stress occurring after traumatic experiences. Those living with PTSD have difficulty initiating sleep. PTSD is not just present in war veterans; it may also occur due to less prominent problems like separation from loved ones, divorce, and so on. Similarly, stress related to carrier and job often leads to poor sleep quality. Emotional reactions of individuals to stress has lots to do with the severity of insomnia.
Extreme stress or PTSD is not a widely prevalent issue. However, researchers are more worried about the stress caused due to minor hassles of daily life. These daily frustrations get accumulated over time, causing marked changes in the sleep pattern, and causing damage to health. Researchers agree that it is minor daily stress that is a more significant threat than major stress. These small stressors disturb sleep in the long run, consistently causing changes in the sleep pattern.
Regretfully, the role of small daily frustrations is not fully recognized by the broader scientific world, as they want to know the exact cause of stress. Thus, in the medical world, stress is only recognized as a reason for disease or insomnia, if a person can describe it. Therefore, no doubt that in most cases, individuals will be able to tell about some major episodes of stress.
This means that though the important predictors of stress like major trauma, depression, illness play an essential role in sleep disturbances. However, health and wellness specialists should not neglect the role of smaller stress factors.
Stress and Sleep
Stress increases the activity of the HPA system and the sympathetic–adrenal–medullary (SAM). This results in cardiovascular changes, higher levels of cortisol, ACTH, and CRH (corticotropin-releasing hormone). The result of these endocrinal changes is altered gastrointestinal function, immunity, changes in positive and negative feedback systems.
High cortisol level negatively affects various brain structures, especially the hippocampus, causing memory issues, sleep disorders.
Increased activity of the autonomic nervous system means a higher level of alertness. This results in prolonged awakening. Prolonged awakening, on the other hand, results in higher levels of cortisol. Thus, a vicious circle is formed.
The role of the immune system in sleep disturbances is less appreciated but critical. Chronic stress down-regulates the activity of B and T cells and Natural killer cells. Recent research shows a strong correlation between altered immune responses and sleep disorders.
Sleep increases levels of growth hormone and sex hormones, helping fight stress. Sleep deprivation also increases ghrelin and reduces leptin, resulting in higher appetite and obesity.
Physiological Sleep Model and Stress Responses
Interestingly, some studies indicate that people with poor sleep not only sleep less, they are also more alert during the day, have a higher rate of metabolism, and have a higher level of endocrinal activity. It means that they have a different kind of brain, a mind that is more sensitive to stressors, and sleep deprivation. It highlights the importance of practicing mindfulness during the day, the importance of reducing the level of hyperactivity.
Behavioral or Cognitive Model and Sleep
As per this theory, people living with insomnia and stress have the wrong kind of adaptive strategy. Instead of reducing stress or making lifestyle changes that improve the duration and quality of sleep, some individuals start going to bed late; others stay awake with their gadgets. This finally results in the formation of habit, conditioned alertness, and chronic insomnia. It means that health and wellness coaches should pay attention to the lifestyle issue, and not just focus on trying to identify stressors. As behavioral changes may last much longer than the initial causative stress period. Further, the behavior is a modifiable factor.
The cognitive model is also like a behavior model in many ways, which states the importance of inappropriate reactions to stress and insomnia. Many people become over-worried, and others start taking naps during the day, while others try to stay in bed late. This, ultimately, leads to bad sleep habits. This means that stress may be a causative factor, however, in the long run, sleep problems have lots to do with wrong habits, and responses, further, underlying the importance of wellness coaching in improving sleep quality.
Thus, the modern view regarding stress and sleep problems is that severe stress leads to acute insomnia, which may last for a few days. However, chronic insomnia and poor sleep quality is a result of maladjustment — the wrong kind of responses to sleep. Condition is made worse by the presence of other small stressors.
Specific theories also propose that people living with insomnia are genetically predisposed to the condition, whereas, stressors only act as precipitating factors.
Managing Insomnia through Daily Stress Management
Since long-term insomnia is a result of wrong habits, and responses, it is maintained by low-level stressors of everyday life, managing physical and mental aspects of lifestyle may help overcome the problem.
Therefore, there is a need to manage stress on a daily basis by learning to maintain work and rest balance, learning to overcome emotional tension, accepting what can be changed and whatnot, planning activities, recording daily routine, setting priorities, practicing mindfulness can help.
Equally important are the physical aspects of stress management. Thus, one should focus on physical activity. Aerobic exercise four to five times a week for at least 30 minutes can help.
Your Coaching Career
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