Month: March 2019

It is well known that sleep is fundamental for our health and well-being, however due to various lifestyle and physiological factors, 33-45% of Australian adults suffer from poor quality and inadequate sleep while insomnia affects around 20% of adults in Australia. ³

The Australian Sleep Association defines insomnia as a chronic and debilitating disorder relating to a difficulty with:

• Sleep initiation: Sleep onset takes more than 30 minutes and/or ⁸
• Sleep maintenance: Being unable to maintain sleep (being awake for more than 30-45 minutes) and/or ⁸
• Early termination: Waking earlier than intended and not being able to return to sleep. ⁸

Insomnia has been linked to a myriad of health complaints including reduced cognitive function, anxiety and depression. It may also contribute to several psychiatric and medical conditions including cardiovascular disease and hypertension. ^{9, 10}

In addition to this, mental health problems (depression and anxiety) and physical health issues (pain and breathing difficulties) are thought to be the primary causes of sleep problems. ^{11, 12}

Insomnia and Inflammation

A common underlying factor associated with insomnia and its concomitant conditions is inflammation. Recent evidence has revealed shorter sleep duration (<6 hours per night), poor sleep continuity and quality to be associated with higher levels of inflammatory markers (IL-1β, IL-6 and TNF-α) suggesting that insufficient or disturbed sleep may play a role in the upregulation of pro-inflammatory cytokines. ^12-14 Chronic insomnia has been shown to disrupt the circadian release of IL-6 and TNF-α resulting in excessive daytime sleepiness, contributing to conditions such as sleep apnoea and narcolepsy. ^{12, 15}

Stress and Inflammation

These same pro-inflammatory cytokines (IL-1, IL-6, TNF-α) have also been shown to activate the hypothalamic-pituitary-adrenal (HPA) axis, stimulating glucocorticoid release, further exacerbating symptoms of stress, sleeplessness, and mood disorders. ^16-18

Chronic stress, via excessive release of glucocorticoids (cortisol), can exacerbate symptoms of insomnia due to the influence of the adrenal glands on the rhythmic release of hormones, this causes dysregulation of the circadian rhythm altering normal sleep cycle. ¹⁹

In healthy persons, reductions in cortisol, corticotropin-releasing hormone (CRH) and a rise in growth hormone (GH) supports sleep onset and maintenance. During times of chronic stress, abnormal HPA axis and sympathetic nervous system (SNS) activation causes disruptions in GH, CRH and adrenocorticotropin hormone (ACTH) release which disrupts the normal diurnal pattern. This results in altered cortisol expression in the evening hours and initial phases of sleep, resulting in sleep fragmentation, raising cortisol even further. ^{19, 20}

Natural Treatments to Reduce Inflammatory Stress and Support Healthy Sleep

As multiple physiological and psychological factors can contribute to insomnia, our practitioners apply a broad spectrum treatment approach which addresses these factors. Furthermore, considering herbs and nutrients with a multitude of beneficial effects in these areas have shown positive results.  For more information about what impacts sleep and how our body is affected when we don’t get enough quality sleep.

Probiotics

• Studies have shown probiotics may have a modulating effect on the HPA axis, reducing symptoms of stress. 2
• A probiotic [available from qualified Naturopaths] taken for 30 days was shown to be beneficial in improving psychological symptom scores, reducing psychological distress scores and decreasing 24 hour urinary free cortisol, showing a beneficial effect on general signs of stress, mild anxiety and low mood. ⁵

References

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3. Adams R, Appleton S, Taylor A, McEvoy D, Antic N. Report to the sleep health foundation 2016 sleep health survey of Australian adults. The University of Adelaide The Adelaide Institute for Sleep Health. 2016.
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