The Damaging Side Effects of Stress
Joseph R. NBH, MD, FACOG. Medical Director NBH Lifetime Health
How often do we hear that a person is having difficulty getting to sleep or staying asleep? We hear it every day in our clinics. The question is what is behind the insomnia? *More often than not, it is stress in a person’s life.
What is Insomnia? What Are Its’ Causes and Effects?
Insomnia (sometimes referred to as sleeplessness), is “a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired.” “As long as desired” is further understood as “do I get enough quality sleep so that I wake up refreshed and ready to go.”
Causes. *Insomnia applies to those who seldom sleep but it also applies to those whose sleep is not “refreshing.” Stress, along with anxiety, depression and tension are the three most common causes of sleep deprivation. *Medications can also cause or contribute to insomnia as can pain or withdrawal from pain medication. *Hormonal imbalances or deficiencies can be a cause of insomnia. As we age our hormones decline and our sleep difficulties increase. Restoring hormones in the young and the aging can often help with stress, depression and of course sleep quality.
Effects. A person with a chronic steep-restricted state can suffer serious symptoms like depression, fatigue and foggy thinking. Further, poor quality sleep can result in memory loss, increased insulin resistance, diabetes and obesity and an increase in the risk of heart disease. Studies, for example, have shown that men who sleep only 4 hours a night for 6 straight nights lose 30% of their ability to respond to insulin (one of reasons stress and sleep deprivation leads to belly fat).
65 Percent of Americans Are Losing Sleep Secondary to Stress
According to several studies, about 65 percent of Americans are losing sleep secondary to stress. 41 million Americans (1/3 of working adults) are getting 6 hours or fewer of sleep a night. Ideally a person should have at least 7 to 9 hours of quality sleep a night. *Over half of the stress induced sleep loss is attributed to personal finances and family issues. People with sleep disturbances have been found to have abnormal elevations in their night time cortisol levels. Essentially they are in a state of “hypercortisolism.”
*As a result of continued high levels of cortisol and a lack of sleep, patients begin to have irritability, cognitive impairment, memory lapses or loss and even hallucinations. The longer the person is under stress and exposed to high levels of cortisol the more likely are they to develop an increased heart rate and a higher risk of heart disease. There can also be an impairment of their immune system with an increase in viral or bacterial infections, Herpes infections and even cancer. The entire immune system is at risk when sleep is a problem.
Risk of Diabetes Increases with Lack of Sleep
*Those patients with a family history of diabetes and even those without a history are at risk for type 2 diabetes. This in turn increases the risk of obesity. High cortisol causes an increase in insulin and deposition of fat, particularly abdominal fat. It’s very much like a person receiving an injection of cortisone or prednisone for a back problem or tendonitis. Invariably there is an increase in one’s weight over a period of weeks.
There is also, an increase in the levels of inflammation resulting in aching muscles and even muscle deterioration over time. It is difficult to believe that sleep disturbances can cause so many problems, but ask the person who is sleep deprived. Better yet, ask those around them.
Why Am I So Tired?
At Natural Bio Health, this is one of the most common complaints of our clients. *In some instances, the answer is “not getting enough quality sleep.” In more severe instances, it is chronic lack of sleep. There are those who feel that they are sleeping well and they may even say, “But I sleep through the night and I could sleep all day.” *This typically means they are not sleeping well. This is why we ask them “do you wake up refreshed.” Most say NO.
*People who think that they are fine on 4 to 5 hours of sleep may be doing themselves irreparable harm in that their brain is working overtime in survival mode as is their immune system. Neurogenesis can be impaired with sleep loss. Neurogenesis is the brain’s ability to “regrow” neurons.
How Do We Know If We Are Stressed?
The diagnosis of hypercortisolism (high cortisol resulting from chronic or prolonged stress) is rather easy with a Heart Rate Variability Test and a 12 Hour Saliva Test. The Heart Rate Variability Test is conducted in the office and is done with the help of computer software and electrodes. The 12 hours saliva test is a “spit” test done at home and mailed to a lab for testing.
The Saliva Test. This test will show the levels during the day and at bedtime. It gives 4 readings starting with the morning cortisol level and ending with the evening reading. It tells us where the person is in their stress condition. The most severe is the “flat liner.” This is the person who due to prolonged exposure to stressful situations has little cortisol to keep them going. Low levels of cortisol are bad just as high levels are bad. Another is the newly stressed person who may have high levels in the morning but they decrease at night. Another is the person whose cortisol levels go up at night when they should go down. This person will definitely have sleep issues just as the flat liners will have sleep issues.
Heart Rate Variability (HRV). This test measures the variation in the time interval between heartbeats. Higher HRV is healthy. Lower HRV can mean STRESS, emotional strain, elevated anxiety, post-traumatic stress disorder, increased risk of heart disease, depression, and other conditions.
It is measured by the variation in the beat-to-beat interval. We recommend this simple, easy test for all clients. A significant advantage is immediate feedback is given and a significant risk factor is identified (or eliminated).
What Can We Do?
The problem is finding a solution. It is obvious that the stressor (or stressors) needs to be removed but this isn’t always possible. *The first thing to do is recognize there is a problem and then to help the persons deal with the stressor. Exercise, Yoga, meditation and massage are just a few simple suggestions. Sometimes, progesterone in women and testosterone in men can help with difficult sleep issues. In postmenopausal women, the lack of estrogen can affect sleep. Similarly, the hormone melatonin can be a factor in insomnia.
Identifying the reason for the stress is important but may not be amenable to a quick solution. *Sometimes, giving patients a mild but natural sleep aid such as Kavinace and/or melatonin can help. These are preferable to the habit forming synthetic drugs like Ambien or Lunesta that are associated with side effects.
*I have found that vitamin “C” 5000 mg a day and magnesium, 500mg at bedtime, helps decrease the levels of cortisol. Since most patients may have cortisol levels higher or lower than normal during the morning and afternoon, the addition of natural herbal supplements known as “Adaptogens” help lower the levels of cortisol when they are high and raise them when they are low. Neuro-feedback can be very helpful in dealing with the effects of stress and having a good night’s sleep.
How Long Do I Have To Take Natural Remedies?
One of the most frequent questions I get after therapy is implemented is “how long will I have to take all this stuff”? *The answer is “when cause of the stress is gone”. This could be weeks, months or years. But our goal is to first identify the effects of stress then help clients tolerate the stress or make it “manageable” so the effects are not so severe. The objective is to prevent the severe consequences that high cortisol levels can cause and work with our clients on an ongoing basis to support them through their stressful time.
We can provide the tools but as long as the stressful conditions continue we can only deal with the medical consequences and provide natural treatments and products that have been proven to prevent further harm and to undo much of the harm already done. *Ultimately, a good night’s sleep can create a beneficial environment for the person to live a better quality of life. Stress can cause severe medical harm and should not be ignored.