One of the worst symptoms of anxiety, sometimes preceding it, is insomnia – a difficulty getting to sleep or staying asleep. When I was suffering from my CFS in my mid-30’s, this was the first symptom to arise. I now know, my stress ‘cup’ was overflowing and my adrenals (the main stress glands) were struggling to cope. It’s as if I was ‘running on empty’.
Stress, of course, is not just a bad day at the office. It covers the whole gamut of physical, chemical and emotional stressors like heavy metals, over-exercising, emotional conflicts, etc. It is the adrenal's job to adapt you to stress by pumping out 2 main hormones: cortisol and adrenaline. Adrenaline is the short-term response meant to activate the system to action, cortisol is the longer-term adaptation hormone, released to help you come back down to normal. Its actions are often thought of as a balance to adrenaline, and in some ways to insulin too, via its effects on blood sugar (it helps to encourage blood sugar to rise if it falls too low by too much insulin). But, if your body is suffering from toxicity, the control system (largely the pituitary gland in the brain) gets its wires crossed and the feedback loop becomes distorted and either:
The adrenals (your gearbox to your cellular engine) become overactive (and racing heart, anxiety, sleeplessness result). Sometimes referred to as 'fight and flight' because you are in a state of preparing for threat - the job of your sympathetic nervous system (part of your autonomic system). Or
The adrenals become eventually exhausted and you find it hard to wake up in the morning, sluggish and brain foggy during the day, only really coming alive at night. (you are 'wired but tired' - here the sympathetic system has moved beyond a mild threat to adrenal burnout, sometimes also called freeze response as it's linked to the stage at which the body is no longer mobilised for threat but is effectively in a protective immobilisation state.
When this happened to me, it started slowly at first. Initially I’d go to sleep as normal and find myself waking early in the morning (usually about 3 - 5), wired and unable to return to sleep. This, it turns out, is due to the toxins (heavy metals, old hormones and by-products of normal metabolism) being dumped into the bloodstream at this time as the liver attempts to detox them. But if your liver is overwhelmed it cannot do the job properly. There is also the problem that if blood sugar drops too low, the adrenals will aim to protect the brain by releasing cortisol and sometimes also adrenaline, into the bloodstream causing you to wake, and, if adrenaline is present too, you feel unexplained anxiety and even dread!
Eventually, it the toxins that are causing this are left unaddressed, the adrenals become more and more depleted and you will find anxiety then prevents you from getting to sleep as well. I had nearly a year of not sleeping, and of course this becomes a stress in itself as you start to worry you cannot cope. An anxiety loop is established – driven by a neurotoxic brain and adrenal system (Hypothalamus, Pituitary, Adrenal - HPA axis). If you simply try to support (stimulate) the adrenals (with supplements etc) without helping to calm the system via addressing the toxicity, you can make the symptoms worse!
One way of finding out which system is dominant is to test your orthostatic blood pressure before sleep. This is the difference between lying down and, immediately after you stand up. Normally if your adrenals were working correctly the Systolic (upper reading) should rise by 10 – 15 points, but if it only rises by 5 points or so, or drops even, then your adrenals are exhausted. If it rises, then the adrenals are in the compensation phase of extra stimulation and your sleep will likely be extremely difficult.
Just knowing what is happening by this simple test would have saved me a lot of worry, when I had no explanation from my doctor who simply prescribed sleeping tablets and/or strong relaxant drugs like amytryptaline. Both made me feel like a zombie. I took them because I was desperate, but although they made me dozy, the sleep was in no way like normal restful dream sleep. And the side effects during the day were horrible.
So, what are the alternatives? Well there are various natural alternatives that help to either:
support/calm overactive adrenals during the day and night. Using any adrenal building product will simply make things worse. Melatonin and 5-HTP /tryptophan in low dose can help.
stimulate tired adrenals during the day (there are many proprietary adrenal formulas), and calm at night (as above).
In addition you may need to support the pituitary gland directly with a compound that contains both botanicals and hormones derived from animal glandulars (e.g. Metavive). In all cases I would advise getting help form a nutritional therapist/functional medicine doc as these are tricky things to get right and an ‘ad hoc’ approach on your own can do more harm than good as I know only too well! And, don’t forget the importance of diet: eating a small amount of protein and/or fat before sleep can be helpful (not carbs!) as will clearing out your toxins (whether by eliminating gluten, amalgam fillings, lead, toxic personal care products, and decreasing emotional stress) is also absolutely vital. You need a multi-pronged approach to reduce the neurotoxic burden.