Which Hormones Affect Sleep?
Health

Hormones That Cause Sleeplessness (and What Can Be Done)!

If you have ever tried to battle insomnia, you’re probably already privy to the concept of a circadian rhythm. This is our naturally occurring sleep/wake cycle. In the modern world, light and dark are the most important external ‘cues’ for regulating our circadian rhythm.

The most critical internal cues are our hormones. If you want to learn how to regulate your circadian rhythm, you’ll need to understand the role of hormones. We’ll discuss how nurturing the health of your hormones can help you get your sleep back on track.

Which Hormones Affect Sleep?

Hormones are chemical ‘messages’ secreted by our glands and released into our bloodstream. These chemical messages mediate how hungry, calm, hot, or sleepy we feel. The following hormones are known to affect sleep.

Adrenaline

Also known as the flight-or-fight hormone, adrenaline causes our blood pressure to rise, our pupils to dilate, and our metabolism to speed up. Adrenaline is released by the adrenal glands (or the central nervous system) when we experience a threat.

A threat could be anything from a physical fight to a frightening horror movie. At one time or another, you’ve probably felt ‘shook up’ by an unexpected stressful experience; that’s adrenaline flooding your system.

Although the immediate symptoms fade quite quickly, it can take many hours for hormone levels to regulate. For this reason, it’s essential to reduce stress and practice relaxation in the evening hours.

Cortisol & Adrenocorticotropic Hormone

Just before we wake up, our cortisol levels peak. Some have referred to cortisol as the body’s own shot of espresso, as it provides us with some natural ‘get-up-and-go’ in the morning.

But cortisol hasn’t earned its title as the ‘stress hormone’ for nothing. Cortisone and cortisol are released by the adrenal glands during periods of stress. If the stress is chronic, and the cortisol remains elevated, insomnia could quickly set in.

The release of cortisone and cortisol is prompted by the release of the adrenocorticotropic hormone in the pituitary gland, at the base of the neck. Cushing’s Disease is caused by an overproduction of cortisol in the body.

The most common cause of this disease is a benign tumor at the base of the neck, near the pituitary gland. This interferes with the release of the adrenocorticotropic hormone, which results in an overproduction of cortisol in the body.

High levels of adrenocorticotropic hormone and cortisol are seen in people who are chronically stressed. If high levels of cortisol persist, this could lead to an anxiety disorder which may impair sleep further. It’s not just emotional stress but also physical stress.

Endurance athletes typically have very high levels of cortisol because they ask a lot of their bodies. One way to manage this is to work out during the morning hours so that cortisol levels have had a chance to reduce before bedtime. It’s important to intervene as soon as possible to stop stress from becoming chronic because once sleep deprivation has started, the cycle becomes hard to break.

Thyroid Stimulating Hormone

Thyroid stimulating hormone (TSH) is responsible for controlling the production and release of thyroid hormones. If too much TSH is available in the body, this suggests an underactive thyroid. If too little TSH is available in the body, this suggests an overactive thyroid. But why is this significant for sleep?

According to a study published on NCBI, people with an underactive thyroid (hypothyroidism) get very little slow-wave sleep. Slow-wave sleep is the very deep ‘stage three’ sleep, which is important for rest and rejuvenation.

Moreover, an overactive thyroid is known to create symptoms of anxiety – which is likely to disrupt sleep. If you are suffering from ongoing sleep deprivation, it is vital to be aware of the symptoms of thyroid conditions – as these conditions sometimes go undiagnosed.

Melatonin

Many of us know about the importance of melatonin for sleep. When it begins to get dark, melatonin is produced in the brain’s pineal gland, sending a message to the body that it’s time to sleep. Studies have shown that melatonin production coincides with (and may be necessary for) a reduction in core body temperature. A reduction in core body temperate occurs just before we go to sleep.

Some studies have shown that encouraging melatonin production is particularly useful for people with delayed sleep syndrome – i.e., those who find themselves falling asleep hours after they’ve gone to bed.

Good sleep hygiene involves sleeping in total darkness, to encourage the production of melatonin. As we’ll discuss, melatonin plays a key role in sustaining our circadian rhythm, so it is vital for sustaining good quality consistent sleep.

Sex Hormones – Estrogen, Progesterone, and Testosterone

The sex hormones have a role to play in mood regulation, temperature control, and melatonin production. An imbalance is often the cause of a sleep disorder.

Estrogen and progesterone are hormones produced in the woman’s ovaries. Contrary to popular belief, women also produce small amounts of testosterone. A delicate balance of estrogen, progesterone, and testosterone is required for optimum health.

During the monthly cycle, levels of these hormones do change, and it is normal to experience some sleep disturbances during the premenstrual period. Also, a condition called polycystic ovary syndrome (PCOS) is characterized by an imbalance in the sex hormones and can cause many sleep-related complaints.

Similarly, women may experience sleepless nights during the menopause and pregnancy because there is a significant shift in the sex hormones.

Symptoms include:

  • Night Sweats
  • Low mood
  • Less REM ‘deep’ sleep
  • Nocturia (the need to urinate frequently)
  • Daytime fatigue

Although women are more commonly affected by hormone imbalances, men are not completely immune. A decline in testosterone begins around age 30 and may have an impact on sleep in some cases. Male endurance athletes are particularly at risk of developing testosterone deficiency – discussed in more detail below.

which hormones affect sleep?

Aldosterone and Antidiuretic Hormone

During the night, our adrenal glands produce more of the hormone aldosterone. This hormone helps to control levels of sodium and potassium. If the correct amount of aldosterone is produced, this should stop us needing to visit the toilet throughout the night.

During pregnancy, a woman produces up to 8 times as much aldosterone to regulate salt in the body. It’s rare for someone to suffer from aldosterone deficiency or imbalance. However, it is occasionally a side effect of diabetic neuropathy or disease of the adrenal glands.

Antidiuretic hormone is produced by the pituitary gland, and it helps to modulate our blood pressure. The antidiuretic hormone can also aid uninterrupted sleep because this hormone stops too much liquid exiting the body as urine.

A condition called diabetes insipidus is related to the underproduction of antidiuretic hormone. The condition results in feeling thirsty and needing to urinate throughout the day and the night – no matter how much you drink.

When there is an overproduction of antidiuretic hormone, this can lead to an increase in blood pressure. If you’ve suddenly started taking diuretics, perhaps to treat high blood pressure, these could cause nocturia.

What Can Influence Hormones?

Hormonal changes can occur throughout the lifespan and can be affected by many biological or lifestyle factors.

The main influences include:

  • Stress – Stress causes cortisol levels to rise, and If cortisol levels remain chronically elevated, insomnia can set in.
  • Menopause – As mentioned, this life change is known to cause many hormonal changes which may impact upon sleep.
  • Pregnancy – Hormonal changes during the first trimester are most likely to impact sleep.
  • Endocrine Disorders – Hyperthyroidism, Hypothyroidism and Hashimoto’s disease are conditions that affect the thyroid. These conditions impact the number of thyroid hormones released into the bloodstream.
  • Poor Lifestyle Choices – Some studies have shown that a diet high in processed carbohydrates and sugar can lead to a condition called polycystic ovary syndrome. This condition can impact upon sleep quality.
  • Sleep Apnea and Being Overweight – Being overweight or suffering from sleep apnea can encourage the production of adrenaline throughout the night, which will significantly impair sleep.
  • Sleep Deprivation – We know that hormones are involved in sleep disturbances. Scientists do tend to disagree whether it’s the hormone imbalance causing the sleep disturbance, or sleep disturbances causing the hormone imbalance. For example, a recent study published on Science Direct found that sleep deprivation caused an overproduction of a thyroid-stimulating hormone and an underproduction of prolactin (a hormone that controls the metabolism).
    Unfortunately, if your sleep condition was caused by a hormonal imbalance, it is probably now being fed and maintained by sleep deprivation. Conversely, if your sleep disorder was caused by something else, it may well have created a hormone imbalance which is worsening your sleeplessness. Thankfully, there are ways to break this vicious cycle!

Hormones and the Circadian Rhythm

We all know that hormones work best when they are ‘balanced.’ Although this is a simplistic explanation of how hormones operate, it is true to say that hormones work in sync with each other.  If one is negatively affected, others are likely to follow suit. As such, we need to be aware of how our hormones work cooperatively to modulate our circadian rhythm.

This is an overview of how hormones sustain our circadian rhythm:

  • Throughout the evening, cortisol levels gradually reduce.
  • When it gets dark, your melatonin secretion increases.
  • When we’re asleep, ghrelin, leptin, and insulin are regulated so that we don’t feel hungry.
  • Aldosterone levels increase so we can sleep-through without needing to go to the toilet.
  • Prolactin levels increase to support metabolic and immune system repair.
  • Growth hormone is released.
  • Oxytocin is produced after around 5 hours of sleep and may contribute towards our dreams.
  • Before waking, cortisol levels peak again, giving us the energy to face the day.
  • Assuming there are no periods of chronic stress, cortisol levels will gradually reduce over the course of the day, until evening time – when the process starts all over again.

If one of these hormones is affected, it can cause the whole sleep/wake rhythm to become deregulated. For example, if we are chronically stressed, and our cortisol levels remain elevated into the evening, this may inhibit the normal production of the ‘sleep hormone’ – melatonin. Achieving good sleep is a balancing act.

Premenstrual Sleep Problems

In the days leading up to menstruation, there will be a sharp drop in progesterone.

A progesterone crash can lead to a number of outcomes, including:

  • Night sweats
  • Less availability of melatonin
  • Reduced REM sleep
  • Low mood and irritability
  • Joint pain

It’s typical for sleep disturbances to start up to a week before menstruation, and they usually get better a couple of days after menstruation has begun. If a woman has particularly bad pre-menstrual symptoms, this suggests that the imbalance between estrogen and progesterone is significant. As such, improving lifestyle through diet, exercise and stress relief is likely to reduce the severity of these symptoms.

Some short-term strategies can also help to counteract the impact of these symptoms. For example, sleeping in a cool room, and paying close attention to sleep hygiene should improve some of these premenstrual sleep complaints.

what hormone controls circadian rhythm?

Menopause and Sleepless Nights

Approximately 50% of all menopausal women will experience sleep disturbances, so it is an issue that needs tackling. Sleep disturbances occur due to the hormonal shifts that occur during this time. To understand this in a little more depth, it is useful to distinguish between perimenopausal, menopausal and post-menopausal hormone changes.

  • Perimenopause – During the perimenopause, there will be fluctuating levels of estriol in the body. At certain times of the monthly cycle, estrogen levels may be very high. Some women do not experience any unpleasant symptoms during the perimenopause. For those that do, it’s common to feel hot and sweaty during sleep. This because when estrogen and progesterone are imbalanced, the body struggles to regulate heat effectively.
  • Menopause – At this stage, estriol levels are no longer fluctuating because a woman no longer has her monthly cycle. Overall, the ovaries produce much smaller amounts of estrogen and progesterone. A reduction in female sex hormones has been linked to many disorders such as depression, anxiety and body dysmorphic disorder – which may interrupt sleep quality.  Also, menopausal women may suffer testosterone dominance, as levels of testosterone do not reduce in line with the female sex hormones. Testosterone dominance is associated with a rise in adrenaline which can make it very difficult to relax.
  • Post-Menopause – The hormone changes involved in the menopause can cause some conditions which may persist into old age. For example, lowered estrogen levels may encourage fat to be stored on the stomach. If obesity or sleep apnea occurs as a result, this will negatively impact sleep. Lowered levels of estrogen can also cause brittle bones, which will ultimately lead to pain and trouble sleeping. There are nutritional, herbal or medical supplements available to counteract the effects of low estrogen.

Does PCOS Affect Sleep?

Scientists don’t fully understand the cause of polycystic ovary syndrome (PCOS), but they know it is somewhat related to hormone imbalance. Some studies suggest that a high carb, high sugar diet, and poor lifestyle choices are the cause of PCOS. Others are not convinced that this is the true cause of the hormone imbalance. However, almost everyone agrees that weight loss, and a healthy balanced diet, will significantly improve the symptoms of this condition.

Women with polycystic ovary syndrome produce higher levels of insulin (because they are somewhat resistant to the effects of insulin). An overproduction of insulin stimulates the ovaries to produce too much testosterone. Testosterone dominance in women can have an impact on the body’s core temperature – so sleep may become uncomfortable. Moreover, PCOS often leads to weight gain. People who are overweight are likely to find it harder to fall asleep and stay asleep because their bodies produce more adrenaline throughout the night.

If not managed effectively, PCOS can lead to infertility and type 2 diabetes. It can also cause women to develop male characteristics such as hirsutism (excessive hair growth), acne, and hair loss at the head’s crown. A degree of stress and anxiety are often experienced with this condition, which can make sleep more challenging.

Do Pregnancy Hormones Affect Sleep?

60-80% of pregnant women report significant sleep disturbances. In the first trimester of pregnancy, progesterone levels skyrocket. This is the reason pregnant women feel overwhelmingly tired, even during the day.

Also, heightened levels of both estrogen and progesterone are thought to interact with cortisol and melatonin. In turn, this can deregulate the circadian rhythm, so pregnant women find themselves napping during the day.

An increase in sex hormones can also cause the nostrils to swell. In some cases, this could cause snoring or breathing difficulties to develop.

Hormones and Dreams

Dreams and nightmares can certainly interrupt our sleep. In fact, recurring nightmares can cause us to avoid sleep, which only makes the situation worse. Studies suggest that two hormones may be involved in dreams – cortisol and oxytocin.

We tend to dream when we are more stressed, so it makes sense that cortisol would have a role to play in dreams and nightmares. Tackling emotional stress is likely to reduce the potency of nightmares.

Oxytocin is a hormone produced in the brain, and it is associated with arousal. It tends to be secreted approximately 5 hours after we’ve fallen asleep, or when we’ve reached a very deep stage of sleep. Oxytocin is secreted during our waking hours too, and some studies have shown that oxytocin influences social behavior.

As a result, some neuroscientists predict that oxytocin enables us to dream about social and emotional issues – which helps to regulate our emotions. This could explain why people that don’t sleep as deeply (i.e., menopausal women) experience low mood and become withdrawn because they are missing out on oxytocin and its emotion-regulating benefits.

Hormones and Sleep Apnea

Sleep apnea causes the throat walls to partially collapse during sleep. This will interrupt normal breathing patterns and can have a big effect on sleep quality.  Sleep apnea can be caused by hormonal imbalances. Also, it can also cause hormone imbalances to develop.

Hormonal shifts that occur during the menopause can cause the throat and neck muscles to become more relaxed, which can lead to sleep apnea. Also, hormonal changes can cause the nasal passage to constrict, which could lead to this condition.

Some other causes of sleep apnea not directly related to hormones include:

Sleep apnea can cause many hormonal issues. For example, it can:

  • Obstruct Melatonin – frequently waking throughout the night is likely to interrupt the body’s production of melatonin which will impact the circadian rhythm.
  • Increase Adrenaline – people with sleep apnea or sleeping problems are likely to have much higher levels of adrenaline throughout the night, which will encourage restlessness.
  • Elevated Cortisol – Sleep apnea is a long-term condition so if the symptoms are not managed or reduced, chronic stress is likely to occur which will cause cortisol levels to become elevated throughout the day and into the evening.

hormone imbalance and sleep disorders

Endocrine Disorders and Sleep Problems

Thyroid conditions are known to cause sleepless nights. Unfortunately, thyroid conditions come with a whole host of unpleasant symptoms. Even so, these conditions can occasionally go undiagnosed or misdiagnosed, so it’s worth being aware of the symptoms. Thyroid conditions can be diagnosed with a blood test.

Hypothyroidism occurs when there is an underproduction of hormones.

Symptoms of hypothyroidism include:

  • Fatigue
  • Pale skin
  • Hair loss or hair thinning
  • Feeling very cold
  • Weight gain
  • Feeling weak and numb

Hyperthyroidism is due to an overproduction of hormones. In contrast to the previous condition, the symptoms convey a state of hyper-arousal. If left untreated, it’s tough to get a good night’s sleep with this condition.

Symptoms include:

  • Sweating excessively
  • Anxiety
  • Frequent bowel movements
  • Weight loss (regardless of what you eat)
  • Rapid heart rate

Overtraining and Sleep Disorders

‘Overtraining’ occurs when we exercise on many consecutive days without rest, or when we do too much too soon – without allowing the body an adjustment period. Overtraining sets off a series of hormonal changes which interrupt sleep. Insomnia then prevents muscles from healing, so an overtrained athlete risks injury as well as sleep deprivation.

Male endurance athletes who have ‘over-trained’ may experience a significant reduction in testosterone levels. Overtraining will keep cortisol levels chronically elevated. In turn, this prevents the body from producing enough testosterone to fuel training, rest, and repair.

Besides fatigue and sleeplessness, low testosterone can cause low sex drive, weak bones, a low mood and poor training performance. This kind of hormone imbalance can usually be corrected by changing your training schedule.

For women, regular exercise can help balance the female sex hormones. However, if the exercise becomes excessive, and rest is overlooked, the ovaries will start producing too little estrogen and progesterone. The menstrual cycle may even stop altogether.

When coupled with the rise in cortisol levels, body temperature will become very difficult to modulate. As such, night sweats are likely to occur. An absent menstrual cycle due to overtraining (and thus low levels of sex hormones) will lead to poor bone strength in the long term, so this should always be remedied.

Sleep Disruption and Weight Gain

It’s important to tackle sleep disruption as soon as it arises, particularly if you are concerned about weight gain. Ghrelin and leptin are two metabolic hormones that can become aggravated by sleep deprivation.

Ghrelin is produced in the stomach lining and helps to determine how hungry we feel. If we get a good night’s sleep, this means that the body will produce an appropriate amount of ghrelin hormone during the day. If we do not sleep enough, there may be an overproduction of this hormone, which could trick us into feeling hungrier than we are.

Some studies have shown that just a single night of sleep deprivation can elevate ghrelin levels and cause us to overeat. When we’re tired and ‘hungry’ we opt for foods that can fill us up quickly (i.e., processed carbohydrates, sweets, and chocolate). This type of food can be really bad for the waistline.

How to Sleep Better

Hopefully, you’ve been able to determine which hormone(s) are involved in your sleep complaints. It should be possible to treat the cause of your sleep disturbances. Remember, hormonal imbalances can be both a cause and effect of sleep disturbances.

To break this cycle of sleep disruption, it’s important to treat the symptoms of sleeplessness, as well as the cause. As we’ve discussed, melatonin, cortisol and the sex hormones play a huge role in regulating sleep.

We’ll discuss how to encourage optimum functioning of these hormones.

Encourage Melatonin Production

First and foremost, you should implement good sleep hygiene. This will support melatonin regulation, particularly concerning your circadian rhythm.

Consider the following methods for encouraging melatonin production:

  • Use blackout curtains or blinds.
  • Sleep with a blackout mask.
  • Do not use electronic devices for at least 3 hours before bed.
  • If you can’t leave your mobile phone outside the bedroom, make sure you install a blue light filter.
  • Consider taking melatonin supplements.
  • When relaxing during the day, or early evening, allow natural light into the room so that your circadian rhythm is supported.

estrogen and sleep disturbances

Balance the Sex Hormones

Balancing the sex hormones (as much as possible) is likely to improve sleep disturbances.

If you’re suffering from premenstrual sleep disturbances or menopausal sleep disturbances, try to focus on improving your overall wellbeing.

  • Exercise gently in the morning – consider Yoga or walking.
  • Eat a balanced diet, rich in plant-based foods.
  • Manage stress effectively.
  • Limit the use of stimulants such as caffeine, nicotine, sugar, and alcohol.

If lifestyle changes fail to improve the symptoms of premenstrual sleep disturbances, you could talk to your doctor about taking an oral contraceptive to control your symptoms. Similarly, if lifestyle changes do not improve menopausal symptoms, you could talk to your doctor about hormone replacement therapy.

Phytoestrogenic supplements (such as licorice and evening primrose oil) may also be useful for correcting hormone imbalances in females, as they may increase levels of estrogen in the body. Supplements are not suitable for everyone, so it is a good idea to consult a homeopathic therapist for personalized advice.

It’s not always possible to correct female hormone imbalances. However, it is possible to limit the effects on your sleep.

Consider the following tips for making sleep more comfortable:

  • Always sleep in a cool room – some people find that to encourage melatonin production, they have to keep their curtains or blinds firmly shut – which can cause the bedroom to become overheated. Try using a blackout mask instead, so that you can keep the curtains open and encourage better ventilation.
  • Keep a glass of cold water next to your bed – If you wake up overheated, this will help you cool down quickly.
  • Wear loose night clothes and choose light bedding.
  • Use earplugs to block out external noise – this should reduce the number of times you wake up throughout the night.
  • White noise machines – anxiety can make you constantly feel ‘on edge.’ At night, this can worsen, as every creak of the floorboard or gush of wind stops you from falling asleep. White noise machines for sleep provide you with some minimal background noise which can help to relax your mind. As a result, many people find they are less likely to be woken up by disturbing noises.

Manage Cortisol Levels

As we’ve discussed, cortisol plays a vital part in regulating our circadian rhythms. Cortisol levels spike in the morning, just before we wake up. It’s important to be responsive to this spike and to resist having a lie-in (especially if your sleep patterns are already out of control!).

When you wake up, try to open the curtains and get out of bed straight away. This will allow you to make the best use of your body’s natural cortisol spike, and your energy levels will be more consistent throughout the day.

If cortisol levels are raised for a significant period of time due to chronic stress, this can lead to insomnia. As such, it’s imperative to manage stress and encourage relaxation.

Try the following tips to manage stress:

  • Commit to regular exercise in the morning hours.
  • Socialize regularly – this has been proven to lower cortisol levels!
  • Try exploring your feelings through journaling, drawing or another creative outlet.
  • Use essential oils to help you sleep, such as lavender to promote relaxation.
  • Improve your posture – studies have shown that ‘power posing’ (walking tall, with your shoulders down and neck elevated) can reduce cortisol levels.

To break the cycle of sleeplessness, try to achieve total wellbeing – this will give your hormones the best possible chance of thriving. In the meantime, there are plenty of remedies you can try to counteract the symptoms of sleeplessness.