As a society, we have learned to adapt to stress and sleeplessness. We have learned to accept that burning the candle at both ends, running on empty, not getting solid sleep, are all “fine” and a part of life’s process.
A common response, when I ask patients about their stress level is, “it’s normal”.
When I ask patients to break down what “normal” means to them, it becomes clear that “normal” is really more like medium to high and “coping” is really what’s going on.
When “normal” is broken down, it becomes clear that we have an enormous amount of pressure on ourselves to perform at work, in our partnerships, as parents, students, really just in general as human beings.
When I ask what sleep is like, I often get, “I wake up every night at 3:30 am and have trouble falling back asleep, but that’s normal” or “I toss and turn for a few hours and eventually fall asleep, but that’s normal.” Here’s the thing, it’s not “normal”.
This is the reason I became an acupuncturist and Chinese medicine practitioner. As a budding graphic designer in NYC in my early twenties, the perceived pressure I felt was so real to me. I let the pressures of my job, my then relationship, the city, all affect me so much that a few sleepless nights turned into many. So much so, that it became my normal. My skin started breaking out in ways it never had before, my digestion was thrown off, I became unhappy, judgmental, insecure, and overall just not myself.
A combination of acupuncture, Chinese medicine, yoga, and meditation all literally saved my sanity. This was my wake up call to change the game. I eventually quit my job, moved out of the country to clear my head (yes, I was that dramatic about it), and came back to start my Masters Degree in Acupuncture and Chinese Medicine vowing to support my community in their efforts to get by as functional human beings in this society.
As acupuncture and Chinese medicine practitioners, stress and sleep are two things that we constantly check in with regardless of your chief complaint. Here is why:
STRESS AND SLEEP AFFECT EVERY SYSTEM OF YOUR WHOLE BODY
It’s true. If you are not addressing your stress and sleep cycle, you are hindering your ability to reach your health goals. Period.
Our bodies are wired, on a primal level, to react to stress. It’s what has kept us alive as a species for this long. We’ve had to fight off some major predators and threats to get where we are today. However, our brain’s ability to decipher between the stress of being chased by a huge predator vs. “oh my god, this traffic is terrible and I’m going to be late for work” or “I can’t believe he said that to me, how are we going to make this work” or “I still haven’t bought a house and I’m x years old”, can be self-limiting.
Enter, the HPA, or hypothalamic pituitary adrenal axis.
THE HPA CYCLE
When you perceive a threat, an alarm system gets tripped throughout your whole body. This alarm system, or stress response system, is the HPA axis. It is a chain reaction of hormone signals and responses that create a feedback loop to the brain. It basically lets you know whether to freak out or take a deep breath and relax. It starts in the brain, specifically the hypothalamus. Your hypothalamus, upon an immediate sign of stress, sends out corticotropin-releasing hormone (CRH). CRH travels to the pituitary gland. Once they get together, the pituitary gland releases adrenocorticotropic hormone (ACTH) which travels down to your adrenal cortex. Your adrenal cortex then releases cortisol in response.
Cortisol stays in your system for hours after immediate contact with the initial stress response. Once your body reaches a certain blood concentration of cortisol, a signal is released to stop the HPA axis and the body goes back to being its balanced, happy self.
Cortisol is the main player here in the happy self-disruption. When cortisol is released, it shuts down any systems that are not immediately necessary for you to fight and or flee the situation. This is huge. This is a “fight or flight” mode. Your blood sugar rises, and your immune, reproductive, healing, growth, and digestive systems all get suppressed so that as much energy as you can muster goes into to battling off this perceived threat. Mood and fear are also altered with the release of cortisol, making your responses and attitude shorter with higher anxiety. Under normal circumstances, the negative feedback loop, mentioned in the paragraph above, eventually stops the release of cortisol and all these systems go back to working just fine.
WHEN THE PROBLEM ARISES
When we are repeatedly exposed to perceived threats and stress in our life, our body habituates and the HPA axis become desensitized to high levels of cortisol. Meaning, it doesn’t shut down and cortisol levels remain high, i.e. bad. Here’s where the sleep piece comes in. We only fall asleep when our HPA axis functions at its lowest. So for many of us, when we’re stressed we don’t sleep well. Not sleeping well further throws off the balance of the HPA axis. Stress and insomnia play off of each other. Therefore, it’s important to regulate them together. When the HPA axis stays in motion and cortisol levels remain high in the body, you are put at risk for issues with:
- Tissue and cellular repair
- Immune response to pathogens
- Weight regulation
- Memory and concentration
That’s a long list!
WHAT CAN YOU DO?
In a 2013 article in the Journal of Endocrinology, a study was presented in which rats endured chronic stress conditions. The group that received acupuncture had lowered blood hormone levels secreted by the HPA axis compared to the group that received no acupuncture.
In another article published in 2013 in Evidence-Based Complementary and Alternative Medicine. Researchers compared the effects of acupuncture, sham acupuncture, and the prescription of Estazolam (a pharmaceutical sedative) in the treatment of primary insomnia. One group received acupuncture and took a placebo pill, one group took Estazolam and received sham acupuncture, and one group took a placebo pill and received sham acupuncture. While all three groups showed some improvement, the acupuncture/placebo pill group showed the most sustained improvement in 2 months post clinical trials.
Chinese herbal formulas are highly effective when prescribed correctly for stress and insomnia. I’ll reiterate when prescribed correctly. Meaning, please do not go on to the internet and self-prescribe or take something that worked for you friend’s aunt. Herbal medicine takes years of rigorous study. The famous axiom in Chinese medicine is “One disease, many patterns. One pattern, many diseases.” The symptoms for some of us might look the same on the outside but the root might be entirely different. It’s important that you talk to a licensed professional about your unique body with your unique set of factors involved.
Whole food diet
Put the good stuff in your body! If your cortisol levels are high, your digestive system is being compromised. Don’t tax it further by adding processed foods into the mix.
Move your body! Physical exercise releases endorphins, the “feel good” hormone in the body. It has been found that even 5 minutes of aerobic exercise can have anti-anxiety effects!
Take 10 minutes every day to just sit quietly with yourself. It doesn’t have to look like anything other than counting your breaths. I usually recommend counting even inhales or exhales, called sama vritti pranayama, in yogic practices: 4 slow counts for an inhale, 4 slow counts for an exhale, or whatever number feels comfortable for you. Pausing for 10 minutes a day to stop the chaos of the mind and focus on the breath eventually trains the brain to incorporate this throughout your day. Since this is a training method, it takes practice. So you have to keep showing up for it.
Really, these are all training methods. You can’t just eat healthy one day and expect a change, or have one acupuncture session and be healed. Unfortunately, that’s not the way it works. As Kiné, the clinic director at Willow Tree Wellness says, “you don’t go to the gym once and then feel ready for the beach, right?” If you notice stress or lack of sleep is affecting your life, pay attention to it. Your health is worth taking care of, so try some techniques that have been proven to work, and show up for them with consistency.
Give me a call at (503) 281-0030 to set up a Free Phone Consult. I am happy to listen to answer any questions you have about how I can best help you!
Koch, C, Leinweber B, Drengberg BC. 2016. “Interaction between circadian rhythms and stress.” Neurobiology of Stress, 6(2017), 57-57.
Randall, M. “The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis.” 2011. Dartmouth Journal of Science. Fall(2010).
Guo J, Wang LP, Liu CZ. 2013. “Efficacy of Acupuncture for Primary Insomnia: A Randomized Controlled Clinical Trial.” Evidence-Based Complementary an Alternative Medicine. 2013. doi: 10.1155/2013/163850.
Eshkevari L, Permaul E, Mulroney SE. “Acupuncture blocks cold stress-induced increases in the hypothalamus-pituitary-adrenal axis in rats.” 2013. Journal of Endocrinology, 217(1): 95-104. doi: 10.1530/JOE-12-0404.