insomnia

Chronic stress, appetite suppression, control and metabolic inflexibility.

It was the famous stress scientist Hans Selye who suggested that stress can be a positive or negative force. But how do we know whether we are dealing with stress effectively? There’s a common theme among clients both male and female who have got used to feeling in control of their health by suppressing appetite, symptoms and a false sense of health by perhaps feeling in control. Is this control a false economy? A well-known symptom of stress is a loss of appetite and skipping breakfast, it feels better to perpetuate the production of stress hormones like adrenaline and cortisol to liberate energy from stored fats and stride through the day with their endorphin like qualities. A common theme of females suffering from poly cystic ovary syndrome (PCOS) is chronic irregular eating or over eating in the obese. High stress can be chronic and perceived as the norm. I’ve observed the former in my eldest daughter through under eating as a product of emotional stress

‘For those habituated to high levels of internal stress since early childhood, it is the absence of stress that creates unease, evoking boredom and a sense of meaningless. People may have become addicted to their own stress hormones, adrenaline and cortisol, Hans Selye observed. To such person’s stress feels desirable, while the absence of it feels like something to be avoided.’ Gabor Mate

It should come as no surprise why some studies suggest that short term fasting, and calorific restriction seem to be productive in reversing aspects of inflammation and auto immune disease. When the body is stressed even eating certain foods becomes stressful. Dairy, sugar, fruits, grains all get the blame. I feel better when I don’t eat these some say. I feel better when I don’t eat others say. Is it the food or is it you? Can you be so fragile that eating some fruit for example is enough to send your biology into a tail spin. Eating sugar in excess can be problematic but then so can eating fat or anything in excess.

Copy of Copy of Copy of Untitled.jpg

A foundation of good health is built upon biological flexibility, potential and far away from equilibrium states.

The inability to utilise carbohydrate is a snapshot of the inflexibility of an individuals’ metabolism and not the carbohydrate. Evolutionary biology has provided efficiency by aerobic metabolism of carbohydrate and fat. The loss of efficient use of carbohydrate/sugar is the hallmark of a loss of function or flexibility and the chronic use of fats as a fuel is problematic due to increased oxidation of these lipids which can damage the aerobic apparatus within the mitochondria. The Randle cycle or glucose fatty acid cycle should allow flexibility between using either fats or carbohydrate as a fuel (Randle, Garland, Hales, & Newsholme, 1963). It’s often the lack of flexibility, decreased oxidation of carbohydrate and perpetual use of fats that damage the energy producing cells. Saturated fats are the preferred fuel of aerobic (oxidative) metabolism but in aggressive metabolism of cancer cells, unsaturated fats are utilised perpetuating the damage, promoting inefficient glycolysis or anaerobic metabolism that creates the acidic state of the cell.

The dogma that persists in nutrition circles is not based on sound reasoning but limited ideas that look at short term studies related to carbohydrate restriction. When a system loses its capacity to regulate sugar, we blame sugar instead of looking at the variety of factors that are responsible for degraded biology, carbohydrate utilisation and insulin responses.

Whether excessive exercise or inadequate nutrition the end result may be similar and its effects are far reaching into metabolism, cardiovascular, sexual and reproductive physiology.

By improving life conditions (in many ways) the hormones of pleasure can have a bigger role in our physiology. I think the experience of pleasure (whatever capacity for pleasure there is) increases the ability to experience pleasure, but I don't offer this with much hope as a therapeutic approach, since I know of people who say that running to exhaustion makes them "feel good" - neither "feeling good" nor "having orgasms" has a clear meaning, at present. Ray Peat

I’m not suggesting that going long periods without eating are necessarily bad, nor if you enjoy running is that bad either. Context is key. If you enjoy running run. If you have the capacity to go long hours without eating, then do that too. However if you have a system that lacks flexibility these actions can be problematic.

Have you ever considered not engaging in intense exercise for a couple of weeks to see how your body really feels?

I think this is a useful test to discover where your biology is really at. It can help determine whether you have been propping up a dysfunctional biology with intense exercise that falsely elevates your body temperature through activation of the sympathetic stress pathway. Slowing down and just focusing on walking and a few stretches shouldn’t feel stressful. Equally an individual who switches to eating regularly every 3 hours or so with the same amount of calories they were previously eating shouldn’t feel stressful. We all have patterns, routines and to the extent that they are effective or not is dictated by the metabolic flexibility that one should have. I’ll also suggest that metabolic flexibility could be analogous to emotional flexibility and mood states. A sign of improvements to metabolic flexibility and flux is return of energy, ability to tolerate exercise, good sleep, libido and emotional responses among other aspects of function. How do you know if it’s working? This diagram suggests what drivers are necessary and how to overcome your unwanted symptoms with the right inputs.

Metabolic inflexibilitY.jpg

Some patience seeking the return of these aspects of function is needed. After all, if you have spent decades constrained by negative symptoms then it may take more than a few weeks or months to fully resolve these patterns. In addition to the foundational work on hormones and chemistry, some people might find a need to address belief systems or require counselling for trauma or emotional grief to help resolve emotional stressors.

 References

Mate, G. (2008). In the realm of hungry ghosts. Close encounters with addiction. Canadian Family Physician.

Randle, P. J., Garland, P. B., Hales, C. N., & Newsholme, E. A. (1963). The glucose fatty-acid cycle its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. The Lancet, 281(7285), 785–789. https://doi.org/10.1016/S0140-6736(63)91500-9

Peat, R. (1997). From PMS to Menopause: Female Hormones in context.

Selye, H. (1987). Stress without distress. In Society, stress, and disease, Vol. 5: Old age. (pp. 257–262). http://doi.org/10.1080/00228958.1983.10517713

 

How to improve sleep-wake cycles.

Do you need to improve sleep? Why is it that sometimes, with the best intentions of going to bed early, we either find ourselves struggling to enter a sleep cycle, or wake up, deep in the hours of darkness? The prominent stress researcher Robert Sapolsky (Why Zebras don’t Get Ulcers) writes fondly of his near death experiences, of little sleep from the arrival of his newborn child. It’s no surprise that security and intelligence operatives use a lack of sleep to disorientate prisoners. Just one nights lack of sleep from me and I will tell you anything! Despite the will to nod off, why is it that many people suffered from poor sleep, or struggle to enter sleep cycles?

Before I delve into some brief hormonal issues that can be manipulated to ensure a deeper sleep it’s worth noting that darkness itself is a stressful experience and we produce many restorative hormones during sleep to combat the metabolic stress of darkness. Therefore one essential component of adequate sleep is exposure to sunlight on a daily basis. This ensures uptake of vitamin D and exposure to the deeper penetrative orange and red lights, which help to restore metabolism and healing of cells. An old blog on light therapy.

Over the years I have found the following issues associated with poor sleep.

  • Low blood sugar levels

  • Increase in compounds of wakefulness

  • Exercise late at night

  • Excessive work stress/blue light exposure

  • Exposure to EMF-electromagnetic stress and Wi-Fi

  • Poor sleep and its vicious cycle

  • Emotional Stress

There are several models to be aware of when it comes to sleep theory and the phases of sleep are categorised as

NREM – Non rapid eye movement- pre REM sleep.

REM - Rapid eye movement- this is the deep restorative part of sleep Active wake

Neurotransmitters and hormones associated with sleep:

Acetylcholine – AcH is the neurotransmitter associated with Rapid Eye Movement or REM sleep.

Serotonin – 5HT this neurotransmitter along with HA is associated with wakefulness.

Norepinephrine/Noreadrenaline - Ne - Hormone of wakefulness.

Gammaminobutyric Acid – GABA. GABA’s role in sleep is well documented but levels vary depending on location of the brain. It’s role is known in decreasing wakefulness and also decreasing deeper REM sleep and involved in producing wakefulness. Histamine- HA involved in wakefulness.

Hypocretin Orexin- PCT /O Involved in wakefulness.

Adenosine- AD involved in entering NREM sleep.

Here is a rough depiction of key Neurotransmitters of REM and NREM sleep. Other neurotransmitters of wakefulness such as Histamine, Serotonin and noreadenaline (hormone) are not depicted but are elevated in waking state and should be lower during sleep cycles. It’s worth noting that the use of serotonin in mood related disorders such as depression is a key agent in insomnia like states.

Common sleep disorders

Insomnia:  The inability to sleep restfully and I would categorise a good nights sleep from 6-9 hours depending on your own needs. The ability to enter deep sleep is dependant on many factors such as hormones, neurotransmitters, stress and available energy. It’s worth noting that the regenerative aspects of REM sleep and brain function have been shown to use as much glucose as when awake. Maintaining adequate available energy is key to getting sound-nights sleep.

Sleep apnoea: inability to enter REM sleep due to issues associated with optimal breathing. Obesity and sleep apnoea do seem to correlate and there is a suggestion of structural abnormalities in a small section of people.

The role of sleep in disease prevention

Sleep's role in psychiatric disorders, depression, metabolic disease and addiction are well documented. A key feature of a lack of sleep, besides on-going fatigue and failure to regenerate is the elevation of adrenalin and cortisol. Elevated levels of cortisol are well known to decrease thyroid function, which can have a significant effect on levels of circulating thyroid hormone and energy production (key to regulation of sleep). The mechanism can tie in with its pervasive actions on management of blood sugar levels. Another noted effect from sleep loss is that we tend to overeat more when tired, which could impact weight gain (and if thyroid is part of the vicious cycle, weight loss becomes increasingly difficult).

Lack of quality sleep can therefore be responsible for an increasing amount of deleterious conditions, such as hypothyroidism, diabetes and obesity, other hormone dys-regulation and cardiovascular disease. Ascertaining whether the issue initially stems from a hormone imbalance can be key in resolving sleep wake issues.

Drugs

There are a variety of drugs on the market that help to improve onset of sleep, however if you seek to improve the biological mechanisms of sleep and perhaps look to the list suggested below, you may find that your sleep improves, without the need for medication.

Cognitive behavioural therapy

The role of CBT in reducing Insomnia has shown effective results even more so than prescriptive medications. Whilst the treatment is not determined whether it effectively targets the mechanics of insomnia its success suggests provides a more desirable approach than long term insomnia medication.

What can you do?

  • Understand the link between production of inflammatory neurotransmitters such as Histamine and Serotonin and seek to lower them. This may be through diet adjustment or exposure to problematic chemicals/hormones.

  • If you get to sleep but wake up, this may be due to poor available energy. Maybe from a low carb diet, low thyroid function and poor production of energy. You may find having something light like a glass of milk with honey, or fruit juice with gelatin may help out. Salt also helps to decrease adrenalin production

  • Wi-Fi, blue light exposure, electromagnetic stress all play their part in interfering with stress and how the cells function. Stopping their use several hours before sleep can help. Do turn off Wi-Fi in house and no phones or electric devices by your bed.

  • Avoid stimulus such as caffeine or exercise in the evening, if you have sleep issues. Caffeine decreases production of adenosine.

  • If under emotional stress, a slow walk before bed may be a useful idea combined with ensuring adequate blood sugar levels are met.

References:

Neurobiology of Sleep. Course notes. Duke University. 2015.

Peat, R. From PMS to Menopause. Female Hormones in Context. 1997

Sapolsky R. Why Zebras don’t get Ulcers. St Martins Griffin. 1998

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941414/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3443758/

http://www.ncbi.nlm.nih.gov/pubmed/27091535

aquarius sleep.jpg