\u00a9 by Elizabeth Lee Vliet MD and Kathy Kresnik<\/p>\n
The \u201cCOVID-era\u201d has brought a marked increase in stress-related health problems in my medical practice. Two in particular\u2014<\/span><\/span>insomnia<\/i><\/span><\/span> and <\/span><\/span>anxiety<\/i><\/span><\/span>\u2014are often medicated with dependency-inducing Rx medicines that can adversely affect memory, balance, and mental clarity.\u00a0 Yet, natural medicine supplements, behavioral, and lifestyle strategies would fix the problem if people would put all the pieces together as Kathy and I describe in today\u2019s Health Tip!<\/span><\/span><\/p>\n A good example is my recent patient, a 62-year-old, professional woman with a high stress job who has been a patient of mine for 10 years. She is post-menopausal and I have treated her with FDA-approved bioidentical estradiol after a hysterectomy 10 years ago. Overall, she\u2019s been in good health and has been very stable on her hormone therapy, that also includes thyroid medication. But at her appointment in February, she described having an extremely stressful year with elderly parents and relatives needing extensive care, overseas travel, long work days keeping up with her own career, plus planning for one of her adult children\u2019s wedding. She described having intensified anxiety, insomnia, difficulty concentrating and felt like she just wasn\u2019t doing as well as she had been since we initially stabilized her on the hormone therapy and her health and resilience supplements. \u00a0None of her prescription medications needed adjustment at her appointment since all her lab results were in optimal ranges on her current hormone doses. She already had a good meal plan and exercise program. I suggested a few changes in her sleep hygiene habits (see my <\/span><\/span>Health Tip: Dr. Vliet\u2019s Guide to Optimal Sleep<\/span><\/span><\/span><\/a>).<\/span><\/span><\/p>\n The big change I recommended was to add our <\/span><\/span>TruInositol\u2122 Complex<\/span><\/span><\/span><\/a> to help reduce the anxiety and stress-related insomnia. \u00a0At her follow up appointment in August, she said <\/span><\/span>\u201cThe inositol complex you recommended made a HUGE difference! My anxiety is gone, I am sleeping a lot better, and I also noticed that the increased appetite I had with all the stress is back to normal, so I think the complex was a really helpful addition to all that you have been doing for me.\u201d<\/i><\/span><\/span><\/p>\n The Vicious Cycle: Stress-insomnia-anxiety-more stress! <\/b><\/span><\/span><\/span><\/p>\n Stress in your life affects your quality of sleep. Then when you don\u2019t sleep well, you are more anxious and don\u2019t feel well, which in turn adds to your stress and creates more problems sleeping and more anxiety.\u00a0 It is a terrible and serious vicious cycle that is reinforcing itself. But it is much deeper than that, since there are major physiological connections with the way stress changes your brain and body biochemically, and even structurally.\u00a0 These changes then affect sleep regulatory pathways and chemical messengers in the brain in adverse ways.<\/span><\/span><\/p>\n The first step to getting a good night\u2019s sleep is to understand how stress disrupts the brain sleep regulation and metabolic-endocrine pathways that need to be in balance for optimal quality of sleep.\u00a0\u00a0 I will briefly explore the effects of stress on the body, then dive deeper into the specifics of how stress disrupts sleep, and the ways I am helping my patients reduce the damaging impact of stress and improve insomnia.<\/span><\/span><\/p>\n What is Stress? <\/b><\/span><\/span><\/span><\/p>\n The formal definition of stress is the body\u2019s normal psychological and physical reaction to <\/span><\/span>stressors, <\/i><\/span><\/span>which are the demands or changes in life that trigger the body to respond and adapt.\u00a0 This is often called the \u201cfight or flight\u201d response, and it means our stress hormones are preparing the body to handle the challenge.\u00a0 Temporary physiological changes occur, such as increased heart rate, increased in blood pressure, and release of \u201cadrenaline.\u201d\u00a0 This is referred to as <\/span><\/span>acute stress, <\/i><\/span><\/span>which by definition is brief in duration and can be helpful in dealing with specific situations.<\/span><\/span><\/p>\n A <\/span><\/span>stressor, <\/i><\/span><\/span>the \u201cstimulus\u201d to which the body responds, can be <\/span><\/span>positive<\/i><\/span><\/span> (e.g., a promotion) or <\/span><\/span>negative<\/i><\/span><\/span> (e.g., a job loss).\u00a0 Stressors can be events in our lives, environmental changes, illnesses, or thoughts (fear <\/span><\/span>or <\/i><\/span><\/span>excitement), as well as many other sources of stimuli.\u00a0 Stressors can be energizing, motivating and stimulating, or they can be sources of fear, apprehension, worry and anxiety. <\/span><\/span><\/p>\n Positive stress is also called <\/span><\/span>eustress<\/i><\/span><\/span>. Eustress helps you get things done. But when stress becomes negative and overwhelming, it becomes <\/span><\/span>distress, <\/i><\/span><\/span>especially when persistent over time. <\/span><\/span>Chronic stress<\/i><\/span><\/span> is a long-term stress caused by persistent stressors over weeks, months, or longer without adequate relief. The body is continually activating the fight or flight response which leads to extensive damage to the body through prolonged exposure to stress hormones like cortisol and adrenaline. High levels of <\/span><\/span>distress <\/u><\/span><\/span>for long periods of time lead to chronic illness and disease.\u00a0 <\/span><\/span><\/p>\n Keep in mind: stressors are present all day long, every day of our lives.\u00a0 We cannot eliminate them and still be alive. The goal is NOT to eliminate all stress. That is impossible. The goal is to control <\/b><\/span><\/span><\/span>how we respond, <\/b><\/i><\/span><\/span><\/span>and work on addressing the <\/b><\/span><\/span><\/span>balance <\/b><\/i><\/span><\/span><\/span>of stressors. <\/b><\/span><\/span><\/span><\/p>\n How Stress Affects the Body: <\/b><\/span><\/span><\/span>While acute stress responses are adaptive and protective, chronic stress leads to sustained hormonal and sympathetic activation that damages multiple organ systems and increases disease risks.<\/span><\/span><\/p>\n Cardiovascular system: <\/b><\/span><\/span>Chronic stress raises heart rate and blood pressure, increasing risk of hypertension, heart disease, heart attack, and stroke. Stress hormones also promote blood vessel constriction, endothelial dysfunction, and increased platelet aggregation, which contribute to thrombosis and atherosclerosis. Stress can also cause unhealthy behaviors such as poor diet, smoking, and low exercise, compounding cardiovascular risk.<\/span><\/span>\u200b<\/span><\/span><\/p>\n<\/li>\n Brain and cognition<\/b><\/span><\/span>: Long-term stress can cause structural brain changes, including shrinkage of regions like the prefrontal cortex and hippocampus. This may impair memory, cognitive function, and emotional regulation, contributing to anxiety, depression, and insomnia. Persistent inflammation and neurochemical imbalance from stress can lead to neuronal damage and loss. <\/span><\/span><\/p>\n<\/li>\n Immune system<\/b><\/span><\/span>: Chronic stress weakens immunity, making the body more vulnerable to infections and slowing healing processes. It also promotes systemic inflammation, which can worsen autoimmune disorders and chronic diseases. <\/span><\/span><\/p>\n<\/li>\n Musculoskeletal system:<\/b><\/span><\/span> Constant muscle tension from ongoing stress often leads to pain, headaches, and musculoskeletal disorders, including chronic pain syndromes. Muscle guarding and atrophy can develop with reduced physical activity due to stress. <\/span><\/span><\/p>\n<\/li>\n Other effects:<\/b><\/span><\/span> Stress disrupts sleep patterns causing insomnia, affects digestive health leading to issues like irritable bowel syndrome, and alters metabolism which can contribute to obesity, diabetes, and weight fluctuations.<\/span><\/span>\u200b<\/span><\/span><\/p>\n<\/li>\n<\/ul>\n BOTTOM LINE:<\/b><\/span><\/span><\/span> Chronic, persistent stress via prolonged fight or flight activation causes multi-system damage significantly contributing to adverse long-term health problems and disease risks (including cancers), and significantly impairs quality of life. <\/span><\/span><\/p>\n How Chronic Stress Affects Sleep:<\/b><\/span><\/span><\/span><\/p>\n Chronic stress negatively affects sleep by making it harder to fall asleep, increases night-time awakenings, and reduces sleep quality. Together, these changes are referred to generally as \u201cinsomnia.\u201d\u00a0 The ongoing sleep disruption is then a form of chronic stress that activates the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system, leading to elevated stress hormones such as cortisol and adrenocorticotropic hormone (ACTH). Increased cortisol heightens alertness and delays sleep onset, while ACTH is associated with more frequent awakenings and fragmented sleep patterns. Stress also suppresses the ovarian axis in women and testicular function in men, which in turn add to the endocrine imbalances that impair sleep.<\/span><\/span><\/p>\n\n