This is Dr.Lam, founder of DrLam.com.
In our clinical practice helping people with adrenal fatigue, one of the most frequent
complaints is that they cannot fall asleep. But those people who do fall asleep have a
tendency to wake up multiple times in the evening after maybe 2 hours sleeping or 3
hours sleeping and they are not able to fall back to sleep anymore, or they can but it
takes some time.
Now this phenomena is called sleep maintenance insomnia, or what we call SMI. So typically
a person goes to sleep, and then after 2-3 hours wake up. Sometimes waking up with night
sweats, sometimes with heart pounding, sometimes with heart palpitations, heart pounding I
talked about earlier and sometimes with racing dreams, and it's very hard to go back to sleep.
Sometimes it takes 30 minutes, 45 minutes, and then when they go back to sleep, there's
frequent awakening again.
Now, what are the physiological reasons for this to happen? There are several reasons.
Metabolically, if your blood sugar is low in the middle of the night, this could happen.
Number 2, if you have a sympathetic system that is on overdrive, causing the body to
be in a fight or flight response, then the norepinephrine as well as the epinephrine
that is released as a result of this HPA axis activation can lead to the body being in an
alert state.
Now, this alert state usually is something that carries on from the day. So most of these
people will have difficulty falling asleep to begin with. But eventually they do fall
asleep because the body gets so overwhelmingly tired. But after sleeping for a couple of
hours, because the underlying neurological endocrine hormones are still being released
and still activated, then the body eventually wakes up. And then when you wake up, sometimes
as I said, you have heart pounding. This reflects the norepinephrine as well as the epinephrine
effect from the sympathetic effect. This is called again sleep maintenance insomnia.
So if you have frequent awakening and you don't have structural problems like lung or
airway obstructions that your doctor has cleared you from. The question you have to ask is
why this happens. Usually a person goes into sleep and goes through various stages and
eventually comes out in daytime and early morning as cortisol rises. So another reason
for the sleep maintenance insomnia is a cortisol curve that is imbalanced. Sometimes we have
to take the cortisol level in the middle of the night just to see how biologically the
rhythm is disrupted.
Most people think of sleep as an independent event that happena from let's say 10'o'clock
in the evening to 6 or 7'o'clock in the morning. But that is a concept that needs to be modified.
If you don't have a biological rhythm that is well balanced throughout the day, then
it's going to have the flow through any imbalances. Dysregulations will flow through into the
night and that is what one of the things you're going to have to look into as far as SMI.
Having SMI therefore is a symptom of adrenal fatigue and SMI is an opportunity for us to
look into the reasons as to why you maybe having this problem and how you can trace
it to the root level, especially with regards to biological rhythma. Once you understand
this concept, then you will understand that by restoring the biological rhythm to its
normal circadian balance, then oftentimes the SMI will resolve. Similarly, if the SMI
is reset, it could be due to metabolic reasons, and if you're able to overcome the metabolic
issues, then the SMI will eventually go away or reduce. So SMI is an important symptom.
It's a symptom that allows us to investigate further and I hope you can understand this
concept.
I've written many articles on this topic, SMI. For those of you who are interested in
pursuing more, go to my website DrLam.com and then put in the search word 'insomnia'
or 'sleep'. There are two articles that particularly come to my mind and one is called 'Sleep and
Adrenal Fatigue Syndrome' another one is called 'Biological Rhythms and Adrenal Fatigue Syndrome'
and both would be a good read for you to understand this topic more.
I hope you've enjoyed this video. For more information on this topic, head over to DrLam.com
where I have written over a thousand articles to help educate people. You can also call
me at 626-571-1234 for more information on Adrenal Fatigue and how to navigate it. Finally,
if you enjoyed this video, please subscribe to my YouTube channel. Thanks for watching.