Woman staying up late browsing phone with stress caused insomnia

Can stress cause insomnia?

Written on November 29, 2022 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Insomnia is when you have trouble falling asleep, staying asleep through the night, or waking up too early in the morning. Sound familiar? Well, if this describes a typical night in your bedroom, you are not alone. Insomnia symptoms occur in approximately 33 to 50 percent of the adult population, while 10 to 15% of us may have chronic insomnia disorder [1].

One of the biggest triggers for insomnia is stress. Stress-induced or stress-related insomnia is not an official medical term, but one that we can all probably relate to at some point in our lives. Stress-induced insomnia is a vicious cycle that many of us struggle to break free from. Stress can cause insomnia, and insomnia can cause stress. They can make each other worse. Also, if you treat one, the other improves. This article will help you better understand and unwind the reciprocal relationship between stress and insomnia.

What are the health risks of insomnia?

Besides being emotionally and physically exhausting and mentally destructive, insomnia can harm your health. In the short term, insomnia can make it hard to concentrate or think clearly. This puts you and your loved ones at risk for car accidents, work and school problems, and relationship challenges. In the long term, insomnia can lead to health issues like diabetes, hypertension, and weight gain [1].

We all know how we feel after several rough nights of tossing and turning—irritable, tired, anxious, and just plain lousy. It is not surprising, then, that those sleep disturbances are nearly universal in psychiatric disorders, especially mood disorders like depression. Two out of every three people with depression will develop insomnia [2]. There is a close relationship between sleep and depression. People with insomnia experience more severe depression and they are more likely to get depressed again, and treating insomnia improves depression [2]. Other mental health researchers believe might have a reciprocal relationship with insomnia include anxiety disorders, bipolar disorders, schizophrenia, ADHD, and Post-Traumatic Stress Disorder (PTSD), just to name a few [3].

When you have insomnia, you become consumed by thoughts of getting enough sleep. But the more you try to sleep, the more frustrated and upset you get. In other words, the more you stress about sleep, the harder sleep becomes. This is how the so-called reciprocal relationship works between stress and insomnia.

How can stress cause insomnia?

Certain types of physiological arousal disrupt your normal sleep patterns. A racing height heart, a rise in body temperature, and increased levels of specific hormones, like adrenaline and cortisol, are all types of arousal that happen in your body and can disrupt your sleep patterns, leading to insomnia. While these responses are an adaptive part of your body’s fight or flight response, designed to help you during a stressful or potentially dangerous situation, they can make a restful night’s sleep difficult.

Typically, cortisol and adrenaline levels diminish once a stressful moment passes, your blood pressure and heart rate return to baseline levels, and your system returns to normal. Chronic stress introduces consistently high cortisol and adrenaline levels into your system. Cortisol and adrenaline stimulate your body to be more alert, blocking the process of falling asleep [4].

Stress-induced insomnia refers to chronic sleep problems caused by ongoing activation of your nervous and endocrine systems. When your body is in the activated fight or flight mode, these two systems produce adrenaline and cortisol. Sleep problems happen when, because of stress, your nervous and endocrine systems remain activated and can’t shut off.

Cortisol levels and stress levels are related—both can disrupt your body’s circadian rhythm, impacting sleep. Your circadian rhythm is like your body’s own internal 24-hour clock that controls your body’s sleep-wake cycle. Melatonin is the hormone driving your circadian rhythms. Disrupting melatonin secretion at night will affect your sleep, make it harder for you to fall asleep, and potentially cause insomnia. And guess what can disrupt melatonin secretion? You guessed it, stress!

Stressful lifestyles increase your risk for insomnia

What are the things that you do when life is stressful? Drink more coffee, stay up late to finish that project, get up early to shoot some emails off, doom-scroll in front of your digital screens? All of these stress-related behaviors are also risk factors for insomnia and disrupters of melatonin secretion cycles. When it comes to triggers for insomnia, here is what we know can increase people’s risk for insomnia [5]:

  • Unpredictable sleep schedule caused by jet lag from traveling across multiple time zones, working a late or early shift, or frequently changing shifts.
  • Poor sleep habits such as having irregular bedtime schedules, taking daytime naps, using your bed for work, eating, or watching TV.
  • Using computers, TVs, video games, smartphones, or other screens within an hour of your bedtime.
  • Eating too much late in the evening may cause you to feel uncomfortable lying down, especially if you have heartburn which can keep you awake and in pain.

When it comes to sleep, it is not just how many hours you log but also the quality of your sleep. The same is true for stress as well. The more stressed you are (how much, for how long, and how often), the greater likelihood of your insomnia getting worse. With stress, it is a combination of factors happening inside our body (cortisol, adrenaline, and melatonin) with the way we change how we live when we are stressed put us at risk for insomnia.

How stress disrupts melatonin supply

Here are a couple of how stress impacts melatonin and your body’s normal sleep-wake cycle:

  1. Increased light exposure, especially at night, can suppress melatonin secretion [4].
  2. Caffeine (which we tend to consume more of when stressed) affects neurotransmitters involved in melatonin release, lowering melatonin levels [6].
  3. Factors that are involved in the synthesis of cortisol have been shown to suppress melatonin. So, the higher your cortisol levels, the lower your melatonin stress [4].
  4. Blue light from digital screens wakes up your brain and suppresses the normal synthesis of melatonin from serotonin that happens when you are sleeping [7]. So if you are stressed out and working on your phone or tablet late into the night, you are preventing your body from making the hormone needed to help you fall asleep.

Before you start to stress about your stress and the lack of sleep it is causing, keep in mind that not getting eight hours of sleep every night does not mean your health is at risk. Different people have different sleep needs. Most people only experience temporary disruptions in their sleep [8]. Sometimes making a few tweaks to fix your sleep cycle and looking at some of your not-so-sleep-friendly coping mechanisms for stress can help get your sleep back on track.

Better health through better sleep and stress reduction

It is not news to you that you probably need more sleep and less stress in your life. But many of us struggle with taking concrete steps to improve our sleep or reduce stress. Are you looking for ways to handle your stress-induced insomnia?

Although you can take steps on your own to help lower stress and improve sleep, if you're experiencing persistent insomnia (more than a month), talk to your healthcare provider about your options [1]. They can help make sure that there are no other medical conditions that could be causing your insomnia. They also can help tailor an insomnia treatment plan that is best for your given stressors and your individual situation.

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References

  1. Insomnia. Cleveland Clinic. Published October 15, 2022. Accessed November 22, 2022. URL
  2. Franzen PL, Buysse DJ. Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci. 2008;10(4):473-481. doi:10.31887/DCNS.2008.10.4/plfranzen. URL
  3. Lancel M, Boersma GJ, Kamphuis J. Insomnia disorder and its reciprocal relation with psychopathology. Curr Opin Psychol. 2021;41:34-39. doi:10.1016/j.copsyc.2021.02.001. URL
  4. Morris CJ, Aeschbach D, Scheer FA. Circadian system, sleep, and endocrinology. Mol Cell Endocrinol. 2012;349(1):91-104. doi:10.1016/j.mce.2011.09.003. URL
  5. Insomnia. Mayo Clinic. Published October 15, 2016. Accessed November 22, 2022. URL
  6. Shilo L, Sabbah H, Hadari R, et al. The effects of coffee consumption on sleep and melatonin secretion. Sleep Med. 2002;3(3):271-273. doi:10.1016/s1389-9457(02)00015-1. URL
  7. West KE, Jablonski MR, Warfield B, et al. Blue light from light-emitting diodes elicits a dose-dependent suppression of melatonin in humans. J Appl Physiol (1985). 2011;110(3):619-626. doi:10.1152/japplphysiol.01413.2009. URL
  8. Insomnia. MedlinePlus. Published May 10, 2020. Accessed November 22, 2022. URL
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