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Articles: Health, Medicine & Pharmacy


The Interdependencies Of Stress & Sleep

The negative impact of stress is discussed in both professional medical and psychological circles, as well as in mass media. The interest in the problem of stress has increased significantly at the end of the last century. Currently, the term ‘stress’ refers to a condition where in response to the stress factor emotional, cognitive, and biological activity of the body is changing. Stress response is characterized by individual nature and depends on the type of stress response characteristics by changing the physiological reactions of the neuroendocrine, immune activity and the behavior.

To start the process of protection and adaptation the central nervous system and the hypothalamic-pituitary-adrenal axis (GGNO) are activated. Excessive stress usually causes both short and long-term variations in homeostasis, as well as changes the activity of various systems of the human body. Stress, especially chronic and negative (distress), leads to the formation of psychosomatic diseases, as well as defines a high risk of chronic disease at any age.

The crucial impact of sleep

An important component of human homeostasis is sleep. Therefore, certain physiological, cyclical, neuroendocrine and autonomic changes take places during sleep. At the beginning of the sleep GGNO activity gradually suppressed, but by the end of the cycle GGNO secretory activity increases to a level close to the maximum of circadian during awakening. Growth of adrenocorticotropic hormone (ACTH) in the morning is a crucial factor in the regulation of sleep closure. When stress occurs it changes the activity of GGNO and disturbances sleep regulation. Sleep disorders are closely associated with stressful events and often perform the first symptoms of stress. And although insomnia is typically emerges and persist for several days (physiological insomnia) during a stressful period, a way more significant problem is chronic insomnia. In situations where the body is forced to adapt to the constantly changing conditions, sleep disorders, especially chronic, are draining adaptation of mechanisms, thereby exacerbating the negative impact of stress.

Stress activates GGNO and sympathoadrenal system, which adversely affects the cardiovascular system by increasing the release of catecholamines, cortisol, ACTH and other hormones. Increased emissions of ACTH during stress lead to early and frequent awakenings. Excessive secretion of cortisol adversely affects neural structures, particularly the hippocampus, which potentially leads to memory impairment.

This is also a place for inverse relationship: insomnia causes physiological changes similar to the effects of stress in the human body. Insomnia significantly increases the risk of psychosomatic illness when exposed to stressors.

During insomnia in the excitation processes the structure of the brain responsible for alertness regulating emotion (hippocampus, amygdala, anterior cingulate) is included, as well as the areas of prefrontal cortex, which determine cognitive function, thereby violating the behavioral and cognitive adaptation. Patients with insomnia experience fatigue and tense and excited state, which is combined with elevated for metabolism, increased secretion of adrenal hormones and cortisol during the daytime. The release of cortisol in the end leads to increased activity of the renin-angiotensin system as well as heart rate, core temperature, oxygen consumption tissue growth and changes in glucose tolerance. Changes may result into renal dysfunction, endothelial disorders and atherosclerosis. Insomnia is one of the most common types of sleep disorders that are associated with a high risk of hypertension, cardiovascular disease and related mortality.

During insomnia a GGNO mediated hypersecretion of cytokines takes place, which entails a change of immune activity. Sleep disorders affect the hormones that regulate appetite; ghrelin activity increases, while leptin index decreases (which sharpens the appetite). Importantly, the growth during the night levels of hormone and testosterone is a normal process, but during insomnia hormonal Factivity decreases.

Thus, on the one hand, stress results in psychophysiological changes which are inconsistent with normal sleep, on the other, sleep disorders drain adaptive physiological mechanisms and thereby reduce stress that necessarily require attention and correction. Therefore, normalization of sleep can be considered as a potential factor in reducing stress handling, and treatment of insomnia is a potential factor in stress management. Therefore, normal sleep with proper phases and absence of awakenings may be one of the keys of the keys to stress treatment.

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