Nutritional Therapy Tips for Stress and Sleep

Nutritional Therapy Tips for Stress and Sleep

In today´s hectic world, exacerbated by the effect of the COVID-19 pandemic, stress has become a pandemic of its own, with significant physical and psychological health implications. A 2021 survey1 reports that 79% of adults in the UK admit to feeling stressed at least once a month, with 30% feeling stressed ten or more days a month. Lack of sleep was singled out as the primary cause of stress for 39% of the participants, with another 2021 survey on insomnia2 reporting a staggering 1 out of 4 adults in the UK admitting to having troubles falling asleep every single night. Stress-induced sleep issues are more and more common and their effects on overall health are daunting and should be treated as such.

How stress affects sleep?

Chronic stress or acute stress episodes may cause an upregulated Hypothalamic-pituitary-adrenal (HPA) axis and a hyperactivated sympathetic nervous system (SNS) resulting in over secretion of stress hormones (e.g. adrenaline, cortisol).3 Elevated stress hormones at night cause general arousal and alertness, accelerated metabolic rate, thus higher body temperature and heart rate, posing difficulties initiating and maintaining sleep. Stress affects the normal circadian rhythm of the organism on which healthy sleep depends, resulting in a vicious cycle of stress, sleep deprivation and low energy levels during the day.4,5,6 The following sections outline two effective and simple strategies that could help modulate stress response and improve sleep.

No caffeine after midday 

Caffeine has an average half-life of 5-7 hours, meaning that if consumed after midday, some will still be circulating in the bloodstream by bedtime. This could disrupt sleep by decreasing the body´s natural feeling of sleepiness in the evening.7 Caffeine works as a stimulant by blocking adenosine receptors in the brain and preventing sleep drive (the build-up of adenosine) from accumulating8 – thus increasing wakefulness, its most sought-after effect during daytime. In addition, caffeine has an effect on the stress response because it activates the SNS and HPA axis, potentially amplifying its physiological effects.7 Overconsumption of caffeine (the safe limit is set at 400mg for an average 70kg adult9) can, in fact, have similar effects on the body as stress – e.g. anxiety, accelerated heart rate. Studies demonstrate that caffeine increases the time it takes to fall asleep (sleep-onset latency), reduces total sleep duration and disrupts slow-wave sleep.10Thus, limiting caffeine intake to the morning hours could help cope better with the effects of stress on sleep and improve sleep quality and energy throughout the day. Even though this measure does not require full abstinence, caffeine is a psychoactive drug and is highly addictive so limiting it might be initially challenging. Table 1 includes some caffeine-free tonifying alternatives, which can be used to improve energy levels in the afternoon and make the switch easier. Symptoms of withdrawal like fatigue and headache are possible and could last for up to 9 days11 – switching to options with lower caffeine content like green tea or decaf (decaf contains a small amount of caffeine) is a good temporary option to smoothen the transition period.

Evening Breathwork Routine (10-30min)

Deep breathwork practices help reduce stress by stimulating the parasympathetic nervous system and increasing vagal tone, which counteracts the SNS upregulation caused by stress.18,19 A study by Tsiouli et al.20 on chronically stressed adults showed a decrease of perceived stress and salivary cortisol levels as a result of diaphragmatic breathing exercises. Another research by Tsai et al.21 demonstrates that deep breathing practices before bedtime improve sleep by decreasing sleep-onset latency and nocturnal awakenings. Thus, including a short (10-30min) breathwork practice to one´s evening routine is an easy and effective method to release stress and improve sleep. There is plenty of information on the different types of breathwork online and the practices do not require physical effort, any new skillset or assistance and could be performed everywhere – mobile applications like Calm, Headspace, and feel better provide a variety of guided sessions free of charge. While the practice is generally safe, it is not suitable for or should be looked on a case by case basis in case of pregnancy, damage to rib cage, spinal injury, collar bone fractures, and those suffering from severe osteoporosis, acute asthma or dyspnea.22

Reference List

  1. CIPHR [Internet]. 2021 [cited 2021 Nov 18]. Available from: https://www.ciphr.com/research/workplace-stress-statistics/
  1. Formulate Health [Internet]. 2021 [cited 2021 Nov 18].Available from: https://www.formulatehealth.com/blog/insomnia-statistics-uk-how-many-people-have-sleep-problems
  1. Sharpley C. Neurobiological Pathways between Chronic Stress and Depression: Dysregulated Adaptive Mechanisms? Clin Med Insights Psychiatry [Internet]. 2009 [cited 2021 Nov 11]. Available from: https://doi.org/10.4137/CMPsy.S3658
  1. Pevet P, Etienne C. Melatonin: Both master clock output and internal time-giver in the circadian clocks network. J Physiol Paris. 2011; 105(4-6):170-182.
  1. Han K, Kim L, Shim, I. Stress and sleep disorder. Exp Neurobiol. 2012; 21(4):141-150.
  1. Walker M. Why we sleep: the new science of sleep and dreams. London: Penguin Random House UK; 2017.
  1. Roehrs T, Roth T. Caffeine: Sleep and daytime sleepiness. Sleep Med Rev. 2008;12(2):153-162.
  1. Kalinchuk A, Basheer R. Biochemical Correlates of Prolonged Wakefulness. In Kushida C, editor. Encyclopaedia of sleep. Elsevier Science & Technology Encyclopedia of sleep. 2013 Kushida C. Elsevier Science & Technology.p. 239-243.
  1. EFSA Panel. Scientific opinion on the safety of caffeine. EFSA J. 2015;13(5):4102.
  1. Roehrs T, Roth T. Caffeine: Sleep and daytime sleepiness. Sleep Med Rev. 2008;12(2):153-162.
  1. Sajadi-Ernazarova K, Anderson J, Dhakal A, Hamilton R. Caffeine Withdrawal. StatPearls [Internet]. 2021 [cited 2021 Nov 18]. Available from: https://pubmed.ncbi.nlm.nih.gov/28613541/.
  1. Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress—Protective Activity. Pharmaceuticals. 2010;3(1):188-224.
  1. Nishimura M, Ohkawara T, Kanayama T, Kitagawa K, Nishimura H, Nishihira J. Effects of the extract from roasted chicory (Cichorium intybus) root containing inulin-type fructans on blood glucose, lipid metabolism, and fecal properties. J Tradit Complement Med. 2015;5(3):161-167.
  1. Jakaria M, Haque E, Kim J, Cho D, Kim I, Choi D. Active ginseng components in cognitive impairment: Therapeutic potential and prospects for delivery and clinical study. Oncotarget. 2018;9(71):33601-33620.
  1. Prasad S, Tyagi A. Ginger and Its Constituents: Role in Prevention and Treatment of Gastrointestinal Cancer. Gastroenterol Res Pract [Internet]. 2015 [cited on 2021 Nov 19];142979. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369959/
  1. Santos-Parker J, Strahler T, Bassett C, Bispham N, Chonchol M, Seals D. Curcumin supplementation improves vascular endothelial function in healthy middle-aged and older adults by increasing nitric oxide bioavailability and reducing oxidative stress. Aging. 2017;9(1):187-205.
  1. Ali S, Obaid Q, Awaid K. Lemon juice antioxidant activity against oxidative stress. Baghdad Sci J. 2020;17(1)207-213.
  1. Breit S, Kupferberg A, Rogler G, Hasler G. Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders.Front Psychol. 2018;9:44.
  1. Laborde S, Mosley E, Thayer J. Heart Rate Variability and Cardiac Vagal Tone in Psychophysiological Research - Recommendations for Experiment Planning, Data Analysis, and Data Reporting. Front Psychol. 2017;8:213.
  1. Tsiouli E, Pavlopoulos V, Alexopoulos E, Chrousos G, Darviri C. Expolre. 2014;10(2):88-98.
  1. Tsai, Kuo T, Lee G, Yang C. Efficacy of paced breathing for insomnia: enhances vagal activity and improves sleep quality. 2015;52(3):388-96.
  1. Tummee.com [Internet]. 2020 [cited 2021 Nov 17]. Available from: https://www.tummee.com/yoga-poses/diaphragmatic-breathing/contraindications