Circadian Misalignment and Stress-induced Insomnia

The COVID-19 pandemic has had a detrimental impact on the nation's mental health, and most populations worldwide. The implication of several lockdowns has had a negative impact on many people’s emotional well-being and mood. Some countries also enforced lockdowns for many months.


With many more of us living very busy lives, chronic stress is unavoidable. Plus, a constantly connected world means that we are relentlessly bombarded by a stream of information, social media, ultra-targeted ads, and mostly negative news.

This has had a huge impact on anxiety levels nationwide on top of media-fulled fear. We see it first-hand in our clinic every day — even to this day.

The ill-effect restrictions and a constant atmosphere of fear, social distancing and social isolation can have on our clients is truly significant. With many people now working from home, routines have changed behind recognitions. Some people have homeschooled their children and this has a huge cost. The price to pay is chronic stress and poor eating and sleep patterns, for the most part — since the routine of yesterday has been replaced with a different working pattern (no office hours means that an individual can take longer breaks during the day, but finishing much later in the evening), different meal times (often replaced by constant snaking, also known as grazing) and variable bedtime (going to sleep and waking up may be different depending on workload).

A recent study revealed that 84% of self-employed people have been affected by poor mental health in the last 12 months (Dec. 2021). The IPSE, the UK's only not-for-profit membership organisation for the self-employed, exposed a 300% rise. 64% said financial worries were their most concerning problem.


The impact of mental ill health

  • 1 in 4 people experience mental health issues each year

  • 792 million people are affected by mental health issues worldwide

  • At any given time, 1 in 6 working-age adults have symptoms associated with mental ill health

  • Mental illness is the second-largest source of burden of disease in England. Mental illnesses are more common, long-lasting and impactful than other health conditions

  • Mental ill health is responsible for 72 million working days lost and costs £34.9 billion each year. It may be as high as £74–£99 billion.

  • The total cost of mental ill health in England is estimated at £105 billion per year


The impact of working from home

Snacking has become a national pastime.

Considering that most snacks are ultra-processed (UPFs), with the main ingredients being sugar and grains, low-quality chocolate (for chocolate-flavoured snacks), and a long list of additives, it is not surprising that many people have reported an increase in weight.

Vegan and so-called healthy snacks are no better if the first ingredient is sugar, no matter the type (e.g., cane sugar, beet sugar, dates, honey or Maltitol).

An instant reward for the brain, sugar is thus highly addictive. It can disrupt circadian rhythms and affect your sleep in the long term.

High blood sugar is a problem. Insulin is produced to reduce the concentration of sugar in the blood to acceptable levels. However, this usually creates a negative output (a delayed response: insulin is still produced while blood sugar levels have already stabilised).

Whenever blood sugar levels drop the brain instructs the adrenal glands to produce stress hormones to increase blood sugar levels but also leads to more snacking. This creates frequent and severe blood sugar fluctuations (a major cause of stress to the body — particularly, hypoglycaemia).

Since sugar is the preferred source of fuel for the brain, repetitive hypoglycaemic episodes can have severe consequences in the long term, affecting every system in the body, particularly the central nervous system. This translates into lower cognitive function (poor memory and concentration), brain fog and fatigue. Never quite feeling your best, tired, and unable to sustain enough energy, your mood may also be impacted. You may become more prone to irritability, anxiety and even depression.

Chronic stress, anxiety and depression affect the HPA axis. If left unaddressed, over-activation of the HPA axis can generate physiological changes in the brain and affect your behaviours and sleep, reducing sleeping time and quality of sleep. You may find it difficult to fall asleep and stay asleep.

Not feeling refreshed upon rising can lead to abuse of (or addiction to) caffeine, sugar or other stimulant, in order to sustain energy levels at the most crucial time of the day: the morning. A time when cortisol levels are at their highest.

Cortisol is what wakes us up in the morning and provides enough energy to go about our day. This is why you may, at times, feel ‘fine’ (or your best) even without breakfast.

Stress and Sleep

Stress-induced insomnia is a problem because stress leads to poor sleep and chronic sleep deprivation is a major stressor for the body. In addition, natural body repair and healing processes mostly occur during the stages of deep sleep. Missing out on sleep can, therefore, affect every organ and tissue in the body.

Debris, toxins and waste are excreted from the brain under the action of the glymphatic system, the immune system of the brain. The glymphatic system is only effective during deep sleep. Accumulation of metabolic waste and toxins in the brain can affect the way we think and feel, and can lead to neurodegeneration and mental disorders in the long term.

Conditions linked to cognitive dysfunction include all forms of dementia, including Alzheimer's disease, and Parkinson’s disease. This is why stress-induced insomnia should not be ignored. The priority should be to address the causes of stress, re-align circadian rhythms and re-establish healthy sleeping patterns.


References:

. Mental Health Taskforce NE. (2016). The Five Year Forward View for Mental Health. Available from: england.nhs.uk
. Ritchie H, Roser M. Mental Health [Internet]. 2018. Available from: ourworldindata.org
. McManus, S. et al. (2016). Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds. Available from: content.digital.nhs.uk
. Public Health England. Health profile for England: 2019. (2019).
​. Centre for Mental Health. (2017). Mental health at work: The business costs ten years on [Internet]. Available from: centreformentalhealth.org.uk
. Stevenson D, Farmer. (2017). Thriving at work: The Independent Review of Mental Health and Employers.

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