Guest Blogger: Dr. Talia Marcheggiani, ND

Gorf is a man of his age, which, in his case, happens to be the Stone Age.

Yes, Gorf is a caveman.

And, perplexingly, Gorf suffers from insomnia.

Gorf wakes up sluggish, long after the sun has risen, wishing he had a snooze button to smash.

He struggles through the day, exhausted. In the early afternoon, he sucks glycogen from the raw meat of a fresh kill to get an extra blood sugar boost.

Gorf prays for someone to discover coffee and refined sugars so that he can join the ranks of modern zombies getting through their 3 pm slumps with artificial pick-me-ups.

When the sun sets, Gorf feels depleted, but also restless and wired. He frustratedly tosses on his bed of mammoth skins beside the dying embers of his campfire while his family snoozes on.

Wide awake at 2 am, Gorf knows that the next morning he’ll begin the cycle again, his body completely out of sync with the Earth’s rhythms. Such is the cursed life of a Prehistoric Insomniac.

If this story seems preposterous, it’s because it probably is. Whatever we imagine prehistoric humans to be, insomniacs is not high on the list.

Those of us who have spent a night outside—whether it was a weekend camping trip or longer—might remember how deeply we slept under the darkness of the starry night sky and how refreshed we woke when the sun began to warm our faces in the early morning.

The closer we get to nature, the better our bodies seem to align with the Earth’s light and dark rhythms.

Now, if we took poor Gorf, dressed him in a suit, and dumped him in a desk chair in an office building in any major modern city, we might believe his claim to insomnia.

Now that Gorf is one of us, his eyes are exposed to bright lights at night as he slogs away at his computer, answering emails, or surfing social media pages into the late hours.

During the day, Gorf now spends his time indoors, where light exposure is 400 times less than that of a bright sunny day.

On bright days when he has a chance to get outside, Gorf protects his fragile eyes with dark glasses.

Welcome to the modern industrial lifestyle, Gorf. Don’t forget to help yourself to the coffee and cookies.

Our Body’s Circadian Rhythms

Our body runs on a 24 hour clock, which is orchestrated by an area in the hypothalamus of the brain called the Suprachiasmatic Nucleus (which we will refer to as “the SCN” from now on).

Our organs, body tissues and cellular processes, from our digestive function, hormones, mood, body temperature, metabolism, sleepiness and wakefulness, cellular repair, to detoxification, among others, have different objectives for certain times of day. The SCN coordinates these functions with the Earth’s daily cycles.

The SCN runs without the aid of outside influence, however several zeitgebers, German for “time givers”, or environmental cues, tell our internal clock what time of day it is to sync our internal and external worlds. The most important zeitgeber is light, which directly activates the SCN through a pathway that connects the retina in our eyes to the hypothalamus (the retinohypothalamic tract).

In our bodies, timing is everything. The more we are able to sync our cycles with the environment, the better our body organs function. Working against circadian rhythms by engaging in activities like sleeping and eating at the wrong time of day can negatively affect our health, decrease our lifespan, and make us miserable (like poor, sad Gorf in his dimly lit office).

The digestive system, for example, is wired to break down, absorb and convert food energy into fuel during the day and repair and regenerate itself at night.

At night, the pineal gland, located in the brain, releases melatonin, a hormone produced in the absence of light, to help us sleep. However, exposure to bright lights before bed can impede the natural release of melatonin, preventing restful sleep.

Even pain and cancer growth follow a circadian rhythm.

Science shows that healthy circadian rhythms equal optimal metabolic health, cognitive function, weight, energy levels, cardiovascular health, immune function, digestive health, coordination and mental health. Regulating our circadian rhythms can increase our health-span.

Our Liver, Muscles and Adrenal Glands Also Have Clocks

While the SCN is the chief executive officer of the circadian cycle, other organs, such as the liver, muscle and adrenal glands, help regulate our body’s rhythms through peripheral clocks.

These clocks register cues from the environment and report back to the SCN. In turn, the SCN tells the organs what jobs they are supposed to be performing according to the time of day.

Dr. Satchin Panda, PhD, a researcher at the Salk Institute, is discovering how important our eating times are for setting our circadian clock.

The first bite of our breakfast tells our liver clock to start making the enzymes and hormones necessary to digest our food, regulate our metabolism, and use the food we eat throughout the day to fuel our cells.

A few hours later, our digestive system requires relief from food intake to invest its resources into repair rather than spending precious resources on digesting food.

Dr. Panda found that restricting a “feeding window” to 8 to 12 hours in mice and human participants (for example, eating breakfast at 7 am and finishing dinner no later than 7 pm), allowed the system to digest optimally, left time for the system to repair itself at night, and also acted as a powerful circadian regulator.

New research suggests that food is a potent zeitgeber, which has the power to regulate our circadian rhythms. This suggests that eating at the right time of day can heal our adrenal glands and sleep cycles.

Fasting for 10 to 16 hours at night, or “Time Restricted Eating”, helps optimize health and increase lifespan in mice. In human participants, it improves sleep and results in modest weight loss.

Similarly, more research shows that eating before bed can lead to adverse health effects and cause us to gain weight.

According to Dr. Panda, we become more insulin resistant at night, which means that late-night snacking makes us more likely to store the calories we consume as fat.

Consuming calories in a state of insulin resistance can also predispose use to metabolic syndrome and type II diabetes.

In addition to light and food intake, rest and movement are important zeitgebers. Therefore, engaging in these activities at the right time of day has the potential to promote physical and mental health.

Circadian Rhythms and the Stress Response are Tightly Connected.

If the internet is any indicator, it seems that everyone is suffering from the modern illness of “adrenal fatigue”, or HPA (Hypothalamic-Pituitary-Adrenal) axis dysfunction

Because of the stress of our modern lifestyles, our adrenal glands and brains are no longer able to regulate the stress response.

This leads to a host of symptoms that wreck havoc on the entire body: fatigue, anxiety, sugar cravings, and insomnia. It also negatively impacts digestion, hormone production, and mood.

Our adrenal glands make cortisol, the “stress hormone”, a hormone involved in long-term stress adaptation but also in wakefulness, motivation, reward, and memory.

Deficiencies in cortisol signalling can result in issues with inflammation and depression. Too much cortisol floating around in the body can cause weight gain, cardiovascular issues, such as hypertension, and metabolic syndrome.

Cortisol has a circadian rhythm of its own. Our cortisol levels rise within an hour of waking; 50% of the total cortisol for the day is released in the first 30 minutes after we open our eyes. This rise in cortisol wakes us up. It allows us to perform our daily activities in a state of alert wakefulness.

Cortisol levels decline steadily throughout the day, dipping in the evening when melatonin rises.

A flattened or delayed rise in morning cortisol results in grogginess, brain fog and altered HPA axis function throughout the day. Elevated cortisol in the evening cause us to feel “tired and wired” and affect sleep. Waking at night, especially in the early morning between 2 and 4 am can be due to cortisol spikes.

Our adrenal glands help regulate our circadian rhythms through the production of cortisol. Both the adrenals and the SCN communicate with each other as early as 2 in the morning to ready the system to generate the waking response a few hours later.

Psychiatrist Dr. Charles Raison, MD says, “The most stressful thing you do most days is get up in the morning. Your body prepares for it for a couple of hours [before waking by activating] the stress system. The reason more people die at dawn [than any other time] is because it’s really rough to get up.”

Waking up is a literal stress on the body.

However, we need the stress response to get through our day effectively and healthy HPA axis function and optimal mood and energy are a result of properly functioning circadian rhythms.

Without these rhythms functioning properly we feel tired, groggy, tense, and depressed. Like Gorf, we need sugar and caffeine to help us through the day.

Circadian Rhythms Affect Our Mental Health

In nearly everyone I work with who suffers from anxiety, depression, or other mental health disorders, I see disrupted circadian rhythms and HPA axises.

Many of my patients feel exhausted during the day and wired at night. They have trouble getting up in the morning (or stay in bed all day) and postpone their bedtime. Most of them skip breakfast due to lack of hunger, and crave sweets after dinner, which further throws off the circadian cycle.

Lack of sleep can disrupt circadian rhythms leading to obesity, depression, diabetes and cardiovascular disease. Even two nights of shortened sleep can affect cortisol production and the HPA axis, worsening mood and energy levels.

Depression severity on the Hamilton Depression Rating Scale (HDRS) falls by 6 full points when sleep is restored, which is enough to bring a patient from moderate/severe depression to mild. In comparison, the standard medication SSRIs, like cipralex, only drop the HDRS by 2.

Bipolar disorder is particularly affected by a misaligned circadian clock. In an interview, Dr. Raison claims that a single night of missed sleep has brought on episodes of mania in his bipolar patients. Their moods level once the sleep cycle is restored.

Our mood is tightly connected to our circadian rhythms and sleep.

Circadian Rhythms and Chinese Medicine

Thousands of years ago, the Chinese developed the Theory of Yin and Yang to describe the dynamics nature, including the cycles of night and day.

Yin and yang (symbolized by a black-and-white circle with dots) represent the process of change and transformation of everything in the universe.

Yang, represented by the white part of the circle, is present in things that are hot, light, awake, moving, exciting, changing, transforming and restless.

Yin is present in material that is cold, dark, soft, inhibited, slow, restful, conversative, and sustaining.

Yin and yang are dependent on each other. Yin feeds into yang, while yang feeds and transforms into yin. Everything in nature consists of a fluctuating combination of these two states.

The circadian cycle transforms the yin night into the yang of daytime.

Yang zeitgebers such as food, light, and physical and mental activity, help stimulate yang in the body, which helps us feel energized, light and motivated.

Before bed, yin zeitgebers like darkness, rest and relaxation help our bodies transition into the yin of night, so that we can sleep restfully.

Lack of sleep and relaxation can deplete our body’s yin energy, causing yin deficiency. Individuals with yin deficiency feel fatigued, anxious, and hot, experiencing night sweats, hot flashes, and flushed skin. Conventionally, yin deficiency can look like burnout compounded by anxiety, or peri-menopause.

Out-of-sync circadian rhythms can result in yang deficiency resulting in morning grogginess, an insufficient rise in morning cortisol, and a failure to activate yang energy throughout the day.

Yang deficiency is characterized by the build-up of phlegm in the body, leading to weight gain, feelings of sluggishness, slow digestion, bloating, weakness, and feeling foggy, pale and cold. Yang deficiency symptoms can look like depression, chronic fatigue syndrome, IBS, estrogen dominance, hypothyroidism, or obesity and metabolic syndrome.

In Chinese medicine, the organs have specific times of activity as well.

The stomach is most active from 7 to 9 am, when we eat our breakfast, the most important meal of the day according to Traditional Chinese doctors. The spleen (which in Traditional Chinese Medicine operates much like the Western pancreas) is active from 9 to 11 am, converting the food energy from breakfast into energy that can be utilized by the body.

According to the Chinese organ clock, the liver is active from 1 to 3 am. Individuals with chronic stress, insomnia and irritability, sometimes called “Liver Qi Stagnation”, frequently wake up restless during those early morning hours.

Entraining our circadian clock with environmental cues can help us remain vital by balancing the flow and transformation of yin and yang energies in the body.

Healing the Circadian Clock:

When I work with patients with depression, anxiety and other mental health conditions, or hormonal conditions such as HPA axis dysfunction, one of our goals is to heal circadian rhythms.

This involves coordinating our internal rhythms with the Earth’s night and dark cycle by setting up a series of routines that expose the body to specific zeitgebers at certain times of day.

How to Heal Your Circadian Rhythms

Morning Activities: Increasing Yang with movement, light and food:

1. Expose your eyes to bright light between the hours of 6 and 8 am. This stimulates the SCN and the adrenal glands to produce cortisol, which boosts mood, energy and wakefulness in the morning and can help reset the HPA axis.

2. Have a large breakfast high in protein and fat within an hour of waking. The intake of a meal that contains all of the macronutrients wakes up the liver clock. This activates our metabolism, digestive function, blood sugar regulation, and HPA axis.

Consider eating 3 eggs, spinach and an avocado in the morning. Or consume a smoothie with avocado, MCT oil, protein powder, berries and leafy greens.

Eating a breakfast that contains at least 20 grams of protein and a generous serving of fat will help stabilize blood sugar and mood throughout the day while obliterating night-time sugar cravings.

3. Move a little in the morning. Morning movement doesn’t necessarily have to come in the form of exercise, however, it’s important to get up and start your routine, perhaps making breakfast and tidying, or having an alternate hot and cold shower (1 minute hot bursts alternating with 30 seconds cold for 3 to 5 cycles).

Muscle movement triggers another important peripheral clock that helps entrain our circadian cycle with the day.

4. Turn on lights in the morning, especially in the winter time. Spend time outside during the day, and avoid using sunglasses unless absolutely necessary so that light can stimulate the SCN. Consider investing in a sunlamp for the winter, particularly if you suffer from seasonal affective disorder.

5. Consume most of your supplements in the morning, with breakfast. Taking adaptogens (herbs that help reset the HPA axis) and B vitamins can help promote daytime energy and rebalance our morning cortisol levels. This, of course, depends on why you’re naturopathic doctor has recommended specific supplements, so be sure to discuss supplement timing with her first.

Night Routine: Increasing Yin with dark and stillness:

1. Maintain a consistent sleep and wake time, even on the weekends. Retraining the cycles starts with creating a consistent routine to get your sleep cycle back on track.

2. Try to get to bed before 11pm. This allows the body to reach the deepest wave of sleep around 2 am. It also allows for 7 to 8 hours of continuous sleep when you expose your eyes to bright lights at 6 to 8 am, when cortisol naturally rises. Of course, this sleep routine will vary depending on personal preferences, lifestyles and genetics.

It’s important to first establish a routine that will allow you to get at least 6 hours of continuous sleep a night. If you suffer from chronic insomnia, working with a naturopathic doctor can help you reset your circadian cycle using techniques like Sleep Restriction Therapy to get your body back on track.

3. Avoid electronic use at least an hour before bed. Our smartphones, tablets, computers and TVs emit powerful blue light that activates our SCN, confusing all of our body’s clocks. Blue light also suppresses melatonin release, making us feel restless and unable to fall asleep.

For those of you who must absolutely be on electronics in the late hours of the evening, consider investing in blue light-blocking glasses, or installing an app that block blue light, such as F.lux, on your devices. These solutions are not as effective as simply turning off electronics and switching to more relaxing bedtime activities, but can be a significant form of harm reduction.

4. Fast for at least 2 to 3 hours before bed. Avoid late-night snacking to give the body a chance to rest and to signal to the peripheral digestive clocks, such as the liver clock, that it’s now time to rest and repair, rather than digestive and assimilate more food.

Avoiding food, especially carbohydrate-rich food, at night can also manage blood sugar. A drop in blood sugar is often a reason why people wake in the early hours of the morning, as blood sugar drops spike cortisol, which wake us up and off-set our entire circadian system.

5. Engage in relaxing activities in dim lighting. Turn off powerful overhead lights, perhaps lighting candles or dim reading lights, and engage in at least 30 minutes of an activity that feels restorative and relaxing to you. This might include taking an epsom salt bath, reading a book while enjoying an herbal tea, doing yoga or meditation, or cuddling with a partner.

Taking this time helps us step out of the busyness of the day and signals to the body and its clocks that it’s time to sleep.

6. Take nighttime supplements before bed. I often recommend sleep-promoting supplements like prolonged-release melatonin (which is a powerful circadian rhythm and HPA axis resetter), magnesium or phosphatidylserine, before bed to help my patients’ bodies entrain to the time of day. Talk to your ND about what supplements might be right for you.

If you suffer from chronic stress and mood disorders, do shift work, or are dealing with jet lag, you may need to engage in these routines diligently for a few months to get your circadian cycles back on track.

These practices can also be beneficial at certain times of year: daylight savings time, periods of stress and heightened mental work, and the transition of seasons, especially early Spring and Fall.

Finally, consider working with a naturopathic doctor to obtain and individual plan that can help you reset your body’s rhythms.