Anxiety, cortisol and meditation and their effects on insomnia | Matthew Walker


[Matt]: And we’ve seen this, too, that if
you look at that emotional brain reaction signature that I just sort of described, and
you repeat that, but with people who are high-anxious and low-anxious, and we know some of the genes
that are associated with being high-anxious and low-anxious. So we’re using anxiety as a sort of a proxy
for perhaps a particular genotype here. What you see is that it’s those high-anxious
people who are the most vulnerable to this impact of a lack of sleep. Those who are low-anxious still have a bad
outcome, but it’s nowhere near as bad. So there seems to be sort of interactions
here between sleep loss and your basic trait levels of being sort of a nervous, anxious
type to begin with. [Rhonda]: That makes sense. [Matt]: And those are the people who are,
sadly, the people who typically don’t get a good night of sleep anyway. [Rhonda]: Right. So you’re saying anxiety is, like, one of
the things that stops me from sleeping. [Matt]: It’s the principal trigger of insomnia. [Rhonda]: Yeah, really, true. [Matt]: It’s the model of insomnia right now,
is that you get…And if you look at the nervous system, that’s how we understand insomnia
right now, is that its principle is…I think ultimately we’ll find that there are multiple
flavors of insomnia, different forms. We already categorized two of them. We’ve got what we call sleep onset insomnia
and sleep maintenance insomnia, difficulty falling asleep, difficulty staying asleep. They’re not mutually exclusive. You can have both, or you can just have one
or the other. But coming back to it, I think the overarching
biological red thread narrative of insomnia is an amplified fight-or-flight nervous system,
that your nervous system is split into these two branches, what we call sort of the sympathetic
and parasympathetic parts of your autonomic nervous system. The sympathetic is anything but sympathetic. It’s poorly named. It’s the fight-or-flight branch of your nervous
system. It ramps you up, charges you up, releases
cortisol, adrenaline. You constantly see an overactive, sympathetic
nervous system in people with insomnia. And when you measure their cortisol across
the 24-hour period, in most of us, just as we’re getting to our natural bedtime, cortisol
just starts to now drop down. We start to see that cycling down of cortisol. The opposite happens in people with insomnia. You get a continued rise right around that
bedroom period. And it seems to be very predictive of sleep
onset problems. If you look throughout the night, cortisol
then starts to plummet, and it drops beautifully down. It’s part of the reason why deep sleep is
the best form of natural blood pressure medication that you could ever wish for. Your heart rate drops down, your vessels relax,
cortisol drops down. But in other insomnia patients, we see this
bizarre spike in cortisol in the middle of the night. And it predicts nighttime awakenings. It predicts sleep maintenance insomnia. [Rhonda]: I have experienced…So that’s one
of the problems that I actually have. It’s much, much better now that my stress
level is, like, maintained. At graduate school, I would get nighttime
awakenings where my heart would start racing. And I would wake up thinking that there was
a spider or some kind of threat. And I would scream, and sometimes fly out
the bed. I mean, you know, and just…it would scare
my husband, you know. At the time, we weren’t married. But, I mean, you know, these nighttime awakenings,
it was something that’s dated back for quite some time. But really, it manifested during a very stressful
period, and that was graduate school. [Matt]: We see that… [Rhonda]: Got much better. [Matt]: …so frequently. [Rhonda]: Yeah. [Matt]: But if you can think about that as
sort of, you know, a stress management component to insomnia, you know, it’s part of what we
call cognitive behavioral therapy for insomnia, which is sort of dealing with that stress,
you know, meditation. There’s great apps out there, like Headspace,
for example. And the data on meditation and insomnia is
very very powerful. You know, I’d known about it a little bit,
but I hadn’t read really all of the studies until I started researching it for the book. And I was so convinced that I started meditating. And I haven’t stopped since. Because it was, you know…Typically, I’m
not a bad sleeper. I’m a light sleeper. I’m a pretty good sleeper. I found it hugely useful for times when I
was under stress, or when I was traveling and jetlag. It’s very beneficial, too. But that underlying theme, I think, as a message
for insomnia, it’s not the only cause of insomnia, but it seems to be if there’s one common sort
of rule that binds many of the patients with insomnia together, it’s this overactive fight-or-flight
branch of the nervous system. And if you can settle that down, you are certainly
on the path towards better sleep. [Rhonda]: Right.


2 Responses

  1. FMF Clips

    February 28, 2019 4:06 pm

    Watch the full episode:

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  2. OrganisedPauper

    April 12, 2019 4:53 pm

    I didn't have any insomnia until menopause and post menopause. During menopause I rarely got over 5 hours and it's sleep maintenance insomnia and poor sleep quality. I did see an improvement with post menopause HRT patches, but it's still not great. I've been regularly meditating for over a month. So far there's been no improvement with sleep, but it's had a positive influence on other areas of my life such as better emotional regulation and concentration. Post menopausal sleep maintenance insomnia seems different somehow to other insomnia.


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