Burnout Part II: Why can’t I sleep when I’m so tired?

 

When you’re starting to burn out or you are totally burnout all you want to do is sleep, from the moment you wake up in the morning, through the afternoon and up until that moment you hop into bed. Then something magical happens, you lay down in your bed, looking forward to having a great sleep and instead all you do is lie there. Your brain won’t stop racing and you’re not thinking about anything in particular at all. Nope, there you lie just wishing that you could fall asleep.  Finally, after what seems like hours you do eventually fall asleep only to wake up 3-4 hours later with your mind racing, thinking about everything you didn’t get done yesterday and what is piling up on your plate for the day to come. You get up to pee, then head back to bed only to have your brain start racing again. After some time you do eventually fall asleep only to have the craziest vivid dreams. It feels as though you are dreaming in colour. Then boom, your alarm goes off and the only thought passing through your head is “when can I go back to bed”.

What is Burnout?

Why does this happen? You feel that if only you could sleep through the night and wake up rested everything would be better. Well, there is a lot going on in your body that is preventing you from having good night’s sleep. This is why things start to spiral out of control. You are tired and can’t sleep and this vicious cycle spirals out of control which ultimately means your quality of life continues downhill.

It has to do with something called your diurnal cortisol curve.

melatonin curve Cortisol is a hormone in your body which under normal healthy circumstances rises quickly in the morning just before you wake up. It is this rise of cortisol which actually wakes you up and gets you out of bed. If your cortisol level is optimized you will wake up, jump out of bed and start your day. After that, your cortisol level starts to drop throughout the day. It gets a small bump halfway through and then as it gets closer to bedtime (or when the sun sets) your cortisol level comes down, almost all the way to zero. Under normal circumstances when your cortisol level continues to drop at night another hormone starts to rise called melatonin. Melatonin continues to rise and peaks between midnight and 2 AM. When melatonin is this high it forces the body to shut down production of cortisol. It is for this reason that normal, healthy sleep is so important to treat burnout. Because if your sleep is not optimized you’re making your burnout worse.

burnout and sleep

Now, what is going on in your body when you’re burnt out? Instead of your cortisol rising quickly in the morning to wake you up it rises very slowly. This is why it feels that it takes forever to truly feel awake or why you feel you need that second cup of coffee. Finally, around 10 or 11 your cortisol is as high as it’s going to get. From there it’s all downhill. It drops mid-afternoon and you feel like you need a nap. Then you get a small bump and drag yourself through the commute home. You fight through dinner and wait for bedtime.

Now, this is where things get interesting. Do you remember when you were in university and you were going out for the night? If you could just stay up until 11 PM you could go all night without feeling tired. That is because if you do not fall asleep when your body tells you to it instead starts to release more cortisol to wake you up and keep you awake.  This is exactly what happens when you’re burnt out. You get that second spike of cortisol way too early in the evening before you have even gone to bed. Now instead of feeling tired and ready to sleep your brain is wide awake.  Because your cortisol has risen it prevents your melatonin from increasing which means you are having a terrible sleep and will not feel rested.

At this point you need help. This is a very difficult cycle to break and often times people are not able to do it on their own and land up at their doctor’s office and are prescribed sleeping pills along with some antidepressants, often at a very low dose.

But you’re not depressed! YOU ARE BURNT OUT! The major difference between being burnt out and depressed is that when you are burnout you still love doing things and laugh at your favourite show, only your motivation to do the things you love is lacking. Whereas when you’re depressed all you want to do is sleep and cry. (Of course, it is more complicated than this, but for the sake of this article we are not going to involve the DSM V)

So what can you do? This is where individualized medicine becomes paramount. There are various phases of burnout and depending on where you are they need to be addressed differently. However, here are somethings you can do to enhance your quality of sleep.

sleep

  1. Develop healthy sleep hygiene
    1. Make sure your bedroom is as dark as possible.
    2. No artificial lights in your bedroom
    3. Cover all little LED blinking status lights
    4. No clock shinning into your face
  2. Develop a bedtime routine
    1. Make a cup of tea part of your bedtime routine.
    2. Boil the water
    3. Steep your tea
    4. Sip your tea while reading a book
  3. Avoid all screens at least 1 hour before bed
    1. Almost all screens are powered by blue light which wakes you up (think police lights and how that makes you feel)
    2. Or if you have to use them use apps like Flux or night mode
  4. Supplements which can help sleep
    1. 5-HTP
    2. GABA
    3. Time release melatonin (delayed release)
    4. Passionflower
    5. Inositol
    6. Ashwaganda
    7. Rhodiola

 

Addressing your sleep is the first step in treating burnout and starting the road to recovery.

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