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The Role of Cortisol in Sleep

Tori Hudson, ND, and Bradley Bush, ND

Abstract
The hypothalamic-pituitary-adrenal (HPA) axis interacts with sleep in multiple ways. This article reviews the effects of the HPA axis on sleep and the converse. The hormones secreted by the hypothalamus and anterior pituitary that interact with the adrenal cortex are discussed, with implications on sleep disturbances and insomnia. A review of the stages of sleep and sleep architecture is given, and particular attention is paid to the role of cortisol. A dysfunctional HPA and alterations in the rhythm of cortisol production is described as a basis for understanding many cases of insomnia. This abnormal cortisol production and cycling is the basis for the hypothesis and the small body of research on the use of natural therapies to regulate the HPA axis and cortisol production.

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