Stressed out and sleep deprived? Your cortisol rhythm may need recalibrating.
Key Points
- Chronic stress and poor sleep can dysregulate cortisol, increasing health risks like insulin resistance.
- Prioritize consistent, quality sleep and stress management to support healthy cortisol levels.
- Daily habits like regular sleep, meals and exercise can also help regulate cortisol.
According to the internet, excess cortisol is responsible for everything from puffy faces to breakouts. But cortisol isn’t the villain social media has made it out to be. It’s a hormone your body relies on to wake up in the morning, respond to stressful situations, manage blood sugar and effectively regulate inflammation. “Cortisol is our body’s built-in alarm system. Levels naturally peak in the morning to wake us up and drop to their lowest at night to allow us to sleep,” explains Simran Malhotra, M.D., DipABLM, FACLM. While excessively elevated cortisol levels can be life-threatening and indicative of Cushing’s syndrome, normal cortisol levels fluctuate throughout the day.
Thankfully, you can support healthy cortisol levels without supplements or complicated protocols. “Daily habits have a substantial impact on cortisol because the hypothalamic-pituitary-adrenal axis is tightly regulated by circadian rhythms and highly responsive to behavioral inputs,” says endocrinologist Maram Khalifa, MD Things like sleep, light exposure, meals, exercise and stress act as signals that tell your body when to release cortisol and when to back off.
Elevated cortisol accompanied by uncontrolled high blood pressure, diabetes, dyslipidemia or osteoporosis requires medical attention, Khalifa shares. But for the rest of us, mild elevations or disruption of the natural cortisol rhythm can often be improved once we address the few key habits that have the biggest impact on cortisol.
Chronic Stress
The never-ending to-do list, email checking, financial worries, relationship struggles—they all add up to an unsustainable level of stress that, for many people, feels like the baseline. While short bursts of stress trigger a cortisol cascade that activates your fight-or-flight response, which is useful when responding to an emergency, the chronic stress that comes from “a day in the life” can be problematic.
“In the short term, stress raises cortisol in a helpful way, but when it becomes persistent, the body keeps cortisol levels elevated for longer than normal and disrupts the usual daily rhythm—especially by increasing evening levels when cortisol should be low,” explains Khalifa. The release of cortisol activates the sympathetic nervous system, and when cortisol levels aren’t allowed to decline due to chronic stress inputs, the parasympathetic system can’t take over to help the body relax and recover. This prolonged period of stress can increase the risk of serious health complications like insulin resistance, heart disease, anxiety and depression.
Poor Sleep
If your bedtime is followed by hours of scrolling, binge-watching your shows or catching up on work, you’re creating the perfect storm for dysregulated cortisol levels. “People with chronically shorter nighttime sleep durations consistently show higher nighttime cortisol levels,” says Malhotra.
Normally, cortisol levels bottom out in the early evening hours, then climb toward their natural peak in the morning. But when you consistently sleep too little, the distance between the highest and lowest cortisol levels gets shorter, and the curve starts to flatten. While the obvious signs of poor sleep will have you feeling groggy and low on energy during the day, behind the scenes, it’s silently wreaking havoc on your health. “This relative evening high cortisol level promotes insulin resistance, impairs glucose tolerance, and increases hormonal abnormalities that drive increased caloric intake and contribute to visceral fat accumulation and metabolic syndrome,” says Khalifa.
The relationship between poor sleep and elevated cortisol can create a self-perpetuating cycle if you don’t take steps to prioritize consistent, quality sleep. Researchers analyzed cortisol levels in 95 young adults in the morning and at bedtime over a two-week period. Those with higher pre-sleep cortisol levels slept for fewer hours and had a flatter cortisol curve than those with longer sleep times and better sleep efficiency.
Because dysregulated cortisol can make it even more difficult to get a good night’s rest, creating and maintaining a sleep routine is essential. “Aim for seven to nine hours of consistent, quality sleep with a regular bedtime and wake time,” advises Khalifa.
Expert Tips for Healthy Cortisol Levels
- Prioritize stress management: Khalifa recommends adding stress-reducing practices such as mindfulness meditation, deep breathing or cognitive behavioral therapy to your routine. If you’re hoping to combine activity and mindfulness, mind-body activities like yoga have been found to effectively lower cortisol levels, even in the presence of stress.
- Move your body: “While intense evening exercise can temporarily raise cortisol, consistent moderate activity over time improves stress resilience and can help normalize cortisol patterns,” says Khalifa. Research has found that physical activity increases the slope from morning to evening, helping reduce the negative effects of a blunted cortisol curve.
- Aim for consistency in your routines: From when you wake up and go to bed to mealtimes, exercise and light exposure, keeping your routine as consistent as possible can support a healthy circadian rhythm and cortisol curve.
Our Expert Take
Cortisol isn’t necessarily the enemy of your health, but disruptions to the natural rhythm of cortisol regulation can contribute to weight gain, mood disruptions and insulin resistance. Chronic stress and poor sleep could be causing dysregulated cortisol. To maintain a healthy cortisol rhythm, skip the expensive supplements and focus instead on evidence-based habits like prioritizing quality sleep, stress management and consistent exercise.
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