Wired but tired? Why your cortisol clock may be out of sync

Are you part of the up-all-night club? Do you lie awake with your mind racing, then feel shattered all day, only to repeat the same pattern the following night? Feeling wired at night and tired all day can be a sign that your cortisol clock is out of sync. Over time, this can leave you exhausted and frazzled, while also taking a toll on your immune system.

Thankfully, what you eat and some targeted supplements may help support a healthier daily rhythm, so you sleep better at night and feel more energised during the day.

The cortisol awakening response

Cortisol is your main stress hormone and a major contributor to your sleep-wake cycle, controlled by something called your hypothalamic-pituitary-adrenal (HPA) axis.

In healthy people, levels of cortisol are low at night and begin to rise during the final hours of sleep and then reach a peak as we wake up in the morning. This peak as we wake is referred to as the cortisol awakening response (CAR) and is designed to get you up and about, ready for your day!

This vital CAR also helps prepare your immune system each morning, supports working memory and attention, and aids emotional regulation. Cortisol should then gradually decline during the day, reaching its lowest point just before we sleep.

Problems arise when our cortisol awakening response becomes blunted or flattened, which can occur because of chronic stress, chronic physical conditions such as type 2 diabetes or autoimmune diseases, drinking alcohol, smoking or having a higher BMI.

This flattened response can leave you waking up exhausted, needing a coffee before you can contemplate starting your day, taking hours to switch on in the morning or feeling like you are walking through treacle all day.

Cortisol peaking at night

Many people with an out-of-sync cortisol clock feel exhausted as bedtime approaches, yet even something as simple as brushing their teeth can leave them feeling wide awake again.

Others fall asleep easily but wake around 4am and struggle to drift off again until 6am, only to sleep through their alarm.

This frustrating pattern is due to cortisol surges just before bed or in the middle of the night, when cortisol should be at its lowest. This is why the evening routine below matters so much, as it helps stop cortisol spiking when you are trying to sleep.

Stress and cortisol

Stress doesn’t always come from a major event. The daily ‘drip, drip’ of school runs, meetings, traffic, doom-scrolling, illness or pain can add up, and what depletes one person may not deplete another.

Repeated activation of the stress (HPA) axis over time causes the cortisol response to become flatter, rather than intensifying. This blunting is the system trying to recalibrate and the pituitary in the brain becoming less responsive to the signals it is receiving, and whilst this can be useful during times of extreme pressure, in everyday life the symptoms can be hard to manage and take time to recover from.

The blunting of the morning rise in cortisol doesn’t mean cortisol is low all day. It can stay stubbornly high through the afternoon or settle into an erratic pattern that climbs again just as you are trying to get to sleep or in the middle of the night.

Symptoms associated with an out-of-sync cortisol pattern can include:

Irritability
Waking up exhausted after a full night’s sleep
Mornings being the worst part of the day, improving in the afternoon
Brain fog and poor memory
Feeling constantly run down
Cravings for salty foods and low blood pressure
Low mood, anxiety, poor stress tolerance

The hormone link

In the lead-up to your period, your hormone levels change, which can affect your sleep and daily cortisol rhythm. This is why so many women complain that they sleep really badly and feel exhausted in the week or even 10 days prior to their period.

Hormones can also affect your sleep during perimenopause when your oestrogen begins to fall. Oestrogen helps dampen down the brain’s wake-promoting signals, so as levels drop, sleep often becomes more broken.

Some women also notice histamine-type symptoms worsen at this stage, such as night sweats, adrenaline surges, a racing mind, migraines or sneezing at night and that is where cutting back on wine and high histamine foods can help to reduce these symptoms and thus improve sleep quality.

It’s the broken sleep itself that seems to unsettle cortisol. In one small study, just three nights of disrupted sleep raised bedtime cortisol by over a quarter and cut the morning cortisol surge by more than half. This helps explain why you may feel very wired at 11pm and totally exhausted at 7am.

Cortisol testing

A GP blood test for cortisol often involves one sample taken around 9am, giving a snapshot rather than showing how levels change throughout the day.

At our NatureDoc clinics, we collect saliva samples at four separate times during the day and evening to assess your cortisol pattern. Repeat testing can help us monitor changes.

How to reset your cortisol clock

Here are some practical ways to support your body when you feel wired but tired. The aim is to support your natural daily cortisol rhythm, helping you feel more alert and energised when you wake, then ready to wind down in the evening and sleep well through the night.

Morning routine

Start the morning with a glass of water with a pinch of salt and lemon juice to provide electrolytes and rehydrate your body. You lose fluid and salt overnight, so this can help prevent the groggy feeling you can wake up with.

Try to get outside within an hour of waking. Morning daylight signals to your brain that the day has begun, supporting your natural daily rhythm and helping you feel more awake and alert.

Start the day with a high protein breakfast, such as Greek yoghurt with berries and seeds, eggs with feta, or smoked salmon and avocado on toast to provide you with steady energy, balance your blood sugar and provide mental clarity.

Avoid starting the day with caffeine and ideally drink it after a high-protein breakfast.

Vitamin C: The adrenal glands which produce stress hormones contain high concentrations of vitamin C, so replenishing it through foods such as red peppers, oranges or berries can help support your body. Focus on consuming vitamin C-rich foods at breakfast and during the day.

B vitamins are also crucial in helping to support the nervous system. They can be found in a variety of different foods such as leafy green vegetables, dairy, meat, wholegrains, legumes and eggs, or can be taken as a B complex supplement. Vegans are at a higher risk of becoming B12 deficient, so it is important to consider supplementing if you do not eat animal products. B vitamins are ideally taken in the morning.

Throughout the day

One of my best tips is to avoid caffeine after midday, as it can affect your sleep quality even hours after you have consumed it. If you need to snack, pair your carbohydrates with a protein and a fat source, such as oatcakes and cheese, apple with almond butter, or vegetable sticks and hummus.

Evening routine

Try swapping an alcoholic drink for something relaxing, such as chamomile tea, which contains apigenin, a compound that acts on the brain’s calming GABA receptor that helps us feel safe. Winding down with a warm Epsom salt bath, dimming the lights and avoiding screens for at least an hour before bed can signal to your body that the day is ending, helping you feel calmer and ready for sleep.

Magnesium is a key nutrient that is responsible for helping the nervous system to regulate itself, and stress increases magnesium loss. Ensuring your diet is rich in magnesium from foods such as leafy green vegetables, dark chocolate, seeds and nuts, or a daily supplement, can help to support your body to come out of a wired state. Magnesium bisglycinate or magnesium L-threonate in the evening can help you wind down.

Lemon balm is a herb that can help to lower stress levels by interacting with chemicals in the brain responsible for promoting feelings of calmness. The herb can be grown in your garden and made into herbal teas, or taken as a supplement. This is a lovely one to have in the evening if you are feeling wired.

Ashwagandha is an adaptogenic herb that can help to regulate the HPA axis, controlling stress reactions. It can be found in many different supplement forms such as capsules, powders or liquid extracts. Many people take it at night to help curb the night-time cortisol spikes. Ashwagandha isn’t suitable for everyone, including during pregnancy or for people with certain thyroid conditions. If you are unsure, reach out to our NatureDoc team who can advise you.

Glycine is an amino acid that can act as a neurotransmitter in the brain, and helps the body cool down slightly at night, which is one of the signals for deep sleep. It is naturally found in foods such as bone broth, meat, fish with the skin on, seeds, nuts and legumes. Again, you can find glycine in supplements and it is one of the key amino acids in many collagen powders.

Round up

Helping to move your body from a wired state in the evenings, and a tired state during the days, can take time. Simple changes can help your body to slowly recalibrate your cortisol clock over a few months, and you should focus on starting with easy swaps rather than trying to overhaul your whole lifestyle.

Try starting with 10 minutes of morning light when you wake up, and a relaxing Epsom salt bath before bed. It is important that these changes don’t add to your stress load, so go with what feels good for you and your routine.

If you are keen to understand the rhythm of your daily cortisol highs and lows and are interested in testing or working one-to-one with our NatureDoc clinical team, then we would be delighted to support you and help you reset and feel well again.

Ask me what supplements can help… make a booking, or anything else!