Feeling exhausted in the middle of the afternoon is challenging. You fight every urge to close your eyes as you yearn for your bed. Want to know what’s even more frustrating? Finally making it to your bed later that night and lying there, wide awake, full of energy and unable to sleep.
Occasionally feeling wired when you are obviously tired could have an easy-to-spot cause: maybe you had caffeine too late that day or were scrolling too close to bedtime. But if tired-and-wired is a regular occurrence for you, it might be time for a closer look to see what’s going on.
Just be careful about blindly attributing your symptoms to “adrenal fatigue” — an idea that’s gaining traction as more and more people search for answers to non-specific symptoms. Instead, take a moment to get the facts and understand the science behind the phenomenon of “tired, but wired.”
What is adrenal fatigue?
If you’re searching for an explanation for your fatigue-insomnia combo, you’ll likely come across the term adrenal fatigue. It describes a group of symptoms that may include:
- Fatigue
- Trouble falling asleep or waking up
- Reliance on stimulants, such as caffeine
- Salt and sugar cravings
- Digestive issues
- Unexplained weight loss
The concept of adrenal fatigue stems from the idea that life’s stressors may become too much for the body to handle. The belief is that when chronic stress overwhelms the adrenal glands — responsible for releasing the stress hormone cortisol — they cannot keep up with the demand to regulate the body’s stress response.
The problem is that adrenal fatigue is not a medically recognized term or diagnosis. According to the Endocrine Society — and multiple studies — there is no evidence showing the adrenal glands get fatigued by chronic stress. However, that doesn’t mean that the symptoms associated with adrenal fatigue aren’t real or that they aren’t related to stress.
The likely culprit: Stress and your HPA axis
Your body’s central stress response system is called the hypothalamic-pituitary-adrenal (HPA) axis. It includes your central nervous system (responsible for communication between the brain), spinal cord and nerves, and endocrine system (responsible for hormone production).
Besides managing your stress response, the HPA axis also plays a role in many other processes, including:
- Digestion
- Energy storage and usage
- Mood
- Sleep-wake cycle
When your HPA axis senses physical, emotional or psychological stress, it jumps into action, setting off a series of physical and chemical responses within your body. One of those responses is the release of cortisol.
Cortisol is not meant to be released for long periods. So, when the HPA axis is activated too often or for too long — which can happen with chronic stress — it becomes unbalanced, and so do your hormones.
An unbalanced, or dysregulated, HPA axis system can cause many of the same symptoms described as adrenal fatigue, including those related to energy and sleep. While a balanced HPA axis is naturally suppressed at bedtime, an activated HPA axis produces high cortisol levels that can cause that “wired” feeling.
Conditions that mimic “adrenal fatigue”
Labeling your symptoms as “adrenal fatigue” could leave you missing the true underlying cause. Chronic fatigue, sleep disruption or HPA axis dysfunction can occur with several diagnosable medical conditions, such as:
- Adrenal insufficiency (Addison’s disease)
- Depression or anxiety
- Obstructive sleep apnea
- Thyroid disorders
Talk to your primary care physician about your symptoms. They can evaluate your medical history, prescription medication and current health to determine whether you need additional diagnostic testing.
Lifestyle tips to manage stress and sleep
Quick fixes such as caffeine, sleeping aids and supplements for adrenal fatigue are not a healthy remedy for your symptoms and could end up doing more harm than good. According to the Endocrine Society, adrenal fatigue supplements may even interfere with your adrenal glands’ ability to make hormones when needed, eventually putting you at risk for a life-threatening condition called adrenal crisis.
Instead, consider making small and consistent lifestyle changes. Actions that may help you gain energy and sleep better include:
- Daily physical exercise
- Eating a healthy, whole-food diet
- Establishing healthy sleep habits, including a sleep and wake routine
- Giving up smoking, alcohol and drugs
- Practicing mindfulness meditation
Remember, stress and sleep are closely related. Rethinking your relationship with stress and partnering with your primary care physician to get the help you need are the best ways to improve your sleep and overall quality of life.
