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A Sleep Doctor Explains How to Fix Your Cortisol and Sleep

Published
2021-09-14
Updated
2024-02-17
Written by
Jeff Kahn
Reviewed by
Dr. Jamie Zeitzer
Woman suffering from sleep loss due to excess cortisol

What You Need to Know

  • Cortisol regulates your sleep cycle: You need higher cortisol levels in the morning to wake up and lower levels in the evening to help you fall asleep.
  • Sleep loss and high cortisol create a vicious cycle: Elevated cortisol can disrupt sleep, and lack of sleep raises cortisol levels, increasing the risk of sleep disorders like insomnia and sleep apnea.
  • Reduce nighttime cortisol naturally: Lower stress, create a relaxing bedtime routine, improve your diet, and enhance sleep hygiene. The RISE app helps manage sleep debt and break the cycle of high cortisol and sleep loss.

Cortisol is known as the stress hormone. It helps prime you for danger when your body’s flight-or-fight mode is activated. It can also be a good thing in times of eustress — or positive stress — as it gives you a short-term boost in energy and focus.

But if you have chronic stress — from endless work deadlines or a demanding toddler — you’ll have high levels of cortisol at all times, and this isn’t good news for your sleep. And as sleep loss can hike cortisol levels, it’s easy to get trapped in a vicious circle of more sleep loss and more cortisol.

But you don’t want constantly low cortisol levels either. Cortisol helps us wake up in the morning and feel alert. You just need the right amount of cortisol at the right times — but this is where things go wrong for many of us.

Below, we’ll answer every question you’ve ever had about cortisol and sleep. And we’ll explain how you can use the to lower your evening cortisol levels and get a good night’s sleep.

Advice From a Sleep Doctor

“Most of the time, you don’t need to know your exact cortisol levels," says Dr. Chester Wu. "But you do want to do healthy sleep and lifestyle habits to keep them in check. Try to maintain regular sleep patterns, get enough sleep each night, and keep stress levels low, especially before bed.”

Dr. Chester Wu is double board certified in Psychiatry and Sleep Medicine, and provides sleep medicine services, medication management, and psychotherapy to adults at his private sleep medicine and psychiatry practice.

What is Cortisol?

Cortisol is a hormone that helps you feel alert. It helps you wake up in the morning and it’s a natural part of your body’s stress response, increasing your heart rate and helping you get ready to fight or run away from danger.

The hormone is produced by the hypothalamic pituitary adrenal axis (HPA axis), which is a part of both the central nervous system and the endocrine system. It’s made up of the adrenal glands at the top of your kidneys and the hypothalamus and pituitary gland in your brain.

The main roles of cortisol Գܻ:

  • Making you feel alert when your body goes into fight-or-flight mode
  • Helping to control your sleep-wake cycle
  • Controlling your metabolism
  • Suppressing inflammation and helping your immune system function properly
  • Regulating blood pressure
  • Regulating blood sugar levels

When everything’s working well, your cortisol levels will naturally rise and fall over the course of the day and night. You want higher cortisol levels in the morning to help you wake up, and lower levels in the evening to help you fall asleep. This is part of the hormone's , a roughly 24-hour cycle.

You’ll also have short-term high cortisol levels when you need to respond to a threat. Levels should return to normal when the stressor has passed. But many of us live in a constant state of high stress. And this is where sleep problems — and a whole host of other health issues — come in.

What Are Normal Cortisol Levels?

Normal cortisol levels will look a little different for everyone, and they even get .

In general, they’ll be higher in the morning, peaking about after waking up. The early is part of what helps you wake up and it’s known as the cortisol awakening response (CAR). Cortisol levels will then gradually decrease as the day goes on, hitting their lowest at around midnight.

This rise and fall in cortisol will happen a little later in the day if you’re a night owl and earlier in the day for early birds. It also shifts earlier as we age.

In healthy adults who sleep from midnight to 8 a.m., normal levels of (measured in nanograms per deciliter) would look like this:

  • 7 a.m. to 9 a.m.: 100-750 ng/dL
  • 3 p.m. to 5 p.m.: < 401 ng/dL
  • 11 p.m. to 12 a.m.: < 100 ng/dL

To find out if you have a cortisol imbalance, you’ll have to get your levels tested in a lab. Your cortisol levels can be measured through your saliva, urine, or blood. There are also companies that sell salivary cortisol or blood testing kits.

But for most of us, we don’t need to worry about the specifics. Some healthy lifestyle and sleep habits will help to rebalance your cortisol levels and your body should start producing the right amount at the right time. More on how to manage your cortisol levels soon.

We asked our sleep advisor and medical reviewer, Dr. Chester Wu, for his thoughts.

“Most of the time, you don’t need to know your exact cortisol levels. But you do want to do healthy sleep and lifestyle habits to keep them in check. Try to maintain regular sleep patterns, get enough sleep each night, and keep stress levels low, especially before bed.”

How is Cortisol Linked to Sleep?

Cortisol isn’t the enemy of sleep. In fact, you need a healthy cortisol rhythm to keep your sleep cycle in check. But if cortisol levels are too high at the wrong times (i.e. in the evenings), you may have trouble sleeping.

shows a hyperactive HPA axis can lead to:

  • Sleep fragmentation — or waking up during the night
  • Decreased slow-wave sleep, also known as deep sleep
  • Reduced sleep duration
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Do High Cortisol Levels Cause a Lack of Sleep?

RISE app screenshot showing how much sleep debt you have
The can work out how much sleep debt you have.

In short, yes. High cortisol levels in the evening can cause a lack of sleep. You might find it hard to drift off, wake up often during the night, or experience insomnia.

All this makes it harder to meet your sleep need — which is the genetically determined amount of sleep you need. And when you don’t meet your sleep need, you start building up sleep debt, the running total of how much sleep you owe your body.

High sleep debt can lead to low energy, poor mood, trouble focusing, and mental and physical health problems.

Not sure how much sleep you need each night? RISE can work out your unique sleep need and whether you’re carrying any sleep debt.

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Does Lack of Sleep Cause High Cortisol Levels?

The sleep loss and cortisol connection goes both ways. Sleep loss is a stressor on the body, so missing out on shut-eye can increase your cortisol levels.

You don’t need to to see the effects — although that can hike your cortisol levels. A highlights multiple studies showing that partial sleep deprivation can lead to an increase in next-day cortisol levels.

Even getting — something some of us do during the workweek — can cause an increase in cortisol levels the next evening.

As well as not getting enough sleep overall, sleep disturbances like waking up in the night (which high cortisol can cause) is also a stressor and this can trigger more cortisol production.

What Causes High Cortisol Levels?

High cortisol levels can be caused by:

  • Stress: Both a short-term hit of stress and a chronic stressful lifestyle, which keeps your body in a state of high cortisol release.
  • Sleep deprivation: Even is enough to hike your cortisol levels the next day.
  • Sleep disorders: Sleep apnea, for example, can cause cortisol levels to spike.
  • Being out of sync with your circadian rhythm: You’ll have high cortisol levels at the wrong time (like when you’re trying to sleep). This can happen in shift workers on or if you have an irregular sleep schedule.
  • A bad diet: Diets high in , fats, refined sugars, and salt have been linked to disturbed cortisol secretion.
  • Medical conditions: Cushing’s syndrome or Cushing’s disease, Addison’s disease, or a tumor on your adrenal glands or pituitary gland.

We’ve covered more on what causes high cortisol levels here, including why it’s so dangerous.

What Are the Symptoms of High Cortisol Levels?

The Գܻ:

  • Insomnia and general trouble sleeping
  • Waking up in the middle of the night
  • Weight gain or obesity
  • High blood pressure
  • Decreased sex drive
  • Erectile dysfunction
  • Depression, anxiety, and irritability
  • Irregular periods
  • Osteopenia (or low bone density)
  • Glucose intolerance
  • Thin skin and bruising easily
  • Digestion problems
  • Brain fog
  • Acne

Poor sleep, as a result of too much cortisol, inflates your sleep debt and deflates your next-day energy levels. But that’s not all.

High cortisol levels can also lead to an increased risk of cardiovascular events, including heart attacks and stroke. And that’s not to mention the many many ill effects of sleep deprivation, like type 2 diabetes, heart disease, and early death.

What Are the Symptoms of Low Cortisol Levels?

The symptoms of low cortisol levels Գܻ:

  • Fatigue
  • Muscle weakness
  • Loss of appetite
  • Unintentional weight loss
  • Low blood pressure
  • Abdominal pain

Low cortisol levels can be caused by adrenal insufficiency, which can come from Addison’s disease or a tumor on the pituitary gland. is also linked with a blunted CAR, which can make it harder to get up in the morning and it’s a risk factor for insomnia. And finally, can increase your evening cortisol levels, but decrease your morning cortisol levels.

Speak to your healthcare provider if you think you have low cortisol levels.

How to Increase Morning Cortisol Levels?

RISE app screenshot showing when to limit caffeine intake
The can tell you when to avoid caffeine.

You want higher cortisol levels in the morning. This helps you wake up, shake off sleep inertia (or grogginess), and feel alert as you head into the day.

You can increase morning cortisol levels by:

  • Staying in sync with your circadian rhythm: Your body can then release cortisol at the right times.
  • Drinking a cup of coffee: Caffeine triggers cortisol release, which is perfect for a morning pick-me-up.
  • Exercising: Intense exercise spikes cortisol, and an early workout can help you sleep later that night, too.

Both caffeine and exercise are great for a morning boost, but they can keep you up at night if you don’t get the timings right. RISE can tell you when to avoid caffeine and late workouts to make sure they don’t disrupt your sleep.

Is Cortisol Linked to Sleep Disorders?

High cortisol levels can lead to and be caused by sleep deprivation, but what about sleep disorders? It turns out there’s a link there, too.

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High cortisol levels may cause chronic insomnia. shows patients with insomnia without depression have high cortisol levels, especially in the evening and when they go to sleep.

The paper states excess HPA axis activation may cause insomnia or keep chronic insomnia going.

Obstructive Sleep Apnea

Obstructive sleep apnea is when your breathing is cut off temporarily in your sleep. When your brain notices low oxygen levels, it wakes you up to kickstart your breathing.

These nighttime awakenings may cause a spike in cortisol. There is some showing those with sleep apnea have elevated cortisol levels, but more research is needed in this area.

High cortisol levels are also linked to obesity, which is a risk factor for sleep apnea.

How to Reduce Cortisol Levels Naturally?

RISE app screenshot showing when to get and avoid bright light
The can guide you through 20+ sleep hygiene habits.

High cortisol levels at night keeping you awake? Here’s how to reduce them quickly and naturally.

  • Lower your stress levels: Try , during the day, talking with friends and family, and doing breathing exercises ( has been shown to reduce cortisol). Speak to a therapist or reach out to friends and family for help.
  • Do a relaxing bedtime routine: This will help to keep stress (and cortisol) in check before bed. Try reading, listening to relaxing music or a podcast, meditating, or doing yoga. have also been shown to improve stress and sleep quality (although there’s no set definition for ). RISE can also guide you through relaxation techniques like deep breathing before bed.
  • Do a brain dump: Writing down your worries can help lower stress and help you fall asleep. In fact, shows writing out your to-do list can help you fall asleep faster. Write it in RISE’s brain dump feature and the app will remind you of everything you write down the next day.
  • Improve your diet: Eat a balanced diet with plenty of . Dark chocolate and green tea may help reduce cortisol, and there’s some evidence supplements can help, such as fish oil and ashwagandha. A found some evidence pro-, pre-, and postbiotics improved cortisol levels. And CBD supplements may help with anxiety, too.
  • Improve your sleep hygiene: Good sleep hygiene will help you fall asleep faster and wake up less often during the night. This makes it easier to keep your sleep debt low. Healthy habits include getting bright light first thing, avoiding evening bright light (as it suppresses the sleep hormone melatonin), and keeping your bedroom cool, dark, and quiet. RISE can guide you through 20+ sleep hygiene habits daily.

You don’t want chronically low cortisol, though. You need the hormone for proper immune function, metabolism, and to wake up effectively. We’ve covered more on how to lower cortisol here, including when you don’t want to lower it.

How to Prevent Cortisol Weight Gain?

High cortisol levels are linked to obesity and weight gain, especially belly fat. High levels of the hormone can lead to overeating, high blood sugar levels, and sleep problems (which also contribute to weight gain).

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But you can break the link. You can stop cortisol weight gain by:

  • Keeping stress levels in check: Do everything you can to keep stress in check. Make lifestyle changes, if possible, like cutting back on work hours or hiring help for an aging parent, for example.
  • Keeping sleep debt low: Short sleep is bad news for both your weight and cortisol. Check RISE to see how much sleep debt you’re carrying and take naps or head to bed a little earlier to pay this down.
  • Exercise: can lower cortisol and help keep weight in check. High-intensity workouts are okay every now and again, but they spike cortisol and can keep you awake if you do them within an hour of bedtime.

Want more weight loss tips in the face of high cortisol? We deep dive into how to stop cortisol weight gain here.

Balance Cortisol for Better Sleep and Better Days

High cortisol levels aren’t always a bad thing. Cortisol helps you feel alert in the morning and handle stressful situations. But when cortisol is constantly high, your sleep can be impacted. Plus, it’s all too easy to slip into a vicious circle of sleep loss and increased cortisol levels.

Use the to break the cycle. RISE can tell you how much sleep debt you have and keep track of it as you pay it back. The app can also predict your circadian rhythm, so you can stay in sync, and coach you through 20+ sleep hygiene habits, to make falling asleep easier to do.

It’s fast, too: 80% of RISE users feel the benefits within five days, so you could be sleeping better within the week.

FAQs

How does cortisol affect sleep?

High cortisol levels have been linked to insomnia, waking up during the night, and less sleep time overall. When cortisol levels are normal, the hormone helps you wake up in the morning (when levels are higher) and drift off at night (when levels are lower).

Can high cortisol cause lack of sleep?

High cortisol levels later in the day and near your bedtime trigger insomnia and other sleep problems. That's because cortisol is an alertness-boosting hormone.

What are symptoms of high cortisol at night?

The symptoms of high cortisol at night include insomnia, waking up throughout the night, increased urination, weight gain, depression, thin skin, and high blood pressure.

How to prevent cortisol spikes at night?

Prevent cortisol spikes at night by keeping stress low, getting enough sleep, staying in sync with your circadian rhythm (or body clock), avoiding late-night intense exercise, and eating a healthy diet.

Low cortisol and sleep

Low cortisol levels in the evening can help you fall asleep. Keep cortisol levels in check by keeping stress low, getting enough sleep, staying in sync with your circadian rhythm (or body clock), avoiding late-night intense exercise, and eating a healthy diet.

Cortisol and sleep and weight gain

High cortisol levels can mess with your hunger, metabolism, and sleep — all of which can lead to weight gain. Keep cortisol levels in check by keeping stress low, getting enough sleep, staying in sync with your circadian rhythm (or body clock), avoiding late-night intense exercise, and eating a healthy diet.

About Our Editorial Team

Written by
Jeff Kahn
Medically Reviewed by
Dr. Jamie Zeitzer
Our Editorial Standards
We bring sleep research out of the lab and into your life. Every post begins with peer-reviewed studies — not third-party sources — to make sure we only share advice that can be defended to a room full of sleep scientists.
Updated Regularly
We regularly update our articles to explain the latest research and shifts in scientific consensus in a simple and actionable way.

References

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