hormones and sleep

Which Hormones Affect Sleep? The Hormone-Sleep Connection Explained

Dr. Jolene BrightenPublished: Last Reviewed: Sleep Leave a Comment

Melatonin, a hormone produced by the pineal gland of the brain, is most commonly associated with sleep as it helps you both fall asleep and stay asleep. Cortisol, a hormone produced by the adrenal glands plays a pivotal role in your ability to wake in the morning. Together, cortisol and melatonin are most closely associated with your sleep-wake cycle, also known as circadian rhythm.

Disrupted sleep can lead to imbalances in these hormones and hormone imbalances can lead to difficulty falling and staying asleep.

Poor sleep quality can lead to imbalances of:

  • Reproductive hormones: progesterone and estrogen levels
  • Thyroid hormones
  • Growth hormone
  • Cortisol
  • Melatonin
  • Insulin
  • Ghrelin and leptin (hunger hormones)

The importance of sleep is often overlooked, yet a great deal of research shows that getting quality sleep is a crucial element in many aspects of health—including regulating blood sugar levels, stabilizing moods, assisting in nervous system functions, and supporting hormone production.

Alarmingly, about one-third of all American adults are deprived of sleep (meaning they get less than 7 hours per night), which helps to explain why conditions such as diabetes, obesity, and reproductive issues are so common.

Let's talk about why adequate sleep is crucial for your hormones—plus how disrupted hormone levels might be impeding your sleep—and what you can do to get the shut-eye you desperately need.

How to get enough sleep

Can Too Little Sleep Lead to Hormonal Imbalance?

Too little sleep or poor quality sleep can lead to a hormone imbalance. Most adults should be sleeping ideally 7-9 hours per night in order to maintain optimal hormone health.

Many of us sacrifice sleep due to busy work schedules, family obligations, stress, and other factors, leading to late nights and early mornings with minimal rest in between.

Looking back, I wish I could tell my younger self to appreciate and embrace the power of sleep. Many of us have underestimated sleep, dismissing it as unnecessary or believing we know better than our body's fundamental needs. But the truth is that neglecting sleep can have serious consequences on our bodies and minds.

Sometimes the rational is that you can make up for it on the weekend. The trouble is, the sleep debt you create 5 days a week can't easily be made up for by sleeping more on the weekend. If you're only averaging 5 hours of sleep a night then you have a minimum sleep debt of 10 hours. That would mean you'd need to sleep and extra 5 hours on Saturday and Sunday.

The main hormone problem associated with sleep deprivation is that it can elevate stress hormones, including cortisol, while suppressing the release of other hormones, including melatonin, the hormone associated with healthy circadian rhythms as well as anti-aging effects.

Sleep disturbances in women can result in:

  • Decreased melatonin
  • Increased TSH or thyroid stimulating hormone, along with fluctuating T4 and T3
  • Increased prolactin
  • Decreased progesterone
  • Increased estrogen in some cases
  • Increased insulin as insulin resistance arises
  • Increased FSH or follicle stimulating hormone (how we mature eggs and produce estrogen)
  • Decreased LH or luteinizing hormone (a key playing in ovulation and progesterone production)

All of these factors can contribute to infertility, irregular cycles, and low libido. It can also make certain conditions worse, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, hypothyroidism, and perimenopause and menopause symptoms.

When you don't get enough sleep, your body perceives this as a stressor and reacts by increasing the production of cortisol. This heightened level of cortisol can have a cascade of negative effects. It can disrupt your hypothalamic-pituitary-adrenal (HPA) axis and your body's normal hormonal balance, leading to issues like increased anxiety, impaired cognitive function, and mood swings. It can also contribute to increased oxidative stress, worsened inflammation, throw off your appetite, and mess with your menstrual cycle.

Furthermore, lack of sleep alters melatonin levels and other important hormones too, disrupting your “internal clock” and making it harder to get enough rest consistently.

How do you know if your sleep issues are actually a real problem or simply a nuisance?

Ask yourself if you experience these sleep-related problems regularly?:

  • Difficulty falling asleep (tossing and turning for an extended time)
  • Frequent nighttime awakenings (sleep fragmentation)
  • Not feeling rested or restored after waking up

If you do, and as a result you deal with daytime fatigue, sleepiness, reduced concentration, mood swings, cravings, and decreased performance, then it's time for you to prioritize getting more sleep!

How Sleep Disruption Affects Your Period
Source: Is This Normal? by Dr. Jolene Brighten

Which Hormones Affect Sleep?

Progesterone, growth hormone, leptin, ghrelin, cortisol, serotonin and melatonin and intimately connected with your circadian rhythmicity and sleep cycle. These circadian-regulating hormones also impact your ovarian hormones, menstrual cycle, fertility, appetite, response to stress, glucose and lipid levels.

Each of these hormones has a unique role in the complex process of sleep regulation, and imbalances in any of them can significantly impact sleep quality and duration.

  • Melatonin – produced by the pineal gland in response to darkness
  • Cortisol – produced by the adrenal glands as part of the waking cycle and stress
  • Insulin – produced by the pancreas in response to glucose
  • Progesterone – produced by the corpus luteum of the ovary only following ovulation 
  • Leptin – produced by fat cells in response to eating
  • Ghrelin – produced by the hypothalamus in response to eating
  • Serotonin – produced by the brain and gut in response to various stimuli
  • Oxytocin – produced by the hypothalamus in response to hugs, petting animals, breastfeeding, orgasms, and other stimuli
  • Growth hormone – produced by the pituitary gland in response to sleep, stress, exercise, low blood sugar, and other stimuli

Here are the main hormones that affect sleep (and that are affected by inadequate sleep):

1. Melatonin

Many think of melatonin as just a hormone that makes us sleepy, however it does much more than this. Melatonin, which is released primarily by the pineal gland in response to darkness, does in fact help signal to the body that it's time to sleep, but it also has other key functions—including providing antioxidant effects against free radical damage, contributing to eye health, and supporting positive moods. Your immune system also depends on optimal melatonin levels, which is one of the ways in which poor sleep can effect your susceptibility to illness. 

Melatonin also play a role in ovarian health and egg quality.

When your body isn't producing melatonin normally, your circadian rhythm becomes dysregulated, resulting in you feeling sleepy and alert at the wrong times. The result is feeling frazzled, unproductive, and anxious.

2. Cortisol

Cortisol is involved in wakefulness and regulating your body’s circadian rhythm. When your nervous system is functioning normally, you should produce less cortisol at night when you typically go to sleep and more in the morning right before you wake up to help you feel alert. However, chronic stress can lead to hypothalamic pituitary adrenal axis dysfunction (HPA-D), which can cause cortisol levels to be elevated in the evening and disruption in circadian rhythmicity.

As mentioned above, elevated cortisol is a primary concern associated with sleep deprivation. It results from increased activation of your sympathetic nervous system, which is responsible for your stress response (or fight or flight response). Being in a constant stress response leads to increased cortisol and an elevated heart rate, higher blood pressure, excess weight gain, and hormone dysfunction.

Over time, consistently high cortisol levels can also have a negative impact on your immune system, increase blood pressure, and heighten the risk of chronic conditions such as heart disease and diabetes.

Furthermore, elevated cortisol can further disrupt sleep patterns, creating a vicious cycle of stress and sleeplessness.

If you've ever dealt with cortisol imbalances then you can probably relate to this scenario: you can't sleep because you're “tired but wired,” meaning your body is exhausted by your nervous system isn't turning off. Racing thoughts, tossing and turning, along with worrying about an inability to fall asleep can create added anxiety and stress.

This underscores the importance of adequate sleep for maintaining stress hormone balance, productivity, and mental health

3. Insulin

Insulin, a hormone that regulates blood sugar levels, plays a significant role in sleep quality and patterns. Fluctuations in blood sugar levels, influenced by insulin, can significantly impact sleep.

High blood sugar levels can lead to frequent awakenings during the night, as the body works to reduce these levels, often resulting in restless and non-restorative sleep. Frequent urination at night is often a sign of high blood sugar.

Conversely, low blood sugar levels can trigger the release of stress hormones like adrenaline and cortisol, which can disrupt sleep. In this scenario, waking is generally accompanied by hunger.

4. Progesterone

Hormonal fluctuations throughout the menstrual cycle, particularly involving progesterone and melatonin, play significant roles in sleep quality, with disturbances often heightened during the luteal and menstrual phases, especially in women with PMDD (Premenstrual Dysphoric Disorder).

The rise in progesterone levels during the luteal phase of the menstrual cycle (after ovulation) leads to a slight increase in body temperature. This change in basal body temperature, which is often tracked for fertility awareness, can also contribute to sleep fragmentation.

The breakdown of progesterone also produces a metabolite called allopregnanolone, which interacts via the GABA receptor in the brain to promote sleep. In pregnant women, progesterone levels are higher, giving way to more allopregnanolone, but this shifts during the postpartum period as progesterone levels drop.

Sleep disturbances can also occur before or during your period, especially if you're someone who experiences PMS. Hormone levels are at their lowest during this phase, and the absence of progesterone, coupled with a slow rise in estrogen, can make sleep more challenging for some women.

5. Leptin and Ghrelin

Leptin and ghrelin are two hormones that, among other things, help regulate how much you eat, how hungry you feel, and how much fat you store by sending a signal to your brain that you’re full. Leptin also has other functions relating to fertility, brain function, and immunity.

Additionally, leptin is a hormone that regulates sleep. Less sleep is associated with reduced leptin and elevated ghrelin, which can result in increased fat storage, cravings, and worsened hormone imbalances.

6. Serotonin and Oxytocin

Serotonin is a neurotransmitter and a precursor to melatonin that plays a role in mood regulation and the sleep-wake cycle. Balanced levels of serotonin are essential for maintaining a healthy sleep cycle and a positive, calm mood.

Serotonin levels in women can decline as the production of the reproductive hormone estrogen is reduced in perimenopausal women, becoming even more pronounced in postmenopausal women. Female hormone replacement therapy (HRT) or menopause hormone therapy (MRT) may be necessary as part of a strategy to improve sleep for menopausal women in certain cases. Learn more about the estrogen-serotonin connection here.

Similarly, oxytocin, often called the “love hormone,” has a calming effect and can help induce sleep. It's released in response to relaxation and physical intimacy, promoting a sense of well-being and stress reduction.

7. Growth Hormone

Growth hormone is released primarily during deep sleep stages and is involved in tissue repair and muscle growth. Disrupted sleep can lead to decreased production of this hormone, impacting recovery and leading to a more difficult time maintaining healthy muscle mass.

8. Adenosine

Adenosine is a neurotransmitter that builds up in the brain during waking hours, leading to “sleep pressure,” aka the urge to sleep. As you sleep, adenosine levels decrease, helping you to feel rested upon waking. But when adenosine isn't depleted enough because you've missed out on sleep, levels remain higher than normal, causing grogginess.

Adrenal Calm

The Consequences of Poor Sleep on Hormones and Health

Sleep disorders not only disrupt daily functioning (can you say brain fog and crankiness!) but also pose severe risks to your general health and longevity. Even short-term sleep restriction can lead to extreme health deficits, although chronic sleep deprivation is the biggest threat.

Among those who are sleep-deprived, there's an increased likelihood of developing health issues, including hypertension (high blood pressure), diabetes/insulin resistance, obesity, depressive symptoms, and heart disease.

Disturbed sleep can lead to:

  • Insulin and blood sugar dysregulation
  • Increased hunger
  • Weight gain
  • Increased inflammation
  • Increased risk of heart disease and cardiovascular issues
  • Poor memory
  • Reduced immunity
  • Increased illness and more frequent infection 

The connection between poor sleep and negative health effects:

  • Impaired Glucose Control (Blood Sugar Dysregulation): Blood sugar regulation is the secret to hormone balance, but unfortunately, the flip side is that impaired glucose control is the gateway to chronic illness. If you're sleeping too little, this can affect blood sugar levels and cause insulin to spike. Blood sugar issues can then, in turn, contribute to elevated stress hormones that make it difficult to sleep. Waking up early in the morning? That can be a sign that you need some quality complex carbs with dinner or an adrenal-calming formula before bed to help normalize hormones so you can sleep through the night more easily.
  • Decreased Leptin (Which Makes You Hungrier): Having trouble maintaining a steady, healthy weight? Well, being tired surely won't help. Poor sleep messes with “hunger hormones” and can leave you with cravings and a bigger-than-usual appetite. Seriously, a lack of sleep may be one reason you are eating more (and giving in to cravings for ultra processed foods) and gaining weight as a result, despite your best efforts! Unfortunately, being overweight can further contribute to poor sleep due to issues such as sleep apnea.
  • Increased Systemic Inflammation: Research shows that chronic, low-level inflammation is at the heart of almost every chronic disease, from rheumatoid arthritis to diabetes to depression. It's also known that elevated cortisol and poor sleep can both contribute to inflammation and impaired defenses against oxidative stress.
  • Elevated Risk for Heart Disease and Mortality: Poor sleep quality is associated with coronary heart disease, which may be in part due to the increase in sympathetic nervous system activity. Fewer hours of sleep has also been associated with increased mortality from other conditions, including cancer and stroke.
  • Poor Mental Health and Cognitive Concerns: Studies show that inadequate sleep can lead to worsened anxiety, depression, fatigue, confusion, poor memory, and trouble learning. It's believed that this occurs due to mechanisms including increased inflammation and disruptions in cortisol production.

12 Natural Ways to Improve Sleep

If you're constantly tired and struggle with falling or staying asleep on a regular basis, it's time to address your lifestyle and get your hormones back on track. Of course, if you've tried just about everything and you still can't sleep, it might be time to discuss potential sleep disorders with your doctor.

There's a lot that goes into getting good sleep, including stress management, dietary strategies, enough physical activity during the daytime, and daylight sun exposure.

Let's focus on immediate solutions for those who need rest now. Here are some tips to help you catch up on much-needed sleep, which can help support hormone balance, boost your energy, protect you from mood disorders, and support cellular repair.

Lifestyle Support:

1. Optimize Sleep Hygiene

Creating an ideal sleep schedule and environment is crucial. This means sleeping in a cool, quiet, and completely dark room. It also involves establishing a regular bedtime routine and sticking to it, which may involve getting to bed earlier.

Additionally, it's beneficial to limit exposure to digital devices/screens at least two hours before bedtime since these emit blue light that can make you feel more alert and interfere with melatonin release.

Try to dim the lights in your home at night to signal to your body that it's time to wind down, then spend the hours leading up to bed doing something calming like reading or journaling.

Sleep Habits to Promote Better Sleep:

  • Stop using electronics two hours before bedtime.
  • Create a bedroom that is dark and cool.
  • Avoid afternoon caffeine.
  • Avoid vigorous exercise within 3 hours of bed.
  • Limit naps to 20 minutes.
  • Turn off all light emitting electronics or place electronics in a separate room.
  • Create a bedtime routine that promotes relaxation 1-2 hours before bed.
  • Avoid watching stimulating TV, reading the news, or activities that make you feel stressed.
  • Shift your bedtime by 15 minutes each night until you reach your ideal bedtime.
  • Reassess your current sleep habits to identify what is and isn't working for you.

2. Support Blood Sugar Balance

Stable blood sugar levels can prevent nighttime awakenings and ensure a more restful sleep. Eating regular, balanced meals rich in protein, fiber, and healthy fats is key to maintaining normal and stable blood sugar levels.

Avoid high-sugar foods, sodas, and excessive processed carbohydrates that are found in most processed foods. Instead, opt for high-quality animal proteins and legumes (if they agree with your digestive system) along with plenty of vegetables, fruits, and fresh plant foods to fight inflammation.

To get started, I created a free recipe guide and meal plan aimed at helping you optimize hormones.

3. Practice Mindfulness and Meditation to Manage Stress

Engaging in mindfulness practices, such as meditation, yoga, and deep breathing exercises, can significantly improve sleep quality. Numerous studies have shown that these techniques are effective interventions for chronic insomnia, helping to quiet the mind and prepare the body for rest.

Try carving about 20 minutes to do something mindfulness-related before bed. This can include stretching, doing a body scan meditation, lying down while listening to calming music, and taking deep breaths.

4. Get Enough Exercise and Regular Movement

Incorporating more movement and regular bouts of exercise into your routine can positively impact both the quality and quantity of your sleep. Physical activity helps regulate your body's natural rhythms and can promote deeper, more restorative sleep. Quite simply, when you move and exert energy during the day, you rest more easily. Exercise also helps fight inflammation and lowers stress, meaning it's a win-win.

Sleep Supplement Support:

5. Magnesium

Magnesium, an essential electrolyte and natural relaxant, can be particularly beneficial when taken in the evening before bed. It supports the nervous system and adrenal glands, helping to alleviate anxiety, fear, nervousness, irritability, and muscular tension in the body.

One systematic review found an association between normal magnesium status and enhanced sleep quality (lower incidence of daytime falling asleep, less snoring, and greater sleep duration).

A starting dose of 150-300 mg of magnesium at bedtime is often recommended to promote a restful night and deep sleep.

I recommend magnesium glycinate, which you'll find in Magnesium Plus, as this is the form of magnesium that is best for sleep. 

6. Ashwagandha

Ashwagandha is a tried and true Ayurvedic herb that has impressive adaptogenic qualities, particularly in supporting adrenal and thyroid health. This herb boasts a multitude of benefits, such as reducing stress, alleviating feelings of anxiety, and lessening depressive symptoms. It may also help boost morning mental alertness, likely because it aids in sleep.

As an adaptogen, ashwagandha excels in helping the body adapt to and manage stress, a common factor in disrupted sleep patterns. Research suggests that when taken consistently for about six weeks or more, ashwagandha can help enhance sleep quality and shorten the time needed to fall asleep.

The recommended ashwagandha dosage for sleep improvement is 100-200mg of a standardized extract with 5% withanolides. It can be taken in capsule form or as a powdered root in smoothies or teas.

My Adrenal Calm formula, which includes ashwagandha, is specifically designed for nighttime use to encourage a restful and rejuvenating sleep.

7. Passionflower

Passionflower is an excellent herbal remedy for sleep. Known for its sedative properties, thanks to how it supports the balance of GABA levels, it can be effective in treating mild insomnia and anxiety. It's particularly useful for those who feel tense or irritable at night.

You can try taking passionflower either as a tincture, 1-2 dropperfuls of passionflower glycerite about 30 minutes before bedtime or as part of a combination formula like Adrenal Calm.

8. L-Theanine

L-theanine, an amino acid in green tea, is celebrated for its soothing properties and benefits, including stress reduction, alleviation of anxiety, and enhancement of mental focus. It's also utilized as a supplement to foster better sleep, especially because it's safe and not likely to cause daytime drowsiness or dependence.

Research suggests L-theanine can help decrease the time it takes to fall asleep, prolong sleep duration, and improve the quality of both REM and non-REM sleep. Dosages of L-theanine are typically between 100 and 200mg/day to start.

9. Progesterone

Trouble falling or staying asleep can often indicate low progesterone levels, as progesterone metabolites aid in the brain's utilization of GABA, a neurotransmitter crucial for quality sleep.

If you're in your reproductive years, you'll want to address the root cause of low progesterone (such as stress, ovulatory dysfunction, a poor diet, or thyroid issues). Learn how to boost progesterone here.

A natural decline of progesterone also occurs during perimenopause and will be at it's lowest in menopausal women. In these stages, it might be necessary to consider progesterone supplementation to help you sleep and function better, which you can discuss with your healthcare provider.

Oral progesterone at 100-200 mg is often the form of choice to promote relaxation and restful sleep. 

10. Other Herbs, Vitamins, and Supplements

In addition to those mentioned above, many other vitamins, minerals, amino acids, and herbs can help you sleep.

It can be overwhelming to include all of the different types in your regular routine, which is why I love my Adrenal Calm formula and take it every night for its calming and relaxing benefits. It’s designed to support the HPA axis and adrenal glands as well as promote healthy sleep. This formula is my go-to when I need a chill pill. It’s especially helpful during high stress when I want to secure a good night’s sleep, and it helps me wake up with enough energy.

Adrenal Calm contains many of the sleep herbs and nutrients I’ve covered, plus others, including:

  • Vitamin C
  • B vitamins – including vitamin B6 and B12
  • Magnesium
  • Taurine
  • L-theanine
  • Lemon balm
  • Passionflower
  • Valerian
  • Ashwagandha
  • Phosphatidylserine

Dig Deeper:

11. Don't Over-Medicate Yourself (Such as With Alcohol or Melatonin)

Alcohol or products containing tetrahydrocannabinol (TCH) might make you drowsy, but they can actually be disruptive to sleep and cause issues with longterm health.

Alcohol can alter the normal progression of the sleep stages and reduce REM sleep (Rapid Eye Movement), which is a restorative phase of sleep. It can also lead to increased wakefulness during the second half of the night, making it harder to return to sleep once awakened.

While THC products may be helpful in moderation, they may be habit-forming and aren't something to rely on solely. They can also sometimes cause side effects, such as dry mouth leading to cavities, nausea, and other issues.

Is it bad to take melatonin every night? In the short term, a melatonin supplement is relatively safe for most people, although it can potentially cause some mild side effects, which is why starting with a low dose is wise. Typical dosages of melatonin are usually between 1 and 5 mg taken 1-2 hours before bed.

Melatonin is also sometimes used for fertility protocols, heartburn, and other medical conditions, so it is best to discuss with your provider if you are taking it.

As far as the long-term use of melatonin, research is lacking, so it’s best to avoid taking melatonin for many months or years unless directed by your healthcare professional. Instead, work on supporting your body's natural production of melatonin by practicing sleep hygiene.

12. Seek Professional Help

If sleep issues persist, consider consulting with a qualified health practitioner. They can assist in balancing blood sugar levels, addressing hormonal issues, and managing any underlying health issues that are standing in your way of sleeping enough.

Additionally, engaging in talk therapy, nutrition or life coaching, or even social activities like lunch with a friend can help alleviate anxiety related to sleep disturbances. Joining a yoga studio or working with a personal trainer can also provide accountability and stress relief, which is beneficial for those suffering from insomnia and other sleep-related issues.

Key Takeaways on Hormones Affecting Sleep

  • Hormonal balance and sleep hygiene are interconnected. Addressing one without the other is often ineffective.
  • Poor sleep can disrupt the balance of hormones, including melatonin, insulin, cortisol, leptin, ghrelin, and others.
  • Hormonal imbalances make it harder to sleep, and lack of sleep interferes with hormone production, creating a vicious cycle.
  • It's essential to get enough sleep to prevent an array of health issues tied to inflammation, poor heart health, mood disorders, and more.
  • If you’ve been wondering how to sleep better and have been doing everything right when it comes to the bedtime routine, give Adrenal Calm a try. It’s formulated to take three caps about an hour before bed to provide various nutrients and herbs that aid in sleep.

For more insights and guidance on achieving hormonal harmony, download my free hormone Ebook today and start your journey towards better sleep and overall health.

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About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.