The HPA Axis and Insomnia

The HPA axis is one of several physiological systems that connect the mind and body.  In addition to contributing to such vital processes as digestion, sexuality, and the immune system, the HPA axis plays a significant role in the management of stress and anxiety, two of the main culprits in primary insomnia.

The HPA axis responds to stress and anxiety experienced during waking hours by producing cortisol — the stress hormone — that can remain in the bloodstream at elevated levels hours later.  This is one of the prime contributors to insomnia.

The effect of increased cortisol is to keep you feeling ramped up.  Even though you may be mentally and physically exhausted, you may find it hard to sleep if you’re stressed out, due to too much cortisol.  This should not necessarily be considered a malfunction of the HPA axis.  Rather, increased cortisol levels may more accurately viewed as the body responding to the information (or possibly misinformation) the brain is feeding it.

A number of drug therapies have been developed to manage the HPA axis, but the most effective method is to address to the real roots of the problem:  management of stress and anxiety.  This may seem obvious, but so many people think pills or drugs or supplements can do the job for you.  They cannot.  Drugs of any kind can only address the symptoms.

Management of stress and anxiety is not strictly a medical issue.  Even with drugs, if you don’t control underlying stress and anxiety, then those issues are still there ramping up blood cortisol and causing ongoing problems.

There are better ways to manage stress and anxiety than lifelong dependency on drugs or relying on anything artificial.

One effective method to manage stress at its roots is to understand your reaction to stressful situations.  We suggest it’s not so much stressful events that cause us problems as it is our reaction to them.  Stressful events may be out of our control, but our reaction is something we can control.   By doing so, we can manage stress and reduce cortisol.

Managing anxiety requires a method to understand the recurring negative thought patterns that largely underlie anxiety.  These negative thoughts are often unrealistic, distorted, and overly pessimistic.  These negative thought patterns are often ingrained and automatic, and may be somewhat beneath our level of conscious awareness.

Yet even if we are unaware we are thinking these recurring negative thoughts, they are still there, hurting us.  So getting a handle on anxiety is one of the very best things you can do to help yourself reduce cortisol levels and sleep better.

That, along with all the other sleep supportive lifestyle practices we recommend of course.  So if you find yourself wide awake at 2 a.m., then yes stress and anxiety may be the reason.

But it could also be that you are allowing too much time in bed.  It may be counterintuitive, but reducing the time allowed for sleep has the effect of increasing sleep drive, and that increase may help reduce middle of the night awakenings.

A combination approach to treat all the possible causes of insomnia at one time is best.  This is what cognitive-behavioral therapy (CBT) specifically designed for insomnia does.  A good CBT-based sleep training program will provide all these methods and tools in one place and at one time to comprehensively address all these potential root causes for most sleeping problems.

In any event, stress and anxiety are lifelong projects for us all.  These issues never go away completely; they are just an inherent and unavoidable part of managing the lifelong process of change.

But rest assured it can be done.  And by getting these issues more under your deliberate and purposeful control, you not only sleep better, but become much healthier and happier overall.

Explore posts in the same categories: Health, Insomnia, sleep

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4 Comments on “The HPA Axis and Insomnia”


  1. […] are correct about the HPA axis, however it’s probable that you have no malfunction.  Instead, your mind-body system is […]


  2. […] many of us, reduced anxiety helps re-enable sleep. Natural sleep, not drug-induced […]


  3. […] the night.  Excessive levels of stress and anxiety can lead to the body’s over-production of cortisol — the stress hormone — among other stimulating hormones, that make it more difficult to […]


  4. […] the night.  Excessive levels of stress and anxiety can lead to the body’s over-production of cortisol — the stress hormone — among other stimulating hormones, that make it more difficult to […]


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