MEASURE HORMONES FOR HEALTHY SLEEP WITH A CORTISOL TEST
Written by Sarah Stasik
Updated: March 3, 2020
More than a third of the adult population in the United States gets less than seven hours of sleep a night on average. According to the Centers for Disease Control and Prevention, less than seven hours a night on average can be classified as sleep deprivation. It also leads to an increase in the likelihood of developing chronic health conditions such as heart disease, diabetes, asthma, and even some cancer.
I. Sleep and Stress Panel Testing Introduction
A lack of sleep can also contribute to risk factors for mental health issues, including depression. Around 14.6% of adults who get seven or more hours of sleep on average each night reportedly have depression, says the CDC. But 22.9% of adults who report sleep deprivation also report depression.
This guide provides a look at sleep and stress panel tests as well as sleep studies, including what they are and how they are performed. It also provides some basic definitions of common conditions that might cause a sleep test to be called for and how those conditions could be treated if they’re diagnosed.
II. Overview of Sleep and Stress Panel
Why Should I Get Tested? Chronic sleep deprivation can wreak havoc on your overall lifestyle and body, but many people don’t realize that their problems with sleep could be related to a disorder. According to the American Academy of Sleep Medicine, there are more than 90 sleep disorders with distinct clinical diagnosis. Getting tested helps your provider understand whether you’re dealing with one of these sleep disorders so it can be addressed and you can have a better chance of getting healthy levels of sleep. But a sleep and stress panel can do more than identify a sleep disorder. It can help identify or rule out serious medical conditions that might be leading to your sleeping problems.
When Should I Get Tested? According to the AASM, a board-certified sleep medicine physician or another experienced clinician should ultimately decide if you need a sleep test or study. Because of the hassle and potential expense involved, sleep studies are rarely the first diagnostic tool used by clinicians when someone is having trouble sleeping. They may try lifestyle adjustments or order a sleep and stress panel first.
However, if you can’t get enough sleep at night and lifestyle changes, such as healthy exercise or decreasing caffeine consumption, haven’t helped, it could be time to reach out to a professional. The National Sleep Foundation lists some issues that warrant a discussion about sleep issues and sleep studies with your medical provider. They include:
Regular difficulty sleeping, including staying asleep or falling to sleep, to begin with
Legs that tingle, ache, or itch at night or when lying down
The feeling that you must move your limbs when you rest (called Restless Leg Syndrome)
Gaps in your breathing during sleep or snoring that keeps someone else awake or wakes you during the night
Inability to function during the day because you’re so tired
Extended periods of sleep issues, such as for longer than two weeks
What Is Required for the Test? Sleep panels and tests come in several types. The requirements for each vary widely; some can be conducted at home while others require spending a night or more in a clinical setting.
Sleep and stress hormone panel. This test can be conducted at home or in a clinical setting. It involves taking urine samples to measure certain hormones that can impact your sleep. For this test, you only need the collection kit so you can collect your urine. You (or your doctor) send the urine to a lab to be analyzed.
Polysomnograms. When someone talks about sleep tests, they often mean sleep studies. This is very different from a sleep and stress panel. A polysomnogram involves being hooked up to leads that measure bioactivity, including your heart rate, brain activity, breathing, eye movement, and muscle tension. These results are recorded and reviewed to get a better understanding of how you are sleeping. The equipment can be set up at home for a home study or in a clinical setting. You may need to set aside one or two nights for the purpose of a sleep study.
What Do I Need to Do to Prepare for the Test? For a sleep and stress hormone panel, prepare as you would for a urinalysis. Clean your genital area to limit contamination of the urine sample. Take the sample midstream as opposed to right when you start or finish peeing for the most accurate results. Otherwise, follow any instructions provided by your medical professional or the home test kit you’re using.
For a polysomnogram conducted in a clinical environment, follow any preparation instructions provided by your clinician. That might include limiting what you eat or drink before the study or not taking in certain substances, such as alcohol or caffeine. You may also want to bring items with you that are conducive to comfortable rest, such as your own special pillow and sleepwear.
If you’re engaging in a sleep study at home, you will be provided with all the equipment by a healthcare professional. They will also instruct you on how to attach all the monitors. In some cases, a medical professional will come to your home to assist you. In others, it might be a good idea to have a trusted friend or family member get the same instructions so they can assist you with preparing for the sleep study. You might also want to make arrangements for limited interruptions during the study, which could call for arranging child or pet care or working with a spouse or other partner on the schedule for the night.
III. The Basics of Conditions Commonly Related to Sleep Tests
Sleep is an integral part of your body’s functionality, and it can be impacted by — and impact — a wide variety of other functions. To that end, a lack of sleep could be related to many health issues or temporary life changes. Here are three common root causes for sleep woes that can also be tested for via a sleep and stress panel or sleep study.
Common Root Causes & Description
Elevated stress levels
Long-term or high levels of stress can break your sleep cycle. That’s because when you’re stressed, your body releases more cortisol. Cortisol is a hormone that helps your body to amp up for the fight or flight response that may be needed in a stressful situation. It’s natural and healthy, but when your stress level stays elevated for whatever reason, so does your cortisol level. And it’s hard to sleep when your body is geared up and pumping extra blood sugar for energy.
Cortisol isn’t the only hormone that can help or hinder your sleep. Melatonin helps regulate your circadian rhythm to ensure you get a good night’s rest, for example. Even if you’re not stressed, an imbalance in certain hormones could be leading to sleep issues
Sleep apnea is a condition caused by breathing that is partly or fully blocked during certain periods while you sleep. This causes you to temporarily struggle to breathe or even stop breathing while you sleep. Risk factors for sleep apnea include being overweight, taking certain medications, drinking alcohol before you sleep, sleeping on your back or having irregularly shaped bones or tissues in or near your airways.
Treatment for kidney issues varies depending on the specific diseases at play and the severity of it. Medication and changes in diet and lifestyle typically come first. At end stages, dialysis or kidney transplants may be recommended
Substance abuse and addiction are commonly treated with rehab and counseling, which can occur in an inpatient or outpatient environment. In some cases, providers may prescribe medication to help someone break free of drug use, especially when they’re at risk of severe withdrawal symptoms
Chlamydia is fairly easy to cure. Treatments include courses of medication, and you have a better chance of being cured if you’re compliant with all your meds
This STD is a bit harder to cure than chlamydia, in part because gonorrhea strains have started to become resistant to some antibiotics. Still, it is curable and is treated with medications. Taking all medications as prescribed and never skipping doses is the best way patients can increase their chances of a successful cure
IV. How Do Sleep Tests Work?
Sleep tests work by either measuring specific factors (such as hormones) that might play a role in sleep or by measuring your sleep itself.
Sleep and stress panels are urine tests that measure the level of hormones your body is producing. They often concentrate on cortisol, melatonin, creatinine, and cortisone because they can play the biggest role in your sleep. Understanding your hormone levels can help you and your doctor determine whether you’re dealing with stress-induced sleep issues or a condition that is driving your hormones up or down inappropriately.
Sleep studies work by giving a sleep technologist and your doctor a clear picture of how you sleep at night. The monitors measure how fast you fall asleep, how many times you wake up, and how long you spend in various parts of the sleep cycle. At the same time, they measure body functions such as breathing or heart rate. Correlations between your body’s functions and your sleep can then be drawn. For example, if you wake up eight times in a night and all of those times correlate to a drop in breathing, the doctor is likely to consider sleep apnea as a diagnosis.
V. Treatment for Conditions Commonly Related to Sleep Studies
Because the reason behind sleep issues can range from a temporary increase in stress to a chronic health condition, the treatments will also vary widely. Treatments for some of the common issues discussed above might include:
Counseling or a change in lifestyle to reduce stress
Medication to assist with stress and anxiety
Changes in diet or lifestyle to better balance hormones
Hormone therapy or supplements to increase hormones that are necessary for sleep