Dr. Lam har en fin artikkel om "Adrenal Fatigue and Sleep"

A common cause of insomnia is the malfunction of the Hypothalamus-Pituitary-Adrenal (HPA) axis.
Lenger ned i artikkelen snakker han om noe han kaller for "Sleep Maintenance Insomnia (SMI)", altså at du faller i søvn, men våkner og sliter med å sove igjen.

Sleep maintenance insomnia is when you are able to fall asleep but tend to wake up in the middle of the night and are unable to fall back to sleep. This is usually due to a number of factors triggering sleep onset insomnia as well as metabolic imbalances such as sugar and insulin dysregulation that happens during sleep. With excessive stress during the day, the body can sometimes fall asleep despite high cortisol and adrenaline levels simply because of the magnitude of physical tiredness. In other words, the physical tiredness often overwhelms the elevated adrenaline and cortisol levels. The body needs a break. It crashes and you go to sleep. You can be wired and tired but also able to fall asleep for a few hours. However, the cortisol and adrenaline remain high during this time, so the body is awakened by these sustained high levels in the middle of the night as the physical tiredness is reduced by a few hours of rest, leading to sleep maintenance insomnia. Once awakened, it is hard to fall back to sleep.

Another factor that contributes to SMI is metabolic dysregulation. Those who suffer from advanced Adrenal Fatigue often have concurrent metabolic imbalances such as insulin dysregulation and hypoglycemia. When blood sugar drops below a certain level during sleep due to lack of glucose supplied from food, it can activate the SNS, leading to adrenaline release and waking up. Blood sugar can be normal by conventional laboratory standards but the body may be extremely sensitive to the roller-coaster ride of the blood sugar level so that even a small drop within normal ranges during the night can trigger awakening. This is often accompanied by symptoms such as heart palpitations, cold sweats, and nightmares.
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