It’s 2021 and most healthcare professionals are embracing the impact that our mental health has on our physical health as well as persistent pain, yet in practise, mental health is influenced by so many factors and finding the elusive silver bullet to break the spell, can be exhausting, if not impossible.

Sleep, however is one factor which is impacted in so many health conditions and also vital for recovery. It’s the reason for prescribing break through medication, advising positions of comfort for sleep, as well as there being a huge market for over-the-counter sleep remedies. Not to mention the intentional use of sleep deprivation during interrogation.

But why is it so important? Why does our health deteriorate without it?

There has been talk of circadian rhythm for many years but this merely described an activity cycle, responding to light, which is relevant if artificial light from technology, street lights, and home appliances are interfering or rest during/before night time. So what? What is the problem with this?

Let’s take one bite at a time as we try to swallow the entire subject of sleep in one small blog and focus on examples from the endocrine system, comprised of small glands throughout the body. Often small in size, these organs have a huge role to play with our health.

Bedrosian et al, explored the endocrine system and the changes that occur during disruption to various glands and their associated hormone production when circadian rhythm is disturbed. An example of this can be noticed as we study the link between sleep, the adrenal glands and cortisol levels, a hormone understood to cause disruption to the digestive system, the cardiovascular system and brain function, when production rises to high levels over prolonged periods of time.  

Equally, reassurance can be gained by knowing that the thymus gland, located in front of the heart has a huge role to play in immunity, autoimmunity and ageing. This gland is of particular interest in persistent pain, given that many conditions with persistent symptoms, such as chronic fatigue, CRPS and others are being managed with consideration of the immune system and autoimmune function. The thymus gland does atrophy over our life time, although premature atrophy (shrinking) has been known due to stress.
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The pituitary gland, also known as the Master Gland controls all other glands and its function within the brain is vital despite being only the size of a pea.

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The pituitary gland has specific regulation of growth hormone, follicle stimulating hormone, beta-endorphin, oxytocin and thyroid stimulating hormone, to name a few. These hormones alone are vital for reproductive health, energy level, growth, recovery and healing, not to mention all the other health benefits of the purity gland.

So how do we maintain good function within our thymus gland? How do we support our Master gland, the pituitary? And the adrenals, how do we maintain a healthy balance?  

Although there is a limited amount of rigorous scientific evidence for interventions that improve endocrine health, there is good anecdotal evidence for good sleep hygiene practices, of meditation, reading before bed, avoiding artificial light to improve the quality of sleep, reducing caffeine intake in the afternoon. Whether these practices have a direct or indirect influence on our endocrine system in isolation, is unknown, but it does seem to work, so given the importance of these amazing glands and the growing promotion of wellness and health services, the investment in ourselves is most definitely worth exploring. Both for our health and also the health of our patients.

It may not be the first thing that you reach for in your bag of rehab tools, but careful consideration with certain patients may well help.