What we help with · Stress & sleep
Stress, sleep & cortisol
Interactive
Cortisol and the stress response, connected
Cortisol + stress response
Cortisol + sleep
Sleep
Cortisol normally falls in the evening and rises before waking. Stress and disrupted daily rhythms can affect sleep timing and quality — and short or poor sleep can, in turn, affect the stress-response system.
Educational overview based on conventional physiology. Associations are not diagnoses, and many factors influence each of these.
From a biomedical perspective
What cortisol is, and its daily rhythm
Cortisol is a hormone made by the adrenal glands. Its release is controlled by the brain through the hypothalamic–pituitary–adrenal (HPA) axis, and it helps regulate energy, blood sugar, blood pressure, inflammation and the body’s response to stress.1
Cortisol follows a daily rhythm set mainly by your internal clock. It rises sharply in the first 30–45 minutes after waking, then falls through the day to its lowest point around midnight.2,3
Stress and sleep influence each other
Falling asleep normally dampens cortisol, and waking stimulates it. Short or poor sleep can modestly activate the stress-hormone system, and activation of that system is associated with arousal and sleeplessness — which helps explain why stress and poor sleep often travel together.3,4
Shift work and your body clock
Working nights or rotating shifts shifts sleep away from your internal clock. Shift work is associated with sleep loss and with higher rates of some metabolic problems,5 and studies have found modest associations with menstrual irregularity.6,7 These are associations from observational research — they don’t mean shift work causes these problems for everyone.
From a Traditional Chinese Medicine perspective · a separate framework
How TCM describes stress and sleep
TCM uses its own diagnostic patterns.10 Tension, irritability, sighing and symptoms that worsen with stress are often described as Liver Qi stagnation. Restless or dream-disturbed sleep may be discussed in terms of the Heart and Shen (mind), and night sweats with poor sleep in terms of Kidney Yin deficiency.
These are TCM concepts, not biomedical findings. The TCM “Liver” is not the liver organ, and it does not “control cortisol.” Dr. Kristina uses these patterns to guide treatment choices, and explains them alongside conventional terms.
At Seven Medicine
Why we ask about sleep, stress, meals, cycles and schedule
- They shape the whole picture Dr. Kristina uses to recommend care.
- Acupuncture may be used as supportive care for sleep and stress. Evidence for insomnia is limited by trial quality,8 and recent reviews for anxiety are encouraging but call for better trials.9
- Food and lifestyle suggestions are individualized — there are no universal rules.
- Seven Medicine does not test or diagnose cortisol levels. If you’re concerned about a hormone problem, your medical provider can evaluate it.
References
Physiology sources describe conventional biomedicine; they are not studies of acupuncture.
- [1]Kaur J, Gandhi J, Sharma S. Physiology, Cortisol. StatPearls (NCBI Bookshelf NBK538239). 2025. PubMed 30855827 (opens in a new tab)· clinical reference
- [2]Stalder T, et al. Assessment of the cortisol awakening response: Expert consensus guidelines. Psychoneuroendocrinology. 2016;63:414-432. PubMed 26563991 (opens in a new tab) · DOI 10.1016/j.psyneuen.2015.10.010 (opens in a new tab)· expert consensus
- [3]Balbo M, Leproult R, Van Cauter E. Impact of sleep and its disturbances on hypothalamo-pituitary-adrenal axis activity. Int J Endocrinol. 2010;2010. PubMed 20628523 (opens in a new tab) · DOI 10.1155/2010/759234 (opens in a new tab)· review
- [4]Nicolaides NC, Vgontzas AN, Kritikou I, Chrousos G. HPA Axis and Sleep. Endotext (NCBI Bookshelf NBK279071). 2020. PubMed 25905298 (opens in a new tab)· clinical textbook chapter
- [5]Kecklund G, Axelsson J. Health consequences of shift work and insufficient sleep. BMJ. 2016;355. PubMed 27803010 (opens in a new tab) · DOI 10.1136/bmj.i5210 (opens in a new tab)· review of meta-analyses
- [6]Stocker LJ, et al. Influence of shift work on early reproductive outcomes: a systematic review and meta-analysis. Obstet Gynecol. 2014;124(1):99-110. PubMed 24901274 (opens in a new tab) · DOI 10.1097/AOG.0000000000000321 (opens in a new tab)· systematic review and meta-analysis
- [7]Lawson CC, et al. Rotating shift work and menstrual cycle characteristics. Epidemiology. 2011;22(3):305-312. PubMed 21364464 (opens in a new tab) · DOI 10.1097/EDE.0b013e3182130016 (opens in a new tab)· cohort study
- [8]Cheuk DK, Yeung WF, Chung KF, et al. Acupuncture for insomnia. Cochrane Database Syst Rev. 2012;2012(9):CD005472. PubMed 22972087 (opens in a new tab) · DOI 10.1002/14651858.CD005472.pub3 (opens in a new tab)· Cochrane systematic review
- [9]Wang D, Sun J, Chuan EY, et al. Efficacy and Safety of Acupuncture for Anxiety Disorders in Adults: A Systematic Review and Meta-Analysis. Psychiatry Investig. 2026;23(8):963-975. PubMed 42613003 (opens in a new tab) · DOI 10.30773/pi.2025.0437 (opens in a new tab)· systematic review and meta-analysis
- [10]World Health Organization WHO International Standard Terminologies on Traditional Chinese Medicine. World Health Organization, Geneva. 2022. Source (opens in a new tab)· terminology standard