7 Surprising Things That Are Stressing Your Nervous System

Written by Dr. Michael Ruscio, DC on April 21, 2023

Written by Dr. Michael Ruscio, DC on April 21, 2023 — Reviewed by Dr. Hannah Hamlin

Tackling These Sneaky Stressors Will Put You in Better Mental and Emotional Shape

What is Your Nervous System and How Does it Get Stressed?|
7 Sneaky Things Stressing Your Nervous System|
Measuring Your Stress Management Progress|
Balancing Your Nervous System Brings Better Health|

Key Takeaways:

Some sources of stress (like work and money worries) are obvious, but there are other surprising ways your nervous system can get overwhelmed.
Less well-known stressors include poor diet, gut inflammation, limbic imbalance, and being sedentary.
Ways to combat undue stress on your nervous system include healing your gut with a healthy diet and by taking probiotics.
Some simple herbal treatments could also help women who are experiencing hormone-related stress to the nervous system.
Moderate exercise and other forms of “good stress”, like cold water immersion, can also help you become more stress resilient.
You can track how balanced your nervous system is by tracking your Heart Rate Variability (HRV) over time.

We can all easily pinpoint the obvious things that cause us acute stress — for some of us, it’s giving a presentation, while for others, it might be a bumpy airplane trip, or a visit to the dentist. Whatever the cause, some common physical symptoms of an acute stress situation include a fast heartbeat, butterflies in the stomach, and a dry throat.

On the other hand, there are other stressors you might not be so aware of. Though their effects may be less obvious, they can still result in high stress levels for your nervous system.

For example, my patient Danielle found that her nervous overwhelm symptoms, including health anxiety and a host of digestive symptoms, were largely down to a dysregulated limbic system. When she started a limbic retraining program, she saw great improvements in overall health and well-being in her daily life.

In this article, I’ll be looking at some of the surprising things that are stressing your nervous system, including limbic imbalance as well as poor gut health, diet, and high blood sugar.

First, let’s look at what your nervous system, stress, and stressors actually are.

What is Your Nervous System and How Does it Get Stressed?

You can think of the nervous system as the body’s control center that manages your thoughts, movements, and emotions. It also controls automatic responses such as digestion and breathing.

Your nervous system controls both voluntary movements like muscle contractions and involuntary or automatic responses like blood pressure, and unconscious breathing. The part of the nervous system that we don’t have conscious control of is called the autonomic nervous system

Stress is what our body experiences when physical or psychological inputs to the nervous system — known as stressors — disrupt the body’s equilibrium [1].

Stressors are sometimes also divided into environmental and psychological, though the definitions are somewhat blurred.

Environmental stress is when a person’s physical environment demands more than their mind/body can handle while staying in balance. The stress may cause a negative psychological response, depending on the person [2].

Examples of physical stressors would include extreme heat or cold, being sedentary (or obsessively exercising), and excess body weight.

Psychological stress doesn’t have a precise definition, but is generally accepted as arising when the relationship between a person and their environment (or another individual) is no longer in harmony [3].

Examples of psychological stress include interpersonal conflict, exam stress, and long working hours.

Not All Stress is Bad

Though it might seem like life would be better if it were stress-free, we actually need some stress to function optimally.

“Good stress” can be defined as just enough stress stimulation to keep us alert and to provoke necessary, adaptive, responses to threats [4].

In fact, just the right amount of physical stressors can stimulate better mental health and resilience. As discussed in more detail in my podcast discussion with Scott Carney, positive physical stressors (hormetic stressors) that can be harnessed to your own advantage include cold exposures, heat exposure, and breathing exercises. The Wim Hof Method is a regimen of ice bathing and controlled breathing that’s been shown to help tamp down an excessive stress response [5].

Good stress can cause the immune system to produce an inflammatory response, which is temporarily beneficial (for example, for fighting infection). However, if inflammation is persistent and widespread — as occurs when stress occurs at a level your body cannot manage — it can contribute to chronic diseases, reduced immune function, and accelerated aging [6].

The Sympathetic vs Parasympathetic Systems

The mechanism whereby stress often plays out in the body is by unbalancing the sympathetic versus the parasympathetic parts of the autonomic nervous system (as mentioned above, this is the part of the nervous system that regulates the organs that cannot be controlled consciously).

Chronic stress can cause the sympathetic (fight-or-flight) branch of the autonomic nervous system to be over-dominant compared with the parasympathetic branch (rest and relaxation). The sympathetic nervous system signals the adrenal glands to release adrenaline (epinephrine) and cortisol. If these hormones are constantly being pumped out and the sympathetic nervous system is always switched on, your system stays on high alert, which can lead to burnout [7].

Though there are ways you can come back from burnout, minimizing unhealthy stressors is a better approach than having to deal with the consequences of chronic stress.

Let’s now move on to listing those surprising things that stress your nervous system, perhaps without you even realizing it.

7 Sneaky Things Stressing Your Nervous System

1. Poor Gut Health

Poor gut health is often caused by imbalances in gut bacteria, with symptoms that include bloating, stomach pain, diarrhea and food intolerances. These gut issues can all stress the nervous system by causing neuroinflammation within the brain and nervous system (8, 9, 10, 11, 12).

In turn, people with gut dysfunction are more likely than healthy people to have dysregulated emotions, with gut imbalances appearing to contribute to anxiety and vice-versa [13].

Many observational studies and larger studies also indicate that anxiety is more prevalent in people with irritable bowel syndrome (IBS) [13, 14, 15, 16, 17], IBD (16, 18), and celiac disease [19, 20, 21, 22].

Though it’s not possible to infer from these types of studies that gut issues directly cause anxiety, or vice versa, improving gut health is nearly always helpful. Certainly for many of my patients with mental and cognitive symptoms like depression, anxiety, and brain fog, it has been a game-changer.

You can use the 8-step process outlined in Healthy Gut, Healthy You as a template to comprehensively overhaul your gut health, or just opt for one or two key changes to begin with. From working with many patients, I’ve found that the changes that make the biggest impact are:

Reducing processed foods. There is more diet advice in point 3 below, but if you start with just one thing, it would be to cut out ultra-processed packaged foods, particularly those high in refined carbohydrates that can feed bacterial overgrowth and imbalances.

Taking a quality probiotic, preferably one with two or three different strains, so you can more thoroughly target different types of microbial imbalance. All-in-One Triple Therapy Powder Sticks — which don’t need to be refrigerated — are a convenient way to do this.

2. A Limbic System Imbalance

The limbic system is made up of various brain structures, including the hypothalamus, the hippocampus, and the amygdala. In evolutionary terms, it’s one of the most ancient parts of the nervous system that regulates emotional behaviors, such as fear, anxiety, and anger. The functions of the limbic and autonomic nervous systems are interrelated, as the limbic system stimulates the fight-or-flight response in response to strong emotions.

Trauma can throw off the balance of the limbic system, making it overly sensitive to a minimally stressful situation. This puts us at higher risk for stress-related health conditions, including cardiovascular disease (i.e. heart disease, heart attacks, and strokes)[23].

The good news is that you can retrain a dysregulated limbic system to respond more appropriately. In my clinical experience, signs that a patient can benefit from limbic retraining include having a lot of anxiety and fear and constantly ruminating over health issues. People who have limbic imbalances will often have seen various practitioners and had a string of lab tests without successful resolution of their symptoms.

Various techniques can be categorized as limbic retraining, but mostly they involve calming the fight-or-flight response. Practically, limbic retraining involves a program of meditation and mindfulness practices to let go of anxiety.

Some other interventions that help rebalance the limbic system include massage, tai chi, craniosacral therapy, breathing/posture techniques, guided imagery, yoga, and hypnotherapy [24].

One study found that limbic retraining improved anxiety, depression, functional impairment, pain catastrophizing, and psychological rigidity in fibromyalgia patients [25].
Another study found that limbic retraining improved daily functioning by as much as 80–100% in chronic fatigue syndrome patients [26].

3. Unhealthy Diet

An unhealthy diet is a known stressor of the nervous system as it can trigger inflammation, which affects both the gut and your emotions/cognitive functions via the gut-brain axis.

Foods most likely to lead to inflammation and heighten the effects of stress are refined starches and artificial trans-fats (in deep-fried fast foods). Research shows that highly refined carbohydrate and calorie-dense meals are associated with higher biomarkers of inflammation (C-reactive protein and interleukin-6) in the body [27].

The most impactful thing you can do diet-wise to avoid extra stress on the nervous system is to cut down on hyper processed food and switch to a less inflammatory, more whole food focused way of eating.

For example the mediterranean diet, with its emphasis on fresh fruit and vegetables, lean protein, whole grains and omega 3 (fish) fats, has been shown to quell inflammation [28], and is a nutritious and tasty way to reduce the impact of stress in their body.

Be aware, however, that if you have been dealing with brain and gut inflammation for a while, you may also develop food sensitivities as a result of your issues, which can create further inflammation..

For instance fewer grains and minimal dairy (aka a Paleo-style diet) has been a game-changer for a number of my patients with gut and brain health symptoms.

For more complex food sensitivities, a more specialized elimination diet may be helpful.

Elimination diets won’t usually be required long term, and you can expect to reintroduce other foods over time as your gut heals.

4. Poor Sleep

Not getting enough good quality sleep is bad for the nervous system — the more stressed we get the poorer we tend to sleep and the less sleep we get the more stressed we are likely to get.

Disturbed sleep and sleeping too long (more than eight hours a night) have been associated with greater levels of inflammation, which can contribute to nervous system dysregulation [29].

For example, sleep and circadian disruption can worsen inflammatory bowel disease (IBD) [30].

On the other hand, sleeping well improves learning outcomes, restores the synapses (junctions) between neurons, solidifies memories, and removes brain waste [31].

To improve sleep efficiency, it’s a good idea to start with the simplest things, including:

Prioritizing sleep (most people should be aiming for 7 hours a night)
Winding down at least an hour before bed
Dimming bright lights and staying off your phone and computer
Keeping a regular bedtime

If these steps aren’t enough, here is a quick overview of some helpful treatments in sleep medicine, according to research:

Cognitive behavioral therapy [32, 33, 34, 35]
Exercise, especially high-intensity interval training [36, 37, 38]
Acupuncture [39, 40]
Mindfulness meditation [41]
Warm bath before bed [42]

Of these, cognitive behavioral therapy, in particular, a regimen called CBT-I (the I is for insomnia) seems to be particularly effective.

A 2022 study that analyzed 54 randomized controlled trials ascertained that those who received web-based CBT-I with a therapist experienced falling asleep faster, had longer sleep, and fewer nighttime disturbances [33].

If you want to track your sleep, I also recommend using the Oura ring. You can hear about my own journey to sleep optimization, (including the misleading advice I received along the way) by clicking here.

5. Female Hormone Imbalances

Hormonal imbalances are also associated with extra stress for the nervous system in women. For example:

One study of women with major depression and nervous system dysregulation found low estrogen and high progesterone compared to healthy controls [43].
Premenstrual syndrome and premenstrual dysphoric disorder (a more severe version of PMS), caused by cyclic fluctuations in hormones, can also cause anxiety, anger, depression, insomnia, and mood swings [44, 45].

Though female hormone balance is complex, it’s fortunately relatively easy to nudge into balance with a combination of a healthy diet and safe and effective herbal remedies, such as black cohosh and vitex. I formulated the Progest-Harmony and Estro-Harmony products specifically because they are adaptogenic, working to bring hormones back into balance regardless of which hormone is too high or too low.

For example, vitex, also known as chaste berry and agnus castus, has been found to help regulate irregular and painful menstrual cycles, improve fertility, and lessen PMS symptoms [46, 47, 48, 49].

Black cohosh may reduce hot flashes, night sweats, and other symptoms, including mood and sleep disturbances in menopausal women [50, 51].

6: High Blood Sugar

High blood glucose in people with diabetes has been associated with low heart rate variability (HRV), which indicates reduced parasympathetic nervous system activity, and poorer overall nervous system health [52].

Nervous system dysregulation also often predicts the development of metabolic syndrome — a combination of high blood pressure, high blood sugar, and high blood cholesterol — that can lead to diabetes [53].

To keep your blood sugar in check, it’s a good idea to moderate the total amount of carbohydrates you consume and choose healthier, less refined carbs that don’t raise your blood sugar as dramatically. All the diets mentioned above — the Mediterranean diet, the Paleo diet, and the low FODMAP diet do this effectively.

Specific foods that have been found to beneficially regulate blood sugar and/or insulin levels include:

Avocados
Anthocyanin-rich berries like blueberries, blackberries, and strawberries [54]
Apple cider vinegar [55]
Almonds and other nuts [56]
Garlic [57]

7: Lack of physical activity

A sedentary lifestyle can negatively affect the nervous system somewhat differently, by delivering too little rather than too much stress (we are obviously talking about physical stress here, as people who don’t move their bodies can still be highly psychologically stressed).

Unfortunately, when you don’t work your muscles much, you may not receive enough physical challenge to build resilience toward various other stressors [58].

Without challenges presented to the body through exercise and movement, muscles can atrophy, and fat can accumulate, resulting in obesity. In addition, exercise helps reduce systemic inflammation and improve sleep quality — which both benefit the nervous system [59, 60].

In one study, physical activity reduced some inflammatory markers (TNF-α and CRP) and increased some protective brain factors (BDNF, IGF-1) in people with mild cognitive impairment. These effects may explain how physical exercise improves brain health [61].
Moderate exercise has separately been shown to prevent or reduce brain inflammation (27, 59, 61, 62, 63, 64).

Steady modest zone 2 exercise, or the type of exercise you can do while still holding a conversation relatively easily, is the best sort for improving stress resilience. On a cellular level, it reduces proinflammatory chemicals (cytokines) and promotes anti-inflammatory cytokines [65].

Brisk walking or gentle jogging gets most people into zone two, and if you can combine doing this a few times a week while being outside in nature, you’ll reap good benefits for your nervous system.

More intense exercise is healthy too, as long as you work up to it. If you’re concerned about an illness or injury, you can check with your doctor to see what kind of regimen is right for you.

Measuring Your Stress Management Progress

If you’ve been trying to manage stress and root out hidden stressors, you’ll be able to track your progress based on your symptoms and anxiety levels.

But if you prefer something a bit more high tech, you could try keeping a track of your heart rate variability, or HRV. HRV is the fluctuation in the length of intervals between heartbeats and is a good way to track sympathetic versus parasympathetic activity [66].

Higher HRV is considered a marker of a balanced nervous system, and low variability is linked to poor health outcomes. You can measure with a tracking device like the Oura ring, or by using the HRV4 Training app in the morning before you get up.

Everybody has an HRV measurement that is personal to them, and day-to-day fluctuations are entirely normal. However you can look for trends over time and regularly measuring HRV can improve your awareness of how various stressors affect your nervous system and bodily functions.

Balancing Your Nervous System Brings Better Health

I hope now you have a little more insight into the surprising things that are stressing your nervous system and the ways you can tackle each of these.

A gut-healthy diet, regular exercise, and optimum sleep are the most crucial basics for keeping your nervous system in good shape, but sometimes you may need extra help to get your nervous system back in balance with strategies like limbic retraining, meditation, and CBT.

If you need extra help with symptoms of a nervous system overload, you can also reach out to us at the Ruscio Institute for Functional Health.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

➕ References

Chu B, Marwaha K, Sanvictores T, Ayers D. Physiology, Stress Reaction. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 31082164.
Gatersleben B, Griffin I. Environmental Stress. In: Fleury-Bahi G, Pol E, Navarro O, editors. Handbook of environmental psychology and quality of life research. Cham: Springer International Publishing; 2017. p. 469–85. (International Handbooks of Quality-of-Life). DOI: 10.1007/978-3-319-31416-7_25.
Monroe SM, Cummins LF. Stress: Psychological Perspectives. In: International encyclopedia of the social & behavioral sciences. Elsevier; 2015. p. 583–7. DOI: 10.1016/B978-0-08-097086-8.25038-1.
Roberts BL, Karatsoreos IN. Brain-body responses to chronic stress: a brief review. Fac Rev. 2021 Dec 16;10:83. DOI: 10.12703/r/10-83. PMID: 35028648. PMCID: PMC8725649.
Petraskova Touskova T, Bob P, Bares Z, Vanickova Z, Nyvlt D, Raboch J. A novel Wim Hof psychophysiological training program to reduce stress responses during an Antarctic expedition. J Int Med Res. 2022 Apr;50(4):3000605221089883. DOI: 10.1177/03000605221089883. PMID: 35437052. PMCID: PMC9021496.
Morey JN, Boggero IA, Scott AB, Segerstrom SC. Current directions in stress and human immune function. Curr Opin Psychol. 2015 Oct 1;5:13–7. DOI: 10.1016/j.copsyc.2015.03.007. PMID: 26086030. PMCID: PMC4465119.
Elbers J, Jaradeh S, Yeh AM, Golianu B. Wired for threat: clinical features of nervous system dysregulation in 80 children. Pediatr Neurol. 2018 Dec;89:39–48. DOI: 10.1016/j.pediatrneurol.2018.07.007. PMID: 30343833.
Dopkins N, Nagarkatti PS, Nagarkatti M. The role of gut microbiome and associated metabolome in the regulation of neuroinflammation in multiple sclerosis and its implications in attenuating chronic inflammation in other inflammatory and autoimmune disorders. Immunology. 2018 Jun;154(2):178–85. DOI: 10.1111/imm.12903. PMID: 29392733. PMCID: PMC5980216.
Sun M-F, Shen Y-Q. Dysbiosis of gut microbiota and microbial metabolites in Parkinson’s Disease. Ageing Res Rev. 2018 Aug;45:53–61. DOI: 10.1016/j.arr.2018.04.004. PMID: 29705121.
Lin L, Zheng LJ, Zhang LJ. Neuroinflammation, gut microbiome, and alzheimer’s disease. Mol Neurobiol. 2018 Nov;55(11):8243–50. DOI: 10.1007/s12035-018-0983-2. PMID: 29524051.
Kennedy PJ, Cryan JF, Dinan TG, Clarke G. Irritable bowel syndrome: a microbiome-gut-brain axis disorder? World J Gastroenterol. 2014 Oct 21;20(39):14105–25. DOI: 10.3748/wjg.v20.i39.14105. PMID: 25339800. PMCID: PMC4202342.
Bravo JA, Julio-Pieper M, Forsythe P, Kunze W, Dinan TG, Bienenstock J, et al. Communication between gastrointestinal bacteria and the nervous system. Curr Opin Pharmacol. 2012 Dec;12(6):667–72. DOI: 10.1016/j.coph.2012.09.010. PMID: 23041079.
Umrani S, Jamshed W, Rizwan A. Association between psychological disorders and irritable bowel syndrome. Cureus. 2021 Apr 16;13(4):e14513. DOI: 10.7759/cureus.14513. PMID: 34007764. PMCID: PMC8121199.
Zamani M, Alizadeh-Tabari S, Zamani V. Systematic review with meta-analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2019 Jul;50(2):132–43. DOI: 10.1111/apt.15325. PMID: 31157418.
Hu Z, Li M, Yao L, Wang Y, Wang E, Yuan J, et al. The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis. BMC Gastroenterol. 2021 Jan 7;21(1):23. DOI: 10.1186/s12876-020-01593-5. PMID: 33413140. PMCID: PMC7791666.
Geng Q, Zhang Q-E, Wang F, Zheng W, Ng CH, Ungvari GS, et al. Comparison of comorbid depression between irritable bowel syndrome and inflammatory bowel disease: A meta-analysis of comparative studies. J Affect Disord. 2018 Sep;237:37–46. DOI: 10.1016/j.jad.2018.04.111. PMID: 29758449.
Simpson CA, Mu A, Haslam N, Schwartz OS, Simmons JG. Feeling down? A systematic review of the gut microbiota in anxiety/depression and irritable bowel syndrome. J Affect Disord. 2020 Apr 1;266:429–46. DOI: 10.1016/j.jad.2020.01.124. PMID: 32056910.
Barberio B, Zamani M, Black CJ, Savarino EV, Ford AC. Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2021 May;6(5):359–70. DOI: 10.1016/S2468-1253(21)00014-5. PMID: 33721557.
Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR, Study Group for Non-Celiac Gluten Sensitivity. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014 May 23;12(1):85. DOI: 10.1186/1741-7015-12-85. PMID: 24885375. PMCID: PMC4053283.
Clappison E, Hadjivassiliou M, Zis P. Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis. Nutrients. 2020 Jan 4;12(1). DOI: 10.3390/nu12010142. PMID: 31947912. PMCID: PMC7019223.
Sibelli A, Chalder T, Everitt H, Workman P, Windgassen S, Moss-Morris R. A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset. Psychol Med. 2016 Nov;46(15):3065–80. DOI: 10.1017/S0033291716001987. PMID: 27605134.
Koloski NA, Jones M, Talley NJ. Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study. Aliment Pharmacol Ther. 2016 Sep;44(6):592–600. DOI: 10.1111/apt.13738. PMID: 27444264.
Seo D, Rabinowitz AG, Douglas RJ, Sinha R. Limbic response to stress linking life trauma and hypothalamus-pituitary-adrenal axis function. Psychoneuroendocrinology. 2019 Jan;99:38–46. DOI: 10.1016/j.psyneuen.2018.08.023. PMID: 30172968. PMCID: PMC6436805.
Carleton RN, Asmundson GJG, Korol SL, LeBouthillier DM, Hozempa K, Katz JD, et al. Evaluating the efficacy of an attention modification program for patients with fibromyalgia: a randomized controlled trial. Pain. 2020 Mar;161(3):584–94. DOI: 10.1097/j.pain.0000000000001746. PMID: 31693540.
Sanabria-Mazo JP, Montero-Marin J, Feliu-Soler A, Gasión V, Navarro-Gil M, Morillo-Sarto H, et al. Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia: A Pilot Randomized Controlled Trial. J Clin Med. 2020 Oct 11;9(10). DOI: 10.3390/jcm9103246. PMID: 33050630. PMCID: PMC7599726.
Can Amygdala Retraining Techniques Improve the Wellbeing of Patients With Chronic Fatigue Syndrome: A Clinical Audit of Subjective Outcomes in a Small Sample – Prohealth [Internet]. [cited 2021 Jul 5]. Available from: https://www.prohealth.com/library/can-amygdala-retraining-techniques-improve-the-wellbeing-of-patients-with-chronic-fatigue-syndrome-a-clinical-audit-of-subjective-outcomes-in-a-small-sample-27689
Schelke MW, Attia P, Palenchar DJ, Kaplan B, Mureb M, Ganzer CA, et al. Mechanisms of risk reduction in the clinical practice of alzheimer’s disease prevention. Front Aging Neurosci. 2018 Apr 10;10:96. DOI: 10.3389/fnagi.2018.00096. PMID: 29706884. PMCID: PMC5907312.
Tsigalou C, Konstantinidis T, Paraschaki A, Stavropoulou E, Voidarou C, Bezirtzoglou E. Mediterranean diet as a tool to combat inflammation and chronic diseases. an overview. Biomedicines. 2020 Jul 8;8(7). DOI: 10.3390/biomedicines8070201. PMID: 32650619. PMCID: PMC7400632.
Irwin MR, Olmstead R, Carroll JE. Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry. 2016 Jul 1;80(1):40–52. DOI: 10.1016/j.biopsych.2015.05.014. PMID: 26140821. PMCID: PMC4666828.
Swanson GR, Burgess HJ. Sleep and circadian hygiene and inflammatory bowel disease. Gastroenterol Clin North Am. 2017 Dec;46(4):881–93. DOI: 10.1016/j.gtc.2017.08.014. PMID: 29173529.
Wigren H-K, Stenberg T. [How does sleeping restore our brain?]. Duodecim. 2015;131(2):151–6. PMID: 26237917.
van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Med Rev. 2018 Apr;38:3–16. DOI: 10.1016/j.smrv.2017.02.001. PMID: 28392168.
Hasan F, Tu Y-K, Yang C-M, James Gordon C, Wu D, Lee H-C, et al. Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis. Sleep Med Rev. 2022 Feb;61:101567. DOI: 10.1016/j.smrv.2021.101567. PMID: 34902820.
Seyffert M, Lagisetty P, Landgraf J, Chopra V, Pfeiffer PN, Conte ML, et al. Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis. PLoS ONE. 2016 Feb 11;11(2):e0149139. DOI: 10.1371/journal.pone.0149139. PMID: 26867139. PMCID: PMC4750912.
Blake MJ, Sheeber LB, Youssef GJ, Raniti MB, Allen NB. Systematic Review and Meta-analysis of Adolescent Cognitive-Behavioral Sleep Interventions. Clin Child Fam Psychol Rev. 2017 Sep;20(3):227–49. DOI: 10.1007/s10567-017-0234-5. PMID: 28331991.
Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: a meta-analytic review. J Behav Med. 2015 Jun;38(3):427–49. DOI: 10.1007/s10865-015-9617-6. PMID: 25596964.
Min L, Wang D, You Y, Fu Y, Ma X. Effects of High-Intensity Interval Training on Sleep: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021 Oct 19;18(20). DOI: 10.3390/ijerph182010973. PMID: 34682718. PMCID: PMC8535574.
Stutz J, Eiholzer R, Spengler CM. Effects of Evening Exercise on Sleep in Healthy Participants: A Systematic Review and Meta-Analysis. Sports Med. 2019 Feb;49(2):269–87. DOI: 10.1007/s40279-018-1015-0. PMID: 30374942.
Zhao F-Y, Fu Q-Q, Kennedy GA, Conduit R, Zhang W-J, Wu W-Z, et al. Can acupuncture improve objective sleep indices in patients with primary insomnia? A systematic review and meta-analysis. Sleep Med. 2021 Apr;80:244–59. DOI: 10.1016/j.sleep.2021.01.053. PMID: 33610071.
Fang Q-Q, Wang X-Q, Liu C-Y, Xi H-Q, Wan Q-Y, Qin S, et al. The efficacy of acupuncture on the sleep structure of patients with insomnia: A systematic review and meta-analysis. Anat Rec (Hoboken). 2021 Nov;304(11):2412–25. DOI: 10.1002/ar.24745. PMID: 34498795.
Gong H, Ni C-X, Liu Y-Z, Zhang Y, Su W-J, Lian Y-J, et al. Mindfulness meditation for insomnia: A meta-analysis of randomized controlled trials. J Psychosom Res. 2016 Jul 26;89:1–6. DOI: 10.1016/j.jpsychores.2016.07.016. PMID: 27663102.
Haghayegh S, Khoshnevis S, Smolensky MH, Diller KR, Castriotta RJ. Before-bedtime passive body heating by warm shower or bath to improve sleep: A systematic review and meta-analysis. Sleep Med Rev. 2019 Aug;46:124–35. DOI: 10.1016/j.smrv.2019.04.008. PMID: 31102877.
Holsen LM, Lee J-H, Spaeth SB, Ogden LA, Klibanski A, Whitfield-Gabrieli S, et al. Brain hypoactivation, autonomic nervous system dysregulation, and gonadal hormones in depression: a preliminary study. Neurosci Lett. 2012 Apr 11;514(1):57–61. DOI: 10.1016/j.neulet.2012.02.056. PMID: 22395084. PMCID: PMC3319257.
Gudipally PR, Sharma GK. Premenstrual Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 32809533.
Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 30335340.
Cerqueira RO, Frey BN, Leclerc E, Brietzke E. Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Arch Womens Ment Health. 2017 Dec;20(6):713–9. DOI: 10.1007/s00737-017-0791-0. PMID: 29063202.
Moini Jazani A, Hamdi K, Tansaz M, Nazemiyeh H, Sadeghi Bazargani H, Fazljou SMB, et al. Herbal medicine for oligomenorrhea and amenorrhea: A systematic review of ancient and conventional medicine. Biomed Res Int. 2018 Mar 18;2018:3052768. DOI: 10.1155/2018/3052768. PMID: 29744355. PMCID: PMC5878906.
Maleki-Saghooni N, Karimi FZ, Behboodi Moghadam Z, Mirzaii Najmabadi K. The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review. Avicenna J Phytomed. 2018 Apr;8(2):96–113. PMID: 29632841. PMCID: PMC5885324.
Verkaik S, Kamperman AM, van Westrhenen R, Schulte PFJ. The treatment of premenstrual syndrome with preparations of Vitex agnus castus: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017 Aug;217(2):150–66. DOI: 10.1016/j.ajog.2017.02.028. PMID: 28237870.
Wong VCK, Lim CED, Luo X, Wong WSF. Current alternative and complementary therapies used in menopause. Gynecol Endocrinol. 2009 Mar;25(3):166–74. DOI: 10.1080/09513590802549866. PMID: 19347706.
Frei-Kleiner S, Schaffner W, Rahlfs VW, Bodmer C, Birkhäuser M. Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial. Maturitas. 2005 Aug 16;51(4):397–404. DOI: 10.1016/j.maturitas.2004.10.003. PMID: 16039414.
Süfke S, Djonlagić H, Kibbel T. [Impairment of cardiac autonomic nervous system and incidence of arrhythmias in severe hyperglycemia]. Med Klin (Munich). 2010 Dec;105(12):858–70. DOI: 10.1007/s00063-010-1150-3. PMID: 21240584.
Licht CMM, de Geus EJC, Penninx BWJH. Dysregulation of the autonomic nervous system predicts the development of the metabolic syndrome. J Clin Endocrinol Metab. 2013 Jun;98(6):2484–93. DOI: 10.1210/jc.2012-3104. PMID: 23553857.
Stull AJ. Blueberries’ impact on insulin resistance and glucose intolerance. Antioxidants (Basel). 2016 Nov 29;5(4). DOI: 10.3390/antiox5040044. PMID: 27916833. PMCID: PMC5187542.
Gheflati A, Bashiri R, Ghadiri-Anari A, Reza JZ, Kord MT, Nadjarzadeh A. The effect of apple vinegar consumption on glycemic indices, blood pressure, oxidative stress, and homocysteine in patients with type 2 diabetes and dyslipidemia: A randomized controlled clinical trial. Clin Nutr ESPEN. 2019 Jul 9;33:132–8. DOI: 10.1016/j.clnesp.2019.06.006. PMID: 31451249.
Hou Y-Y, Ojo O, Wang L-L, Wang Q, Jiang Q, Shao X-Y, et al. A Randomized Controlled Trial to Compare the Effect of Peanuts and Almonds on the Cardio-Metabolic and Inflammatory Parameters in Patients with Type 2 Diabetes Mellitus. Nutrients. 2018 Oct 23;10(11). DOI: 10.3390/nu10111565. PMID: 30360498. PMCID: PMC6267433.
Hou L, Liu Y, Zhang Y. Garlic intake lowers fasting blood glucose: meta-analysis of randomized controlled trials. Asia Pac J Clin Nutr. 2015;24(4):575–82. DOI: 10.6133/apjcn.2015.24.4.15. PMID: 26693740.
Lu S, Wei F, Li G. The evolution of the concept of stress and the framework of the stress system. Cell Stress. 2021 Apr 26;5(6):76–85. DOI: 10.15698/cst2021.06.250. PMID: 34124582. PMCID: PMC8166217.
Petersen AMW. The anti-inflammatory effect of exercise. J Appl Physiol. 2005 Apr 1;98(4):1154–62. DOI: 10.1152/japplphysiol.00164.2004. PMID: 15772055.
Kelley GA, Kelley KS. Exercise and sleep: a systematic review of previous meta-analyses. J Evid Based Med. 2017 Feb;10(1):26–36. DOI: 10.1111/jebm.12236. PMID: 28276627. PMCID: PMC5527334.
Ma C, Lin M, Gao J, Xu S, Huang L, Zhu J, et al. The impact of physical activity on blood inflammatory cytokines and neuroprotective factors in individuals with mild cognitive impairment: a systematic review and meta-analysis of randomized-controlled trials. Aging Clin Exp Res. 2022 Jul;34(7):1471–84. DOI: 10.1007/s40520-021-02069-6. PMID: 35025094.
Khosravi N, Stoner L, Farajivafa V, Hanson ED. Exercise training, circulating cytokine levels and immune function in cancer survivors: A meta-analysis. Brain Behav Immun. 2019 Oct;81:92–104. DOI: 10.1016/j.bbi.2019.08.187. PMID: 31454519.
Stigger FS, Zago Marcolino MA, Portela KM, Plentz RDM. Effects of Exercise on Inflammatory, Oxidative, and Neurotrophic Biomarkers on Cognitively Impaired Individuals Diagnosed With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Gerontol A Biol Sci Med Sci. 2019 Apr 23;74(5):616–24. DOI: 10.1093/gerona/gly173. PMID: 30084942.
Ticinesi A, Lauretani F, Tana C, Nouvenne A, Ridolo E, Meschi T. Exercise and immune system as modulators of intestinal microbiome: implications for the gut-muscle axis hypothesis. Exerc Immunol Rev. 2019;25:84–95. PMID: 30753131.
Li X, Yang T, Sun Z. Hormesis in health and chronic diseases. Trends Endocrinol Metab. 2019 Dec;30(12):944–58. DOI: 10.1016/j.tem.2019.08.007. PMID: 31521464. PMCID: PMC6875627.
Shaffer F, Ginsberg JP. An overview of heart rate variability metrics and norms. Front Public Health. 2017 Sep 28;5:258. DOI: 10.3389/fpubh.2017.00258. PMID: 29034226. PMCID: PMC5624990.

➕ Links & Resources

Further Reading:

Getting Started

Book your first visit