I’ve never had great sleep, but in the past couple of years, it has felt like this lack of sleep has affected me on deeper levels.

Most of the time, it takes me anywhere from one to four hours to fall asleep. Even if I do manage to fall asleep quickly, I sometimes go through weeks in which I wake up at 4 a.m. and can’t nod back off. I rarely wake up feeling rested, and could always do with more sleep.

Regular readers will know by now that fatigue and brain fog are my greatest endometriosis symptoms these days, and it can be easy to presume that sleep won’t make much of a difference. But when I do have a good night’s sleep, it’s remarkable how strong and capable I feel, how positive my mindset is, and how stable my energy is over the day. The fatigue I live with doesn’t entirely disappear, but life becomes much easier.

As I study to become an endometriosis coach, I’m also learning just how important sleep is for women’s health – especially for good hormone and blood sugar balance.

I’ve talked about estrogen dominance as a common imbalance for people with endometriosis, and balanced blood sugar is a key way to manage our hormones. Sleep deprivation negatively affects our blood sugar by causing heightened insulin resistance, resulting in higher blood sugar levels. This imbalance causes a cascade of imbalances in the body, including with our hormones.

I’ve had countless conversations with other endometriosis patients who also suffer from insomnia, and although it’s not listed as a symptom of endometriosis, I do think it’s connected. I wrote a column on sleep and blamed insomnia on anxiety and depression, but what if we’re not battling with those issues?

Now I’ve uncovered two other possible culprits: estrogen dominance and deregulation of cortisol, another hormone. We already know that people with endometriosis are more likely to have estrogen dominance, and insomnia is a symptom of this. But perhaps the chronic stress of living with endometriosis is causing cortisol deregulation, which in turn can cause insomnia, disturbed sleep, and a host of other problems that might sound familiar.

So why is cortisol important? Cortisol follows a pattern throughout the day that allows our body to wake up feeling alert, and then unwind, and fall asleep. If this pattern is disturbed, we might find it hard to wake up or fall asleep, or we may just feel tired all day long.

I’ve been experimenting with my own routines to see whether they have a positive effect on my sleeping patterns — and they do.

The first change I made was getting a light alarm clock. Instead of being awakened by a shrill alarm, I’m now awakened gently by light and music. This clock mimics natural light, which helps the body realize it’s morning and follow its correct circadian rhythm.

Although this has helped with my mornings, it hasn’t really helped at night. So, I started making changes to my nighttime routine, including sticking to a strict 10 p.m. bedtime. But I still found myself wired and awake for half the night. As I dug further, I discovered that some of my daytime patterns were probably having a negative impact.

I work from home, and to quiet my anxiety, I tend to get working as soon as possible once I’m showered and dressed. This means that getting outside and exercising happen in the afternoons and evenings. Yet daylight signals to the brain that it’s morning, and sleep experts often recommend that we get some sunlight first thing in the morning to let our bodies know it’s time to start the day. Exercise also increases our cortisol levels, taking us further away from a relaxed resting state and making it harder to fall asleep later on.

Then there’s the issue that I work on my laptop all day, and once I’ve finished working, I start studying. I don’t close my laptop until nearly 9:30 p.m. That blue light is affecting my circadian rhythm. What the body really needs to begin relaxing is lower lighting and limited exposure to screens.

I’ve now changed my routine so that I get outside for at least 10 minutes in the mornings. I also exercise before I start work and make sure that any of my stimulating supplements are taken before lunch. In the evenings, I try to switch my laptop off by 8:30 p.m., and I’ve started using sidelights and turning off the main lights as much as possible.

These seem like simple changes, but I’ve already noticed more sustained, stable energy, and a relaxed sensation in the evenings. I’ve been sleeping better and I haven’t had a sleepless night in weeks!

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Note: Endometriosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Endometriosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to endometriosis.