Trichotillomania and Tiredness

Trichotillomania and Tiredness

Evidence is emerging that many people with trichotillomania are permanently or too frequently on emergency alert, and therefore sleep may be difficult. Some people have too much cortisol and some too little. Those with too little sleep more, while those with too much sleep less.

It is not unusual for people with trichotillomania to suffer from extreme tiredness. To our knowledge, all medication currently prescribed for trichotillomania causes tiredness, thus urges to pull are often increased by trichotillomania medication.

“Having good sleep hygiene is especially important in BFRBs as tiredness kills hair” says Neo, Trichotillomania Consultant and Habit Reversal Specialist with

Light is particularly detrimental to sleep and tricsters are often highly sensitive to light.  A good sleep mask, such as this, which is great for eyelash pulling because it doesn’t touch the eyelashes, is a great remedy for a good night’s sleep.

The human body requires a fine balance between mitochondria and chemicals known as neuro-transmitters to make energy. CORTISOL, often referred to as the “stress hormone”, can deplete energy levels in a number of ways.

Cortisol is the one hormone which we simply could not survive without, as we simply wouldn’t wake up. Cortisol is designed quite literally to wake us up in the mornings, get us motivated throughout the day and to fall again at night time so that we can sleep. When a person has a stress-related condition or has not mastered the free management of mitochondria, cortisol can build up and up throughout the day in the form of stress, and therefore interfere with sleep.


Cortisol levels are designed to REDUCE throughout the day and rise in the morning. However, when an emergency, stressful situation needs dealing with, the body is designed to keep cortisol levels high, so we don’t fall asleep and fail to deal with the emergency.

This system seems to be impaired in many individuals with trichotillomania, especially older people. We highly recommend tyrosine, gaba and PQQ supplementation for anyone experiencing low energy levels. Obviously you should consult your doctor before supplementing, although you don’t have to mention having trichotillomania to your doctor, if you would prefer to keep it quiet.

Neo : “In my own case, since I was a baby I have always had terrible sleep problems. In the 60s, the advice was to let the baby cry.

My parents put me on the third floor of the house and moved their bedroom downstairs, so I would literally cry all night. My mother was very fond of telling the story that I was such a bad baby that I “gave myself” a hernia from screaming too much. When I went into hospital to have the hernia treated, the family finally got some sleep!

By testing my own cortisol levels, I have observed that they lower around 4 am although they “should” lower around dusk time. My (un)natural body clock is therefore telling me to sleep from 4 am to midday although of course that would be very inconvenient.

I therefore have to do a LOT of stress relieving techniques such as meditation in the evenings and also play at least one relaxation recording every single night in bed. If I miss a night, I just don’t sleep.”

The reason we take so long to wake in the mornings is because the cortisol has been so severely depleted the night before, that it takes ages and ages to rise again in the morning to wake us up.

Taking melatonin tablets (available online but not in the UK shops) can help as melatonin (only produced in the body by natural sunlight) helps the body to produce serotonin, which wakes us up and keeps us in a good mood.

Read more about stress relief and how to achieve work-life balance.

Read about some of our members and how they 

have grown to manage, and in many cases, 

overcome, hair pulling.

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Accounts of people with trichotillomania

The BFRB blogs and experiences described in this section may be disturbing so don’t read on unless you’re sure you are up to it.

how can I stop pulling my hair out

Adam Alpa Anna
Anne Angela Annette
Athena Caillin Caroline
Carrie Cathy Christine
Clarkie Cleo Donna
Ellen Faith H
Holly Iris Jan
Jane Jason Jayne
Jess Jo Joanna
Joanne Kat Kati
Kristina Krystal Laura
Lisa Lisa W Louise
Lucy Mairen Mike
Neil – OCD Patience
Robin Sandy Sara
Shannon Terri Tracey
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We are particularly interested in success stories, and there are very many people on the site who have achieved long-term freedom from pulling.