Catching Your ZZZZZZs

“Sleep is the golden chain that ties health and our bodies together.” - Thomas Dekker

Why do we crave sugary food, and more food in general when we are sleep deprived? 

Insufficient sleep results in increased ghrelin, our primary hunger hormone, and decreased leptin, one of the hormones that tells our brain we are not hungry, thus increasing appetite. Sleep deprivation also causes a stress response in the body, resulting in higher cortisol levels, which causes storage of fat in the abdomen and causes insulin resistance. In addition, reduced sleep increases the reward value of food in our brains. In addition to increasing appetite and accumulation of fat, studies show that those who stay up late and sleep in late consume on average 250 kcals more per day than early to bed- early risers, and most of those excess calories are consumed after 8 pm.

We know that lack of sleep increases appetite and leads to weight gain, but how does sleep affect weight loss? When comparing subjects who were sleeping 5.5 hours per night compared to 8.5 hours per night in a weight loss study, the subjects in the two groups lost a similar amount of weight. However, the sleep deprived subjects had a 60% increase in muscle mass loss compared to the adequate sleep group, and only 25% of the weight they lost was from fat loss. The sleep deprived group also had a 400 calorie greater reduction in metabolism compared to the adequate sleep group. A 1-hour reduction in sleep is associated with an increase in BMI, and every additional hour of sleep decreases the incidence of obesity by 30%! Insulin sensitivity drops by 30% with just 4 nights of sleep deprivation.

It is therefore not surprising that insufficient sleep is associated with numerous medical conditions, including obesity, type 2 diabetes, coronary artery disease, hypertension, and premature death. It is estimated that reducing sleep from 7 hours to 6 hours increases the risk for diabetes by 9% and increasing from 7 to 8 hours of sleep would reduce the risk of type 2 diabetes by 14%. 

*Pearl: I recommend pushing bedtime up by 15-minute increments, rather than trying to get to bed an hour of two prior to the usual bedtime to allow for the circadian rhythm to gradually adjust to an earlier bedtime. 

So far, we have only discussed sleep time, but of course there are other factors to consider when discussing sleep, such as Obstructive Sleep Apnea, Restless Leg Syndrome, and Insomnia, all of which can affect the quality of sleep.

25% of US men and 9% of US women have sleep apnea, and in people with severe obesity, the prevalence is 93.6% for men, and 73.6% for women.  

Restless-Leg Syndrome (RLS) affects 2-15% of the population and can also interfere with sleep.

Insomnia is defined as the inability to fall asleep within 30 minutes more than three times a week for at least one month. Insomnia may be short-term or chronic, and the most common cause for insomnia in women is anxiety. Depression is also a common cause of insomnia. Anxiety is typically more associated with difficulty falling asleep, while depression is often associated with an inability to stay asleep. The first line of treatment for insomnia is to optimize sleep hygiene and Cognitive Behavioral Therapy for Insomnia (CBTi).

*Pearl: There is an app called CBT-I Coach for insomnia which can be extremely helpful for patients with insomnia

To improve your sleep hygiene, consider the following strategies:

·        Avoid blue-light emitting technology (turn off phones, TVs, etc. at least 30 minutes prior to bed, or use blue-light filters)

·        Optimize room temperature: optimal sleeping temperature is 60-67 degrees Fahrenheit

·        Keep your bedroom dark: avoid bright lights from alarm clocks etc. Use light blocking window coverings or eye mask if needed

·        Use a fan or white noise machine to drown out sounds, or use earplugs

·        Use relaxing scents: Lavender can be a calming scent to assist with sleep

·        Take a warm bath or shower before bed

·        Engage in meditation/ prayer/ gratitude practice before bed

·        Create a bedtime routine and follow the routine each night

·        Wake up at the same time every morning, even on weekends. Try to go to bed at the same time every night

·        Avoid caffeine after noon. Avoid alcohol

·        Avoid strenuous exercise within 3 hours of bedtime

·        Engage in moderate to vigorous exercise during the day

·        Avoid eating large meals 3 hours before bed

If you are concerned about the quality or quantity of your sleep, please follow up with a qualified medical professional to help you get the sleep your body craves and needs to help you be your healthiest, happiest self!

Take care everyone, and I hope you have the sweetest dreams!

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