Sleep On It

Written by Molly Watson

As a health educator at Greenlite Medicine, many of my discussions with our patients address the more “obvious” aspects of weight management such as dietary choices, physical activity, and behavioral triggers when it comes to food consumption. All of these issues are very important, but there is another one that is often overlooked and is just as crucial in weight management and overall health — SLEEP.

An estimated 50-70 million Americans suffer from some form of insomnia, with the affliction most common among the obese population and those with hypertension (high blood pressure), anxiety, and depression. Numerous studies have linked sleep loss with weight gain, as sleep duration may be an important regulator of body weight and metabolism. Lack of sleep disrupts the body’s balance of hormones such as insulin, leptin, and ghrelin. Leptin is responsible for regulating energy intake and expenditure, and acts on receptors in the brain to suppress appetite. Ghrelin, on the other hand, is known as the “hunger hormone,” playing a role in promoting meal initiation and lowering feelings of satiety after meals. A recent study conducted at the Howard Hughes Medical Institute at Stanford University concluded that subjects with short sleep cycles (less than 6 hours a night) showed increased levels of ghrelin and reduced levels of leptin in their morning blood samples.

Insufficient sleep can also affect body weight on a less clinical level. When we are deprived of sleep, we often feel lethargic and are too tired for exercise. Being tired can also make us feel depressed and moody, making us more susceptible to increased carbohydrate cravings and to using food as a tool for cheering us up.

Sleep medication may be one solution to severe or chronic sleep problems, but here are a few organic approaches to achieving a good night’s sleep:

  1. Reduce caffeine — Over 55% of the U.S. adult population drinks coffee daily. Aside from coffee, caffeine is found in some teas, soft drinks, chocolate, and certain over-the-counter medications. Caffeine is a central nervous system stimulant which takes effect, in part, by allowing the adrenal glands to release adrenaline into the bloodstream. A moderate amount of caffeine will make you feel more alert and energetic, but excessive amounts can result in anxiety, agitation, and restlessness, ultimately disrupting sleep patterns. Additionally, “our ability to excrete caffeine decreases with age,” according to Dr. Arthur Spielman, a leading scientist in neurology and sleep disorders. So as we get older, we may need to cut back on our caffeine intake, especially later in the day.
  2. Increase exercise — A study published in the journal Sleep Medicine reports that as little as 20-40 minutes of moderate aerobic activity 4 times a week improved sleep quality in the participants. Researchers state that the participants, after maintaining a regular exercise schedule for 16 weeks, raised their status from “poor” to “good” sleeper, and also reported increased energy, fewer depressive symptoms, and less drowsiness and lethargy in the daytime. Just remember not to exercise too close to bedtime, as this may increase body temperature, heart rate, and endorphins, leading to poor sleep quality.
  3. Herbal teas — A warm cup of tea before bed can do wonders for relaxing the body and calming the mind. There are many blended “sleep” formula teas on the market, but other common herbs to promote tranquility are chamomile, valerian, lemon balm, and passion flower. Find one that appeals to you and incorporate it into your nighttime ritual.
  4. Melatonin — Melatonin is a hormone produced in the brain that regulates the body’s circadian rhythm, or it’s sleep-wake cycle. Studies have shown that melatonin, taken as a supplement, decreases the time it takes to fall asleep, increases feelings of sleepiness, and may enhance sleep duration. Taking 0.1 to 0.3 milligrams of melatonin before bedtime can help induce a good night’s sleep.
  5. Relaxation techniques — There are many practiced relaxation techniques that can help calm the body and mind before bedtime. These range from meditation to deep breathing to guided imagery. There are a wealth of CD’s and downloads available on this subject, as well as short courses offered at many schools and medical centers. When practiced regularly, relaxation techniques not only help promote better sleep, but often reduce daily stress and anxiety levels.
  6. Sleep environment — Ultimately, you can’t sleep well if you’re not comfortable. Achieving the best quality sleep might be as easy as adjusting your sleeping environment. Make sure your mattress is supportive…if it has dips, lumps, or if you wake up stiff and sore, it might be time to replace it. Over or under-stuffed pillows may affect breathing patterns, and unclean sheets may harbor allergens. Reduce or eliminate as much noise and light as possible – turn the tv and lights off when you get into bed. Set your climate control to a pleasant temperature.

Hopefully, employing one or a few of these tips will help you push the “reset” button on your sleep quality. After all, as W.C. Fields said, “The best cure for insomnia is to get a lot of sleep.”

Can sleep help you lose weight?

Over the past several decades, obesity has grown to epidemic proportions.  In parallel with this rise in weight is the rise in chronic sleep deprivation. According to annual surveys done by the National Sleep Foundation, by 2005 only 26% of American adults were obtaining 8 hours of sleep and 40% of American adults report obtaining <7 hours of sleep.

Evidence has grown over the past decade supporting a role for short sleep duration as an independent risk factor for weight gain and obesity.

Total sleep deprivation experiments in animals and humans have consistently found sleep deprivation produces increased intake of food, especially high fat and high carbohydrate foods. These changes corresponded with elevations in serum ghrelin (a hormone that stimulates hunger and food intake) and reductions in serum leptin (a hormone associated with satiety and feelings of fullness).    

In a large sleep study that has been going on in Wisconsin for over 15 years, researchers found that people who slept less were on average heavier. People who slept less had lower levels of leptin and higher levels of ghrelin, which is likely to increase appetite. In other words, short sleep might stimulate appetite, which increases weight. 

Similar findings were seen in the Québec Family Study where short-duration sleepers (5-6 hours of sleep) were found to have leptin values significantly lower than predicted values and correlated with increased body fat mass and risk of being overweight/obese.

A study restricting sleep for six consecutive days found a similar reduction in leptin that persisted throughout the 24 hour day.

Although there may be other mechanisms which link short sleep duration and increased weight, optimal sleeping hours may positively influence the hormones which regulate appetite and body weight, and should be a lifestyle factor to address when managing weight loss and long term weight maintenance.

 

Spiegel K. et al. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab 2004; 89:5762–5771

Sivak M. Sleeping more as a way to lose weight. Obes Rev 2006; 7:295–296

Dinges DF et al. Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night. Sleep 1997; 20:267–277.

Spiegel K. Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141:846–850.

Chaput JP. Short sleep duration is associated with reduced leptin levels and increased adiposity: results from the Québec Family Study. Obesity 2007; 15:253–261

Taheri S. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 2004; 1:e62.