Stop bragging about your lack of sleep. (It could be ruining your health)!

Sleep is the ‘most sedentary activity’ yet it may be the ONLY sedentary one that protects people from weight gain

As much as people don’t want to believe it, sleep is a VERY important factor in successful weight loss and maintenance of weight loss.  Many people consider sleep to be a waste of time – and erroneously think that the more hours they spend awake, the more calories they get to burn.  Unfortunately, there is copious evidence to refute this point.  In fact, given the importance of sleep, many obesity researchers would claim that sleep is as important as nutrition.  

The brain uses a great deal of energy every day. In fact, up to 20% of the energy we eat goes to support the cells of the brain so that they can do their job.  One of the byproducts of energy metabolism is biological waste – the cells have to discard what they don’t need.  Because of the high amount of energy expenditure, there is a great deal of biological waste that accumulates in the brain every day.  As you might imagine, there isn’t a great deal of extra room inside the brain to store this waste, so the brain has to be particularly adept and rapid at removing the debris.  That’s what sleep is for – the pressure inside the brain goes down during sleep, which opens up small pores (called glymphatics).  Essentially, during sleep, the tide slowly ebbs, which allows the cellular waste to be carried into the bloodstream for disposal.  If you aren’t sleeping enough, you aren’t giving your brain time to clear out the junk – and your brain and your body pay for it.

Unfortunately, only 26% of Americans are getting 8 hours of sleep nightly

(we really need about 8.5 hours every night)

Sleep deprivation impairs:

• Normal immune system activity
• Carbohydrate metabolism
• Endocrine function

Insufficient sleep is associated with:

• Obesity
• Type II diabetes (with higher fasting glucose and higher A1C even in those without diabetes)
• Coronary heart disease
• Hypertension (high blood pressure)
• Premature death

How?  Poor sleep is associated with:

• Decreased glucose tolerance
• Decreased insulin sensitivity (30% decrease after only 4 nights of sleep deprivation)
• Increased evening cortisol
• Increased ghrelin
• Decreased leptin

All of which results in increased hunger and appetite

                               (each line represents a different study)

Adults sleeping less than or equal to 5 hours per night are 55% more likely to have obesity than those that sleep > 5 hours per night.  Children that sleep less than 10 hours per night are 89% more likely than their peers to have obesity

Being a late sleeper also affects weight.  The average BMI of “morning people” or “early risers” is lower than the average BMI of people that stay up later in the evenings and sleep in later in the mornings.  People that sleep late in the mornings consume on average 248 more calories each day with the majority of those excesses occurring at dinner and after 8 pm.

People that sleep more on average have:

• Improved mood
• Better focus
• Decreased daytime sleepiness
• More willingness to exercise
• Decreased caffeine intake
• Less cravings for sweet/salty foods in the evenings

Furthermore, when poor sleepers lose weight, they tend to lose more lean body mass and less body fat – by a lot!

Why aren’t people sleeping?

• Obstructive Sleep Apnea (OSA)
  • 25% of men and 9% of women suffer with this
  • Up to 94% of men and 74% of women with severe obesity suffer with this
• Restless Leg Syndrome
  • 2-15% of the population
  • Caffeine exacerbates, SSRIs (antidepressants) can help
• Insomnia
  • Leading cause in women is anxiety
• Poor Sleep Hygiene

How to improve sleep hygiene:

• Lighting – avoid screens for at least an hour before sleeping.  If you can’t avoid them, avoid blue light (use nighttime settings on phone) 
• Turn over alarm clocks on nightstands
• Temperature (optimal is 60-67 F)
• Sounds – white noise is helpful
• Scents – lavender
• Cut out caffeine by 2-4pm
• Avoid alcohol (it suppresses REM sleep)
• Night shower or bath
• Meditation or hypnosis (Rick Collingwood has a good app)
• Routine to wind down
• Go to bed and wake at roughly the same time
• “Trick yourself” – force yourself to stay awake (without electronics!)
• PZIZZ is a free app to try
• Progressive relaxation
• Melatonin:  1-3 mg about 7 hours before bedtime

What can you do to prioritize this very important (and potentially weight-negative) behavior?

If you need to talk about it further, you know where to find me!

Courtney Younglove, M.D.