Written by: Kevin Cann
I am a firm believer that health and disease are placed upon a spectrum. The more behaviors we take part in that encourage positive gene expression the healthier we will be. With that said I am reluctant to say one aspect is more important than another, but there is one that stands out and that is sleep. This is an area that most of us can do better in and further increase our nation’s health.
Sleep deprivation is a relatively new phenomenon. It did not become prevalent until about 20-30 years ago. This has not come without negative health consequences and has correlated with a rise in obesity, diabetes, heart disease, and cancer. These are the major causes of death in industrialized countries. The majority of studies give three reasons for sleep contributing to obesity and diabetes and they are as follows; alteration in glucose metabolism, increased appetite, and decreased energy expenditure (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1991337/ ).
Studies have shown that sleep deprivation causes a decrease in glucose tolerance and alters endocrine function. One study showed these effects when subjects were restricted to 4 hours of sleep over the course of 6 days (http://www.sciencedirect.com/science/article/pii/S0140673699013768 ). 6 days of decreased sleep is not unusual in this day and age. In my experience counseling clients, the typical person stays up until 11 or 11:30 at night and wakes up early to get to work. The majority of research studies recommend that we get 7-9 hours of sleep per night. Most of my clients fall in the 6 hour range. This is a major reason why reaching targeted weight loss can be difficult and energy levels tend to be chronically low.
Other studies suggest that even one night of sleep deprivation can cause insulin resistance (http://www.ncbi.nlm.nih.gov/pubmed/20371664 ). If insulin resistance occurs after one night of sleep deprivation, what will chronic sleep deprivation lead to? Prolonged insulin resistance is an underlying mechanism of weight gain and type 2 diabetes. Insulin, leptin, and adrenaline are all in constant communication with one another. Once we develop resistance in one, we develop resistance in all three. Leptin controls our body fat set point and our satiety, while adrenaline controls fat being released from fat cells. This can set up a scenario where we overeat and get really good at storing fat, but not burning it (http://robbwolf.com/2013/07/18/meal-frequency/ ). Studies have also shown that sleep deprivation in healthy young men was associated with decreased leptin levels and increased ghrelin levels. This led to increased hunger and appetite (http://isites.harvard.edu/fs/docs/icb.topic197607.files/Due_Wk_11_Nov_28/SPIEGEL_2004.pdf ). That study showed increased hunger and appetite in healthy young men, what would happen to someone with some range of metabolic dysfunction? My guess is it would be even worse.
Sleep deprivation also affects our thyroid. During sleep deprivation thyroid stimulating hormone (TSH) becomes significantly elevated and remains elevated throughout the day (http://www.sciencedirect.com/science/article/pii/016517819390039J ). Our bodies increase TSH levels when our active thyroid hormones are low. If our active thyroid hormones are low it can be difficult to lose weight and energy levels can fall. This is a way our body slows everything down to conserve energy. Elevated TSH levels are found in obese patients (http://www.ncbi.nlm.nih.gov/pubmed/18852923 ).
Sleep deprivation may be a major underlying issue associated with cancer. Oxidative stress forms reactive oxygen species (ROS). Once these ROS overpower our antioxidant capabilities we are at an increased risk for almost all modern disease. During sleep deprivation we get an increased amount of ROS (http://www.ncbi.nlm.nih.gov/pubmed/23371889 ). Couple this with a diet void in nutrients and/or high in anti-nutrients and we have a body riddled with oxidative damage.
Sleep deprivation can also limit our performance at work and in sports. In a meta-analysis of sleep deprivation on performance, researchers concluded that “Results of the analysis of 143 study coefficients suggest that overall sleep deprivation strongly impairs human functioning. Moreover, it was found that mood is more affected by sleep deprivation than either cognitive or motor performance, and that partial sleep deprivation has a more profound effect on functioning than either long-term or short-term sleep deprivation. Results indicate that the effects of sleep deprivation may be underestimated in some narrative reviews, particularly those concerning the effects of partial sleep deprivation” (http://psycnet.apa.org/psycinfo/1997-07865-006 ). Not only do we get decreased performance, but mood is even more greatly affected.
Then we need to ask ourselves if it is worth getting up early in the morning to exercise. Anything less than the 7-9 hours of recommended sleep may lead to weight gain, diabetes, cancer as well as decreasing mood and performance. What if the morning is the only time you can work out? If we get up early to go to the gym we may be swapping one negative for another. There are a few options here. One, go to bed earlier so that you can get the required amount of sleep. If that is not an option, find a way to become more physically active throughout the day. Walk or bike to work if possible, stand at work and practice bracing for a couple minutes every hour, go for walks during breaks at work, and so on. The best case scenario is to do both. Get to bed earlier, exercise, and stay physically active throughout the day.
If getting to bed earlier is tricky, or falling asleep is difficult for you here are a few tips. Our body has a 24 hour sleep wake cycle. This is controlled by our suprachiasmatic nucleus (SCN), a small part of our hypothalamus. The SCN responds to light and dark. We live in an environment where we are chronically exposed to artificial light. This can confuse our SCN, and our SCN is in charge of the circadian rhythm (24 hour cycle) of all of our hormones. Dysfunction in circadian rhythm can lead to being tired in the morning and wired at night time. Light also stops the conversion of serotonin to melatonin which may increase cancer risk (http://www.sciencedaily.com/releases/2014/01/140120085058.htm ). Sleep deprivation creates dysfunction in the SCN and reduces the circadian rhythm output signal (http://www.ncbi.nlm.nih.gov/pubmed/17425221 ). This can lead to increased hunger and appetite, as well as increased weight, decreased energy levels, and mood (http://robbwolf.com/2013/09/18/chronic-inflammation-circadian-rhythm/ ).
Try not to expose yourself to too much artificial light within at least 1 hour, but preferably 2-3 hours before bed. If you are going to watch TV try to purchase a pair of amber colored glasses to block the blue light. Reading a thrilling or exciting novel can also increase stress hormones, so that may not be a good idea either. Try finding a relaxing activity to do such as listening to calming music. This is also a good time to actively practice stress management techniques such as meditation. Getting adequate levels of physical activity can also help. Physically active people have an easier time falling asleep than sedentary people. Remember though, that exercise is a stressor and too much is not a good thing. Listen to your body and be aware of the signs and symptoms of overtraining. Some signs and symptoms include poor sleep, low energy levels, increased soreness, decreased performance, decreased cognitive ability, and decreased mood.
Sleep is a major component of good health. Unlike nutrition, the research is pretty clear that a good night’s sleep is required for good health. We also have control of our sleep quality. A good night’s sleep is often overlooked by many trying to take charge of their health. Make a good night sleep a priority and see for yourself the increased health benefits.
A few links for more information on this topic: