Perchance to Sleep

July 26, 2005

Perchance to Sleep 

 Competency # 7  SLEEP                               Reference:  Horm Res 2005; 64 Suppl 3:8-15. 

Americans now sleep 2 hours a night less than we did 40 years ago. (Job, kids, marriage…)  Research supports that the reason KIDS are overweight is based NOT on how much TV they watch, but how much sleep they get, or don't get.  That's what started the research into the connection between the two.  From Wisconsin: in the Wisconsin Sleep Cohort Study: 3000 government employees being followed that shows a clear association between amount of sleep and being overweight. (inverse relationship).  

From New York: Columbia University research: 6 hours of sleep, 23% more likely to be overweight.  5 hours of sleep 50% more likely to be overweight, 4 hours of sleep 74% more likely to be overweight. Less sleep = more weight!  Why?  I thought I burned more calories being awake and active.  Not so!  The answer is counterintuitive.  

We have two hormones that affect our appetite that sleep affects dramatically. LEPTIN: put out by fat cells - tells the brain to stop eating. GHRELIN: made by the stomach -  tells the brain to keep eating. The less you sleep, the lower the leptin and the higher the ghrelin.  About a 15% swing is all it takes in the hormone levels.  When you are tired, you munch.  We all know that.   Apparently, the brain sees the drop in leptin as a starvation signal and also signals your body to go into low burn mode.  You become more efficient at the calories you got. 

Finally, sleep deprivation affects insulin resistance, blood glucose levels and these two are key to setting up the "Metabolic Syndrome".  (Definition of metabolic syndrome = abdominal obesity, low HDLs, high triglycerides, high blood pressure and slightly high glucose). How This Affects Me:  Research at Chicago - 11 young men in their twenties were limited to 4 hours of sleep for 6 straight nights.  They induced a pre-diabetic state with a 40% reduction in ability to clear glucose, a 30 % slower insulin release effectively making the natural metabolic response of an 80 year old. 

 WWW: What will work for me?   Sleep is not just for your brain.  It's for your body as well.  I’m trying to get at least 7 good hours.  I’m also aware that I sleep better if I resist the temptation to snack after 8 pm; at most an apple.  Practicing good sleep habits requires going to bed at the same time every night.  Giving myself some quiet reading time prior to sleep.   Don’t watch exciting cop shows just before sleep.  (They end up in my dreams in odd pieces.)  Caffeine after 4 pm keeps me awake at 2 am.  And easy on the late night water, so I don’t have to wake up to go potty.  If I do all that, I find it’s easier to make it through the day without snacking.  The literature now proves that! If you are a snorer, get to a sleep lab for evaluation of sleep apnea.  Sleep apnea is everything stated above in capital letters because you aren't getting any good quality sleep and all of your metabolic markers are 10 times worse.  Fifteen million Americans have sleep apnea and don’t get treatment.  If you snore, have pauses in your breathing during sleep, are tired all day, wake up with headaches, wake frequently during the night, see your doctor and get to one of our leading sleep centers.  Your risk of heart attack is MUCH higher!  Lose weight and your sleep apnea may get dramatically better.  It may even go away completely.)  

This column was written by Dr. John E Whitcomb, MD, Brookfield Longevity, Brookfield, WI. (262-785-5300)