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According to national sleep surveys, most of us would benefit by more sleep, better sleep. Unfortunately for sleep-deprived America, near every morning is torturous – the norm, and the inevitable consequence of awakening unrested. Although the snooze alarm may provide 2 to 3 merciful reprieves, we’re eventually forced to “take the pain” and get the day started. Running on empty hurts and there are no options. And, while still half awake and sitting zombie-like on the side of our bed, many of us will wistfully consider breakfast (bear paws and espresso, for instance) – if not for temporary comfort, at least to re-boot our stamina. It’s the yawn of a new day.
Scenarios like this were once infrequent, at least a generation ago . . . but no more. Over the past 20 years we’ve averaged about one less hour of sleep per night (2 hours less if we look back even further – to the mid sixties). The experts tell us that our optimum sleep requirement remains relatively constant throughout our adult life even though it will vary from person to person. Nevertheless, most of us would benefit from 8-9 hours of sound sleep per night (complete with REM’s), but we’re averaging only 6.9. Now let’s see . . . Over the past 25 (or so) years, we’re sleeping less, weighing more, and becoming more insulin resistant. Is there a valid link or is this merely coincidental?
Sleep Deprivation and Obesity
Do expect to hear more in the immediate future about the sleep-obesity-syndrome X connection. To date, the evidence for a causal relationship (sleeplessness on insulin resistance and weight gain) is rather impressive. For example: - Leptin, a hormone produced in the body’s fat stores, signals the brain to stop eating – good for the waistline. Unfortunately, leptin levels drop (significantly) when a person gets less than adequate sleep. The result: increased appetite.
- If leptin is the yin of appetite control, ghrelin (pronounced GRELL-in) qualifies as the yang. Synthesized in the stomach, ghrelin levels increase dramatically during sleep deprivation, sending strong signals to the hypothalamus to initiate hunger.
- Sleep deprivation also causes our adrenal glands to produce more of the primary stress hormone, cortisol, resulting a boost in appetite for comfort foods, predisposition to abdominal fat storage, and increased risk of insulin resistance.
- European researchers have determined that obesity in children has a strong inverse tie-in to hours slept per night.1 Surprisingly, the relationship of body weight to hours spent watching TV (or video games and computers) was not as viable.
- In a study of 3000 state-government employees, those who slept less than 8 hours per night were more likely to be overweight.2
- In a New York City investigation of sleep time vs. obesity:
Those who averaged 6 hours of sleep per night were 23% more likely to be obese than those who averaged 8 hours per night.
Those who averaged 5 hours of sleep per night were 50% more likely to be obese than those who averaged 8 hours per night.
Those who averaged 4 hours of sleep per night were 73% more likely to be obese than those who averaged 8 hours per night. 3
Sleep ApneaCompounding the detriment of sleep deprivation is sleep apnea - a condition affecting an estimated 15 million U.S. adults. Sleep apnea occurs when the soft tissue in the back of the throat relaxes and momentarily blocks airflow to the lungs. The result: dragon snoring with frequent interruptions. Although not all people who snore have sleep apnea, many do. The consequence of repetitive episodes of restricted air flow during sleep may be frequent night-time awakenings, fatigue and difficulty concentrating the next day, and headaches while sleeping (or when waking up). While losing weight may help to reduce the excessive soft tissue blocking the windpipe, CPAP (continuous positive airway pressure) is the most effective treatment to date. Surgery and dental appliances have been proven to help some (but not all); drugs and supplements are virtually ineffective.
Let There Be (Less) Light
Although the sleeplessness/weight-gain hypothesis is convincing to most, some researchers insist that excess light exposure is at least part of the problem. “The light bulb put us out of sync with nature” contends Mr. William Beatty, whose book review appears at Amazon.com. The book Beatty critiqued, Lights Out: Sleep, Sugar, and Survival, was published in 2000 and written by Samsun Medical Clinic researchers T. S. Wiley and Brent Formby. Light’s Out is similar to The Paleolithic Prescription (Eaton et al, 1988) and Eat Right 4 Your Type (D’Adamo, 1996) as all three use evolutionary anthropology as the basis for formulating good health in today’s adaptation-unfriendly technological world. Specifically, Wiley and Formby assert that exposure to artificial light (in addition to natural light) is a relatively new occurrence (in the history of man). Consequently, Greater total light exposure = altered circadian rhythms
= altered hormonal levels (less melatonin, etc.)
= increased consumption of sugar
(like prehistoric summertime hoarding)
= increased body weight, decline in health
So, can we blame Tom Edison for the current obesity epidemic? Hardly. Home illumination has been in widespread use for about a century. During the 1900’s, obesity and sugar consumption increased, but at a near-snail’s pace for 75-80 years. From 1980 to the present, however, body weights has skyrocketed . . . ditto for sugar consumption. Metabolic syndrome is now estimated to be 3-4X higher in American adults compared to just 25 years ago. And, the recent decline in hours slept per night has a much stronger link (chronologically and theoretically) to the neoteric threat to our health as a nation, than excess light exposure. Could excess light from bulbs, TV’s, and computers be part of the problem? Theoretically, yes. But really . . . is pursuing a life of minimal artificial illumination and governed by seasonal light variations (with inherent dietary requirements) ever going to happen? Suggestion: Plan on getting one or more extra hours of sleep each night. This will decrease your personal sleep deficit, while simultaneously reducing light exposure. Improving Sleep Health: A Compendium of Suggestions 1. Establish and Maintain a Regular Bed Time and Wake-Up Time
Hormonal circadian function can be strengthened by adhering to a scheduled bedtime and wake-up time. In turn, falling asleep and waking up become easier (no alarm clock needed). To make this work, however, requires repetition – even on weekends and holidays. 2. Establish and Maintain a Relaxing (and Pleasurable) Bedtime Routine
Pre-bedtime activities that may induce sleep include: soaking in a hot tub or bath (showers not recommend), sauna, meditation, relaxation therapy, soothing music, reading something spiritual or religious. Avoid bright lights and loud noises.
3. Sleep on Comfortable Bedding
Most mattresses wear out after a decade of use. If your mattress is older than 10 years, consider replacement. Also, make certain to use comfortable pillows, sheets, blankets, and comforters.
4. Designate Your Bed and Bedroom For Sleeping and Sex, Only
Watching TV or doing work in bed are not relaxing and may lengthen the time to fall asleep.
5. Avoid TV (and Other Over-Stimuli) Before Bedtime
Over-stimulation of the brain (an inherent outcome of most TV programming) prior to bedtime may increase the time required to fall asleep. (Ditto for paying bills, participating in competitive games and activities, work, etc.) In addition, excess exposure to artificial light (TV, room lights, etc.) may disrupt pineal gland function causing a postponement in the release of melatonin (and a further delay in falling asleep).
6. Remove Stress-Inducing Stimuli
From the Bedroom If possible, remove any items that are stressful reminders: newspapers, photos, briefcase, desk, etc.
7. Create a Bedroom Environment That is Comfortable
For optimum sleep health, the bedroom environment should be dark, quiet, cool (70o or less), free of allergens, free of stress-promoting reminders (work papers, etc.), and include comfortable bedding. Remove obvious inhibitors to sound sleep such as clocks with chimes or cuckoos, powerful scents, etc. If applicable, consider using blackout curtains, eyeshades, earplugs, "white noise," humidifiers, fans and other devices to optimize comfort.
8. Sleep in Complete Darkness (or as Close as Possible)
The “third eye” (pineal gland) is sensitive to even small amounts of illumination. Sleeping with the lights on (or with light from TV’s, computers, closets, hallways, other rooms, etc.) can inhibit the production of sleep-inducing melatonin and serotonin.
9. Avoid Bright Lights During Night Awakenings
If you must get up in the middle of the night, do not turn on the lights. Exposure to bright lights (bedroom, bathroom, etc.), however brief, will nearly always inhibit release of melatonin from the pineal gland. Instead, use as little light as possible such as indirect low-wattage night-lights.
10. Try Listening to White Noise, Relaxing Music, or Relaxing Sounds
Those who have difficulty falling asleep because of unwanted sounds may be helped by white noise - a mixture of sound waves extending over many frequencies that help mask noises interfering with sleep. Still others find the sounds of nature (oceans, forests) or meditation-type music helpful in falling asleep.
11. Turn Your Alarm Clock 180 degrees-
Staring at the alarm clock on a sleepless night (3am . . . 4am . . .5am) exacerbates the stresses of not sleeping and other worrisome issues. Turn the alarm clock around. 12. Avoid Alarm Clocks That are Loud or Make Annoying Sounds
Waking to sounds similar to a submarine dive alarm can be very stressful. Instead, consider waking to peaceful CD’s and/or to a Sun Alarm (simulates sunrise).
13. Where Possible, Reduce Electro-Magnetic Fields (EMF’s) in the Bedroom
EMF’s are generated by appliances and electric circuits. Some experts believe these can adversely affect the pineal gland and the production of melatonin and serotonin. Checking for EMF’s requires a gauss meter.
14. Wear Socks to Bed
The feet often feel cold before the rest of the body, since they generally have the poorest circulation. One study has shown a reduction in night awakenings by those wearing socks.
15. Exercise – But Not Close to Bedtime
Regular exercise makes it easier to fall asleep and to sleep sounder. However, since elevated metabolic activity (and alertness) can inhibit sleep, exercising within 3 hours from bedtime is not advised.
16. Lose Weight
Being overweight increases the risk of sleep apnea, a condition that, for many, prevents deep sleep.
17. Avoid Eating Within 2 Hours of Bedtime
Eating near bedtime can contribute to sleeplessness by gastro-intestinal disturbance and heartburn. Also, consumption of excessive high-glycemic sweets just prior to sleep may trigger reactive hypoglycemina – causing us to wake up several hours later with a craving for more sugary foods.
18. Avoid Liquids Within 2 Hours of Bedtime
This will reduce the frequency of bathroom trips.
19. Avoid Foods That You May Have a Sensitivity To
Food sensitivity reactions (such as to dairy or gluten products) can inhibit sleep by causing apnea, congestion, and gastro-intestinal disturbance.
20. Eat a Small Protein-Fruit Snack Several Hours Before Bedtime
Consuming a small snack, such as a tuna-mango salad, provides L-tryptophan (for serotonin and melatonin synthesis). The gentle boost to blood sugar (via fructose from fruit) assists in the transit of tryptophan across the blood-brain barrier.
21. Consider Other Bedtime Snack Ingredients That May Make Us Sleepy (or Help Us Stay Asleep)
• Passion fruit contains harman and harmine (phytochemicals that are slightly sedative).
• Foods containing melatonin include bananas, Brazil nuts, plums, cherries, oats, sweet corn, rice, ginger, tomatoes, and barley.
• If you have a nagging cough that may cause you to wake up, add honey to your bedtime snack.
• Deep green lettuces contain hyoscyanin that combines with inherent morphine-like compounds to produce a slight sedative effect.
• Potatoes contain a peptide that helps to maintain satiety longer than other foods.
• The scent of basil, lavender, orange, and cloves – according to Ayurveda – is said to induce sleep. 22. Drink a Cup of Valerian Tea, Chamomile Tea, or Decaffeinated Green Tea 2 Hours Before Bedtime Valerian (especially when combined with hops or lemon balm) and chamomile teas help to relax. Decaffeinated green tea may stimulate alpha wave activity making it easier to fall asleep. Other herbs said to help induce sleep include: Ashwaganda, Astragalas, Passionflower, Skullcap, Lavender Flower. Black Horehound, Borage, Hyssop, Lavender, Red Clover, Cramp Bark, Black Haw. Mugwort, Motherwort, Lobelia, Linden, Damiana, California Poppy, Wild Lettuce, Jamaica Dogwood.
23. Avoid Caffeinated Foods After Mid-Afternoon
Caffeine is a sleep-unfriendly stimulant found in coffee, tea, soft drinks, chocolate, and some diet pills. The half life of caffeine (for non-smokers) is approximately 4 hours. This means that the caffeine from a cup of coffee consumed at 6 pm will be reduced by half (in the body) by 10 pm. By 2 am, one-quarter of the caffeine will still be found in the blood stream – a possible contributor to insomnia. Although the caffeine found in tea, colas, and chocolate is much less than in coffee, it is still a good idea to limit caffeine intake after 3 pm. Note: In one study, chocolate was linked to nightmares – another reason to avoid it before bedtime. 24. Avoid Spicy Foods, Beans, and Nutmeg Spicy foods may cause heartburn and gastro-instestinal disturbance. Beans are notorious for causing gas. Nutmeg, for some sensitive individuals, may disrupt sleep.
25. Avoid Alcoholic Beverages Close to Bedtime Although considered a sedative, alcohol in excess disrupts sleep and causes frequent awakenings. For optimum sleep, limit alcohol intake to 2 drinks per day, maximum, with the last drink consumed at least 2 hours (or more) before bedtime.
26. Avoid Smoking Close to Bedtime Nicotine is a stimulant which can cause difficulty falling asleep, staying asleep (nightmares, withdrawal symptoms), and waking in the morning – more good reasons to quit smoking.
27. Try the Emotional Freedom Technique (EFT) for Chronic Insomnia (Emotional Issues) EFT is a self-help finger tapping therapy for insomnia that utilizes acupuncture meridians and affirmations. Practitioners claim that it helps remove the source of insomnia at a deeper level. For instructions on how to perform EFT, surf to http://www.mercola.com/forms/eftcourse2.htm.
28. For Insomnia, Try Journaling Before Bedtime
Journaling before going to bed helps to calm a racing mind.
29. Ask Your Physician About Medications You are Taking and Their Effects
on Sleep Many medications, both prescription and over-the-counter, can reduce sleep or sleep quality. Question your physician about your current medications, their effects on sleep, and possible alternatives. 30. For Chronic Insomnia, Ask Your Physician About Adrenal Testing Resent research has shown a link between chronic insomnia and elevated levels of stress hormones (ACTH and cortisol). Studies Cited and Recommended Online Sources of Sleep Information
1. Schardt D. 2005. Perchance To Eat. Nutrition Action Healthletter. Vol. 32 No. 6.
2. Taheri S, Lin L, Austin D, et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index [In Process Citation]. PLoS Med. (United States), Dec 2004, 1(3) pe62.
3. Gangwisch J. 2005. Unpublished Study. Columbia University. New York, NY.
4. American Academy of Sleep Medicine (http://www.aasmnet.org)
5. American Sleep Apnea Association (http://sleepapnea.org)
6. Better Sleep Council (http://www.bettersleep.org)
7. King Koil (http://www.kingkoil.com)
8. National Center on Sleep Disorders Research (http://nhibi.nih.gov/about/ncsdr/index.htm)
9. National Sleep Foundation (http://www.sleepfoundation.org)
10. Sealy (http://www.sealy.com)
11. Serta (http://www.serta.com)
12. Simmons (http://www.simmons.com)
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