Not sleeping enough or getting a bad night’s sleep over and over makes it hard to control your appetite. And that sets you up for all sorts of health problems, including obesity, heart disease, high blood pressure and Type 2 diabetes.
The link between poor sleep and a greater body mass index (BMI) has been shown in study after study, but researchers typically relied on the memories of the participants to record how well they slept.
Sleep apps on fitness trackers, smartphones and watches have changed all that. In a new study, published Monday in JAMA Internal Medicine, researchers tracked sleep quality for 120,000 people for up to two years.
The results showed sleep durations and patterns are highly variable between people. Despite that, the study found people with BMIs of 30 or above – which is considered obese by the U.S. Centers for Disease Control and Prevention – had slightly shorter mean sleep durations and more variable sleep patterns.
It didn’t take much less sleep to see the effect. People with BMIs over 30 only slept about 15 minutes less than their less weighty counterparts.
There were some limitations to the study. Naps were excluded, other health conditions could not be factored in, and people who use wearable tracking devices are typically younger, healthier and from a higher socioeconomic status than those who do not wear trackers.
“These are quite pricey devices, and remember, they are not approved by the U.S. Food and Drug Administration,” said sleep specialist Dr. Raj Dasgupta, the associate program director of the Sleep Medicine Fellowship at Keck Medicine of the University of Southern California.
“The results would need to be validated by the appropriate FDA-approved devices, and because the study is likely on younger people who are more economically well off, does that really apply to older folks we worry about with poor sleep?” said Dasgupta, who was not involved in the study.
However, Dasgupta added, a major plus for the study is that it did monitor people for over two years, and the results corroborated prior research and were “not surprising.”
“While we cannot determine the direction of association from our study result, these findings provide further support to the notion that sleep patterns are associated with weight management and overall health,” the authors wrote.
“The findings also support the potential value of including both sleep duration and individual sleep patterns when studying sleep-related health outcomes.”
LINK BETWEEN SLEEP AND EATING
There is a scientific reason why a lack of sleep is linked to appetite. When you’re sleep deprived, research has shown, levels of a hormone called ghrelin spike while another hormone, leptin, takes a nosedive. The result is an increase in hunger.
“The ‘l’ in leptin stands for lose: It suppresses appetite and therefore contributes to weight loss,” he said. “The ‘g’ in ghrelin stands for gain: This fast-acting hormone increases hunger and leads to weight gain,” Dasgupta said.
Another reason we gain weight is due to an ancient body system called the endocannabinoid system. Endocannabinoids bind to the same receptors as the active ingredient in marijuana, which as we know, often triggers the “munchies.”
“When you’re sleep deprived, you’re not like, ‘Oh, you know what, I want some carrots,'” said behavioural neuroscientist Erin Hanlon, who studies the connection between brain systems and behavior at the University of Chicago, in a prior CNN interview.
“You’re craving sweets and salty and starchy things,” she added. “You want those chips, you want a cookie, you want some candy, you know?”
A 2016 study by Hanlon compared the circulating levels of 2-AG, one of the most abundant endocannabinoids, in people who got four nights of normal sleep (more than eight hours) to people who only got 4.5 hours.
People who were sleep-deprived reported greater increases in hunger and appetite and had higher afternoon concentrations of 2-AG than those who slept well. The sleep-deprived participants also had a rough time controlling their urges for high-carb, high-calorie snacks.
GET BETTER SLEEP
Want more control over your appetite? Depending on your age, you are supposed to get between seven and 10 hours of sleep each night.
Getting less has been linked in studies to high blood pressure, a weakened immune system, weight gain, a lack of libido, mood swings, paranoia, depression and a higher risk of diabetes, stroke, cardiovascular disease, dementia and some cancers.
So sleep a full seven to 10 hours a night, stick to a regular bedtime and get up the same time very day, even on weekends, experts advise.
Adding exercise to your daily routine is a great way to improve your sleep and improve your health. After finishing one 30-minute physical activity, you’ll have less anxiety, lower blood pressure, more sensitivity to insulin and you’ll sleep better that night.
You can also train your brain to get more restful sleep with a few key steps:
During the day, try to get good exposure to natural light, as that will help regulate your circadian rhythm.
Avoid stimulants (coffee, tea) after 3 p.m. and fatty foods before bedtime.
Establish a bedtime routine you can follow each night. Taking a warm bath or shower, reading a book, listening to soothing music, meditating or doing light stretches are all good options.
Make sure your bed and pillows are comfortable and the room is cool: Between 60 and 67 degrees is best. Don’t watch TV or work in your bedroom; you want your brain to think of the room as only for sleep.
Eliminate all lights – even the blue light of cellphones or laptops can be disruptive. Dull sounds, too. Earplugs or white noise machines can be very helpful, but you can create your own with a humidifier or fan.
What if someone told you there was a magic potion by which you could prevent disease, improve your intellect, reduce your stress and be nicer to your family while you’re all cooped up together during the pandemic?
It sounds too good to be true, as if solving those problems would really require dietary supplements, workout programs, diets, meditation and a separate room to cry alone.
It turns out that sleep, according to numerous studies, is the answer. It’s the preventive medicine for conditions related to our physical, mental and emotional health. And despite how important sleep is, it can be difficult to make it a priority.
“During a pandemic such as Covid-19, there’s a potential to induce or exacerbate many sleep issues,” Dr. Matthew Schmitt, a doctor of sleep medicine at Piedmont Healthcare in Georgia, told CNN.
“A lack of quality sleep not only affects how we feel during the daytime, but can also impair our immune system function, which is vital in protecting us from common viral illnesses.”
A sleep routine is just one of the behaviors that is part of sleep hygiene, a buffet of efforts needed to sleep well that include eating healthy meals at regular times and not drinking too much coffee, said Dr. Meir Kryger, a professor of pulmonary medicine and a clinical professor of nursing at Yale School of Medicine in Connecticut.
“All of these things are really interconnected in terms of their function. All of them are connected to the body clock,” Kryger said. “The body is like an orchestra where there’s an orchestra leader that’s sort of the main timer, but everybody else is playing it together and they’re optimizing what they are doing.”
Once you’ve developed your sleep routine,
here are 10 benefits you could gain from the regimen.
1. Helps your body heal and repair itself
Our nightly shut-eye is our bodies’ time for healing and repairing itself from performing its taxing daily functions.
“Imagine you’re a car or something that’s running for 16 hours during the day,” Kryger said. “You’re going to have to do stuff to get back to normal. You just can’t keep on running.”
During sleep is when we produce most of our growth hormone that ultimately results in bone growth. Our tissues rest, relaxing our muscles and reducing inflammation. And each cell and organ have their own clock that “plays a really important role in maximizing or optimizing how our body works,” Kryger added.
2. Lowers risk for disease
Sleep on its own is a protective factor against disease.
When people get too much or too little sleep, “there appears to be an increased risk of deaths … and other diseases raising their ugly heads,” Kryger said, such as heart problems and diabetes. The healing period during sleep also factors in, as it allows cells that would cause disease to repair themselves.
3. Improves cognitive function
Sleep feeds our creativity and cognitive function, which describes our mental abilities to learn, think, reason, remember, problem solve, make decisions and pay attention.
“As you sleep, memories are reactivated, connections between brain cells are strengthened, and information is transferred from short- to long-term,” said a National Sleep Foundation article on the subject. “Without enough quality sleep, we become forgetful.”
4. Reduces stress
Slumber of great quantity and quality can enhance your mood and also encourage the brain’s ability to regulate emotional responses to both neutral and emotional events.
5. Helps maintain a healthy weight
Getting your beauty sleep can help you to maintain a healthy weight or increase your chances of losing excess fat.
Two hormones control our urge to eat: leptin and ghrelin. Leptin tells us that we’re full, while ghrelin communicates hunger.
When we don’t sleep enough, both hormones veer in the wrong direction, Kryger said — ghrelin spikes while leptin declines, resulting in an increase in hunger and the potential to overeat and gain weight.
Sleep helps our bodies to maintain normal levels of the stress hormone cortisol as well, which determines how we hang on to excess fat.
6. Bolsters your immune system
Kryger has seen the immune systems of patients with sleep disorders fail to normally function. Sleep helps our bodies to produce and release cytokines, a type of protein that helps create an immune response by targeting infection and inflammation.
Additionally, “research done actually years ago showed that when people are sleep deprived, they do not have as vigorous a response to vaccination,” Kryger added.
“As we’re thinking about vaccination that’s being developed” for Covid-19, that kind of research is going to be important.
7. May improve your social life
The emotional benefits of sleep can transfer over into your social life. “Just imagine you don’t sleep enough and you’re cranky,” Kryger said. “Who’s going to want to be around you? Another part of it is being cognitively sharp.”
Adequate sleep can help you to be more confident, be more easygoing and support your efforts to do your part at home, he added.
8. Supports your mental health
Mental health disorders are often associated with substandard sleep and a sleep deficit can lead to depressive symptoms even if the person doesn’t have the chronic disorder, Kryger said.
“Getting the right amount of sleep is really important in possibly preventing a mental illness or the appearance of a mental illness,” he added. And in addition to the benefits for mood and stress regulation, sleeping enough “may make the treatment of the mental illnesses more efficacious if the person sleeps enough.”
9. Reduces pain sensitivity
Extending participants’ sleep time during the night or with midday naps, a 2019 study found, restored their pain sensitivity to normal levels in comparison to sleep-deprived individuals, who had a lower threshold for pain.
How this happens would have to be in the realm of perception, Kryger said, which ultimately traces back to the brain. “The brain is where sleep is,” he explained.
10. Increases your likelihood for overall success
Since sleep can improve our health on all fronts, it consequently can help us be the best versions of ourselves. Healthy cognitive functioning, emotional regulation, coping and social life are all foundational to pursuing and achieving our goals and overall well-being.
People React Better to Both Negative and Positive Events
With More Sleep
New research finds that after a night of shorter sleep, people react more emotionally to stressful events the next day — and they don’t find as much joy in the good things. This has important health implications: previous research shows that being unable to maintain positive emotions in the face of stress puts people at risk of inflammation and even an earlier death.
New research from UBC finds that after a night of shorter sleep, people react more emotionally to stressful events the next day – and they don’t find as much joy in the good things. The study, led by health psychologist Nancy Sin, looks at how sleep affects our reaction to both stressful and positive events in daily life.
“When people experience something positive, such as getting a hug or spending time in nature, they typically feel happier that day,” says Nancy Sin, assistant professor in UBC’s department of psychology. “But we found that when a person sleeps less than their usual amount, they don’t have as much of a boost in positive emotions from their positive events.”
People also reported a number of stressful events in their daily lives, including arguments, social tensions, work and family stress, and being discriminated against. When people slept less than usual, they responded to these stressful events with a greater loss of positive emotions. This has important health implications: previous research by Sin and others shows that being unable to maintain positive emotions in the face of stress puts people at risk of inflammation and even an earlier death.
Using daily diary data from a national U.S. sample of almost 2,000 people, Sin analyzed sleep duration and how people responded to negative and positive situations the next day. The participants reported on their experiences and the amount of sleep they had the previous night in daily telephone interviews over eight days.
“The recommended guideline for a good night’s sleep is at least seven hours, yet one in three adults don’t meet this standard,” says Sin. “A large body of research has shown that inadequate sleep increases the risk for mental disorders, chronic health conditions, and premature death. My study adds to this evidence by showing that even minor night-to-night fluctuations in sleep duration can have consequences in how people respond to events in their daily lives.”
Chronic health conditions – such as heart disease, diabetes, and cancer – are prevalent among adults, especially as we grow older. Past research suggests that people with health conditions are more reactive when faced with stressful situations, possibly due to wear-and-tear of the physiological stress systems.
“We were also interested in whether adults with chronic health conditions might gain an even larger benefit from sleep than healthy adults,” says Sin. “For those with chronic health conditions, we found that longer sleep – compared to one’s usual sleep duration – led to better responses to positive experiences on the following day.”
Sin hopes that by making sleep a priority, people can have a better quality of life and protect their long-term health.
Nancy L. Sin, Jin H. Wen, Patrick Klaiber, Orfeu M. Buxton, David M. Almeida. Sleep duration and affective reactivity to stressors and positive events in daily life.. Health Psychology, 2020; DOI: 10.1037/hea0001033
University of British Columbia. “People react better to both negative and positive events with more sleep.” ScienceDaily, 15 September 2020
Materials provided by University of British Columbia. Note: Content may be edited for style and length. September 15, 2020
When Dr. Christopher Callahan examines older patients, he often hears a similar refrain.
“I’m tired, doctor. It’s hard to get up and about. I’ve been feeling kind of down, but I know I’m getting old and I just have to live with it.”
This fatalistic stance relies on widely-held but mistaken assumptions about what constitutes “normal aging.”
In fact, fatigue, weakness and depression, among several other common concerns, aren’t to-be-expected consequences of growing older, said Callahan, director of the Center for Aging Research at Indiana University’s School of Medicine.
Instead, they’re a signal that something is wrong and a medical evaluation is in order.
“People have a perception, promulgated by our culture, that aging equals decline,” said Dr. Jeanne Wei, a geriatrician who directs the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences.
“That’s just wrong,” Wei said. Many older adults remain in good health for a long time and “we’re lucky to live in an age when many remedies are available.”
Of course, peoples’ bodies do change as they get on in years. But this is a gradual process. If you suddenly find your thinking is cloudy and your memory unreliable, if you’re overcome by dizziness and your balance is out of whack, if you find yourself tossing and turning at night and running urgently to the bathroom, don’t chalk it up to normal aging.
Go see your physician. The earlier you identify and deal with these problems, the better. Here are four common concerns that should spark attention — only a partial list of issues that can arise:
Fatigue. You have no energy. You’re tired all the time.
Don’t underestimate the impact: Chronically weary older adults are at risk of losing their independence and becoming socially isolated.
Nearly one-third of adults age 51 and older experience fatigue, according to a 2010 study in the Journal of the American Geriatrics Society. (Other estimates are lower.) There are plenty of potential culprits. Medications for blood pressure, sleep problems, pain and gastrointestinal reflux can induce fatigue, as can infections, conditions such as arthritis, an underactive thyroid, poor nutrition and alcohol use.
All can be addressed, doctors say. Perhaps most important is ensuring that older adults remain physically active and don’t become sedentary.
“If someone comes into my office walking at a snail’s pace and tells me ‘I’m old; I’m just slowing down,’ I’m like no, that isn’t right,” said Dr. Lee Ann Lindquist, a professor of geriatrics at Northwestern University’s Feinberg School of Medicine in Chicago.
“You need to start moving around more, get physical therapy or occupational therapy and push yourself to do just a little bit more every day.”
Woman with photo of elderly woman’s eyes on hers’
Appetite loss. You don’t feel like eating and you’ve been losing weight.
This puts you at risk of developing nutritional deficiencies and frailty and raises the prospect of an earlier-than-expected death. Between 15 and 30 percent of older adults are believed to have what’s known as the “anorexia of aging.”
Physical changes associated with aging — notably a reduced sense of vision, taste and smell, which make food attractive — can contribute. So can other conditions: decreased saliva production (a medication-induced problem that affects about one-third of older adults); constipation (affecting up to 40 percent of seniors); depression; social isolation (people don’t like to eat alone); dental problems; illnesses and infections; and medications (which can cause nausea or reduced taste and smell).
If you had a pretty good appetite before and that changed, pay attention, said Dr. Lucy Guerra, director of general internal medicine at the University of South Florida.
Treating dental problems and other conditions, adding spices to food, adjusting medications and sharing meals with others can all make a difference.
Depression. You’re sad, apathetic and irritable for weeks or months at a time.
Depression in later life has profound consequences, compounding the effects of chronic illnesses such as heart disease, leading to disability, affecting cognition and, in extreme cases, resulting in suicide.
A half century ago, it was believed “melancholia” was common in later life and that seniors naturally withdrew from the world as they understood their days were limited, Callahan explained. Now, it’s known this isn’t so. Researchers have shown that older adults tend to be happier than other age groups: only 15 percent have major depression or minor variants.
Late-life depression is typically associated with a serious illness such as diabetes, cancer, arthritis or stroke; deteriorating hearing or vision; and life changes such as retirement or the loss of a spouse. While grief is normal, sadness that doesn’t go away and that’s accompanied by apathy, withdrawal from social activities, disturbed sleep and self-neglect is not, Callahan said.
With treatments such as cognitive behavioral therapy and anti-depressants, 50 to 80 percent of seniors can expect to recover.
Weakness. You can’t rise easily from a chair, screw the top off a jar, or lift a can from the pantry shelf.
You may have sarcopenia – a notable loss of muscle mass and strength that affects about 10 percent of adults over the age of 60. If untreated, sarcopenia will affect your balance, mobility and stamina and raise the risk of falling, becoming frail and losing independence.
Age-related muscle atrophy, which begins when people reach their 40s and accelerates when they’re in their 70s, is part of the problem. Muscle strength declines even more rapidly — slipping about 15 percent per decade, starting at around age 50.
The solution: exercise, including resistance and strength training exercises and good nutrition, including getting adequate amounts of protein. Other causes of weakness can include inflammation, hormonal changes, infections and problems with the nervous system.
Watch for sudden changes. “If you’re not as strong as you were yesterday, that’s not right,” Wei said. Also, watch for weakness only on one side, especially if it’s accompanied by speech or vision changes.
Taking steps to address weakness doesn’t mean you’ll have the same strength and endurance as when you were in your 20s or 30s. But it may mean doctors catch a serious or preventable problem early on and forestall further decline.
By Judith Graham, Kaiser Health News Fri December 16, 2016
(Reuters Health) – Getting too little sleep may activate the same chemical pathways in the brain that are involved in heightened attraction to and enjoyment of junk food associated with marijuana use – also known as “the munchies” – according to a small U.S. study.
Researchers found that a night of restricted sleep was followed by extended peaks, later in the day, in natural signaling chemicals that regulate hunger and pleasure. They think that may be one reason sleep deprivation is linked to weight gain.
“Our current study adds to that growing literature and suggests that along with changes in leptin and ghrelin, alterations in endocannabinoids – all changing in the direction to favor food intake – may be mechanisms by which sleep restriction promotes overeating,” said lead author Erin Hanlon, a research associate in endocrinology, diabetes and metabolism at the University of Chicago.
“And, on a larger scale, evidence from both laboratory and epidemiologic studies have consistently associated insufficient sleep or short sleep with increased risk of obesity,” Hanlon said.
The researchers studied 14 healthy young adults ranging in age from 18 to 30 years who got four nights of sufficient sleep, about eight and a half hours, then four nights of sleep restricted to 4.5 hours. The two sleep tests took place in a sleep lab and were separated by a month.
During waking hours, participants were housed in a private room and kept basically sedentary. They had three identical meals at 9 a.m., 2 p.m. and 7 p.m.
In each test, calorie intake was controlled for the first three days and on the fourth day participants were allowed to eat as much or as little as they liked from a buffet tailored to individual preferences. Meanwhile, researchers monitored participants’ calorie intake and analyzed blood samples.
Participants also answered questions about their hunger, appetite, energy level and mood during the 24-hour period of blood sampling, 25 minutes before each meal and one hour and 35 minutes afterward.
When sleep deprived, participants had higher levels of endocannabinoid 2-arachidonoylglycerol (2-AG), a chemical signal that makes foods, particularly junk foods, pleasurable. This blood chemical is usually low overnight and rises steadily during the day, peaking in the afternoon.
But in the sleep-deprived phase, 2-AG remained elevated late in the evening and participants reported higher hunger scores, according to the results in the journal Sleep.
“These are the first results showing that sleep restriction influences the endocannabinoid system in humans,” said Frank Scheer of the Medical Chronobiology Program at Brigham and Women’s Hospital in Boston who wrote a commentary alongside the new study. “This opens up a new insight into systems involved in energy balance and food reward,” he told Reuters Health by email.
“Previous studies had shown that experimental sleep loss causes an increase in ‘hunger hormone’ ghrelin and a decrease in ‘satiety hormone’ leptin,” Scheer said. “The increase in the peak in endocannabinoids following sleep restriction provides an additional mechanism that could help explain an increase in hunger.”
Adults should aim for seven to nine hours of sleep per night, he said.
“With decreasing amounts of sleep, the metabolic effects appear to become progressively stronger,” Scheer said.
Music, said English poet and playwright William Congreve, has charms to soothe the savage beast. But does music have the power to quash the dieter’s appetite?
Maybe. After all, consider how widely your moods and memories are associated with music. Joggers know that you can press yourself a little farther with the right tunes coaxing you on; soothing music in the doctor’s or dentist’s office can help calm frightened patients. Spiritual music can inspire.
According to Brooklyn doctor Edward Podolsky, fast music ratchets up your metabolism and muscular energy, accelerating your heartbeat and elevating your blood pressure. A slow beat does the exact opposite.
What effect does music have on appetite?
Taste is the most obvious sense associated with food, but it is by no means the only sense we engage to enjoy a good meal. In fact, all our senses come into focus when we eat. Think of the sizzle of a steak on the barbecue, or the contrasts of textures in a smooth crème brûlée topped by a crisp sugar crust. Imagine an attractively laid-out meal or the scent of your mother’s roast dinner. All of these scenarios describe food through a different sense, and all are capable of stimulating appetite.
A Johns Hopkins study found that music has the ability to influence the speed with which we eat. Slow music slows us down: test subjects listening to slow music downed three mouthfuls of food per minute, as compared to the five mouthfuls diners listening to a fast beat consumed.
Hoteliers and restaurateurs know that taste is only one aspect of a good meal. A recent British survey examined consumer responses over eighteen evenings. Diners were treated to classical music, pop music or no music during their meals. Results showed that people were willing to (and actually did) spend more money on the evenings they ate to the strains of classical music.
What does this mean to the average dieter?
Be aware that sounds – and music, especially – can trigger eating habits you may or may not want. If playing Christmas carols sends you into a frenzied state of Christmas baking, you might want to time your music selection accordingly. Experiment with music while you eat. Do you eat less to the strains of Bach? Or does the beat of the latest boy band have you up and moving around instead of snacking in front of the fridge?
The bottom line
Pay attention to how your body reacts to the external stimuli it receives. Sight, sound, smell, touch and taste are all part of the equation.