Sleep and Weight

It’s amazing how sleep can affect our weight. There are whole books written on the subject. A very useful, informative one is Sleep Away the Pounds by Cherie Calbom with John Calbom. A lot of the information in this lesson comes from their book.

Our Sleep Affects the Hormones

This is where the whole hormone scene comes into play. Our sleep affects the hormones that govern metabolism and fat accumulation and use. If we sleep well, our hormones will work well but if we don’t sleep enough or if we sleep poorly, our hormones get out of sync and can’t work as they’re supposed to.

 There are several key hormones dealing with weight that are affected by sleep or sleeplessness. This outline will over-simplify their effects but it’s important to remember that our bodies are an integrated whole and we can’t disrupt one part of our lives without upsetting other areas. Thus sleep is an important ingredient in being healthy just as exercise and eating wholesome food are.

Appetite-Suppressing Hormone

Leptin (only discovered in 1994), produced in fat cells, is an appetite-suppressing hormone. If it is working properly it will tell your brain (among other things) when you’re hungry and when to begin fat storage. Thus it has important metabolism and weight functions. It also helps regulate reproduction. In studies, people who were deprived of sleep had a dip in leptin levels which corresponded to being deprived of 1000 calories per day. So you might think, give me some leptin and my hunger will be suppressed. But it’s more complicated than that – leptin resistance can develop. If this happens, you will crave sugar or other carbs, lose energy and put on weight around your waist.

We’ve all heard of insulin and its connection to diabetes. This hormone is made by the pancreas and it decides whether cells will use blood sugar for immediate needs or store it as fat for later use. If we don’t get enough sleep, insulin production is disrupted and our bodies don’t metabolize carbohydrates well which leads to insulin resistance. Cells won’t accept blood sugar so blood sugar levels rise. The pancreas puts out more insulin but eventually it can’t keep up and diabetes develops. Insulin resistance has been noted in sleep-deprived subjects of studies in just a week.

An appetite-stimulating hormone made in the stomach and upper intestine is ghrelin. It can cause eating binges and cravings for fattening foods like ice-cream, candy, and salty snacks like pretzels or chips. It also suppresses fat utilization. Again, too little sleep can cause ghrelin production to spike. This hormone works in conjunction with growth hormone, insulin and leptin.

Cortisol, the Stress Hormone

It is released by the brain at various times during the day and night. It is part of the fight-or-flight response that kept our early ancestors alive. If we are sleep deprived, cortisol release will make us feel hungry. It will raise insulin levels the effects of which were noted above. It also causes a lot of other problems like fluid retention, muscle weakness, memory loss and high blood pressure. If we are sleeping correctly, cortisol should peak in the early morning allowing us to start the day energized. But many of us have levels that are too high throughout the day and night and this causes us to sleep fitfully or wake often.

Growth Hormone

It is produced in the pituitary gland in the brain and it builds tissue, repairs damage, utilizes fat, undoes some of the negative effects of cortisol, and causes metabolism to increase. This hormone is secreted in small amounts at various times of the day, but the largest amount is released during deep sleep. If we don’t get enough deep sleep, and therefore enough growth hormone, we will develop changes that are associated with aging.

So it can be seen that sleep is very important to our health in regulating hormones that affect our weight.

To Do

To counter the above-mentioned negative effects, we need to incorporate some lifestyle changes. We need to get enough sleep. Also, get enough exercise and eat in a healthy way. This means:

• Try new foods or a new way of eating. A cookbook I found particularly helpful because it talked about different types of food and encouraged creativity in cooking/eating was The Yeast Connection Cookbook. Although it was written with a particular problem in mind, I found it generally useful.
• Perhaps try something like a raw diet. If not full time, try it for snacks or for one meal per day. Groups that advocate unusual diets like this can give you a lot of information and they also provide forums for support and education.²
• Avoid refined carbs like pasta, bread, sweets and alcohol.
• Avoid saturated fats like those in meat.
• Avoid trans fats like those in margarine, fried foods and snack foods.
• Avoid polyunsaturated fats like those in corn oil, soy, sunflower oil, safflower oil.
• Increase foods rich in omega-3 fatty acids like salmon, mackerel, trout, cod-liver oil.
• Increase leafy green vegetables. A good way to do this is to make green smoothies sweetened with fruit. Vary the greens you use. We use spinach, mixed salad greens, romaine lettuce, or whatever looks freshest in the grocery store when we shop. We usually sweeten with apple and pear although we’ve tried banana and mango and several other combinations. Wash the greens, cut up the fruit and mix in a good strong blender. At first, my daughters ate only a spoonful but they gradually increased their intake so that they now eat a cupful at a time. One daughter suffers from asthma and she remarked one day that since eating green smoothies, she uses her puffers a lot less.
• Eat nuts, especially walnuts, and seeds, especially flax seeds.
• Increase fruit and vegetables with bright colours.
• Increase beans.
• Avoid artificial sugars, flavours and fats.
• Try taking magnesium as a supplement as most of us in North America are magnesium deficient. I’ve seen 400 mg as a suggested dose before bed with an acid-rich juice like tomato juice for a sedating effect. You might want a calcium supplement, too. You can ask your doctor about these.
• Don’t eat after 6 pm. Someone I know tried this simple idea and found that she no longer had to get up to the bathroom in the night. Getting up had been disrupting her sleep so that she couldn’t get back to sleep again and she was relieved to find such a simple solution to her problem.

Use these dietary suggestions in conjunction with the ideas mentioned in previous lessons to get as good a night’s sleep as possible. You’ll notice a change for the better in your sleep very soon.

Can weight loss improve sleep apnea?

We always encourage our patients to lose weight while they are on CPAP therapy to treat their sleep apnea. For patients with sleep apnea, weight loss sometimes, but not always, results in a complete resolution of the disorder. However, even though a patient’s sleep apnea probably won’t go away entirely, it can lead to lower pressure settings, which can make CPAP therapy much more tolerable.

On the other side of the coin, increased weight gain can also lead to needing higher pressure settings, which can make CPAP therapy more difficult to tolerate. The more tissues found in the throat impeding airflow, the higher the pressure needed to keep these tissues from collapsing into the airway. High pressure settings is often one of the most cited reasons patients abandon CPAP therapy altogether, which can be detrimental to their overall health.

Both sleep apnea and obesity share many common health risks including high blood pressure, coronary heart disease, stroke, diabetes, heart attack, heart failure, and decreased quality of life. Losing weight not only improves tolerable pressure of a CPAP device, but also reduces patient risk for severe health conditions.

Patients with untreated sleep apnea often find themselves in a vicious cycle:

• Poor sleep caused by sleep apnea, leads to decreased energy during the day, which in turn leads to a more sedentary lifestyle devoid of healthy activities and exercise.
• Decreased quality of sleep also contributes to unhealthy food cravings for sugary foods and foods high in carbohydrates.
• Untreated OSA decreases metabolism making weight loss more difficult.

Patients who find themselves using CPAP therapy to treat sleep apnea get better quality sleep at night. This in turn leads to higher energy levels during the day, making exercise to reduce their weight much easier to perform. Patients who continue to maintain healthy lifestyle choices can end up with less apnea events each night leading to lower pressure settings on their CPAP, or even become candidates for dental appliances used in treating sleep apnea patients with mild to moderate symptoms.

If you believe that you may have sleep apnea, and are ready to get proactive about it. Contact The Alaska Sleep Clinic by clicking the link below, and a sleep educator will contact you for a free 10-minute phone consultation to discuss your symptoms and determine if a sleep study is right for you.