Sleep More to Lose Weight
It always amazes my patients that I recommend that they sleep more to lose weight. This seems to counter many of our beliefs about how burning more calories then we eat is the one thing necessary for weight loss. It seems as though spending more time in a state where you burn very few calories(sleep) would cause you to gain weight. However, this couldn’t be further from the truth. Sleep deprivation causes some distinct metabolic changes that end up favoring weight gain. I hope to unpack some of this during this blog post so people can begin to understand the importance of sleep as it relates to weight regulation. Certainly poor sleep can cause problems in every system of the body and lead to an increased risk of many diseases (diabetes, cancer, etc.), but today’s focus will be on sleep deprivation and it’s effect on body weight.
The metabolic consequences of sleep deprivation are numerous but we are going to focus on the ones that most pertain to weight loss and gain. We know from multiple studies that people eat more when they are sleep deprived, and they eat more than is necessary for the additional hours that they are awake. Why is this? Well, the hormones that affect hunger and satiety, leptin and ghrelin, are key regulators of how much food we eat and help explain this increased hunger. When we are sleep deprived, leptin levels go down causing decreased satiety(how full we feel) and ghrelin levels go up, increasing our hunger. So we are eating more food which is leading to weight gain. However, there is even more to this story.
The other scary thing that we see even with one night of sleep deprivation is problems with the hormone insulin. Now, most people are only familiar with insulin as it relates to diabetes and blood sugar, and certainly this is one of the jobs of insulin. Insulin puts both glucose and amino acids in cells, and, it turns out, even one night of sleep can impair insulin’s ability to do this. This is known as insulin resistance and leads to an elevated blood sugar level. Over time this can elevate insulin and glucose levels chronically leading to many of our modern metabolic diseases (obesity, hypertension, diabetes, etc.).
On top of all these hormonal changes, we also see that sleep deprivation leads to changes in the brain that govern decision making. These changes lead us to seek out higher calorie foods that predispose to weight gain. In fact, chronic sleep loss seems to lead to poorer decision making and reaction time at a level that is similar to alcohol intoxication. Of course, this is why drinking and driving is so dangerous, but sleep deprivation can be just as dangerous. Some data actually shows that after being awake for 17 hours a person has the reaction time equivalent to a blood alcohol level of 0.05 (for reference 0.08 is considered legally intoxicated in most states).
So what can we do about all this? The real answer is to get 7-9 hours of high quality sleep per night. However, in our modern culture this is much easier said than done. The first thing that I educate my patients on is that our circadian rhythms are governed by light. This means that we should have plenty of blue light early in the day and dimmer red/orange spectrum light later in the day. Blue light exposure should be minimized at night. This can be challenging because most screens emit blue spectrum light. People should also aim to wake up at the same time every day. Caffeine should be limited to earlier in the day. Also, 30-60 minutes before bed you should do something relaxing that will allow your body to relax in anticipation for sleep. The temperature of the room you sleep in should be pitch black and cool (70 degrees or less). There should be no screens or lights in the room as this can disrupt sleep. If unable to sleep, a person should never lie in bed awake for more than 15-20 minutes and should instead get out of bed and do something relaxing. Of course, this is basic sleep hygiene that is the tip of the iceberg, but these recommendations are a good start for most people. Also, stress management is an important part of this whole picture, and I will address this in future posts. Sleep well.
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Dr. Dan Horzempa is an Integrative and Functional Medicine physician in private practice in Tucson, Arizona. He completed residency in Family Medicine and a Fellowship in Integrative Medicine at the University of Arizona. His clinical interests include: disease prevention, sleep physiology, enhancing longevity, nutrition, movement and exercise physiology, supplementation, herbal medicine, functional medicine, heart rate variability analysis, mind body medicine and hormonal optimization.