Impaired sleep is a chief contributor to metabolic conditions such as obesity and diabetes. This holds true regardless of the type of sleep difficulties a person is having. The reason for this is due to the effects on our hormones that regulate metabolism, appetite, and our blood sugar levels. Additionally, this shift in hormones contributes to unhealthy behaviors that result in weight gain. Considering these vast implications on our health, sleep difficulties are far too commonly overlooked as a cause for disease.
According to the Center for Disease Control more than 25% of Americans report having some form of sleep impairment. This includes a number of situations such as mild difficulties falling or staying asleep, inadequate total duration, sleep apnea, and insomnia. The negative effects on metabolism can be seen with any of these circumstances.
How Sleep Affects our Hormones
Ghrelin, leptin, and insulin are three key hormones affected by our sleep/wake cycle and when out of balance contribute to metabolic dysfunction. Leptin and ghrelin help regulate our hunger level, with ghrelin signaling to our brains that we are hungry, and leptin that we are satiated. Typically during the night leptin levels are elevated allowing our bodies to sleep throughout the night without feeling hungry even though we are in a fasting state. When our sleep is impaired we produce less leptin and more ghrelin, leading to feeling hungrier yet also having a slowed metabolism due to the body thinking there is a calorie shortage.
In addition to ghrelin and leptin, insulin is equally important to our metabolism and is also affected by our sleep habits. Studies show that sleep deprivation leads to decreased insulin sensitivity resulting in elevated fasting glucose and post-meal glucose levels throughout the day. Additionally, it contributes to an increase in endogenous glucose production, meaning an increase in the amount of glucose produced within the body independent of diet. This can help explain why some people have mildly elevated sugar levels regardless of healthy eating patterns. It should be noted that these effects can be the result of only a few nights worth of restless sleep, not necessarily months or even years.
Unhealthy Habits Caused by Lack of Sleep
While these hormonal fluctuations have negative physiological effects on our bodies that we cannot feel or even realize are happening, they also drive certain behavioral patterns that worsen metabolic conditions. When leptin and ghrelin are out of balance, people can get surges of hunger late in the evening or even at hours when we should be asleep. This leads to overeating at night with the calories being stored as fat. Additionally, people then wake not feeling hungry and skip breakfast, which slows down metabolism and contributes to weight retention. Often times this is followed by binge eating later in the day when a person starts crashing and hunger sets in. When the body is not responding properly to insulin, our cells are not receiving the sugar needed for energy. This causes the body to feel as if we are lacking fuel, which in turn makes us crave sugar and carbohydrates.
Reasons for Restless Nights
We know lack of sleep has many negative implications beyond just slowed metabolism, yet getting a good nights rest is much easier said than done. There are a number of reasons why this can be the case. Some of the most common causes are anxiety, thyroid diseases, menopause, pain, and sleep apnea. Because not any two people are the same, it is important to address the root cause for each individual.
- Anxiety. This is one of the primary reasons a person cannot get a good nights rest. Whether this manifests as having a restless mind when trying to fall asleep or waking up with ruminating thoughts, this mental overdrive is undoubtedly overly stimulating. Additionally, when we suffer from anxiety, our bodies produce excessive amounts of cortisol, a hormone that makes us alert rather than relaxed. Cortisol worsens ones ability to sleep and also feeds into the issue with increased abdominal weight gain seen with metabolic conditions.
- Thyroid Disease. Our thyroid functions as our body’s engine, so when levels are off our body has a hard time regulating energy levels. This can make people feel awake rather than tired and often contributes to other symptoms that inhibit relaxation such as anxiety, excessive sweating and palpitations.
- Perimenopausal and Menopausal Shift. This can manifest in a number of different ways, including waking frequently during the night, sleep being impaired from frequent urination or hot flashes, or early morning waking. The cause for this is the shift in hormonal levels, primarily estrogen and progesterone.
- Pain. This can manifest in many different forms and severities, any of which can impair sleep. Because the majority of adults have some level of physical pain, such symptoms are dismissed or minimized in significance. However, pain can drastically affect a person’s everyday life, causing constant discomfort and inhibiting a good nights rest. This is a viscious cycle causing lack of sleep that worsens pain. In addition, being overly tired usually results in having less physical activity, another factor that will inhibit healing.
- Sleep Apnea. This is a condition in which a person repeatedly stops breathing for short lengths of time while sleeping. This not only affects the quality of rest you get, but has even more serious implications on health including being a risk factor for cardiovascular disease. Many people assume they do not have sleep apnea if they don’t fit the typical picture of a person who snores loudly or is obese, yet this is a commonly under-diagnosed condition affecting a wide range of people regardless of such characteristics. Often times people with this condition wake very tired regardless of how many hours they slept for, and continue to have extreme sleepiness throughout the day.
Correcting Sleep Issues
Anxiety, thyroid disease, hormonal shifts, pain and sleep apnea are just a few of the reasons people are lacking good quality sleep. This list is far from being complete. The first step is to find the root cause for the issue. If you know you suffer from anxiety or even a mildly restless mind, there are a number of steps you can take to overcome this. These range from practicing good sleep hygiene habits such as not using electronic devices prior to bed, to relaxation techniques, to herbal or mineral therapies, to medications. Every person is different and needs to be evaluated on an individual level to see what steps are right for you.
Hormone levels can easily be checked through blood work or saliva testing, and can be used to look at thyroid levels and sex hormones such as estrogen, progesterone, cortisol and testosterone. Even mild variations in any of these hormones can impair sleep. There are tons of great natural treatments that can be used to address such imbalances, such as nutritional support, mineral therapy, herbal medicines, or gentle hormone replacement.
When suffering from pain, the first step is to figure out its cause so it can be treated properly. Nutritional deficiencies such as Vitamin D or magnesium are frequently overlooked contributors yet are easy to check for. Management may include various types of bodywork, an anti-inflammatory diet, acupuncture, or supplement therapy for symptomatic relief.
If you or your physician suspect sleep apnea may be present, it is worth being evaluated. Many people are hesitant about this because they do not want to go through a sleep study or have to wear a Cpap machine if the diagnosis is made, however I strongly advise this is properly worked up if it is in question. It is better to have a proper diagnosis when it comes to something like sleep apnea due to its potentially serious effects on a person’s health. It is possible for people to manage this without the need for intervention through proper lifestyle changes such as weight management.
When a person has a metabolic condition such as obesity or diabetes, we need to take a holistic approach when trying to make effective changes. While lifestyle factors such as nutrition and exercise are crucial, it is equally important to assess other aspects of ones life such as sleep habits. Sleep disturbances are sometimes the missing link getting in the way of a person’s good health. With 25% of Americans suffering from such disturbances, it is important to discover and address the cause in order to make lasting changes. The amount of positive benefits a good nights sleep has on a person are innumerable and should not be underestimated.