Lesson 10: Why Sleep Matters

We all need sleep, and we all know we need sleep. Unfortunately, most of us don’t get enough of it.

But did you know inadequate sleep can cause much more than feelings of tiredness? Yep, sleep deprivation may even predispose you to weight gain and compromise your overall health and well-being. 

Rest easy, though! Dr. Cederquist and Nicole RD share how you can win back those Zzzs and regain ownership of your health.

 

Nicole: Hello, everyone! Nicole and Dr. Cederquist here. Welcome back to the Foundamentals of Weight Loss. 

Nicole: Now raise your hand if you are currently struggling or have ever struggled with sleep. *Raises hand* Yes, I think we can safely say most people have experienced sleep issues sometime in their lives, and some may struggle with it more than others, but it is extremely common. 

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Dr. Cederquist: So common, Nicole. In fact, one in three adults don't get enough sleep according to the CDC. When we say enough, the National Sleep Foundation suggests that adults sleep seven to nine hours each night. And when I read that, I fell over laughing. I was like seven to nine hours. Like, who are these people? But that being said, I believe that they're the experts. So seven to nine hours is what they're recommending. So yeah, we're not getting that.

Nicole: But there's many reasons as to why you may not be getting enough sleep each night, such as sleep disruptions. Maybe you have to get up in the middle of the night to use the restroom, or you're having night sweats and heartburn or hot flashes, or maybe you have a sleep disorder like sleep apnea, or simply just staying up too late watching Netflix or scrolling on your phone. All of these things can negatively impact your overall health and can make losing weight more challenging. 

Dr. Cederquist: And more and more research really points to the importance of adequate sleep for weight management, which is what we're talking about here. So let's explore the potential ways in which sleep deprivation might predispose you to weight gain. 

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Dr. Cederquist: Some studies show sleep deprivation increases your appetite and hunger, which often leads to higher caloric intake especially for foods rich in fat and carbs. This is likely due to elevations in grehlin and reductions in leptin. If you recall from our hunger and cravings lesson (insert link), grehlin means “Go time!” for eating while leptin helps with satiety, or those feelings of fullness. 

Nicole: And to add, increased wake time means more time to raid the fridge and the snack drawer.There's even research that shows that sleep-deprived individuals burn similar calories to those of us who are well-rested, but they have a net gain of 385 calories per day. And if you do the math, that could equate to about 36 pounds gained in one year from inadequate sleep. Like, my mind is blown by that, right?!

Nicole:And to make matters worse, when we're sleep deprived, we feel tired all the time. And when we're tired all the time, we don't feel like exercising and we might grab for that sugar-laden snack or coffee and caffeine as a pick-me-up later in our day.

Dr. Cederquist: Yes, and then we have effects from that. And unfortunately, that cycle continues and can be tough to break. Lastly, some studies show sleep deprivation lowers core body temperature and impacts energy expenditure, which is the amount of energy we use to maintain essential body functions like physical activity.

Dr. Cederquist: Other studies suggest sleep deprivation is a strong risk factor for insulin resistance, diabetes, high blood pressure, heart disease and stroke. Lack of sleep may even lead to premature death. So it's safe to say sleep deprivation is not to be taken lightly here.

Nicole: Yes. And some studies suggest weight gain can cause an increase in things like reflux, asthma, or other medical issues that could be potentially disrupting your sleep. As an example, sleep apnea is often an underdiagnosed sleep disorder and can be very serious and warrants medical diagnosis and treatment. 

Nicole: Some common symptoms of sleep apnea include things like loud snoring, feeling tired or sleepy during your day, even after a full night's rest. Episodes where someone might stop breathing or they're gasping for air in their sleep, morning headaches, dry mouth, or even difficulty staying asleep. 

Nicole: And carrying excess weight can increase the risk of sleep apnea, which greatly impacts your sleep overall and can make metabolic syndrome and diabetes worse. In fact, even the smallest amount of weight loss can improve sleep apnea and these metabolic issues, although we still highly recommend reaching out to your doctor to discuss further.

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Dr. Cederquist: But also know there are steps you can take to start developing healthy sleep hygiene, like eating earlier and smaller dinner to prevent reflux. Also, ease up on the amount of alcohol consumed at dinner. This was extremely common at the medical center when we would see women who were like perimenopausal, who would say they had very poor sleep on the nights they drank alcohol. But when they drank less or not any at all, they shared that their sleep was so much better. They noticed fewer hot flashes and started to see the correlation between sleep deprivation and these symptoms.

Dr. Cederquist: Another thing is to avoid simple carbs and sugar before bed, as this can later lead to a drop in blood sugar, which wakes you up. And it wakes you up wide awake, 2:00 a.m., 3:00 a.m., like what is that? So we usually recommend not eating before bed, but if you do need something to help balance your blood sugar, make sure it has protein with it so that it doesn't cause this dip.

Dr. Cederquist: Another thing that has been found in all the research is to limit screen time to at least one hour leading up to bedtime. It's because our screens emit these pixels and this blue light that's very, very stimulating to the brain, and it makes it harder for the body to turn off after that or for the brain to turn off.

Dr. Cederquist: Another very important suggestion would be to practice an evening ritual. But Nicole also mentioned some breath work that she does as part of her ritual. And I was wondering if you could help share what that might be like, you know, is it difficult? Is it time consuming? Is it hard to learn? 

Nicole: Yeah, I think if it was difficult or hard to learn, I wouldn't be doing it. No, breathwork is actually really simple and what I love about it is that it doesn't take a lot of time at all. So what I tend to really enjoy is the 4-7-8 breathing technique where I just lay down on my bed or I lay down on a mat on the floor. 

Nicole: And the 4-7-8 breathing technique basically involves where you breathe in for a count of four through your nose, then you hold your breath for a count of seven, and then you breathe out for a count of eight through your mouth, and you repeat that three times. So super easy to do. I was doing it when at the medical center in between patients sometimes. That's how quick it can be and easy to do. 

Nicole: I even have a little five-year-old who also likes to practice breath work too. In fact, he surprised me one day because he learns it at school. And he likes to do the whole five-finger breathing technique, which basically what you do is as you are breathing through your nose and exhaling out through your mouth, you're tracing your five fingers and going through that. So those techniques are really easy to do. Even my five-year-old is doing them and it's just really quick too, which is nice.

Dr. Cederquist: That's wonderful. I love how our children can teach us things. Getting back to a few sleep hygiene tips. Another thing that's really important is to keep the room cool and dark for sleep. The light out shades are really a good investment. Keep the light out. Multiple studies show that if you have night lights on and all this other stuff, it really interferes with sleep.

Dr. Cederquist: And try to get the room really pretty cold, which is definitely a challenge when you live in Florida, but cold and dark really leads to much better sleep. In order to get tired and come down at the end of the day, reading a book is actually much preferred versus screen time. And I think a very important thing is to do not check emails before bed. Do not look at stuff that will go ahead and get things going and riled up. 

Dr. Cederquist: And many people do know this, but it bears repeating to really limit caffeine later in the day, such as after 2:00 p.m. Well, maybe people might not have a full coffee. They might have Diet Coke or some other things that have caffeine. And some of us are just much more sensitive to the effect of caffeine. So really trying to limit that and to earlier in the day can help. 

Dr. Cederquist: Another thing that I have found really helpful for sleep is to write down in a notebook or journal any to-dos or disturbing thoughts or things that are causing me stress or that are running through my mind. For me, it's not necessarily something disturbing, but I find using a capture tool is really helpful. 

Dr. Cederquist: When things come up that I need to remember that I want to put on my to-do list, I will put it right down a piece of paper or to be honest, I like type it into my cell phone under the note section. Because the brain has a hard time trying to remember things. It's a whole process of keeping memory cycling. 

Dr. Cederquist: So if even on a subconscious level, you're like, “Don't forget to buy eggs when you go to the store. Don't forget that you need to call your sister for her birthday in two days.” You know, the brain keeps this part active. So being able to put it into something else that you know you got it out of your brain, it's into something else that you can look at the next day. “Oh yeah, I need to go pick up this at the store!” and all that. It really, really helps.

Dr. Cederquist: Because otherwise we're like, “Oh, what was that thing that somebody told me about?” or whatever and you're racking your brain. That racking of your brain is what's happening when you're trying to go to bed at night sometimes. So get it off your brain and into something else. 

Dr. Cederquist: In our medical center, we certainly use supplements like magnesium glycinate or melatonin. Magnesium can help with sleep as it helps the nervous system regulation, which can help calm anxiety and stress and it can also help relax muscles and avoid leg cramps, which can wake people from sleep, which is terrible, but certainly check with your doctor if you think that any of those might be something you want to take.

Dr. Cederquist: And lastly, it really is a good idea to try to schedule your sleep and set a specific bedtime and wake time to try to ensure your seven to nine hours of sleep per night, which can help reset or just set your internal circadian clock. It makes a difference. 

Dr. Cederquist: So even if you have so much going on that you can't commit to a full seven to nine hours, even with the benefits it might have with your weight, just really work on it. Go to bed sooner. Get these things off your brain. Get your makeup off. Get ready for bed. Do the rituals. 

Nicole: Yes, so many great suggestions, Dr. Cederquist. And there's tons of more suggestions too. So with this lesson, we included a sleep suggestion handout just to offer all of these suggestions because some may speak to you more than others. So it takes a little bit of trial and error and trial and success to find what works for you. But in any case, it's always important to seek help from your physician or a sleep specialist if you're truly struggling with sleep.

Dr. Cederquist: Yes. So this week, focus on being intentional with these sleep tips to ensure a good night's rest. If you find yourself seeing slow weight loss progress or feeling like the scale will budge, looking at your sleep can be extremely beneficial, even beyond losing weight!