Sleep: The New Weapon Against Obesity

The National Center for Health Statistics has reported that 63% of Americans are overweight. At the same time, the National Sleep Foundation has reported that approximately 67% of adults suffer from sleep problems. Is this coincidental or does a lack of enough sleep lead to weight gain?

Many researchers have tackled this problem and there is a consensus that short-duration or interrupted sleep disrupts the normal operation of our metabolic and hormonal systems and predisposes many to weight gain and possibly diabetes.

Understanding sleep without being an expert
There are five different stages of sleep. Rapid Eye Movement sleep (REM) where we do are dreaming. Stage I and Stage II sleep which are classified as the "light" sleep phases, and Stage III and Stage IV sleep: the deep sleep cycles.

It is during level IV sleep that our body re-energizes and "reboots" itself by producing the various hormones necessary not only to maintain our metabolic system, but the immune and cognitive systems as well.

Did You Get To Stage IV Sleep Last Night?
- Did you wake up tired or even exhausted?
- Did you wake up with achy joints or pains?
- Did you wake up feeling poorly?

If you answered yes to any of these questions, obviously you did not get enough Stage IV sleep.

What is enough sleep?
Most researchers agree that 7 - 8 hours of sleep is needed each night, especially as we age, to ensure the optimal benefits sleep can afford. However, many researchers also say too much sleep--9 hours a day or more--can be just as harmful as too little sleep.

So how do you get better sleep?
While helpful to some, lifestyle changes such as avoiding caffeine, alcohol, and shutting off your TV or avoiding the internet well into the night may not be enough.

Hormone deficiency in sleep and weight disorders
Countless volumes and papers have been written about the role of the "sleep hormone" Melatonin so only a brief explanation will be given here. Melatonin is secreted by the pea-sized pineal gland in the center of our brains to regulate our sleep patterns. Our bodies make it from the well known sleep inducing amino acid tryptophan.

As we age (centering around the age of 45) we seem to produce less melatonin and this has been suggested as one of the reasons why our aging population has difficult sleeping patterns.

Indeed many studies have linked Melatonin deficiency with the inability to obtain or maintain deep sleep. But is Melatonin the only hormone we should be looking at? How about testosterone?

Testosterone Deficiency
Androgen (Testosterone) deficiency is well documented not only in aging men but in aging women as well. Low levels of circulating testosterone in the blood has been linked to many of the ailments of aging including those linked with sleep depravation: increased body fat, abdominal obesity, decreased muscle mass, higher incidence of Type 2 Diabetes, and further with risk of cardiovascular problems, and sexual function. Researchers have also established influence on sleep duration and quality of sleep.

The Testosterone Sleep Circle
While studies suggest that testosterone impacts sleep and obesity dysfunctions, sleep can also negatively influence the production of testosterone. Thus the circle begins, you don't get enough sleep to produce enough testosterone and you are not sleeping enough because you are low in testosterone.

Breaking The Circle
It is usually not hard to convince a man that restoring depleted testosterone levels is a good thing for improving sleep, aiding in weight loss, and other health benefits, but convincing a women testosterone can be beneficial in the face of perceived images of building muscle mass, can be.

Women And Testosterone
Although testosterone is considered primarily a male hormone, a woman cannot feel entirely female without it. It increases her sex drive, boosts muscle strength, lowers body fat, increases bone density, and enhances a sense of well-being.

Yet, in light of all this, medical institutions have been reticent in using it to treat women with androgen deficiencies. Although androgen therapy for women has been around since 1936, many myths have deterred women from experiencing its benefits. Some women are afraid of masculine-related side effects like developing a deeper voice, facial hair, and acne. These side effects are rare and dose-dependant and can be remedied by reducing the amount of testosterone used.

Testosterone And Your Physician
In our practice we order a blood test for total testosterone, as well as free testosterone, to which we pay special attention. Free Testosterone or the lack of it, is most responsible for symptoms or alleviation of symptoms associated with low testosterone.

Once determined that Testosterone supplementation is needed, we prescribe, for the most part, its application in skin cream form and monitor the patient's Testosterone levels with blood testing at regular intervals.

Is Testosterone Right For You?
This needs to be discussed with your physician, Not everyone will benefit from Testosterone supplementation. The goals, realities, and risks of Testosterone supplementation should be discussed, at length, with your physician prior to onset of treatment. Men taking testosterone supplementation should have twice yearly PSA tests and once yearly manual examination of their prostate gland. No evidence suggests that testosterone supplementation causes prostate cancer. In fact, studies show a higher incidence of prostate cancer in men with a lower baseline level of testosterone. Studies do suggest that in the presence of existing prostate cancer, testosterone supplementation may accelerate tumor growth.

Comments

[InformedSources]

Dr. Darrow, you seem to have discovered that critical relationship between good sleep and wieght control--good for you. But there are other hormones besides testosterone that are essential for weight control, especially HGH (human growth hormone), leptin, and ghrelin. Check the research of Dr. Eve Van Cauter at the University of Chicago. She is the one who first sounded the alarm on the relationship between poor sleep and obesity. You seem to have overlooked her ground-breaking research.

And maybe the solution is not hormonal supplementation, but just getting more and better sleep! Relaxation techniques, regular exercise, daily sunlight exposure, caffeine and alcohol moderation, stress management, positive lifestyle changes, a dietary tune-up--I would look at all these things, too. Sometimes it takes just one little tweak to bias the human system in favor of better sleep.

A personal example: One glass of wine at dinner gives me a nice, calm feeling and tastes great. Two glasses of wine at dinner means shallow, fragmented sleep and usually a 60-minute awakening at 3 a.m. Of course, your mileage, and tolerance may vary, but the point is that most people have yet to explore and exploit the many simple, non-invasive lifestyles measures that can restore natural, restful sleep.

Testosterone is not "THE ANSWER" although it may be part of the solution for some people. With respect, I think you are missing the wider view.

[isis]

People also need to check their drains and the drains at work for sewer gas. That also causes sleep problems and nasal and eye problems. We had some of this at work.

[EliDavidson]

Great post Dr. Darrow. "Funky to Fabulous" has other tips to clear the silent sleep debt.

Another tip I just gave on TV is to 'set your alarm clock' to go to bed.

[Guitarsandmore]

Whole Foods has a Homeopathic kit for snoring that will help sleep apnea. It includes three different homeopathic remedies: one for post nasal drip, one for sinus, and the other for over eating. It helps.

The Breath Right strips also help.

Keeping your house clean and dust free helps a great deal. Clean the fireplace; throw out all newspapers and magazines; change the filter on the furnace; use the Miele vacuum cleaner or better. Vaccum once then throw away the bag. Change the Hepa filter annually. Rip out the carpet and install hardwood floor!

Most people can lose 10 " 30 pounds just by giving up soft drinks and diet soft drinks.

Drink Chamomile tea before bed.

[wm1066]

I used a sound activated tape recorder at night to show me how I slept. If I woke up I looked at the clock and said the time outloud. This told me in the morning how I slept. You sometimes feel your up all night but alot of times you get more sleep than you realize. This also told my sleep was bad at the start of the night but my sleep was better after 12 o'clock.

[desertdweller]

It is indeed a vicious cycle since excess weight tends to exacerbate conditions such as obstructive sleep apnea. Overweight individuals, particularly those who exhibit snoring and other breathing difficulties during sleep, should be evaluated for sleap apnea. Relief of apnea symptoms, through surgical or non-surgical intervention, can be a beneficial adjunct to the hormonal therapy described above.