sleep and weight

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{{More medical citations needed|date=September 2019}}

Sleep and weight is the association between the amount of sleep an individual obtains and the weight of that individual.

Numerous studies have demonstrated an association between sleep disturbances and weight gain, and more specifically, that sleep deprivation is related to overweight.{{cite journal | vauthors = Geiker NR, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR | title = Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? | journal = Obesity Reviews | volume = 19 | issue = 1 | pages = 81–97 | date = January 2018 | pmid = 28849612 | doi = 10.1111/obr.12603 | s2cid = 33787860 | department = review }} Furthermore, body weight also influences the quality of sleep and the occurrence of sleep disorders like obstructive sleep apnea.{{cite journal | vauthors = Strobel RJ, Rosen RC | title = Obesity and weight loss in obstructive sleep apnea: a critical review | journal = Sleep | volume = 19 | issue = 2 | pages = 104–15 | date = February 1996 | pmid = 8855032 | doi = 10.1093/sleep/19.2.104 | department = review | doi-access = free }} Oversleeping may also contribute to weight gain.

Additionally, there is a decrease in sleep duration and quality among most populations due to modern lifestyles which include an increased time spent looking at artificial lights from screens.{{cite journal | vauthors = Van Cauter E, Spiegel K, Tasali E, Leproult R | title = Metabolic consequences of sleep and sleep loss | journal = Sleep Medicine | volume = 9 | issue = Suppl 1 | pages = S23-8 | date = September 2008 | pmid = 18929315 | doi = 10.1016/s1389-9457(08)70013-3 | department = review | pmc = 4444051 }}{{cite journal | vauthors = Chahal H, Fung C, Kuhle S, Veugelers PJ | title = Availability and night-time use of electronic entertainment and communication devices are associated with short sleep duration and obesity among Canadian children | journal = Pediatric Obesity | volume = 8 | issue = 1 | pages = 42–51 | date = February 2013 | pmid = 22962067 | doi = 10.1111/j.2047-6310.2012.00085.x | s2cid = 22227733 | department = primary }} The availability of night-time use of electronic devices and communication devices are associated with shorter sleep duration and increased body weight in children.

Relationship between stress, sleep and weight

The biological reaction to a stressor is the activation of the HPA-axis. In a stressful environment the body will release multiple hormones including cortisol. Over a long duration high cortisol concentrations can have negative effects on the immune system,{{cite journal | vauthors = Cacioppo JT | title = Social neuroscience: autonomic, neuroendocrine, and immune responses to stress | journal = Psychophysiology | volume = 31 | issue = 2 | pages = 113–28 | date = March 1994 | pmid = 8153248 | doi = 10.1111/j.1469-8986.1994.tb01032.x | department = review | doi-access = }} attention and memory{{cite journal | vauthors = Lupien S, Lecours AR, Lussier I, Schwartz G, Nair NP, Meaney MJ | title = Basal cortisol levels and cognitive deficits in human aging | journal = The Journal of Neuroscience | volume = 14 | issue = 5 Pt 1 | pages = 2893–903 | date = May 1994 | pmid = 8182446 | pmc = 6577490 | doi = 10.1523/jneurosci.14-05-02893.1994 | department = primary }} and can increase the risk of psychological disorders, such as depression.{{cite journal | vauthors = Checkley S | title = Neuroendocrine mechanisms and the precipitation of depression by life events | journal = The British Journal of Psychiatry. Supplement | volume = 160 | issue = 15 | pages = 7–17 | date = February 1992 | pmid = 1356360 | doi = 10.1192/S0007125000296633 | s2cid = 7893987 | department = review }} Also, too much stress can have an impact on sleep and is a risk factor of insomnia.{{cite journal | vauthors = Nakata A, Haratani T, Takahashi M, Kawakami N, Arito H, Kobayashi F, Araki S | title = Job stress, social support, and prevalence of insomnia in a population of Japanese daytime workers | journal = Social Science & Medicine | volume = 59 | issue = 8 | pages = 1719–30 | date = October 2004 | pmid = 15279928 | doi = 10.1016/j.socscimed.2004.02.002 | department = primary }}

Stress can have an effect on sleep patterns, food intake and consequently weight gain. Stress has been found to be associated with increased emotional reward of palatable foods, which in turn can also lead to obesity. There seems to be only a one-sided relationship between cortisol levels and sleep deprivation. High cortisol levels due to high stress can lead to decreased sleep duration. However, 24-hour sleep deprivation does not seem to lead to changes in cortisol levels in healthy adults.{{cite journal| vauthors = Lee J, Kim J, Shin H |date= December 2013 |title=Effects of sleep deprivation on pain sensitivity in healthy subjects |journal=Sleep Medicine|volume=14|pages=e180|doi=10.1016/j.sleep.2013.11.422 | department = primary }}

However, it is believed that chronic sleep deprivation has a negative effect on the neuroendocrine system and seems to change the ways in which people deal with challenges.{{cite journal | vauthors = Meerlo P, Sgoifo A, Suchecki D, Henson LC, Schotz MC, Sabath LD | title = Current status of treatment of pneumonia | journal = Southern Medical Journal | volume = 68 | issue = 12 | pages = 1507–11 | date = December 1975 | pmid = 18222099 | doi = 10.1016/j.smrv.2007.07.007 | department = primary }} The first changes appear to be on emotional perception, but might also change the fundamental properties of the neuroendocrine stress axis in the long run.

= Metabolism =

Sleep is an important modulator of neuroendocrine function and glucose metabolism and sleep loss has been shown to result in metabolic and endocrine alterations, including decreased glucose tolerance, decreased insulin sensitivity, increased evening concentrations of cortisol, increased levels of ghrelin, decreased levels of leptin, and increased hunger and appetite/ There is evidence that the circadian rhythm is tightly associated with sleep and metabolism.{{cite journal | vauthors = Huang W, Ramsey KM, Marcheva B, Bass J | title = Circadian rhythms, sleep, and metabolism | journal = The Journal of Clinical Investigation | volume = 121 | issue = 6 | pages = 2133–41 | date = June 2011 | pmid = 21633182 | pmc = 3104765 | doi = 10.1172/JCI46043 | department = review }} Disruption of this coordination can lead to the metabolic syndrome or type 2 diabetes. Recent epidemiological and laboratory evidence confirm previous findings of an association between sleep loss and increased risk of obesity.{{cite journal | vauthors = Sawamoto R, Nozaki T, Furukawa T, Tanahashi T, Morita C, Hata T, Komaki G, Sudo N | title = Higher sleep fragmentation predicts a lower magnitude of weight loss in overweight and obese women participating in a weight-loss intervention | journal = Nutrition & Diabetes | volume = 4 | issue = 10 | pages = e144 | date = October 2014 | pmid = 25347608 | pmc = 4217002 | doi = 10.1038/nutd.2014.41 | department = primary }}

Metabolism involves two biochemical processes that occur in living organisms. The first is anabolism, which refers to the buildup of molecules. The second is catabolism, the breakdown of molecules. These two processes work to regulate the amount of energy the body uses to maintain itself. During non-REM sleep, metabolic rate and brain temperature are lowered to deal with damages that may have occurred during time of wakefulness.{{cite journal | vauthors = Trenell MI, Marshall NS, Rogers NL | title = Sleep and metabolic control: waking to a problem? | journal = Clinical and Experimental Pharmacology & Physiology | volume = 34 | issue = 1–2 | pages = 1–9 | date = 2007 | pmid = 17201728 | doi = 10.1111/j.1440-1681.2007.04541.x | s2cid = 17742756 | department = review | doi-access = }}

Sleep is important in regulating metabolism. Mammalian sleep can be sub-divided into two distinct phases - REM (rapid eye movement) and non-REM (NREM) sleep. In humans, NREM sleep has four stages, where the third and fourth stages are considered slow-wave sleep (SWS). SWS is considered deep sleep, when metabolism is least active.

In normal metabolic function, the pancreas releases insulin after blood glucose levels raise. Insulin signals muscle and fat cells to absorb glucose from food. As a result, blood glucose levels return to normal.

Sleep loss can affect the basic metabolic functions and glucose homeostasis.{{cite journal|last1=TOUMA|first1=C.|last2=PANNAIN|first2=S.|date=2011-08-01|title=Does lack of sleep cause diabetes?|journal=Cleveland Clinic Journal of Medicine|volume=78|issue=8|pages=549–558|doi=10.3949/ccjm.78a.10165|pmid=21807927|s2cid=45708828|issn=0891-1150|doi-access=free}} Reduction of sleep from eight hours to four hours produces changes in glucose tolerance and endocrine function.{{cite journal|last1=Spiegel|first1=Karine|last2=Leproult|first2=Rachel|last3=Van Cauter|first3=Eve|date=October 1999|title=Impact of sleep debt on metabolic and endocrine function|journal=The Lancet|volume=354|issue=9188|pages=1435–1439|doi=10.1016/s0140-6736(99)01376-8|pmid=10543671|s2cid=3854642|issn=0140-6736}} Researchers from the University of Chicago Medical Center followed 11 healthy young men for 16 consecutive nights. The first 3 nights, the young men slept for the normal 8 hours. The next 6 nights, they slept for 4 hours. The next 7 nights, they spent 12 hours in bed. They all had the same diet. They found that there were changes in glucose metabolism that resemble that of type 2 diabetes patients. When the participants were tested after sleep deprivation, they took 40% longer than normal to regulate blood sugar levels after a high-carbohydrate meals. The secretion of insulin and the body's response to insulin decrease by 30%. Sleep deprivation also alters the productions of hormones, lowering the secretion of thyroid stimulating hormone and increasing blood levels of cortisol.

Sleeping more to promote weight loss

A regular sleep schedule can contribute to weight loss.{{medical citation needed|date=November 2022}}{{clarify|reason=A regular sleep schedule of >8 hours of sleep or <5 hours of sleep would be regular but would not contribute to weight loss. Also, a regular sleep schedule over a long time should lead to a stable weight, not weight loss.|date=November 2022}} While sleeping more than an average of 6.5 hours per night may have beneficial effects on weight, sleeping over 8.5 hours per night has been shown to contribute negatively to weight.{{medical citation needed|date=November 2022}} Getting adequate sleep may also reduce snacking that occurs throughout the course of the day due to feeling lethargic.{{cite web | first = Melanie | last = Haiken | title = Change Your Sleep Schedule To Lose Weight, Study Shows | url = https://www.forbes.com/sites/melaniehaiken/2013/11/21/easiest-weight-loss-tip-ever-change-your-sleep-schedule/ | work = Forbes Magazine }}

Effect of oversleeping

There have been many connections made between oversleeping and certain disorders. Many of these have been made without any identifiable reason for correlation, and are mainly observational. WebMD reports that sleep apnea may cause oversleeping because of disruptions in the normal sleep cycle, that individuals who sleep more may be more prone to headaches because of neurotransmitters imbalances, back pain can increase with oversleeping because a certain level of physical activity is not being maintained, and that oversleeping may be correlated with depression and higher death rates.{{cite web | url = http://www.webmd.com/sleep-disorders/guide/physical-side-effects-oversleeping | title = Oversleeping Side Effects: Is Too Much Sleep Harmful? | work = WebMD | date = 22 November 2014 }}

However, these connections have not been subject to rigorous examination. On the other hand, there have been studies that have looked into the potential physical side effects of oversleeping on weight and weight-related conditions. A study of the life habits of 276 subjects over a 6-year period and found that about 20% of those with long (9+ hours) of sleeping time developed type 2 diabetes or impaired glucose tolerance as compared to 7% in those that slept an average amount of time.{{cite journal | vauthors = Chaput JP, Després JP, Bouchard C, Astrup A, Tremblay A | title = Sleep duration as a risk factor for the development of type 2 diabetes or impaired glucose tolerance: analyses of the Quebec Family Study | journal = Sleep Medicine | volume = 10 | issue = 8 | pages = 919–24 | date = September 2009 | pmid = 19332380 | doi = 10.1016/j.sleep.2008.09.016 | s2cid = 13520525 | department = primary | url = https://curis.ku.dk/ws/files/14771969/Chaput_JP.pdf }}

Long-duration sleepers (9–10 hours) were 25% more likely to experience a 5-kg weight gain, and a 21% increase in risk of obesity, when adjusted for age, sex, and baseline BMI, as compared to average duration sleepers (7–8 hours). Even after adjusting for energy expenditure and physical activity levels (among other covariates), these relationships remained significant. A U-shaped relationship between hours of sleep and type 2 diabetes, coronary heart disease and weight is observed, but the metabolic mechanisms affected by long sleep duration are less clear than with sleep restriction and remain somewhat speculative.

A Nurses' Health Study analyzed a group of about 72,000 US women who did not report having coronary heart disease at the onset of the study, and assessed the relationship between their reported sleep durations and incidence of a CHD event over a period of 10 years.{{cite journal | vauthors = Hu FB, Willett WC | title = Diet and coronary heart disease: findings from the Nurses' Health Study and Health Professionals' Follow-up Study | journal = The Journal of Nutrition, Health & Aging | volume = 5 | issue = 3 | pages = 132–8 | date = 2001 | pmid = 11458281 }} At the conclusion of the study, the data indicated that women who slept a longer duration (9–11 hours) were 38% more likely to have CHD than women who slept 8 hours. However, the researchers had no plausible explanation for a cause-and-effect relationship.{{cite journal | vauthors = Ayas NT, White DP, Manson JE, Stampfer MJ, Speizer FE, Malhotra A, Hu FB | title = A prospective study of sleep duration and coronary heart disease in women | journal = Archives of Internal Medicine | volume = 163 | issue = 2 | pages = 205–9 | date = January 2003 | pmid = 12546611 | doi = 10.1001/archinte.163.2.205 | department = primary }}

Sleep deprivation and type 2 diabetes

Baseline levels of insulin do not signal muscle and fat cells to absorb glucose. When glucose levels are elevated, the pancreas responds by releasing insulin. Blood sugar will then rapidly drop. This can progress to type 2 diabetes.

Sleep loss can affect the basic metabolic functions of storing carbohydrates and regulating hormones. Reduction of sleep from eight hours to four hours produces changes in glucose tolerance and endocrine function. Researchers from the University of Chicago Medical Center followed 11 healthy young men for 16 consecutive nights. The first 3 nights, the young men slept for the normal 8 hours. The next 6 nights, they slept for 4 hours. The next 7 nights, they spent 12 hours in bed. They all had the same diet. They found that there were changes in glucose metabolism that resemble that of type 2 diabetes patients. When the participants were tested after sleep deprivation, they took 40% longer than normal to regulate blood sugar levels after a high-carbohydrate meals. The secretion of insulin and the body's response to insulin decrease by 30%. Sleep deprivation also alters the productions of hormones, lowering the secretion of thyroid stimulating hormone and increasing blood levels of cortisol.{{cite web|url=https://www.sciencedaily.com/releases/2008/01/080101093903.htm|title=Lack of Deep Sleep May Increase Risk of Type 2 Diabetes|publisher=Science Daily|access-date=November 30, 2011}}{{ums|date=November 2017}}

It has also been shown that when slow-wave sleep was suppressed for three nights, young healthy subjects were 25% less sensitive to insulin. They needed more insulin to get rid of the same amount of glucose. If the body does not release more insulin to compensate, the blood-glucose levels will increase. This resembles impaired glucose tolerance, which can result in type 2 diabetes.{{ums|date=November 2017}}

Sleep in the media

As obesity has become an issue of nationwide focus, media sources have begun to explore and report on the link between sleep and weight. The coverage spans from articles in Women's Health Magazine on "6 Ways Sleep Can Help you Lose Weight," to NPR's story on the research linking a lack of sleep to obesity, to Harvard School of Public Health's discussion of sleep as an "obesity prevention source" on their site.{{cite web | last = Merz | first = Julia | url = https://www.womenshealthmag.com/weight-loss/a19924272/sleep-weight-loss/ | title = 6 Ways Sleep Can Help You Lose Weight | work = Women's Health | date = 18 July 2014 }}{{cite web | last = NeighMond | first = Patti | title = Report Links Lack of Sleep and Obesity | url = https://www.npr.org/templates/story/story.php?storyId=89457935 | work = NPR | date = 7 December 2004 }}{{cite web | url = http://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/sleep-and-obesity/ | title = Obesity Prevention Source. | work = Harvard School of Public Health | date = 2014 }}

Although it is often presented like this in the media, sleep is not a universal solution to obesity, direct evidence for losing weight because of sleeping more does not exist.{{cite journal | vauthors = Sivak M | title = Sleeping more as a way to lose weight | journal = Obesity Reviews | volume = 7 | issue = 3 | pages = 295–6 | date = August 2006 | pmid = 16866976 | doi = 10.1111/j.1467-789x.2006.00262.x | department = review | hdl = 2027.42/75728 | s2cid = 5684090 | hdl-access = free }} Rather there are several aspects of sleep deprivation that might contribute to weight gain. Horne (2008) claims that especially for short sleepers, who normally sleep 5 hours per night, to sleep more will not be a working strategy to lose weight, since habitually short sleep develops over many years.{{cite journal | vauthors = Horne J | title = Short sleep is a questionable risk factor for obesity and related disorders: statistical versus clinical significance | journal = Biological Psychology | volume = 77 | issue = 3 | pages = 266–76 | date = March 2008 | pmid = 18243480 | doi = 10.1016/j.biopsycho.2007.12.003 | s2cid = 206107439 | department = review }}

References

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