Nora Gedgaudas

The health benefits of sleep are no snooze!

The health benefits of sleep are no snooze!

Sleep is an essential health commodity that is in decidedly short supply in today’s modern world. Coffee shops print clever and amusing catch phrases on their cups and t-shirts like “Life is short. Stay awake for it!” while busy folks everywhere looking to make the fragmented pieces of their harried lives fit together rationalize that “I can sleep when I’m dead.” Cute as these modern day memes are they are incredibly damaging to the fabric of your everyday health.  The morning coffee ritual in households across the Western world seems to be symptomatic of something gone awry. Far too many people can identify with the phrase “not worth a damn without my morning coffee.” It seems most people today can’t wake up and get going without some form of stimulant—be it coffee, black tea, a cigarette or a Red Bull. What is really going on here?

Sleep is an essential health commodity that is in decidedly short supply in today’s modern world. Coffee shops print clever and amusing catch phrases on their cups and t-shirts like […]

Sleep deprivation, sleep disturbances[i], poor sleep habits, and working odd shifts[ii], together with insomnia are a virtual epidemic in this day and age with very real consequences.   The impact all this has on your immune system, your brain and metabolic health are anything but trivial. In a German study and comprehensive review published in The Lancet Diabetes and Endocrinology researchers stated that: “An increasing number of epidemiological studies show an association between short sleep duration, sleep disturbances, and circadian desynchronisation of sleep with adverse metabolic traits, in particular obesity and type 2 diabetes. Furthermore, experimental studies point to distinct mechanisms by which insufficient sleep adversely affects metabolic health. Changes in the activity of neuroendocrine systems seem to be major mediators of the detrimental metabolic effects of insufficient sleep, through favouring neurobehavioural outcomes such as increased appetite, enhanced sensitivity to food stimuli, and, ultimately, a surplus in energy intake.” The authors speculated that “Although long-term interventional studies proving a cause and effect association are still scarce, sleep loss seems to be an appealing target for the prevention, and probably treatment, of metabolic disease.”[iii]

Sleep, quite simply, is the opportunity your body and brain takes—in concert with your internal microbiome (healthy bacteria) to detoxify, rest and regenerate itself from the myriad of challenges we impose upon it in our daily lives, including stress and free radical oxidation. The endogenous melatonin your brain produces at night has a profound regulatory and detoxifying effect not achievable through oral melatonin supplementation (in fact, taking oral melatonin can really screw up these natural circadian rhythms long-term and is decidedly not recommended).

The time we sleep is the time of day in which we do our internal housekeeping, give our minds desperately integrative REM sleep (without which we would die—and too little of which can generate fibromyalgia-like symptoms in a short period of time) and where our stress hormones—the ones that (in excess) can break us down physically and mentally/cognitively, damage our insulin sensitivity/blood sugar regulation and make us fat–are given a needed rest.   The time we sleep gives us that vital respite from modern day sympathetic (fight or flight) nervous system dominance—something the modern world has unnaturally imposed upon our lives–into critical calm and relaxing parasympathetic dominance. Healthy and sufficient, restful sleep also helps rejuvenate your brain and nervous system and helps support healthy brain aging.

In a recent (2015) peer reviewed journal article in the Annual Review of Psychology called “Why Sleep Is Important for Health: A Psychoneuroimmunology Perspective”[iv], author Dr. Michael R. Irwin states “Research over the past decade has documented that sleep disturbance has a powerful influence on the risk of infectious disease, the occurrence and progression of several major medical illnesses including cardiovascular disease and cancer, and the incidence of depression.” In this article clear connections were made with respect to restorative sleep’s vital impact upon chronic infectious, inflammatory, and neuropsychiatric diseases.   Imbalances occurring between melatonin and cortisol can readily lead to susceptibility to not just inflammation, but also immune disturbances and susceptibility to infection (ever get sick within a day or two after pulling an all-nighter?), not to mention adverse neurological changes and effects.

GOT WEIGHT ISSUES? GET SLEEP!

A number of well-designed studies (and meta analyses) have forged a virtually inextricable link between poor sleep and increased risk of obesity and other metabolic diseases, including cardiovascular disease. It turns out that the more poorly you sleep, the higher your waist circumference and BMI and the greater your risk for everything from diabetes to cancer and heart disease [v],[vi],[vii],[viii].

One meta analysis that looked at 17 studies and over 600,000 people showed a clear link between poor sleep and enhanced proneness to increased body weight and obesity.[ix] It showed a whopping 55% increased likelihood of significant unhealthy weight gain in those that regularly got 5 hours of sleep per night or less. In yet another meta analysis study those that consistently had issues falling asleep showed a 57% increased risk of diabetes, while those having trouble staying asleep increased their risk by an incredible 84%.[x] The mechanism behind this seems to involve a more than one factor. Additional research has uncovered the impact of sleep deprivation on glucose tolerance and insulin resistance[xi], while others show a tendency toward clearly increased appetite, cravings and food intake[xii].   Also noted in studies was an increase in the hunger hormone, ghrelin.

When you sleep does seem to make a difference, as well. Going to sleep late and sleeping later is also adversely associated with weight problems and other metabolic issues[xiii]. Our ancestors typically went to bed when the sun went down and awoke with the morning sunrise, which is what we seem to be designed to do. But this modern invention of artificial sunlight known as “electricity” has changed everything, causing far too many of us to stray from the sleep patterns we were best designed for and adopt unhealthy tendencies toward late nights, late night TV/computer work, and shortened sleep patterns that are too often “compensated” for with stimulants day to day.

One other health risk factor associated with poor sleep involves increased risk of hypertension (high blood pressure)[xiv],[xv]. Still other studies have forged a link between poor sleep and a shorter lifespan, overall (i.e., all-cause mortality)[xvi]. We need to reckon with our very real need for consistently sufficient and restful sleep!

With chronic insomnia affecting over 25% of the population, the implications for both physical and mental health are massive. Inflammatory issues generated by insomnia (and obviously also dietary and environmental factors) are a known vector for mental health issues such as depression and anxiety-related disorders. It turns out that chronic insomnia can even predict vulnerability to depression up to 14-fold over a year’s time![xvii]

During normal, healthy sleep your catabolic stress hormones subside and numerous growth factors such as melatonin, prolactin and growth hormone rise, facilitating the regeneration, healing and repair of stressed or damaged tissues. Healthy sleep modulates a healthy inflammatory and immune response (utterly critical if you happen to have an autoimmune condition), but disrupted sleep can lead to a dysregulated inflammatory response leading to increased daytime inflammation, blood sugar issues and other endocrine dysregulation. Women seem especially susceptible to this type of sleep-related inflammatory issue, displaying more inflammatory markers (CRP and IL-6) when getting less than eight hours of sleep per night[xviii]. When this drags on for four days or more inflammation becomes more significantly dysregulated—though one study showed that it may be possible to compensate a bit with daytime naps.[xix]

Some people (typically “Type A personalities” and macho-types) seem convinced and insist that they can get by with a mere 4-5 hours of sleep per night, but the science tells us that most everybody—men and women both–requires no less than 6-8 solid hours per night. Exceptions to this are truly rare and mostly non-existent.

TOO MUCH, VS. NOT ENOUGH SLEEP

Not dissimilarly to the problems inherent in getting insufficient sleep, too much (nine hours or more a night) can also disrupt your healthy circadian rhythms, interfering with normal cellular energy production and mitochondrial health leaving you vulnerable to unhealthy, energy zapping and inflammatory/immune dysregulating oxidative processes[xx]. In one other study chronic excess sleep was even clearly associated with a 30% shorter lifespan![xxi]   Finding your own effective and optimal balance or “Sleep Zone”—and sticking to it consistently is critical toward supporting your best health, longer life and your healthiest weight.

SO WHAT CAUSES INSOMNIA ANYWAY?

I went into this subject in considerable depth in my book, “Rethinking Fatigue: What your adrenals are really telling you and what you can do about it”.   In it, I offer a detailed self-screening description of different types of cortisol/circadian rhythm dysregulation of what forms of support might be useful for each. –Let’s just say it’s not necessarily a “one size fits all.” In short, there are numerous potential vectors for chronic insomnia, including cortisol circadian rhythm dysregulation, brain-related issues, food sensitivity issues, blood sugar issues, and chronic inflammation[xxii]. For some people it can be a combination of more than one of these. It turns out that your brain may reap the greatest rewards—or consequences of all when it comes to sleep. In fact, the health of your brain may even be at the root and greatest risk of many sleep related issues—making this issue a true and urgent priority. Neurodegenerative processes commonly lead to disturbed circadian patterns and are a common vector for early dementia and even Alzheimer’s disease. Identifying the dysregulated pattern that best fits your symptoms is an important first step in addressing this critical issue. Rethinking Fatigue[xxiii] can help you do just that. I don’t mean to bait you with pointing you to this other book, but the important and most helpful details are in all honesty simply too involved for a mere blog post.

SOME GENERAL ADVICE FOR A GOOD NIGHT’S SLEEP

Paying attention to your foundational diet is indispensible toward addressing any health concern. You can go broke taking supplements that offer the promise of better sleep or really do a number on your long-term wellbeing by relying on sleep medications to “fix” your insomnia. In truth, nothing can possibly take the place of supplying your body and brain’s biochemistry with the raw materials they need in order to regulate and support every single bodily process.

Overall, there is decidedly evidence that the ancestrally oriented, low dietary carbohydrate, fat-based dietary approach we advocate in this program and that I write about at length in my book, Primal Body, Primal Mind can be of significant help to many insomnia sufferers[xxiv], [xxv]. In addition, making a point of keeping to a regular sleep schedule, allowing for getting to bed before about 11 PM where slow wave activity conducive to deep restful sleep is most likely to occur is a good rule of thumb. –Be disciplined about this! Avoiding caffeine and other stimulants at any point during the day–but especially in the afternoon can also help. Make sure you sleep in as totally dark a room as you can, with no night lights that might disrupt melatonin production (and/or use a sleep mask for this purpose) and avoid working on your computer late at night where the screen’s blue light wavelengths can similarly thwart melatonin production. Using blue-blocker glasses (available from multiple sites online) in the evening when watching TV or working on your computer can help this issue substantially. There is also free computer software you can download that is designed to dampen blue light wavelengths on your computer screen after dark[xxvi].   Avoid keeping your cell phone in your bedroom and if at all possible turn off your wi-fi router while you sleep at night. (I talk a lot more about the adverse effects of EMF pollution in my book, Primal Body, Primal Mind). Try taking a warm bath in Epsom salts, which contain magnesium sulfate that can literally absorb into your bloodstream transdermally (through your skin) and help relax you. You can also drink a warm cup of gelatin-rich bone broth before bed, as gelatin is rich in the calming amino acid glycine, which has even been studied for it’s positive effect on insomnia[xxvii]. Herbal teas containing chamomile, passionflower, skullcap and valerian can also be useful bedtime tools, as can the calming amino acid supplement, L-theanine (typically taken 100-200 mg twice a day for best effectiveness). Doing heart rate variability training using an M-Wave device or iPhone software called ‘Inner Balance” by HeartMath is a great calming and centering tool. I have also been thanked about a million times by those that have purchased the DAVID Audio-Visual Entrainment (AVE) device called the DAVID Delight (and Delight Pro) sold by MindAlive[xxviii]. As a neurofeedback provider for over 20 years I can also attest to the sheer power of the human brain to learn self-regulation and re-establish its own healthy sleep rhythms (and much more) with proper neurofeedback training (you can find a qualified practitioner nearest you by going to www.EEGDirectory.com). Getting out into nature more regularly with your shoes and socks off to better ground your body and align it with beneficial and anti-inflammatory negative ions in the earth can work wonders for many people. Finally, few things can be more affordable or can match the long-term effectiveness of a regular meditation practice in cultivating a more grounded, calm, parasympathetically dominant nervous system.

IN CONCLUSION

Cultivating a regular discipline and making an absolute priority of getting to sleep early and sleeping 6-8 hours consistently is every bit a part of the Paleo or Primal lifestyle as eating a natural, nourishing and nutrient dense diet. We all need healthy sleep, together with the raw materials supplied to our body and brain’s biochemistry we were best designed for. We also need regular physical movement and hourly breaks from sitting in one place. Finally, we all need fresh air and sunshine and physical contact with the earth that sustains us to truly embrace The Paleo Way and a long and healthy life!


 

[i] Hall MH, Okun ML, Sowers M, et al. “Sleep is associated with the metabolic syndrome in a multi-ethnic cohort of midlife women: the SWAN Sleep Study.” Sleep 2012; 35: 783-790.

[ii] Puttonen S, Viitasalo K, Härmä M. “The relationship between current and former shift work and the metabolic syndrome.” Scand J Work Environ Health. 2012; 38: 343-348.

[iii] Schmid SM, Hallschmid M,  Schultes B, et al.  “The metabolic burden of sleep loss.”  The Lancet Diabetes and Endocrinology. Volume 3, No 1 p52–62, January 2015  DOI: http://dx.doi.org/10.1016/S2213-8587(14)70012-9

[iv] Vol. 66: 143-172, January 2015.  DOI: 10.1146/annurev-psych-010213-115205

[v] Sperry SD, Scully ID, Gramzow RH, Jorgensen RS. “Sleep Duration and Waist Circumference in Adults: A Meta-Analysis”. Sleep. 2015 Jan 12. pii: sp-00440-14.

[vi] Ryu JY, Lee JS, Hong HC, Choi HY, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM. “Association between body size phenotype and sleep duration: Korean National Health and Nutrition Examination Survey V (KNHANES V).” Metabolism. 2014 Dec 17. pii: S0026-0495(14)00376-X. doi: 10.1016/j.metabol.2014.12.001.

[vii] Lee J, Ellis JM, Wolfgang MJ. “Adipose Fatty Acid Oxidation Is Required for Thermogenesis and Potentiates Oxidative Stress-Induced Inflammation.” Cell Rep. 2015 Jan 7. pii: S2211-1247(14)01052-3. doi: 10.1016/j.celrep.2014.12.023.

[viii] Marseglia L, Manti S, D’Angelo G, Nicotera A, Parisi E, Di Rosa G, Gitto E, Arrigo T. “Oxidative Stress in Obesity: A Critical Component in Human Diseases.Int J Mol Sci. 2014 Dec 26;16(1):378-400.

[ix] Cappuccio FP, Taggart FM, Kandala N-B, et al. “Meta-analysis of short sleep duration and obesity in children and adults”. Sleep 2008; 31: 619-626.

[x] Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. “Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis.” Diabetes Care 2010; 33: 414-420.

[xi] Spiegel K, Leproult R, Van Cauter E. “Impact of sleep debt on metabolic and endocrine function.” Lancet 1999; 354: 1435-1439.

[xii] Beebe DW, Simon S, Summer S, Hemmer S, Strotman D, Dolan LM. “Dietary intake following experimentally restricted sleep in adolescents.” Sleep 2013; 36: 827-834.

[xiii] Baron, KG, Reid KJ, Kern AS, Zee PC.  “Role of sleep timing in caloric intake and BMI.” Obesity (Silver Spring) 2011 Jul;19(7):1374-81. doi: 10.1038/oby.2011.100. Epub 2011 Apr 28

[xiv] Meng L, Zheng Y, Hui R. “The relationship of sleep duration and insomnia to risk of hypertension incidence: a meta-analysis of prospective cohort studies.” Hypertens Res Off J Jpn Soc Hypertens 2013; 36: 985-995.

[xv] Gangwisch JE, Feskanich D, Malaspina D, Shen S, Forman JP. “Sleep duration and risk for hypertension in women: results from the nurses’ health study.” Am J Hypertens 2013; 26: 903-911

[xvi] Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. “Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies.” Sleep 2010; 33: 585-592

[xvii] Lee E, Cho HJ,  Olmstead R., et al.  “Persistent sleep disturbance: a risk factor for recurrent depression in community-dwelling older adults.” Sleep.  2013 Nov 1;36(11):1685-91. doi: 10.5665/sleep.3128

[xviii] Miller, MA, Kandala NB, Kivimaki M., et al.  “Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study.”  Sleep.  2009 Jul;32(7):857-64

[xix] Vgontzas AN, Zoumakis M, Papanicolaou DA, et al.  “Chronic insomnia is associated with a shift of interleukin-6 and tumor necrosis factor secretion from nighttime to daytime.”  Metabolism.  2002 Jul;51(7):887-92

[xx] Buxton OM, Marcelli E. “Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States.” Soc Sci Med. 2010 Sep;71(5):1027-36. doi: 10.1016/j.socscimed.2010.05.041.

[xxi] Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. “Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies.” Sleep 2010; 33: 585-592.

[xxii] Raison CL, Rye DB,  Woolwine BJ., et al.  “Chronic interferon-alpha administration disrupts sleep continuity and depth in patients with hepatitis C: association with fatigue, motor slowing, and increased evening cortisol.”  Biol. Psychiatry.  2010 Nov 15;68(10):942-9. doi: 10.1016/j.biopsych.2010.04.019. Epub 2010 May 26.

[xxiii] http://www.primalbody-primalmind.com/rethinking-fatigue/

[xxiv] Feinman, RD, Pogozelski, WK, Astrup, A, et al.  “Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base.”  Nutrition. Volume 31, Issue 1January 2015, Pages 1–13

[xxv] Jönsson T, Granfeldt Y, Lindeberg S, et al.  “Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes.” Nutrition Journal 2013,12:105

[xxvi] https://justgetflux.com/

[xxvii] Bannai M, Kawai N.  “New therapeutic strategy for amino acid medicine: glycine improves the quality of sleep.”  J Pharmacol Sci. 2012;118(2):145-8. Epub 2012 Jan 27

[xxviii] http://www.primalbody-primalmind.com/mind-tools/

By Nora Gedgaudas

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