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Expanding Role for SleepóObesity and Diabetes

The role of sleep has been debated since ancient times. The traditional view is that sleep refreshes the brain and spinal cord. Nevertheless, suggestions of a wider role for sleep date from early Roman medicine, according to an editorial by British sleep researchers in the October 16, 2012, Annals of Internal Medicine. One Roman practitioner listed lack of sleep as an important cause of illness, while another prescribed restricted sleep for weight loss.

A small but important study reported in the same issue of Annals found that the Romans were close to the mark. The weight loss prescription, however, was backwards. ď[The Roman doctor] should have argued in favor of prolonged sleep for the treatment of extra weight,Ē the editorial declared.

ďHumans spend up to one third of their lives asleep, yet the function of sleep remains a topic of intense debate,Ē Broussard and colleagues wrote in introducing the study. Building on an earlier study linking lack of sleep to obesity and diabetes, they set out to measure the effect of sleep deprivation on the ability of fat cells to respond to insulin. This is important because fat cells safely store lipids, preventing them from spilling out into the blood stream and surrounding tissues. Fat level in the blood also communicates energy balance to the brain, distorting appetite and body weight control. In addition, insulin resistance is an early indication of Type 2 diabetes. Simply put, weíve got trouble when our fat cells are unable to respond properly to insulin.

The study subjects, average age 24, were alternately tested after being allowed to sleep 4Ĺ hours for four nights and then, after a break of four weeks, 8Ĺ hours for four nights. (Most adults need between seven and nine hours of sleep a night.)

Sleep deprivation showed up in subcutaneous abdominal fat cells and throughout the body.

The subcutaneous abdominal fat cells of those who were in bed for 4Ĺ hours were 30% less responsive to insulin than the cells of those in bed for 8Ĺ hours. Thatís a big deal. ďIt is the equivalent of metabolically aging 10 to 20 years,Ē said co-author and senior researcher Matthew Brady, an associate professor of medicine at the University of Chicago.

Participants were also injected with glucose and then insulin to measure the effect of sleep on insulin sensitivity throughout the body. Sleep deprivation was found to reduce whole-body insulin sensitivity by 16%, much less than the effect on fat cells alone.

If this study is correct, sleep affects our metabolism. It challenges the traditional view that the role of sleep is confined to the central nervous system, consisting of the brain and spinal cord.

ďTo our knowledge, this is the first clinical study linking sleep restriction to an alteration of a molecular metabolic pathway,Ē the sleep researchers wrote in the editorial accompanying the study. ďThese results point to a much wider influence of sleep on bodily functions, including metabolism, adipose tissue, cardiovascular function, and possibly more.Ē  

ďThe authors deserve commendation for a study that is a valuable contribution to the understanding of the causal pathways by which reduced sleep duration may directly contribute to diabetes and obesity,Ē they added

We must keep in mind that this is a small study, consisting of seven healthy young subjects, and that more diverse and larger clinical studies will be required to fully understand the role of sleep. One thing we do know is that adequate sleep is important for good health.

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Youíll find numerous articles online about how to get a good nightís sleep. They all say pretty much the same thing. Go to bed and get up at the same time every day. Ear a healthy diet and get plenty of exercise. Donít drink coffee or exercise too close to bedtime. Use your bed for sleeping and sex only. If you canít go to sleep, get up and do something else until you feel sleepy. And maybe a few more general rules.

Iíll tell you what works for me now that Iím older and find it harder to sleep through the night.

First, sleeping pills are not the answer. The problem is that they work too well. You soon convince yourself that you canít go to sleep without them. If you think you canít do without the pill, you canít. Now, youíve got a bigger problem; one thatís bad for your brain or your body. Donít go down that road. Itís far better to find a routine that works for you. Thatís what I have done.

I go to bed about 9:30 in the evening and get up at about 7:00 in the morning; I do this most days. Youíll notice that I spend more than the recommended 8 hours in bed. That gives me 30 minutes to an hour to read and get my mind off the trials and tribulations of the day. The other hour or so of extra time allows me to read some more if I wake up during the night, as I often do. The key is to find a book that captures your imagination and takes your mind off your worries.  

I am currently making my way through novels of suspense by J. A. Jance; marvelously prolific, she has written about 50 books. I have yet to find one I didnít really enjoy. Her character development and multifaceted story telling is about as good as it gets. She almost always puts my mind at ease and allows me to go back to sleep. If nothing else, it relaxes me to reflect on her remarkable writing skills. (My main problem is finding shelf space.)

I also find that I sleep better on workout days. Knows this keeps me active on off days as well. Everything goes better when I keep moving throughout the day.

My bedtime snack also helps. Some discourage eating before going to bed, but it works for me. My current bedtime snack is Naturally More peanut butter on a slice of Eziekiel bread, topped with stewed apples. Itís delicious and Iím convinced that it helps me sleep. Going to bed hungry makes no sense. Needless to say, I also eat regular meals and snacks during the day. I donít let myself get hungry, which helps control my weight and sleep more soundly.

Finally, when itís time to sleep I cover my eyes to keep out the light. I donít have a sleep mask; I simply cover my head with the covers. I never paid much attention to light before, but I began to ponder the fact that sun light coming through the bedroom window wakes me up like an alarm clock. I also noticed that Carol covers her head when I turn the light on in the middle of the night. So I started doing it when Iím ready to go to sleep and I believe it does help. The trick is to avoid smothering yourself, which takes a little practice.

Iím not saying that my way will work for you, but it might trigger some ideas that will help keep your brain and your body healthy.

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