New research shows how getting too little sleep, at erratic times, may cause changes in the body that increase the risk of weight gain and diabetes. The study was done with 21 volunteers who spent 6 weeks living in a laboratory. After a period of normal sleep, they spent the next 3 weeks getting an average of 5.6 hours a night. They were allowed to sleep only at varying times of the day or night. This pattern was designed to imitate rotating shifts or jet lag. During this time, people's blood sugar went up after meals -- in some cases, to pre-diabetic levels. This occurred because the pancreas produced less insulin. Metabolism fell by 8%. People were kept on a diet to avoid weight gain. But researchers said without the diet people could have gained 10 to 12 pounds a year under similar conditions. The journal Science Translational Medicine published the study. The Associated Press wrote about it April 16.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Not getting enough sleep has been linked with multiple medical problems, such as obesity. People who get fewer than 6 hours of sleep per night are more likely to be overweight. Higher body weight increases your risk of developing diabetes.
People who work the night shift, especially those who rotate between day and night shifts, are at even higher risk for both obesity and diabetes. So is anyone who has a very erratic sleep schedule. Sure, these people tend to get less sleep than recommended. But what else is happening in the body?
Researchers at Brigham and Women's Hospital in Boston designed a way to study this question. They invited 21 healthy people to live in a controlled environment for 6 weeks. The researchers decided everything -- what time they slept, how many hours of sleep were allowed, their diet and their activities.
For the first 12 days, people went to bed at the usual time and got enough sleep. Then they were allowed only an average of 5.6 hours of sleep per day during the next 3 weeks. And sleep started at different times, including daytime. This altered their biologic clocks to simulate a state of 4 hours of jet lag every day. A 9-day recovery period came next.
During the 3 weeks of abnormal sleep, people's sugar control went haywire. Their bodies did not release enough insulin after a meal. So blood sugar levels rose to higher levels than the first 12 days of the study. Some people had blood sugars that reached pre-diabetes levels.
People's metabolism rates also slowed during the 3-week interval. The researchers controlled diets so that people did not gain weight. However, researchers estimated that without the diet the average weight gain would be 10 to 12 pounds over one year of erratic sleep.
What Changes Can I Make Now?
Quality of sleep matters just as much as the amount. This can be a real challenge for people who work the night shift or can't get into bed when it's dark outside.
If you are fortunate enough to have a regular sleep schedule, here are some ways to help you get better quality sleep:
Establish a regular bedtime and a relaxing bedtime routine. Examples might include taking a warm bath or listening to soothing music. Use your bed only for sleeping or lovemaking. Avoid reading and watching television in bed. If you can't sleep after 15 to 20 minutes, get out of bed and go into another room. Read quietly with a dim light. Don't watch television. The light from the TV has an arousing effect. When you feel sleepy, get back into bed. Don't delay your scheduled wake-up time to make up for lost sleep. Get plenty of exercise. Build up to 45 minutes of moderate exercise nearly every day. Get your exercise early in the day. Try some easy stretching exercises or yoga to relax your muscles and your mind at bedtime. Whenever possible, schedule stressful or demanding tasks early in the day. Do the less challenging activities later. This helps you to wind down at the end of your day. Adjust what you eat and drink.
Don't go to bed hungry, but don't eat a big meal right before getting into bed. If you want a bedtime snack, keep it bland and light. Limit caffeine. Consume it at least 4 hours before bedtime. To decrease urination during the night, don't drink any liquids after dinner. Avoid alcohol after dinnertime. Although many people think of it as a sedative, it can actually impair your sleep. Be sure your bed is comfortable and your bedroom is dark and quiet. Consider a sleep mask or earplugs. Don't let yourself get overheated. Keep the bedroom at a constant, comfortable temperature. Don't take long naps during the day. If you need a nap, restrict it to 15 to 20 minutes in the early afternoon. Turn the alarm clock around so you won't worry that you are still awake. Practice relaxation breathing. Use slow breaths, especially when you exhale.
If you do have an irregular sleep schedule, try to avoid bright lights for at least an hour before you get into bed. Wear sunglasses if necessary.
If you work the night shift, you will need to adjust these recommendations based on your schedule. For example, go directly to bed as soon as you get home from work. Be sure the bedroom is dark, quiet and cool.
What Can I Expect Looking to the Future?
The advice for adults to get 7 to 9 hours of good quality sleep per day will not change.
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