AAP EDUCATION

Your Sleep & Your Health - What is the relationship?

This article combined data in the US from 3 sources;

  • Sleep Cycle (sleep tracking app)
  • US Census
  • Centre for Disease Control in the US

to evaluate relationships between sleep quality/duration/snoring and various health metrics and diseases. I am not aware of such data gathering in Australia, but it does bring together several important health considerations that we can take on board clinically. The analysis helps to show that our physical, mental, and sleep health have multi-directional effects on each other.

Those cities in which participants were experiencing good sleep had some similar characteristics;

  • higher leisure time
  • lower diabetes scores
  • lower obesity scores

 Higher Leisure Time

Sleep is connected to mental and emotional health, and issues with sleep quality/duration have been linked to depression, anxiety, bipolar disorder, and other conditions. We all know a few nights of poor sleep, can start to effect our judgement and perception, let alone short sleep over several months. When examining the causes of secondary insomnia (i.e. reasons for not enjoying a good night of sleep) in a NZ private practice*, the two most common causes listed by patients were anxiety and depression. Having more leisure time enables pursuits like exercise, linking with community and family, nurturing creative aspects of self, and time for self reflection. It is near impossible to go to sleep when your body is saturated with adrenaline and cortisol, released through out the day following numerous 'stress bombs' associated with day to day challenges of life and work. Having regular leisure time goes a long way to annulling the chemicals released in association with the stress response. A key feature in sleep education, is teaching clients how to deal with the day's stress during the day.

One aspect of dealing with stress is to utilise exercise. Exercise is a great way to burn off released adrenaline and cortisol, but when tired and unmotivated, it can be hard to take that first step (literally), lace up the joggers and head out.

 Less Diabetes & Obesity

Dr. Michael Grandner a sleep expert, notes that sleep is closely tied to health, in that "not only can lifestyle factors influence sleep health, but sleep problems can lead to more problems with maintaining a healthy diet". An important consideration in understanding a healthy diet/ability to achieve a healthy weight, is that our urge to eat and the food choices that we make, are strongly influenced by our sleep quantity and quality. Let's unpack that in more detail. Your urge to eat (i.e., appetite) and the effects of eating, that is feeling full (i.e., satiety) are regulated by hormones. The culprits are called leptin, which provides a sense of being full (i.e. satiety) and ghrelin, which provides a sense of hunger. Researchers have shown that short sleeping (i.e. 4.5 hours) of just one night, reduced blood levels of fullness feeling leptin (18%), while guzzling ghrelin increased (28%)**. Not only had the urge to eat more increased, but the preference for the type of food changed towards salty (e.g., chips, salted nuts), starchy (e.g., pasta, bread, potatoes) and sweet (e.g., cakes, ice cream, pastries). Further, when short sleeping, the appetite enhancing effects of cannabinoids interact with the reward systems of dopamine and opioids, resulting in a stronger desire to eat in excess of energy needs***. Is it any wonder that as the average hours of sleep have decreased, average BMI has increased.

If we as clinicians, are involved in assisting clients to achieve a healthy body weight, and only addressing their exercise level and their calorie intake, then we are missing the essential foundation for both, that is achieving adequate sleep.

The umbrella of sleep influences a broad range of health related features and while not studied in this article, other health metrics like fertility, learning, concentration, work accidents, blood pressure/heart attack/strokes and immune function are also affected by poor quality or quantity of sleep. You can learn more about how you can integrate sleep education into your clinical practice here.

 Sleep Hygiene Download

If you are interested in adding the professional skill of sleep education into your clinical practice, you can download our most popular pdf from the Sleep Mastery Course titled Sleep Hygiene Guide here.

The guide covers 16 points associated with good night and day sleep hygiene.

 References

* Arroll B, Fernando A, Falloon K, Goodyear-Smith F, Samaranayake C, Warman G. Prevalence of causes of insomnia in primary care: A cross-sectional study. British Journal of General Practice. 2012;62(595):e99-e103. doi: 10.3399/bjgp12X625157.

** Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Annals of Internal Medicine. 2004;141(11):846-50.

*** Hanlon E, Tasali E, Leproult R, Stuhr K, Doncheck E, de Wit H, Hillard C, Van Cauter E. Sleep restriction enhances the daily rhythm of circulating levels of endocannabinoid 2-arachidonoylglycerol. Sleep. 2016;39(3):653-64. doi: 10.5665/sleep.5546.