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The Effect of Sleep on Metabolism

The Effect of Sleep on Metabolism. Kendal Shaffer. Objectives. Discuss the purpose of sleeping Review sleep recommendations Discuss metabolic changes in the body associated with insufficient sleep. Examine methods to improve sleep. Common Beliefs. Restorative powers

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The Effect of Sleep on Metabolism

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  1. The Effect of Sleep on Metabolism Kendal Shaffer

  2. Objectives • Discuss the purpose of sleeping • Review sleep recommendations • Discuss metabolic changes in the body associated with insufficient sleep. • Examine methods to improve sleep

  3. Common Beliefs Restorative powers Recharges our batteries Important during illness Important for healing Improves ability to focus

  4. Sleeping How much sleep did you get last night? How much sleep do you usually get each night?

  5. Sleeping A necessary part of overall health Sleep duration and quality are both important Sleep plays a critical role inmetabolism, emotions, behavior, health, daily performance and learning/ memory filing A lot has been discovered but there is still so much more to uncover (1)

  6. Recommendations (1,2,3) Above 18: 7-8 hours 10-17 y/o: 8.5-9.25 hours 5-9 y/o: 10-11 hours 3-5 y/o: 11-13 hours Under 3: 12-15 hours

  7. Reality (1,2,3) 72% of adults sleep < 8 30% of adults sleep < 6 70% of teenagers sleep < 8 15 million children in the US do not get enough

  8. Evolution of Sleep • Average sleep duration reported by Americans: • 1960: 8-8.9 hours • 1995: 7 hours • 2004: 6 hours or less • 25% of Americans take some form of sleep medication (1,4)

  9. Evolution of Sleep Decrease in sleep coincides with the increase in prevalence of obesity, diabetes and other chronic diseases Coincidence or not? (1)

  10. Consequences of Loss of Sleep • Can lead to metabolic & physical changes: • Altered glucose utilization/insulin resistance • Type 2 Diabetes • Increased appetite • Fatigue • Obesity • Delayed brain responses • Decreased memory/learning • Impaired immune system (2,4,6,7,8,9,10)

  11. http://frequencyapps.com/node/15

  12. Disposition Index Marker that predicts the risk for diabetes DI = AIRg x SI AIRg= acute insulin response to glucose SI= insulin sensitivity (4)

  13. Glucose Metabolism • Impaired glucose regulation • Insulin resistance • Lower disposition index • A marker for diabetes risk (>2000 ideal) • Disrupted secretions of counter regulatory hormones (2,4,6,7,8)

  14. Response to Dietary Intake • After eating: • Insulin stimulates uptake of glucose by cells • Counter regulatory hormones: oppose insulin • Glucagon • Growth hormone • Cortisol • Cathecholamines (4,6,8)

  15. Counter Regulatory Hormones • Growth hormone rises in sleep deprivation • High GH associated with reduced uptake of glucose • Cortisol rises in sleep deprivation • High levels in the evening = reduced insulin sensitivity the next day • Sleep loss of 2 hrs/night associated with high cytokine levels (4,7)

  16. Sleep Deprivation Lowered glucose tolerance – 40% Glucose effectiveness lowered – 30% Reduced insulin response – 30% Lower insulin sensitivity – minimal Disposition index – fell below 2000 (4)

  17. Diabetes/ Sleep Statistics • 57% more likely in those who had trouble falling asleep • 84% more likely in those who could not stay asleep all night • When compared with 7-8 hours/night, those sleeping 6 or less are: • 28% more likely to be diagnosed w/ Diabetes (11)

  18. Obesity & Increased Appetite • Loss of sleep affects the normal levels of ghrelin and leptin • Hormones that regulate appetite • More time to eat • Increased calories consumed • Less physical activity • Less energy for cooking and exercise (4,6,7,10)

  19. Leptin Inhibits hunger/food intake Promotes utilization of fat for energy Increases energy expenditure Increases after food is consumed and satiety is reached (4,6)

  20. Ghrelin Stimulate appetite and hunger Promotes retention of fat Reduced energy expenditure Levels are quickly reduced after a meal is consumed Levels resurge a few hours later and hunger returns (4,6)

  21. Normal Conditions • Plasma leptin and ghrelin levels both rise at night • Ghrelin spontaneously decreases during the second half of sleeping • Hypothesis- when sleep is cut short, ghrelin misses its spontaneous decrease • Result: elevated ghrelin upon waking (4,6,7)

  22. Sleep Deprivation Leptin levels decrease as much as 20% Ghrelin levels increase as much as 28% Leptin responds more to chronic deprivation Ghrelin responds quickly to acute deprivation 5 hours of sleep- 220 extra calories on average 4 hours of sleep- 300 extra calories on average (4)

  23. Sleep Duration and BMI • Lowest BMI associated with 7-8 hours a night • Sleep duration below or above 7-8 is associated with a higher BMI • Sleeping • <5 hours: 1.14kg increase • 6 hours: 0.71kg increase (4,6,10)

  24. http://www.bettycjung.net/BG2012/Sleepobesity.gif

  25. Immune System Increased stress response (high CRP) Systemic inflammation Impaired immunological memory Reduced immune response (4,9

  26. Stress Response/Inflammation Sleep loss of 2 hrs/night associated with high cytokine levels Cytokines contributes to inflammation Effect adaptation in starvation (4,7,9)

  27. Immunological Memory Antibodies- proteins that help fight antigens When you are exposed to something your body “remembers” At second exposure, body responds faster and stronger Same concept used in vaccines (9)

  28. http://classes.midlandstech.edu/carterp/Courses/bio225/chap17/lecture5.htmhttp://classes.midlandstech.edu/carterp/Courses/bio225/chap17/lecture5.htm

  29. Immunological Memory • Sleep after vaccinations strengthens the response • Sleeping subjects had 4x the antigen specific antibodies • Levels remain higher 1 year later • Mice repeatedly exposed to influenza did better with adequate sleep (4,9)

  30. Immunological Cells

  31. Reduced Immune Response • Adequate sleep strengthens the interaction between antigen presenter cells and T cells • Inadequate sleep Decreases the production of : • T cells (9)

  32. Heart Disease (12) Increased BP Inflammation/ CRP Impaired vasodilation Decreased anti-oxidant activity

  33. Wound Healing (6) Common misconception Wound healing is no faster in mice with adequate sleep compared to sleep deprived mice

  34. Physicians Role • 10% of physicians feel their knowledge on sleep and sleep disorders is adequate • Of 121 primary care clinics screening questionnaires: • 100% inquired about smoking, drugs & alcohol • 93% asked about eating habits/behaviors • 86% inquired about physical activity level • 43% asked about sleeping habits (1)

  35. Prescription Medications • Prescription: sedative hypnotics • Barbiturates • Benzodizepines • Hypnotics • Can be dangerous and habit forming (13)

  36. Side Effects Changes of appetite burning/tingling in extremities Constipation or diarrhea balance disruptions & dizziness drowsiness dry mouth, headache Heartburn & stomach pains uncontrollable shaking of body parts unusual dreams weakness (12)

  37. Side Effects • Parasomnias • Behaviors/actions done in a sleep state • Can range from sleep walking to sleep driving • Can be very dangerous (13)

  38. Natural Remedies • Exercise • Warm bath • Natural/ineffective • Valerian • Melatonin • Kava (11)

  39. Conclusion • Research has shown a consistent association between sleep and chronic disease risk • Science still needs more evidence to declare any direct correlations • Lack of specific mechanisms and causes for associations • Sleeping is an important aspect of patient health • Improving sleep habits may improve patient health

  40. Questions?

  41. References Perry GS, Patil SP, Presley-Cantrell LR . Raising awareness of sleep as a healthy behavior. Preventing Chronic Disease. 2013: 10(1): 133-137 Lindseth G, Lindseth P, Thompson M. Nutritional effects on sleep. Western Journal of Nursing Research. 2011: 35(4): 497-513 National sleep foundation http://www.sleepfoundation.org/article/how-sleep-works/how-much-sleep-do-we-really-need. Knutson KL, Spiegel K, Penev P, Van Cauter E. The metabolic consequences of sleep deprivation. Sleep Medicine Reviews. 2007 : 11(3): 163-178 Zelevansky N. ten surprising things about how animals sleep. Vetstreet.com. May 14, 2012. http://www.vetstreet.com/our-pet-experts/10-surprising-things-about-how-animals-sleep Morselli LL, Guyon A, Spiegel K. Sleep and metabolic function. European Journal of Physiology. Jan 2012: 463(1): 139-160 Van Cauter E, Spiegel K, Tasali E, Leproult R. Metabolic consequences of sleep and sleep loss. Sleep Medicine Reviews. Sept 2008: 9(1): 23-28 Nedeltcheva AV, Imperial JG, Penev PD. Effects of sleep restriction on glucose control and insulin secretion during diet influenced weight loss. NIH Public Access Author Manusript. April 2012: 20(7): 1379-1386 Besedovsky L, Lange T, Born J. Sleep and immune function. European Journal of Physiology. 2012: 463(1): 121-137 Peppilyytikainen OR, Lahelma E, Lallukka T. Association of sleep duration with weight and weight gain: a prospective follow up study. Journal of Sleep Research. Jun 2011: 20(2): 298-302 Schardt D. Sleep on it: when counting sheep isn't enough. Nutrition Action Health Newsletter. Center for Science in the Public interest. April 2012. http://0-web.ebscohost.com.maurice.bgsu.edu/ehost/pdfviewer/pdfviewer?sid=c302cd43-ee8f-49e7-9c10-534df7075b3d%40sessionmgr111&vid=2&hid=118 Naughton MT, Geraldo LF. Sleep in Heart Failure. Progress in Cardiovascular Diseases. 2009. 51(4): 339-349. Mayo Clinic. Prescription sleeping pills. The Mayo Clinic. 2011. http://www.mayoclinic.com/health/sleeping-pills/SL00010

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