Get Rest or Get Fat

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Loss of sleep affects hormone creation.

By Theresa Garnero, APRN, BC-ADM, MSN, CDE

If you miss out on sleep, you mess with your waistline. How so?

It all starts with the master hormone called dopamine. Specialized cells in the brain (in the hypothalamus) release dopamine according to your circadian rhythm — your 24-hour cycle that controls many functions in the body. Much like nature has a pattern of four seasons, your body has internal responses to hormones based on sleep patterns throughout the year. Loss of sleep means you will not make enough dopamine.

Without enough dopamine, a cascade of several other hormones occurs, resulting in increased release of glucose from the liver, cellular inflammation, and fat storage. Excess abdominal fat is typically accompanied by an increase in free fatty acids and a decrease in adiponectin, an important hormone made by fat that is a key regulator of fat and glucose metabolism. This interferes with your body’s ability to use insulin.

Medical jargon aside, once you reach a new weight, your biochemical clock perceives this as your new “normal” weight. This makes it difficult to lose weight and is a main factor why we typically gain a couple pounds a year as adults. This may also explain why the world is getting fatter — we are suffering from loss of sleep, which doesn’t allow our bodies time to make enough dopamine!

Adding to the complexity, many people with diabetes already have low morning levels of dopamine. [For people with type 2, a new type of diabetes medication has emerged to address this issue: a dopamine-agonist called Cycloset, or as I think of it, a dopamine helper. Taken with food within 2 hours of waking in the morning, it helps to reset the circadian rhythm to those experienced by healthy, lean individuals.]

Other medical considerations include:

• Sleeping less than 5 hours or more than 8 has been associated with increased risk of diabetes.
• Experiments on sleep deprivation showed an impact on increased appetite and increased insulin resistance.
• Obstructive sleep apnea is an independent risk factor for type 2 diabetes (symptoms include snoring, awakening with a headache, or being sleepy during the day).

Prevent loss of sleep by maximizing your sleep to at least 7 hours daily. Some sleep hygiene tips include:

• Set a regular time to go to bed and wake up.
• Avoid napping during the day (or limit the nap to a max of 40 minutes).
• Avoid caffeine, alcohol and heavy/spicy/sugary foods 4-6 hours before bedtime.
• Avoid strenuous exercise with the 2-4 hours before bedtime.
• Use comfortable bedding and a comfortable temperature setting (cool may be best).
• Block out noise and as much light as possible.
• Consider products such as an eye mask, black out shades, or white noise generators to help create a comfortable sleep environment. Special pillows or mattress may help reduce pain.
• Reserve the bed for sleep and sex, or sex and sleep (no TV, computer in the bedroom).
• Establish a bedtime ritual (i.e. warm milk, relaxation techniques, a hot bath or shower 90 minutes before bed).
• If you can’t fall asleep, get up and do something boring.
• Expose yourself to bright light upon awaking.
• Keep a sleep journal to better understand patterns.
• Discuss factors such as pain, hot flashes, medication, aging, or other physical or psychological problems (i.e. anxiety or depression) that may be facilitating your loss of sleep.
• If you are the caregiver for an infant or dependent adult, plan for a regular night off. 

A dietitian colleague of mine is known to say, “Sleeping is an essential nutrient.” She’s right. It is a critical factor to overall health and weight management.

Read Theresa’s bio here.

Read more of Theresa Garnero's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.