References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489488/pdf/jomes-27-004.pdf
https://www.sleepfoundation.org/physical-health/weight-loss-and-sleep
https://www.hsph.harvard.edu/nutritionsource/sleep/
https://www.ninds.nih.gov/health-information/patient-caregiver-education/brain-basics-understanding-sleep
https://www.sleepfoundation.org/physical-health/sleep-and-overeating
https://www.sleepfoundation.org/physical-health/obesity-and-sleep/.

Transcript:
You are listening to the fresh focus podcast where VA dietitian nutritionists are serving up health and Wellness information for veterans and their families in addition to being in clinic chatting over the phone or using video connect, we are increasing your access with this podcast.

The VA has an amazing weight management program called move. This comprehensive program gives you not only a blueprint to follow but the tools needed to meet your individual goals so grab a notebook and get ready for tangible tips to conquer those barriers.

You are listening to fresh focus podcast I'm Angie your host for today. I work at the Saint Louis VA healthcare system in Saint Louis Missouri. I'm a registered dietitian nutritionist in our health promotion and disease prevention department. Please don't forget to like and subscribe to this podcast and leave a review for the fresh focus team. In the last few episodes, you've heard from several folks within our move weight management program here at the VA and in this episode, I'm going to dive right into sleep.

Why is sleep such a big deal? Sure, we all wanna feel energetic and well rested but why is sleep so important and what are some other reasons to make sure we are getting good sleep? First of all, we need it as much as we need food and water for survival. We also need adequate sleep. In many ways sleep is absolutely necessary for our physical and mental growth and development. It's important for learning, creating new memories, concentrating or focusing as well as responding quickly when needed. Sleep also clears the mind.

Sleep helps to remove toxins that build up while we are awake especially in the brain. The brain uses a lot of energy to function, and it generates waste just like any other system. That waste has to go somewhere otherwise it can lead to poor mental function as well as neurodegeneration.

Good sleep can help manage our risk of many issues such as high blood pressure, cardiovascular disease, diabetes, depression and obesity. It also improves our mood, aids in digestion, helps our bodies heal and recover from activity. Helps us to build muscle more effectively, boosts our immune systems, improves our energy and helps with weight management. Yes, it is true that there are connections between sleep and body weight.

Many things influence our body weight and sleep is one of them for several reasons. Most obviously when we are tired due to not getting enough sleep or experiencing poor sleep, we have less energy therefore we are less likely to engage in regular physical activity which is an important part of the equation for weight management among other health issues.

Also, when we stay up later than our body needs, we simply have more awake time opportunities to eat so it's possible to ingest more calories overall. For that reason, contributing to weight gain there are also thermal changes. Ghrelin is a hormone that signals to us that we're hungry and it will actually increase the longer we are awake or with shorter sleep duration on the other hand Leptin is a hormone that tells us we are satisfied or full decreases so there is a dysregulation in these appetite centered hormones.

When we don't get enough sleep, we may feel hungrier overall and not feel full as quickly not only that there are strong associations between poor sleep and how many calories we burn at rest as well as after we eat. So not sleeping well can actually reduce our metabolism and when we are sleep deprived, we tend to desire foods that are higher in calories especially in the form of carbohydrates and fat. So, a lot of things work against our weight management goals without good sleep to back us up.

Additionally, there is something of a vicious cycle. Overweight or obesity can lead to poor sleep which then leads to less activity and energy which then leads to further risk of weight gain. Having excess body fat can increase our risk of things that affect our quality of sleep.

These things include being another cause of that dysregulation of the hormone’s ghrelin and leptin, sleep apnea, where we actually stop breathing briefly throughout the night, depression and anxiety, Gerd or reflux commonly called heartburn which is worse when lying down and can keep us uncomfortable and awake asthma which can affect our ability to fall asleep and stay asleep and I feel arthritis which can cause joint pain and disturbed sleep.

So, what are some signs that we might be able to improve our sleep? Many people might not realize that their sleep quality might be lacking. Here are some things to consider, do you easily doze off while reading or watching TV or driving or riding in a car? Does it take you more than 15 minutes to fall asleep after your head hits the pillow? Have you been told you snore loudly? How sleepy are you when you go to bed? Do you have trouble concentrating during the day due to feeling sleepy? Do you feel groggy for half an hour or more after getting out of bed in the morning and how many times do you wake up at night?

Of course, nobody wants poor sleep and it's easy to ask ourselves what we are doing wrong. Well let's go easy on ourselves we aren't sleeping poorly on purpose. How do we sleep is a lifestyle habit that can be better managed over time just like what we eat our physical activity stress levels etcetera.

Luckily, we can improve what's called our sleep hygiene or our daily practices that affect our quality and quantity of sleep. Believe it or not some of us have accidentally trained our brains to think of our bed as a place where we might not sleep. This happens when we do things other than sleep while in bed repeatedly overtime such as scrolling through social media on our phone, watching TV, eating, etcetera. Even being restless tossing and turning for an hour or more trying to get to sleep trains are body to be awake while we're in bed.

We are creatures of habit. As well as connections in the context of learning a skill this is referred to as practice specificity that basically just means that we get used to doing things in a certain context so much so that the brain will start to expect us to do things in the same way. For example, if we always eat when we watch TV our brains will expect food every time we sit in front of that screen whether we are hungry or not. Hopefully I've convinced you that sleep hygiene matters.

Luckily there are really so many options and habits to choose from when it comes to improving our sleep. One way to look at it is what can we do right before we go to bed as well as during the night if we do wake up. While this can be tricky aiming to go to sleep and wake up at about the same time each day can sort of help train our bodies to fall asleep and wake up at those times on a regular basis. This includes weekends. Our bodies work in cycles.

If we disrupt that too much it can make sleep more difficult. Before getting in bed, it can help to do something to improve our blood flow to our hands and feet arms and legs too like take a warm bath or shower wear socks or use a heating pad and avoid caffeinated beverages. Also eliminate the blue. Much of our modern lighting and screens omits a large amount of blue light from the color spectrum and it has been found that this tends to mimic sunlight and can stimulate the brain therefore keeping us awake. Make sure lights are minimized at that time and overnight watch out for those digital light displays on phones, clocks, fans and even those little lights that are on all the time like on a router for example should be covered.

Blackout curtains or eye mask can help some people as well choose low voltage warm temperature bulbs 3000 K or less for your bedside lamps and overhead light. If you do have to get up during the night make sure you try to expose yourself to as little light as possible. Try to avoid turning on too many lights especially bright ones. A low wattage or even a red tone motion activated night light could be appropriate for certain areas. Be mindful of noise try to eliminate or block any potential disruptive noises. White noise machines can be helpful to drown out sporadic sounds, fans can also be helpful for sound as well as comfort since we sleep better in a cooler environment. So, keep the thermostat at a comfortable level but also make sure you have enough coverage, warm pajamas, socks, blankets or whatever is needed to keep your body warm enough by the time morning hits.

Avoid alcohol within ideally 3 hours of going to bed. You may think it will help but alcohol actually disrupts our sleep cycles and can cause us to wake abruptly due to headache or dehydration and it even relaxes our throat muscles which can lead to snoring or sleep apnea. Consider settling down, relaxing and destressing about an hour before bed. You can try meditation guided imagery or gentle music and again ideally no screens within 30 minutes to 2 hours of that time. If you have a lot on your mind or perhaps, you're stressing out about how the things you need to do the next day, keep a notebook by the bed and write everything down.

This way you can get it out of your head, clear your mind and focus on restful sleep. Also, if you find yourself awake in bed for up to 20 minutes don't stay in bed remember you don't want your brain to associate bed with restlessness. Get up and do something boring. I've heard of people who read the backs of shampoo bottles again with low or no light until you feel sleepy. Again, some people have success with reading a real book mind you not a screen. But for others this can just make things worse. You can also practice deep breathing taking up to 6 to 8 seconds for the inhale, hold and exhaling can divert our focus to the breath and help us to settle into a calmer state. Finally trying not to go to bed with 2 full of a stomach.

This can sort of distract our body from what it needs to do to get us to sleep as some of its focus is done on digestion instead. Not to mention for some this can lead to an increase of symptoms such as heartburn and indigestion. We also want to make sure we're not trying to go to sleep on an empty stomach. It can be hard to sleep when we're hungry.

There is absolutely a happy medium and you'll figure out what that is for you. A lot of it will come down to how you structure your meals throughout the day which your dietitian can help with if you have any questions. Speaking of daytime, another big area to think about for better sleep is actually how do we spend our waking hours. We can set ourselves up for better sleep by thinking about doing a few things differently during the day. Make sure to get enough exposure to sunlight, get outdoors or when that's not an option keep your blinds or shades open or even the window itself weather permitting. This can help us stay more alert during the day and help our body recognize that when it is dark it is time to sleep. It can be especially helpful to increase our sun exposure in the afternoon and evening hours as this helps boost melatonin production which helps us sleep. Use your bed only for sleep and sex even outside of bedtime. So ideally not being on our phone in bed for any reason, not watching TV while in bed, not eating in bed, or even reading in bed. This helps our brain to understand that when our body is in bed it's time for sleep. Yeah, most of us love a good nap however keeping naps to 20 to 30 minutes tops can help keep us ready for sleeping at night. They can also improve our alertness and our mood without putting us into a deep sleep which can make us groggy or more tired to wake up from and if you are a frequent napper, it is good to try and keep it at a specific time each day just like we wanna try and do with our sleep wake cycle at night.

If you struggle with getting up at night to go to the bathroom, try to get all your fluids in earlier in the day and taper it down towards the evening. Believe it or not making sure to stay physically active and keep our bodies moving throughout the day can help make sure we are ready for rest when our head hits the pillow. On the flip side if we get too much exercise or intense exercise shortly before bed this can make it harder to fall asleep too. Try to get those intense workouts in earlier in the day. Hopefully you heard at least one strategy to try that can help you sleep better and feel better. I hope this was helpful and I wish you sweet dreams.