• Lose weight with sleep!

    BabySleepBy Dr. Micaela Wexler

    Are you overweight? Are you getting enough sleep?

    As I was getting ready to plan my New Year weight loss strategy, I was thrilled when I entered the words sleep and obesity in Google and found countless articles showing that lack of sleep, as in less than seven hours a night, leads to increase in weight.

    Leptin – the “obesity hormone”

    Leptin is a hormone made in the fat cells, secreted into the blood stream. It lets your brain know you have enough energy to engage in activities that require energy. In other words, it stimulates your metabolism.

    When leptin levels go down, your brain thinks you are starving. Your vagus nerve (a rest and digest nerve) is stimulated making your appetite increase. Besides making you hungry, low levels of leptin put you at risk for food addiction.

    Lack of sleep makes leptin go down

    Sleep has been shown to affect the level of the hunger inducing hormone leptin secretion in children, and there is no reason to believe the same doesn’t happen to adults; sleep deprivation causes the decision making center of our brain to become less active, and leads to junk food cravings; sleep deprivation leads to decreased energy and motivation, which results in decreased exercising; sleep loss has a negative impact on metabolism, increasing the risk of obesity and diabetes.

    So, if people want to lose weight, instead of starving themselves or hitting the gym, why don’t they just SLEEP more?

    As a psychiatrist who listens to people complain of insomnia all day long, I can tell you it isn’t that easy. Many of my patients with sleep problems are also overweight.

    Sometimes the reasons people for insomnia are obvious: They have a small baby, they are depressed or anxious, they work nights, they are worried about debt or losing their jobs, they don’t have a job, they have a job but work too many hours (that would be me).

    Other times, the reasons are obvious to me and not to them: they have relationship conflicts, they are fighting with or attracted to someone at work, they are watching TV right at bedtime, they are sleeping with smart phones next to their heads and texting and posting all through the night. Some people just have bad sleep hygiene (again, that would be me).
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    Then there are the people with chronic insomnia who have medical issues preventing sleep, such as chronic pain, restless leg syndrome, obstructive sleep apnea, post traumatic stress disorder, severe mental illness, to name just a few.

    If you aren’t getting enough sleep, you first need to rule out any medical issues. A medical sleep evaluation includes a physical exam, a medical history, a sleep history and a screening for depression or anxiety.

    There are some things you can do in addition to your medical evaluation. Determine what your sleep hygiene is. Sleep hygiene consists of the activities you engage in during the two hours prior to bed time. Do you “work ’til you drop (like I do)? That will keep you up at night. You need to spend those two hours before bed time slowing things down. Don’t expect to fall asleep until at least two hours after you have stopped working. Find relaxing activities to do during that time, such as some stretching exercises followed by a bath. Get your clothes ready for tomorrow, regardless of whether or not you are planning on leaving the house. Plan what your day will be.

    A consistent daily schedule can lead to better quality of sleep according to a new study led by Natalie Dautovich, a psychologist at the University of Alabama at Tuscaloosa, published in the Journal of Gerontology: Series B. Adults under age 60 who went to sleep and ate dinner at about the same time every day fell asleep more quickly and woke up fewer times. Something as simple as going outside at the same time can lead to higher quality sleep.

    LoseWeightAnything you didn’t get done today, just put on the list for tomorrow. My feeling is this: if I didn’t get all my tasks done, it’s because I didn’t plan my day properly. Better luck tomorrow. I happen to work as a psychiatrist in a critically under served area, so I’m always going to have too much on my plate. That makes it easy for me to let myself off the hook, which I realize is not true for everyone.

    Let’s say you’ve dutifully done your sleep hygiene and you STILL can’t sleep. Something that helps me is to keep a small notebook by my bed and write down the thoughts which are racing through my head. If I forget to put the notebook and pen under the pillow, then my toddler tears my thoughts to shreds the next morning, but, nothing is perfect. That usually means that since I didn’t see her sneak up and get it, then I did get to sleep.

    I strongly recommend you use paper and pen rather than your smartphone. You will still be able to read it, even if you write in the dark. (Try it right now: close your eyes and write something with a pen.) And, your mind will be focused only on what you are writing, which is not possible with a smartphone.

    Writing these thoughts down will help you determine why you are not sleeping. You will be able to figure out if you have insomnia because you’re worried about work, or because you are depressed. If you find that you are writing thoughts that reflect hopelessness and doom, or that you are ruminating over the same things over and over again, or you have so many thoughts you can’t get them all written down, then you may need to see a psychiatrist or therapist. Or, both.

    If you go too many nights in a row with insomnia, despite your efforts, you should bring this up to your therapist or psychiatrist. Sleep disturbance can be a sign of depression. For people with bipolar disorder, decreased sleep is often an early clue that a person is at risk of a manic or mixed-manic episode.
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    The bottom line is that we have an important weight losing tool at our disposal: sleep. Maybe I’m just lazy by nature, but the way I look at it, before I start starving myself or start killing myself in the gym to lose weight, I think I’m going to start with something a little bit easier: sleep.

    Dr. Micaela Wexler provides child, adolescent and adult pscyhiatric services in Kansas.

    Please visit Wexler Family Psychiatry to schedule an appointment.
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    Logo Copyright Debby Bloom

    Categories: family psychiatry, obesity

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