Sleep and Hormones
World Sleep Day was March 17th. Did you sleep well that night? How about last night? How often do you wake up in the morning saying “Wow, that was a great night’s sleep! I feel energized and ready to start my day?”
I treat people with hormone imbalance. That includes people with slowing metabolism, chronic fatigue, weight problems, diabetes and sleep.
Sleep and hormones, you ask?
Most of us spend weeks to months at a stretch without awareness of our hormones but the sleep hormone melatonin makes itself known when we experience jetlag. Yes, melatonin is the hormone that is famous for regulating sleep. It responds to darkness (which for eons, used to be sunset but these days only happens when we turn our home lights off or stop staring into bright digital screens). After our body realizes its dark outside, melatonin starts making us sleepy over the next few HOURS. So, I end up explaining to my patients that the reason they can’t fall asleep as soon as they upload their last Instagram post is because melatonin starts entering the system generally 2-3 hours after darkness sets in. Here’s the kicker: Deepest sleep is meant to be around 2am in the animal kingdom, because melatonin (with many other hormones) take at least 6-7 hours after darkness to create deepest sleep. But wait, I shutoff my laptop at midnight and my alarm is set to wake me up at 7am- ummm, no wonder it’s so hard to wake up!!
That’s why modern folk often feel their sleep is not so refreshing, because their deepest sleep is getting compromised due to the artificial lighting that has hijacked our natural bedtimes. It’s like living with a little bit of jetlag every day.
“Fine, I will turn off my bright lights and gadgets three hours before bed. But I get hungry at night too. What about that?”
Great question! Melatonin has a bunch of comrade hormones that coordinate important tasks the body completes while we physically rest. Memory, immunity, fertility, growth, repair, dreams, metabolism: there are so many fantastic things the body is upto at night! The coordination between digestion, appetite and sleep is the responsibility of a hormone family called orexins. Sadly, the orexins are getting very confused these days by our chronic sleep deprivation and unnatural sleep patterns. If you pay attention to the plant and animal kingdoms, the rest of Nature (besides humans) still honors the laws of the Sun. Nature designed us to not be hungry or interested in food when it’s dark. Have you ever seen sparrows out under manmade street lamps, chirping and searching for seeds? Birds are cleverly sleeping!
We get more hungry than usual when our sleep hormone system gets hijacked by artificial lighting or even a few nights of poor quality sleep.
“Okay, okay- I will pay attention to my hunger signals. But I am trying to lose weight and this hunger is making things difficult.”
Great observation. If, for argument’s sake, I could create an identical twin of you, I could run this experiment. I’d let your identical twin have the exact same life and health parameters as you: except sleep. One twin with great sleep, one with not so great sleep. Then I would guide both of you towards some sensible lifestyle changes for weight loss. Science has shown that the twin with poor sleep would be less successful at weight loss efforts than the one with sound sleep. Why, you ask? Poor sleep is important to the body. Remember, most of the animal and plant kingdom (besides humans) sleeps well. The only time animals are restless at night is when they sense some natural danger, like an earthquake, a flood, or in those remarkable cases where pet dogs or cats have rescued their sleeping owners from fires or intruders.
“What does that have to do with weight gain?”
It has everything to do with it for humans who also developed an ability to protect themselves over the ages from invading enemy tribes, floods and predatorial animals in the jungle. If a human perceived danger in their environment, they stayed awake watching over and protecting their family.
Staying awake due to stress is a protective mechanism Nature gave us to survive and avoid disaster.
“So what? What does that have to do with weight gain? I’m not being attacked by invading armies!”
Think about it. Imagine you are living in the wilderness the way Nature designed your body to. Imagine you are faced with a forest fire, an invading enemy tribe, or an earthquake. How easy will it be to find/store food during those catastrophic times? Not so easy, right? So what does the body do during times of stress?
During times of Natural calamity, the human body slows metabolism down and avoids letting go of precious fat stores which will be the only source of energy for the indefinite uncertain risks ahead.
“But I’m not stuck in a flood or famine! There is plenty of food!”
Yup. But your poor sleep is giving a stress signal to your body. The body doesn’t know why you aren’t sleeping well. The software code is written for the stress hormone (cortisol) to avoid weight loss if sleep is bad. It can’t tell the difference between office stress and famine.
“Okay. I will improve my sleep however you say. But my problem is this bad relationship/financial situation/other life stress.”
Yup. The body is not familiar with dealing with stress that goes on for years. This is unnatural chronic stress. Generally, natural calamity or predatorial animals kept us stressed for shorter periods than modern day stress. Our bodies have not evolved to be immune to a constant sense of impending threat. These days we carry our “stress tigers” with us wherever we go and our physical health gets impacted.
“Great. So now what? I can’t just make myself sleep better and that won’t even solve my stress issue.”
Yup. This is where a multifaceted approach is needed. Solving sleep problems is necessary and possible. It often takes a series of small changes.
Here are some for starters.
- Build a sleep routine, and improve your sleep hygiene.
- Limit bright lights and screens for a few hours before bed.
- Switch to a book instead of a gadget!
- Relaxation rituals before bed can help.
- Pay attention to how eating heavy meals right before bedtime affects your sleep. Mindful eating doesn’t mean you “must stop eating after ___o’clock”. It means you get to decide. You are making changes for your own sake, so let the changes be on your terms. Get curious and try something different. If it feels good, you decide what’s next!
- Exercise regularly.
- Find a stress reduction technique. Meditation, journaling, creative outlets and self-help books are great ways to start getting in touch with what bothers us.
- If despite all these efforts
- You are sleepy all day
- You’re unrefreshed when you wake up
- You have loud snoring
- You wake up with choking episodes in the night
- Your spouse says your breathing stops/pauses for a few seconds and then you breathe with a long hard gasp
- You really need to get to your doctor and get tested for obstructive sleep apnea which is a serious health issue that needs medical attention.
- If you are really struggling with stress that you are unable to handle on your own, please ask for help. There are counsellors, therapists and psychologists who can help you find ways to cope. It’s not a sign of weakness, rather it takes strength and courage to admit you need help! Most of us were not taught in childhood how to handle stress, negative emotions or difficult relationships, and so it is really ok and important to get help when we need it.
If you want to talk to us about your sleep in more detail, we will be happy to help!
Dr Roshani Sanghani [M.B.B.S (Bom), MD Internal Medicine (American Board), Endocrinologist (American Board) Specialist in Diabetes, Weight, Thyroid,Hormones & Metabolism ]