Sleep

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    For some women, a connection may exist between poor sleep and hormones

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    Original Post | Washington Post Health

    By Leigh WeingusSeptember 18, 2021 at 9:00 a.m. EDT

    I’ve struggled with sleep since I was a teenager, and have spent almost as long trying to fix it. I’ve absorbed countless books and articles on getting better sleep that instructed me to go blue-light free at least two hours before bedtime, take nightly baths to lower my body temperature, keep my phone far from my bedroom and avoid caffeine after 12 p.m.

    In between all my diligent sleep hygiene work, I couldn’t help but feel like there was a larger force at play. My sleep seemed to change throughout my menstrual cycle, for example, getting worse in the days before my period and significantly better afterward. When I was pregnant, I experienced the best sleep of my life, and when I stopped breastfeeding, I didn’t sleep for days.

    Hormones and Women Sleep

    I finally started to ask myself: When we talk about getting better sleep, why aren’t we talking more about hormones?

    According to the National Sleep Foundation, the lifetime risk of insomnia is 40 percent higher for women than it is for men. Blaming this discrepancy entirely on hormones oversimplifies it — women also tend to take on the bulk of household worrying and emotional labor, and they tend to experience higher levels of anxiety.

    But according to Mary Jane Minkin, an obstetrician-gynecologist and clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale School of Medicine, anecdotal evidence and studies suggest that hormones likely play a role.

    If you look at the curve of hormonal secretion throughout the average menstrual cycle, Minkin says, you’ll see varying levels of estrogen and progesterone throughout the month, with a big drop of estrogen occurring right before menstruation.https://414a56c8c82860bb2b57ff47754d945d.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

    “Many people will tell me that a day or two before their period, their sleep is terrible,” Minkin says.

    When a woman enters perimenopause, she starts to experience more fluctuations and produces less estrogen and progesterone throughout the month, which may wreak havoc on her sleep. The true correlation between these hormone dips and fluctuations and insomnia needs to be studied more extensively, Minkin and other experts say, and understanding this connection is confused by how a lack of estrogen is associated with hot flashes, which can disrupt sleep.

    Studies of women on hormone replacement therapy (HRT) and sleep strongly suggest a connection between female hormones and insomnia, Minkin and other experts say.

    HRT is often prescribed to women going through menopause (and the years after it) to help them deal with unpleasant side effects of that transition, which include sleep problems, Minkin says. Some types of HRT include only estrogen, while others have a combination of estrogen and progesterone. High levels of estrogen and progesterone occur naturally during pregnancy, which may explain why some pregnant women like me often experience blissful sleep, Minkin says.

    “During pregnancy, guess what? Your levels of estrogen and progesterone are very high,” Minkin says.

    Although postmenopausal women have very low levels of estrogen and progesterone, once the process of menopause is complete, they often begin to sleep better. “We think hormone fluctuations can be more bothersome to some women than their actual hormone levels,” Minkin says.

    She adds that if a postmenopausal woman does struggle with insomnia, low hormone levels could be the culprit, so it’s a good idea to talk with a medical professional about HRT options. A 2008 randomized, controlled study of some 2,000 postmenopausal women in the United Kingdom found “small but significant” improvements in sleep after a year of HRT vs. those taking a placebo.

    Hadine Joffe, a psychiatry professor who is executive director of the Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital at Harvard, says hormonal fluctuations may be a cause of insomnia for some women. But for others, she says, sleep disruptions might be anxiety-related, or caused by noisy neighbors or a snoring bed partner.

    She says that while some women experience amazing sleep during pregnancy, many others report terrible insomnia during that time of life. Her advice? If you want to figure out whether any connection exists for you, track it.

    “Try a [sleep] app or even a conventional sleep diary,” Joffe says. “If you track your sleep for several months, you may start to notice a pattern emerge, like more waking in the middle of the night right before your period.”

    If you do notice a pattern, she says, that information may be helpful going forward.

    “If you know there are two or three days in every month when you don’t sleep well, make sure that’s a time when you practice the best possible sleep hygiene, avoid alcohol, and if you have a partner you share family responsibilities with, you can ask them to get up with the baby or toddler,” Joffe says.

    Sometimes targeted treatment for those days can help, too, she adds. For example, supplementing with a few milligrams of melatonin before bedtime — the hormone our brains naturally produce in response to darkness — can help signal to the brain that it’s time to sleep. Or if you have a prescription for a sleep aid, this could be the time to use it, she says.

    While it’s not always possible due to work or family responsibilities, Kin Yuen, a sleep medicine specialist at Stanford Medicine, suggests trying your best to honor your natural daily hormone fluctuations to help keep your sleep on track. To do this, you’ll have to try to figure out when your body naturally releases cortisol (the hormone we produce in the morning that helps us wake up) and melatonin (the hormone we produce at night to help us fall asleep).

    By figuring out when you have the most energy — are you an “early bird” who wakes up full of energy, or a “night owl” who still feels sluggish at 9 a.m.? — you can better pinpoint when your body naturally releases these hormones. If you adjust your schedule to honor these rhythms, you may experience fewer sleep disruptions even in the face of constantly fluctuating female hormones, Yuen says.

    Finally, while HRT is not prescribed for women who have not yet gone through menopause, both Minkin and Joffe say that if someone is sure that their insomnia is hormone-related — preferably by having kept a diary for a while and after having tried other techniques without success — it’s worth talking to their doctor about taking a birth control pill.

    “Hormonal birth control can smooth out the ups and downs that just aren’t good for some people’s brains,” Joffe says. “It has to be the right treatment for the right person, but it can help.”

    Of course, there are side effects to birth control. Some women report nausea, headaches and lower libido. Although rare, more serious side effects have been reported, too, such as blood clots.

    But for many women suffering from what seems to be hormonally related insomnia, the benefits may outweigh the risks.

    Minkin says that even for patients going through menopause, if they are otherwise healthy, she’ll often prescribe birth control pills. Birth control pills have higher levels of hormones than traditional HRT, and if a woman has used them in the past and hasn’t experienced negative side effects, this can be a good indication that they will work well for her.

    “The only drawback is that we have no way of knowing when a woman is done with menopause, because the pill will artificially give her a period,” Minkin says. “So in order to find out if she’s done with menopause, she has to stop the pill.”

    At this point, Minkin and other experts say more research needs to be done to truly understand how the ebbs and flows of female hormones impact sleep.

    Sleep diaries, trackers and apps can be powerful tools to help a woman understand whether a connection exists for her, and they can help her act accordingly, the experts say.

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  • Uncategorized

    7 Midnight Snacks That RDs Say Can Help Lull You Back To Sleep

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    Original Post | Well + Good Food and Nutrition

    We’ve all had those nights where we inexplicably wake up in the middle of the night with a grumbling belly. Maybe it was that HIIT workout you braved for the first time, your marathon of meetings-slash-evening-errands that left you with little time to eat an adequate dinner, or maybe you were just dreaming about delicious pasta (the best type of reverie).

    While you could certainly go forth and eat gobs of Nutella straight from the jar—convenience and tastiness are both extremely key, after all—you don’t need to be an registered dietitian to conclude that the sugar content isn’t exactly a recipe for sound sleep the rest of the night. “High fat and high sugar foods like ice cream and cookies are a double whammy of not helping you sleep well, because fat takes a long time to digest,” says Dawn Blatner, RDN, author of The Superfood Swap. “Giving your gut foods that are difficult to digest distracts your body from sleep, and then sugar causes spikes and crashes of blood sugar and those will interrupt sleep, too.”

    Blatner also suggests avoiding alcohol since, even though your nightcap can make you feel sleepy, it will disrupt your sleep cycle later in the night and lead to lower quality sleep. Caffeinated teas or too much of anything liquid should also be consumed in moderation, she adds, as having to use the bathroom can keep you awake.

    So what should you eat if you’re in the mood for a mid-snooze nosh? Read on for these RD-approved suggestions for healthy midnight snacks that will help you get right back to your REM cycle.

    7 healthy midnight snacks that will help lull you back to sleep

    1. Tart Cherries

    “Tart cherries are a natural source of melatonin, a hormone that regulates the body’s internal clock and sleep-wake cycle,” says Blatner. If you can’t find tart cherries at the supermarket, she suggests opting for tart cherry concentrate, which is the super-charged version of tart cherry juice with two tablespoons packing in the equivalent of a whopping 60-plus cherries. Instead of guzzling it (remember that sugar and excessive amounts of liquid can keep you awake), create yourself a little ‘natural’ jello shot before bed. “All you do is mix two tablespoons of tart cherry concentrate with a tablespoon of chia seeds and chill it in the fridge. Try topping it with greek yogurt to combat the tartness,” Blatner says.RELATED STORIES‘I’m a Registered Dietitian, and This Is the One Food I Always…Why Snacking on Hemp Seeds Can Help You Sleep More Soundly

    2. Pumpkin Seeds

    “Pumpkin seeds are an excellent source of magnesium, and studies have found that magnesium improves insomnia and sleep efficiency,” says Blatner. Almonds, cashews, and peanuts are other good sources of magnesium that all make for ideal healthy midnight snacks.

    3. Cottage Cheese

    Cottage cheese contains the amino acid L-tryptophan. “Tryptophan plays a role in the production of serotonin, a neurotransmitter that’s associated with healthy sleep,” says Blatner. “Research has found people who ate cottage cheese about 30 minutes to an hour before going to bed experienced better metabolic health, muscle quality, and overall health than people who didn’t.”https://79dbc014217aa09ddae4500b65493fc3.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

    We know it’s no cheesy mozzarella pizza or ricotta cheesecake, but you can optimize your enjoyment of cottage cheese with a sprinkle of cinnamon (which has its own sleep benefits). “You can also try topping it with tahini or sunflower seed butter, which both contain tryptophan as well,” says Blatner.

    4. Warm Milk

    “New research suggests that the casein protein in cow’s milk interacts with trypsin, a digestive enzyme in the stomach, to produce a sleep-enhancing peptide complex called CTH, or casein tryptic hydrolysate,” says Blatner. “The added vitamin D in milk may also play a role in maintaining healthful sleep.”

    5. Kiwi

    “Research suggests that the antioxidants and natural serotonin in kiwis can improve both sleep quality and quantity,” says Blatner. Kiwis are naturally sweet and delicious as-is, but you can jazz them up by lightly dipping them in dark chocolate. “Dark chocolate has magnesium, a helpful sleep mineral, but it also has a little caffeine, so go easy on it.”

    6. Banana with Peanut Butter

    “Foods that contain unsaturated fats, like peanut butter, can help improve serotonin levels and boost satiety to keep you feeling satisfied and full during sleep,” says Carissa Galloway, RDN, a nutrition consultant at Premier Protein. “Eating bananas with peanut butter can also be helpful before bed, as bananas contain magnesium which, as mentioned, help support good sleep.” The combination of bananas plus peanut butter makes for one of the most delicious healthy midnight snacks out there.

    7. Chamomile Tea

    “There are numerous studies that support the benefits of chamomile tea in promoting a healthy nighttime routine,” says Galloway. Chamomile tea contains flavonoids, which are compounds found in certain foods, including one called apigenin. “Apigenin connects with receptors in our brains to help reduce insomnia and promote a state of steady sleep.”

    So when you find yourself wide awake in the wee hours, sip a cup of chamomile tea with a splash of steamed almond milk, or have a batch of Blatner’s chamomile cookies on hand.

    All that said, bear in mind that more important than what you eat before bed, is the amount. “Having a large amount of any food will take too much effort for your body to digest instead of resting,” says Blatner. A light nosh of one of the foods recommended here, on the other hand, will send you right into the sweetest of dreams.

  • Uncategorized

    The Effects of Sleep Deprivation on Your Body

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    Original Post | Healthline May 15 2020

    The following is a fantastic article describing the effects of sleep deprivation on your body, broken down by system. Medically reviewed by Stacy Sampson, D.O., Family Medicine — Written by Stephanie Watson and Kristeen Cherney on May 15, 2020

    If you’ve ever spent a night tossing and turning, you already know how you’ll feel the next day — tired, cranky, and out of sorts. But missing out on the recommended 7 to 9 hours of shut-eye nightly does more than make you feel groggy and grumpy.

    The long-term effects of sleep deprivation are real.

    It drains your mental abilities and puts your physical health at real risk. Science has linked poor slumber with a number of health problems, from weight gain to a weakened immune system.

    Read on to learn the causes of sleep deprivation and exactly how it affects specific body functions and systems.

    Causes of sleep deprivation

    In a nutshell, sleep deprivation is caused by consistent lack of sleep or reduced quality of sleep. Getting less than 7 hours of sleep on a regular basis can eventually lead to health consequences that affect your entire body. This may also be caused by an underlying sleep disorder.

    Your body needs sleep, just as it needs air and food to function at its best. During sleep, your body heals itself and restores its chemical balance. Your brain forges new thought connections and helps memory retention.

    Without enough sleep, your brain and body systems won’t function normally. It can also dramatically lower your quality of life.

    A review of studies in 2010Trusted Source found that sleeping too little at night increases the risk of early death.

    Noticeable signs of sleep deprivation include:

    Stimulants, such as caffeine, aren’t enough to override your body’s profound need for sleep. In fact, these can make sleep deprivation worse by making it harder to fall asleep at night.

    This, in turn, may lead to a cycle of nighttime insomnia followed by daytime caffeine consumption to combat the tiredness caused by the lost hours of shut-eye.

    Behind the scenes, chronic sleep deprivation can interfere with your body’s internal systems and cause more than just the initial signs and symptoms listed above.

    Central nervous system

    Your central nervous system is the main information highway of your body. Sleep is necessary to keep it functioning properly, but chronic insomnia can disrupt how your body usually sends and processes information.

    During sleep, pathways form between nerve cells (neurons) in your brain that help you remember new information you’ve learned. Sleep deprivation leaves your brain exhausted, so it can’t perform its duties as well.

    You may also find it more difficult to concentrate or learn new things. The signals your body sends may also be delayed, decreasing your coordination and increasing your risk for accidents.

    Sleep deprivation also negatively affects your mental abilities and emotional state. You may feel more impatient or prone to mood swings. It can also compromise decision-making processes and creativity.

    If sleep deprivation continues long enough, you could start having hallucinations — seeing or hearing things that aren’t really there. A lack of sleep can also trigger mania in people who have bipolar mood disorder. Other psychological risks include:

    You may also end up experiencing microsleep during the day. During these episodes, you’ll fall asleep for a few to several seconds without realizing it.

    Microsleep is out of your control and can be extremely dangerous if you’re driving. It can also make you more prone to injury if you operate heavy machinery at work and have a microsleep episode.

    Immune system

    While you sleep, your immune system produces protective, infection-fighting substances like antibodies and cytokines. It uses these substances to combat foreign invaders such as bacteria and viruses.

    Certain cytokines also help you to sleep, giving your immune system more efficiency to defend your body against illness.

    Sleep deprivation prevents your immune system from building up its forces. If you don’t get enough sleep, your body may not be able to fend off invaders, and it may also take you longer to recover from illness.

    Long-term sleep deprivation also increases your risk for chronic conditions, such as diabetes mellitus and heart disease.powered by Rubicon Project

    Respiratory system

    The relationship between sleep and the respiratory system goes both ways. A nighttime breathing disorder called obstructive sleep apnea (OSA) can interrupt your sleep and lower sleep quality.

    As you wake up throughout the night, this can cause sleep deprivation, which leaves you more vulnerable to respiratory infections like the common cold and flu. Sleep deprivation can also make existing respiratory diseases worse, such as chronic lung illness.

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    Digestive system

    Along with eating too much and not exercising, sleep deprivation is another risk factor for becoming overweight and obese. Sleep affects the levels of two hormones, leptin and ghrelin, which control feelings of hunger and fullness.

    Leptin tells your brain that you’ve had enough to eat. Without enough sleep, your brain reduces leptin and raises ghrelin, which is an appetite stimulant. The flux of these hormones could explain nighttime snacking or why someone may overeat later in the night.

    A lack of sleep can also make you feel too tired to exercise. Over time, reduced physical activity can make you gain weight because you’re not burning enough calories and not building muscle mass.

    Sleep deprivation also causes your body to release less insulin after you eat. Insulin helps to reduce your blood sugar (glucose) level.

    Sleep deprivation also lowers the body’s tolerance for glucose and is associated with insulin resistance. These disruptions can lead to diabetes mellitus and obesity.

    Cardiovascular system

    Sleep affects processes that keep your heart and blood vessels healthy, including those that affect your blood sugar, blood pressure, and inflammation levels. It also plays a vital role in your body’s ability to heal and repair the blood vessels and heart.

    People who don’t sleep enough are more likely to get cardiovascular disease. One analysis linked insomnia to an increased risk of heart attack and stroke.

    Endocrine system

    Hormone production is dependent on your sleep. For testosterone production, you need at least 3 hours of uninterrupted sleep, which is about the time of your first R.E.M. episode. Waking up throughout the night could affect hormone production.

    This interruption can also affect growth hormone production, especially in children and adolescents. These hormones help the body build muscle mass and repair cells and tissues, in addition to other growth functions.

    The pituitary gland releases growth hormone throughout each day, but adequate sleep and exercise also help the release of this hormone.

    Treatment for sleep deprivation

    The most basic form of sleep deprivation treatment is getting an adequate amount of sleep, typically 7 to 9 hours each night.

    This is often easier said than done, especially if you’ve been deprived of precious shut-eye for several weeks or longer. After this point, you may need help from your doctor or a sleep specialist who, if needed, can diagnose and treat a possible sleep disorder.

    Sleep disorders may make it difficult to get quality sleep at night. They may also increase your risk for the above effects of sleep deprivation on the body.

    The following are some of the most common types of sleep disorders:

    To diagnose these conditions, your doctor may order a sleep study. This is traditionally conducted at a formal sleep center, but now there are options to measure your sleep quality at home, too.

    If you’re diagnosed with a sleep disorder, you may be given medication or a device to keep your airway open at night (in the case of obstructive sleep apnea) to help combat the disorder so you can get a better night’s sleep on a regular basis.

    Prevention

    The best way to prevent sleep deprivation is to make sure you get adequate sleep. Follow the recommended guidelines for your age group, which is 7 to 9 hours for most adults ages 18 to 64.

    Other ways you can get back on track with a healthy sleep schedule include:

    • limiting daytime naps (or avoiding them altogether)
    • refraining from caffeine past noon or at least a few hours prior to bedtime
    • going to bed at the same time each night
    • waking up at the same time every morning
    • sticking to your bedtime schedule during weekends and holidays
    • spending an hour before bed doing relaxing activities, such as reading, meditating, or taking a bath
    • avoiding heavy meals within a few hours before bedtime
    • refraining from using electronic devices right before bed
    • exercising regularly, but not in the evening hours close to bedtime
    • reducing alcohol intake

    If you continue to have problems sleeping at night and are fighting daytime fatigue, talk to your doctor. They can test for underlying health conditions that might be getting in the way of your sleep schedule.

  • Sleep Health

    Diabetics who sleep badly are at greater risk of dying prematurely, study suggests

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    Original Article | CNN Health By Sandee LaMotte, CNN

    (CNN)People with diabetes who had trouble falling or staying asleep were 87% more likely to die of any cause over the next nine years than people without diabetes or sleep problems, a new study finds.

    Poor sleep linked to weight gain in 2-year smartphone sleep tracking studyKnutson and her team also compared people with diabetes who slept well to people with the condition who often experience poor sleep.”People with diabetes who slept badly were 12% more likely to die over a nine-year followup period than people with diabetes who slept without frequent sleep disturbances,” Knutson said.The study is the first to look at the combination of diabetes plus sleep disturbances and mortality risk, she added.

    Known link between diabetes and sleep problems

    A study of this type can only show association and not causation, said sleep specialist Dr. Raj Dasgupta, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California, who was not involved in the research.Enter your email to subscribe to the Results Are In Newsletter with Dr. Sanjay Gupta.“close dialog”

    Sign up for the Results Are In NewsletterGet the latest expert advice to live
    a healthier and happier life
    Sign Me UpNo, ThanksBy subscribing you agree to ourPrivacy PolicyWhile the study’s findings are disturbing, he said, they are not surprising.”Diabetes is a deadly disease and it can be easily affected by sleep — or the other way around,” Dasguta said. “Are you getting poor sleep because your diabetes is poorly controlled or is the poor sleep making your diabetes worse?”For example, Dasgupta said, people with Type 2 diabetes, the most common type, tend to be overweight and may suffer from obstructive sleep apnea, when throat muscles relax and close the airway, thus disrupting sleep.

    Get better sleep by cuddling up with your partner“People with Type 2 diabetes are also predisposed to kidney issues and make multiple trips to the bathroom in the night because they’re always urinating, especially if their diabetes is poorly controlled,” he added. “They can also have damage to blood vessels which causes leg pain called neuropathy, and It’s hard to go to sleep because of that pain.”It’s also possible that poor quality sleep may impact the body’s ability to regulate blood sugars, thus contributing to the development of diabetes, Knutson said.”There’s experimental work which shows that if you take healthy people and disturb their sleep you see impairments in insulin sensitivity,” she said. “There could be a bidirectional association between the two, so if you have sleep issues for a long period of time it may actually lead to the development of diabetes.”

    What to do?

    Acknowledge and tackle your sleep problems, regardless of whether or not you have diabetes, Knutson said. Sleeping poorly is a risk factor for premature death from any cause all by itself.

    Sleep hygiene: 8 ways to train your brain for better sleep“If you usually have trouble falling or staying asleep, you need to talk to a physician and really get at the root of the problem. Find out why aren’t you sleeping well and then figure out how to fix it,” she said.Want some tips for better sleep? SIGN UP FOR CNN’s SLEEP, BUT BETTER newsletterIf you have diabetes, “treat your diabetes — that’s the take home message from this study,” Dasgupta said.”Diabetes is something that needs to be managed by your primary care doctor and endocrinologist.”If you’re not sleeping well, it may be harder to manage your diabetes, Knutson said.Get CNN Health’s weekly newsletter

    Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.”It’s not easy to do and then if you’re sleep deprived, maybe you’re just not as good at remembering to take your medication or measure your blood sugars,” she said.A sleep specialist may also need to do a sleep study to see if you have an underlying sleep disorder, Dasgupta said.”When you tell me someone’s waking up quite a bit and they have diabetes, I may not only do need to treat the diabetes, I need to treat sleep apnea or restless leg syndrome or another sleep issue,” Dasgupta added. “Don’t hesitate to get the help you need.”

  • Sleep Health

    Make Disease Disappear With Sleep

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    Sleep is one of the most undervalued components of our health – if we can improve the quality of our sleep, we can improve the quality of our lives.

    Getting more sleep improves every aspect of our lives – it makes us less prone to injury when we exercise, boosts our productivity and enhances our ability to lose weight. Yet so many of us struggle to get a good night’s sleep and wake up feeling refreshed.

    Can sleep help make a disease disappear?

    Dr. Rangan Chatterjee thinks you can. Often referred to as the doctor of the future, Rangan is changing the way that we look at illness and how medicine will be practiced in years to come. He highlighted his methods in the groundbreaking BBC TV show, Doctor In The House, gaining him much acclaim from patients, his contemporaries and the media.

    His own journey of learning was accelerated when family members fell ill and now Rangan is helping people to take control of their health by addressing the root causes of their illnesses, something which is often not achieved in 21st century health care, evidenced by a steady increase in the rates of chronic disease.

    Follow his blog for more information at: https://drchatterjee.com/how-to-get-a-good-nights-sleep-the-very-best-tips-on-sleep/