Get Your Zzzzzzzz

Tools for success

• Recognize factors that can disrupt natural sleep cycles and lead to obesity and chronic diseases
• Identify sleep habits that can improve your sleep and contribute to long term weight management

There’s Nothing Like a Good Night’s Sleep

Sleep provides restorative functions like muscle growth, tissue repair, and protein synthesis. Sleep leaves us feeling refreshed and energized, restores us physically and mentally, and enhances our productivity. According to the National Sleep Foundation, adults need between seven and nine hours of sleep.1 But two-thirds of American adults say they rarely get a good night’s sleep on weeknights, averaging less than 7 hours. Many experience sleep problems such as snoring, waking in the night, waking up too early, or feeling unrefreshed when they get up in the morning. This isn’t just a problem of daytime sleepiness: poor sleep takes a toll on our bodies, contributing to obesity, diabetes, high blood pressure, and heart disease.

How Could a Sleep Deficit Contribute to Obesity?

• Short sleep is associated with changes in the hormones that work to keep appetite and satiety in check. Leptin, a hormone which suppresses appetite, decreases with short sleep. Ghrelin, a hormone which stimulates appetite, increases with inadequate sleep. This disruption to our hormones leads to overeating and weight gain.
• Habitual short sleep leads to more waking hours with extra time to consume more calories.

Sleep Fundamentals

Sleepiness is regulated by our physiological need for sleep and the body’s circadian rhythm. Most people feel sleepiest from midnight to 7 am. But many factors can disrupt our natural sleep cycles including:

• Caffeine
• Nicotine
• Alcohol
• Sleep disorders like obstructive sleep apnea or restless leg syndrome
• Hormonal issues causing night time hot flashes
• Psychological disorders and depression
• Exercise too close to bedtime
• Large meals and/or excessive fluid intake too close to bedtime
• Chronic pain
• Medications such as decongestants, steroids, and beta blockers
• Disruptions in the environment such as noise, lighting, and uncomfortable temperatures
• Lack of exposure to daytime sunlight
• Work schedules that require overnight shifts

What Can You Do to Optimize Your Sleep?

Talk with your clinic staff about any issues that may be affecting your sleep:

• chronic or acute pain
• severe snoring or episodes when you briefly stop breathing or seem to be gasping for air
• restless legs
• getting up in the middle of the night to eat
• inability to fall asleep or to stay asleep
• night sweats or night time hot flashes

It’s also helpful to follow these sleep hygiene suggestions to promote a restful night’s sleep.8 Circle one suggestion from each section that you will sample this week.

Personal lifestyle habits

1. Establish a set time for going to bed and waking and keep those the same, even on weekends.
2. Avoid day time napping as much as possible. If you do take a nap, limit it to less than 30 minutes at least 3–4 hours before your bedtime.
3. Avoid caffeine, alcohol, and spicy or heavy foods for 2–3 hours before bedtime.
4. Exercise regularly but ideally not within 3 hours of bedtime.
5. Avoid drinking fluids after 8 pm to reduce the need to make bathroom trips during the night.

Arrange your sleep environment for maximum comfort

• Use comfortable bedding that is the correct weight for the season.
• Keep your bedroom at a comfortable temperature, not too hot or too cold. Most people sleep best in a moderately cool room.
• Block out as much noise and light as possible. This may require the use of ear plugs or “white noise machines” and room darkening shades.
• Reserve television viewing and computer work for other rooms as the bright light emitted from these screens is known to disrupt sleep patterns.
• Consider placing your pet in its own bed next to yours. Their movements or pet dander may be disrupting your sleep.

Bedtime Routines

• Avoid the use of lighted technology devices (computers, tablets, smartphones, etc.) for 1 hour before bedtime.
• Practice relaxation techniques 15–30 minutes before bedtime. Take a bath or do yoga or deep breathing exercises.
• If worries about your daily life keep you from falling asleep or plague you in the middle of the night, keep a pad of paper and a lighted pen on your nightstand. Use this to write down your concerns or thoughts when you can’t sleep.
• If you wake up and can’t fall back asleep within 20 minutes, get up and go into another room. Do not turn on bright lights. Sit quietly in a chair, take a bath, or do a quiet activity. Do not watch television or do challenging activities. Try going back to sleep after 30 minutes.

Key Goals

Using the tips in this module, develop 2–3 goals to work towards.

1. _________________________________________________

2. _________________________________________________

3. _________________________________________________

References

1. National Sleep Foundation. How Much Sleep Do We Really Need? www.sleepfoundation.org/article/how-sleep- works/how-much-sleep-do-we-really-need. Accessed 3.19.13

2. National Sleep Foundation. Annual Sleep in America Poll Exploring Connections with Communications Technology Use and Sleep. http://www.sleepfoundation.org/article/ press-release/annual-sleep-america-poll-exploring- connections-communications-technology-use- Accessed 3.18.13

3. US Department of Health and Human Services.

Healthy People 2020 - Sleep Health. http://www. healthypeople.gov/2020/topicsobjectives2020/overview. aspx?topicid=38 Accessed 3.19.13

4. US Department of Health and Human Services. Your Guide to Healthy Sleep. August 2011. http://www.nhlbi.nih.gov/ health/public/sleep/healthy_sleep.pdf Accessed 3.19.13

5. Kondracki, Nancy The link between sleep and weight gain. Today’s Dietitian. June 2012.

6. Taheri S et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass. PLoS Medic, Dec 2004;1(3):210-217

7. Spiegel K et al. Brief Communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med, 2004;141:846-850

8. Sleep Hygiene: Helpful Hints to Help You Sleep at the University of Maryland Medical Center (http://www.umm. edu/cgi-bin/printpage.cgi)

9. Breus M. How to Sleep Better (http://www.webmd.com/ sleep-disorders/guide/sleep-hygiene?print=true)

Additional Resources

• Sleep-Wake Cycle: Its Physiology and Impact on Health. National Sleep Foundation 2006 www.sleepfoundation.org

• Vorona RD et al. Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. Arch Intern Med, Jan 2005;165:25-30

• 2008 Sleep in America Poll: Summary of Findings. National Sleep Foundation 2008 www.sleepfoundation.org

• Patel SR et al. The association between sleep duration and obesity in older adults. International Journal of Obesity, Oct 2008, 1-10

• Vgontzas et al. Short sleep duration and obesity: the role of emotional stress and sleep disturbances. International Journal of Obesity, 2008;32:801-809

• Shaw JE et al. Sleep-disordered breathing and type 2 diabetes. A report from the International Diabetes Federation Taskforce on Epidemiology and Prevention. Diabetes Research and Practice, 2008,81:2-12

• Punjabi NM and Polotsky VY. Disorders of glucose metabolism and sleep apnea. J Appl Physiol, 2005,99:1998-2007

• Loube DI et al. Weight loss for obstructive sleep apnea: the optimal therapy for obese patients. JADA, 1994;94(11):1291-1295

• Tuomilehto HPI et al. Lifestyle intervention with weight reduction. Am J Respir Crit Care Med, 2009;179:320-327

• Kansanen M et al. The effect of a very low calorie diet- induced weight loss on the severity of obstructive sleep apnea and autonomic nervous function in obese patients with obstructive sleep apnea syndrome. Clin Physiol, 1998;18(14):377-385

• Treatment options for adults with obstructive sleep apnea. Education Bulletin from American Sleep Apnea Association. www.sleepapnea.org

OPTIFAST® Program materials may not be reproduced in any form without the prior permission of Nestlé Health Care Nutrition, Inc.

All trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland. ©2017 Nestlé. All rights reserved. OPTI-13952-1017