One absolutely vital factor in weight loss that is often ignored—by both health professionals and by individuals—is sleep. It has been shown that it is much more difficult to lose weight without adequate sleep—and that the less you sleep, the more likely you are to gain weight—even when you are trying to lose it!
Excessive Daytime Sleepiness
Excessive Daytime Sleepiness or EDS is a real and a common problem—according to some estimates, it occurs in about 30% of the general public. It is associated with psychiatric, cardiometabolic, and sleep disorders, and is closely associated with depression, obesity, and sleep apnea. Obesity is also a major risk factor for EDS—and when people lose weight, the EDS can become “cured”.
One common cause of EDS—also associated with obesity—is sleep apnea, or the disruption of normal breathing patterns during the night. People with Obstructive Sleep Apnea (OSA) can fight to breathe during the night. Often, they wake up (slightly) many times as a result. These episodes of partially awake states disrupt the natural sleep cycles which consist of cycles of lighter and deeper sleep. As the end result, the person with OSA doesn’t get a good night of sleep and feels drowsy or fatigued during the day. Besides obesity, OSA is associated with high blood pressure and snoring.
Insomnia and a condition called narcolepsy can also cause EDS. Insomnia has many different causes, but indicates either trouble falling asleep or trouble staying asleep.
Obesity and Sleep
Not every overweight person has OSA and not every person with OSA is overweight. However, if you don’t get enough sleep, there are both physical and psychological reasons that make it more difficult to lose weight.
- Lack of sleep causes a slight increase in energy output, but also causes the body to store more energy as fat. In addition, lack of sleep disrupts the melatonin cycle. Melatonin is a hormone produced by the pineal gland in the brain and regulates sleep and wake cycles. With a disruption in the melatonin cycle, people tended to gain weight.
- The hormone ghrelin tells your brain and body that it is time to eat. Ghrelin levels increase along with prolonged sleep deprivation
- The hormone leptin works to oppose ghrelin—leptin tells your body and your brain that you have had enough to eat—time to stop! Prolonged lack of sleep decreases the levels of leptin in your body.
- These two hormones normally work together to maintain a healthy appetite and body weight. Since lack of sleep increases ghrelin while decreasing leptin, this results in a true “double whammy”!
- Especially in the adrenal body type, but true in all body types, a lack of sleep can cause a spike in the levels of the adrenal hormone cortisol—this is interpreted by your body as the signal to store more energy in the form of fat. Remember that cortisol is also known as the “fight or flight” hormone because of its effects on energy storage. Extra energy is needed whether you stay to “fight” whatever is chasing you and extra energy is needed to run away from whatever is chasing you.
- Other studies have shown that lack of sleep disrupts overall metabolism. Lack of sleep effects various hormones and tends to increase appetite, change energy balance, increase insulin resistance and increase fat cell volume. It is as if the lack of sleep “resets” the metabolism towards increased fat storage and decreased effective use of those energy stores., 
- In addition to changes in metabolism, a constant feeling of fatigue or sleepiness cause you to become more depressed, more irritable and less able to stick to a healthy diet plan OR a healthy exercise plan.
- Depression and irritability are catalysts for over-eating and eating “comfort food”. And as you probably already know, most comfort foods are not part of a healthy diet! Common comfort foods to avoid include high-carbohydrate snacks such as cookies, cakes, breads, ice cream, chips and dips, fast foods, candy and chocolate—an all-time, all-around favorite!
- A tired brain and mind does not make good decisions. One study showed that those who were sleep deprived were more likely to choose high-fat and/or high carbohydrate snacks over healthy snacks. Another study showed changes in brain patterns after sleep deprivation that increased the desire for unhealthy snacks.
Tips for Getting a Better Night’s Sleep
There are a number of ways to help yourself get a better night’s sleep.
- Cut off any and all electronics an hour before you want to go to sleep. The reason for this is that the lights and sounds from various gizmos, gadgets and entertainment devices are stimuli, which will tend to keep you awake and alert. Our bodies naturally follow the daily cycle of sunrise and sunset. Instead of electronic stimulation, try reading a book, playing a board game, working on a crossword puzzle or mind game, listen to soft music or have a quiet conversation. You can also try a warm shower or bath about an hour before bedtime.
- Keep all lights (inside and out) out of the bedroom. If there is an outside street light that shines into your room, get curtains that block it out. If you live in a noisy neighborhood, consider using some “white noise” such as a babbling brook, the ocean or the sound of quiet birds chirping to overcome outside noise.
- Avoid heavy snacks, eating and especially sugar close to bedtime… Most weight-loss coaches recommend no food after dinner or at least 3-4 hours before bed.
- Create a “going-to-bed” ritual—the same idea that you may have used to get your kids to go to sleep at a reasonable hour. The ritual can be a shower or bath, meditation, a relaxing yoga stretch or a time to curl up with a good book.
Eating right and getting some exercise are the obvious approaches to a healthy weight—but remember the not-so-obvious and just as important “sleep well” and “relax well” too! Remember, good health comes from daily decisions. Don’t get bogged down if you have a lot of changes to make. Just focus on one day (or one meal or one hour) at a time. . . and celebrate your successes by noticing the way you feel. For just today, drink more water, consume more vegetables, get some daily exercise, and a goodnight’s sleep and if you can meditate for a few minutes that’s great too. And tomorrow when you wake up, try to do it again… for just “today”. Remember, YOU have the power to transform your health … ONE healthy choice at a time!
-  Fernandez-Mendoza, Julio, et al. “Natural history of excessive daytime sleepiness: role of obesity, weight loss, depression, and sleep propensity.” (2015).
-  Markwald, Rachel R., et al. “Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain.” Proceedings of the National Academy of Sciences 110.14 (2013): 5695-5700.
-  Schmid, Sebastian M., Manfred Hallschmid, and Bernd Schultes. “The metabolic burden of sleep loss.” The lancet Diabetes & endocrinology 3.1 (2015): 52-62.
-  Moraes, Danilo Alves, Daniel Paulino Venancio, and Deborah Suchecki. “Sleep deprivation alters energy homeostasis through non-compensatory alterations in hypothalamic insulin receptors in Wistar rats.” Hormones and behavior 66.5 (2014): 705-712.
-  Cain, Sean W., et al. “Enhanced preference for high-fat foods following a simulated night shift.” Scandinavian journal of work, environment & health 41.3 (2015): 288-293.
-  St-Onge, M. P., et al. “Sleep restriction increases the neuronal response to unhealthy food in normal-weight individuals.” International journal of obesity 38.3 (2014): 411-416.