Sleep is an essential part of our lives; from finding ways to avoid it as young children to longing for just a few more hours as adults. From finding ways to avoid it as young children to longing for just a few more hours as adults, sleep is an essential part of our lives. Over the last decade, there have been a vast amount of studies conducted on sleep deprivation and the effects it may have. Early findings demonstrated sleep deprivation to have an effect on memory, attention span, mood, learning, and loco motor skills. More recently, there has been a shift in how it harms our physical health, more specifically the worsening of or causing different disease states and conditions. For example, sleep deficiency and deprivation has been linked to diabetes, high blood pressure, and obesity to name a few.

Sleep Deprivation

According to the National Institutes of Health (NIH), sleep deprivation can be defined as a condition that occurs if one does not receive adequate sleep. Sleep deficiency is a broader term defined as not getting enough needed sleep, sleeping out of one’s body’s sync (circadian rhythm), not sleeping well throughout the night, or having a sleep disorder that prevents one from getting quality sleep.¹ Currently, the National Sleep Foundation recommend 7-9 hours of sleep per night for adults aged 18-64 years.³ They also state that less than 6 hours of sleep may compromise one’s health and well-being.³ Sleep deprivation is a common health problem in the United States and people of all age groups report not getting enough sleep.¹ In fact, the Centers for Disease Control and Prevention claim that about 7-19 percent of adults in the United States reported not getting enough sleep everyday.¹ The NIH explains that “sleep deficiency is linked to many chronic health problems, including heart disease, kidney disease, high blood pressure, diabetes, stroke, obesity and depression.” One of the greatest areas of concern found across over 10 different published scientific articles is the link between sleep deprivation and weight gain.

The Effects Of Partial Sleep Deprivation On Energy Balance

Recently, an article published by the European Journal of Clinical Nutrition titled The Effects Of Partial Sleep Deprivation On Energy Balance: A Systematic Review and Meta-Analysis provided results and conclusions that were drawn from a collection of sleep-related trials and studies. Meta-analyses and Systematic Reviews, such as the one conducted in this article, have the highest level of evidence and clinical use. This is because their conclusions are drawn from several randomized controlled trials. Systematic reviews are used to grant FDA-approval on many medications. In addition, they can be used to develop clinical guidelines used by health care professionals for patient-related decision-making.

The main objective of the study was to investigate whether short sleep duration causatively contributes to weight gain. There has been much conflict in studies examining the effect of partial sleep deprivation (PSD) on energy balance components.² The main goal of the study was to conduct a systematic review and meta-analysis of sleep intervention studies assessing the effect of PSD on energy intake (EI) and energy expenditure (EE).² EI and EE are fundamental factors in assessing and tracking weight gain or loss.²

One of the eleven randomized trials used in the systematic review and meta analysis was titled Eating Decisions Based on Alertness Levels after a Single Night of Sleep Manipulation. This trial found a relationship between change in sleep behavior and feeding behavior.³ There were fifty young, healthy participants that had their amount of time in bed changed by 60-130% compared to normal. The results showed a statistically significant increase in total caloric consumption as well as a greater number of calories consumed from less healthy food.³ Both the participants and investigators rated the foods that would be considered “less healthy”. In addition, decreased objective alertness was associated with less healthy food choices and the consumption of more food from caloric-dense items.³ This study is just one of several that shows how people experiencing even moderate sleep loss may be more willing to eat “unhealthy” foods. It also showed how the sleep-deprived may prefer food that is dense in calories. Both of these findings were statistically significant.³

Trials and Research

The Effects Of Partial Sleep Deprivation On Energy Balance: A Systematic Review and Meta-Analysis used trials and research from EMBASE, Medline, Cochrane CENTRAL, Web of Science and Scopus. Seventeen studies were included into the review and eleven of these into the meta-analyses.² After extrapolating data from the eleven studies, the meta-analyses showed that Energy Intake (EI) was significantly increased by 385 Kcal following partial sleep deprivation compared with those with normal sleep when all studies were taken into account.² The definition of short sleep duration varied greatly among studies including less than 4 hours in some studies to less than 8 hours in others.² All the studies had highly restrictive sleep schedules conducted in controlled laboratory conditions over a short period of time (1 day to 2 weeks).² The authors of the article conclude by stating “Our results propose that sleep may be a potential novel target for weight management in addition to physical activity and dietary management in the clinical setting.” The article also states that in the long term, this 385 Kcal daily increase can lead to weight gain. This weight gain can later lead to other health issues such as diabetes, high blood pressure and heart disease.

Using this information, patients can take action to either knowingly select healthier food when they are sleep deprived or, and maybe more importantly, make lifestyle changes to improve sleep quantity and quality. However, for many this is easier said than done considering our sleeping habits, like any habits, are hard to change. Research has also shown that the frustration caused by people trying to obtain adequate sleep but failing to do so can lead to less sleep in and of itself. For this reason, patients must make sure they understand what good sleep hygiene is and how to achieve it.  According to the National Sleep Foundation, “Sleep hygiene is a variety of different practices that are necessary to have normal, quality nighttime sleep and daytime alertness”.⁴ Some examples of practices that will improve sleep hygiene include avoiding stimulants (caffeine or nicotine) too close to bedtime, avoiding naps during the day, avoiding food before sleep, exercising regularly, establishing a regular/relaxing bedtime routine and lastly, associating your bed with sleep only.⁴ More examples and explanations can be found at the National Sleep Foundation website if patients are in need. If the healthy sleep hygiene practices are done correctly and they are still sleep deficient, patients should reach out to health care professionals for additional help.

From young children and teenagers to college students and parents, sleep is a necessity. Our understanding of the importance of adequate sleep has reached new levels from how it hinders our memory or concentration to more health-specific topics such as weight gain. By using scientific published trials to prove a causal relationship between sleep deprivation and harmful effects to one’s body and having resources for improving sleep hygiene, we can hopefully expect patients to be less sleep deprived. As patients and health care professionals learn about sleep deprivation and more research is released perhaps we can see sleep increase in value and importance on a national scale. As for those individuals trying to reach certain calorie intake goals, they should keep in mind that, at least in this particular case, if you don’t snooze you lose.

References

1. National Institute of Health: Topics – Sleep Deprivation and Deficiency (SDD). Feb 2012. https://www.nhlbi.nih.gov/health/health-topics/topics/sdd

2. Al-Khatib HK, Harding SV, Darzi J, et al. The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. Eur J Clin Nutr. 2016 Nov 2 doi: 10.1038/ejcn.2016.201

3. Pardi D, Buman M, Black J, et al. Eating Decisions Based on Alertness Levels after a Single Night of Sleep Manipulation: A Randomized Clinical Trial. 2016 Oct 20. Pii: sp-00425-16

4. Thorpy, M. National Sleep Foundation. Sleep Hygiene Sept 2003

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