How what you eat affects how you sleep

A study looked into how what you eat affects your sleep and found diet quality and influence sleep quality.

A recent study held by researchers from the Institute of Human Nutrition at Columbia University Medical Center in New York has found that a person's diet greatly affects the quality of sleep that they get.

"Our main finding was that diet quality influenced sleep quality," study leader Marie-Pierre St-Onge, PhD, assistant professor in the department of medicine and Institute of Human Nutrition at Columbia University Medical Center, said in a press release.

The study, published in the Journal of Clinical Sleep Medicine, found that a diet containing more saturated fat and more sugar and less fiber is linked to less restorative, disrupted sleep.

"It was most surprising that a single day of greater fat intake and lower fiber could influence sleep parameters," St-Ongeadded.

The study looked into the sleep quality of 26 adult participants (13 men and 13 women). These participants weighed normally and had an average age of 35. They were given controlled diets for four days and were given freedom to choose the food they want on the fifth day of the study.

The participants spent five nights in a “sleep lab,” spending 9 hours in bed from 10 p.m. to 7 a.m. They slept an average of 7 hours and 35 minutes every night. Participant sleep data were gathered every night using polysomnography. Moreover, the data were analyzed after three days of feeding on controlled diets and after the fifth night where the participants chose their own food.

The researchers found that, when a participant consumes more fiber and less sugars and less saturated fat,he/she will be spending more time in the stage of deep, “slow wave” sleep, which is more restorative. On the other hand, greater sugar intake was linked to a heightened number of arousals during sleep.

The researchers also found that the participants were able to sleep quicker when they ate the fixed meals, which had low amounts of saturated fat and higher amounts of protein compared to the meals the participants themselves selected. These fixed meals were provided by a nutritionist.

The participants, after eating the meals they selected on their own, were able to sleep an average of 29 minutes after consuming their food and drink. On the other hand, it took them only an average of 17 minutes to sleep after eating the meals provided by the nutritionist.

"The finding that diet can influence sleep has tremendous health implications, given the increasing recognition of the role of sleep in the development of chronic disorders such as hypertension, diabetes and cardiovascular disease," St-Onge said.

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How sleep impacts a person's health

This article explains how sleep can impact many factors of a person's overall health, such as dietary choices.

The mechanisms of sleep are only partially clear and remain the subject of intense research according to the National Sleep Foundation.

"Determining the specific amount of sleep that is sufficient for optimal health is difficult since it may vary depending on age of the individual, performance, co-existing health problems and life-style and environmental factors," said Dr. Lydia Kaume, nutrition and health education specialist, University of Missouri Extension.

As a guideline, Kaume says studies indicate getting enough sleep — 8 to 10 hours for adults — may provide significant long-term health benefits. About two-thirds of Americans lack enough sleep.

A 2011 National Sleep Foundation poll found that 43 percent of Americans between the ages of 13 and 64 say they rarely or never get a good night's sleep during the week. In addition, more than 60 percent report a sleep problem every night, including: snoring, waking in the night or waking up too early.

Researchers are also searching for links that demonstrate a relationship between sleep and its influence on individual dietary choices.

"Some studies have demonstrated that those who sleep less are more likely to consume energy-dense foods, including fats or refined carbohydrates, more likely to have more irregular meal patterns, and less likely to consume adequate amounts of vegetables," said Kaume.

A review published in Nutrition Research (April of 2012) shows these relationships. The studies show that foods most helpful in promoting sleep increased bioavailability of tryptophan and production of serotonin.

Tryptophan is an essential amino acid (the body cannot make it and has to be consumed in the diet), and is found in cheese, chicken, eggs, milk, peanuts, pumpkin seeds, sesame seeds, soy and tofu, turkey.

"Our bodies' body uses tryptophan to make serotonin, a neurotransmitter, a chemical that is thought to promote sleep and balanced mood, and multiple functions including effects on appetite and memory," said Kaume.

With regard to health, several studies support the link between sleep disturbances and immune function, and inflammation. Although these relationships are complex and unclear, sleep deprivation is known to result in increased levels of inflammatory markers, which then lead to further activation of the inflammatory cascade.

Studies have also shown associations between sleep disorders and in inflammatory bowel disease (IBD), a chronic immune-mediated inflammatory disease of the gastrointestinal tract.

"As more of such studies are published, it is becoming apparent that individuals need to consider taking action to ensure they sleep better to prevent health problems associated with sleep disturbances," said Kaume.

Most researchers agree that eliminating habits or foods that interfere with sleep would be a great way to deal with sleep problems. Here are some tips from several tips that may help you sleep better according to Kaume.

Avoid caffeine at least four-hours before bed time. Caffeine typically stays in the body for four to six hours and may decrease melatonin levels in the body.

Avoid alcohol before bed, although it may make individuals doze off easier, the sleep is shallow causes one to awake later in the night.

Avoid nicotine, and spicy meals may also be helpful as they interfere with sleep.

Keep a regular schedule and to your best to sleep at the same time every night.

Light sleepers may wear ear plugs.

Avoid liquids near bed time to avoid getting up needing to use the bathroom.

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Common issues that hurt your sleep

This article discusses common issues that hurt people's sleep, and tells you what to do about them.

You might remember a time when you could drift off to sleep in an instant and remain in a state of blissful slumber well past lunchtime the next day. Now your sleep is more likely to be lighter and more fitful, and when you wake up in the morning you don't always feel refreshed.

A lack of good-quality sleep could be a natural consequence of changing sleep-wake patterns after menopause. It's also likely that the issue is physical--and fixable. Many conditions can disrupt your rest, and they can be treated. It's important to address these issues. Lack of sleep does more than make you drowsy. Chronic insomnia has been linked to a variety of health problems, including obesity, high blood pressure, heart disease, diabetes and depression.

Go through this list to see whether you might have one of these sleep-stealing conditions. Also check your medicine cabinet. Some medications, including corticosteroids, beta blockers, cold and flu remedies, and certain antidepressants also can interfere with sleep.

1. Sleep apnea

The conventional image of sleep apnea is of the overweight man who snores, but women of any size can also develop these repeated pauses in breathing while they sleep.

"A woman who has a narrow jaw or a change in muscle tone can get apnea," says Dr. Julia Schlam Edelman, clinical instructor in obstetrics and reproductive biology at Harvard Medical School and author of "Successful Sleep Strategies for Women and Menopause Matters: Your Guide to a Long and Healthy Life." Either of these anatomical issues can block oxygen from reaching your lungs (and subsequently the rest of your body) while you sleep. Snoring might not be your main symptom if you do have sleep apnea, but you will notice that you're especially sleepy during the day.

Solution: See a specialist for a sleep study. You may be able to relieve apnea with a few lifestyle adjustments, such as sleeping on your side or losing weight. Your doctor might also suggest an oral appliance or a CPAP machine that blows air into your airways to keep them open at night.

2. Diet

What you eat can affect your sleep. Spicy foods can contribute to painful heartburn. Big meals leave you uncomfortably full, and over time can contribute to obesity--a well-known risk factor for sleep apnea. Too much caffeine could keep you wide awake, even if you finish your coffee in the morning.

"It takes six hours to clear half of the caffeine from your body. If you have enough caffeine, it's still in your body at 4 in the morning," says Dr. Edelman. And though a glass of wine or two with dinner will make you feel relaxed or even sleepy, it won't help you sleep. "You can fall asleep, but once you're asleep you can't sleep deeply," she says.

Solution: Eat dinner at least a couple of hours before bedtime, and keep the meal light. Avoid spicy, fatty foods, as well as alcohol and caffeine. Also, don't drink too many fluids before bed. Having to constantly get up to go to the bathroom can disrupt your sleep, too.

3. Lack of exercise

Sleep and exercise complement each other. Working out regularly can help you sleep better, and conversely, you're more likely to exercise if you get a good night's rest.

Solution: Exercise every day if you can, ideally in the morning. Doing a high-energy aerobic routine too close to bedtime can have the opposite of the intended effect, making you too energized to sleep. A gentle yoga stretch before bed probably won't hurt, though. It might even help you relax.

4. Pain

Arthritis aches or any other kinds of pain don't make for restful slumber. Conversely, a lack of sleep can increase your pain. Researchers believe that a lack of sleep may activate inflammatory pathways that exacerbate arthritis pain. Poor sleep can also make you more sensitive to the feeling of pain.

Solution: In addition to the pain remedies your doctor recommends, try using a heating pad or taking a warm bath before bed to soothe achy joints or muscles. Lying against a body pillow can put you in a more comfortable position while you sleep.

5. Restless legs syndrome

Women are twice as likely as men to have restless legs syndrome (RLS)--a condition that causes a creepy, crawly feeling and uncontrollable movements in the legs at night. It's often linked to hormonal changes early in life and during pregnancy, but RLS can continue as you get older. RLS isn't just miserably uncomfortable--researchers at Harvard have linked this condition to an increased risk for heart disease and depression in women.

Solution: Try simple interventions first. Exercise every day, take a hot bath before bed, massage your legs, and cut back on things that can make you jittery--like caffeine and tobacco. If these measures don't work, your doctor may recommend one of several medicines that reduce RLS symptoms--including ropinirole (Requip), pramipexole (Mirapex), rotigotine (Neupro), or gabapentin enacarbil (Horizant).

6. Depression

"Depression is a common compromiser of sleep, and it's much more common in women than in men," Dr. Edelman says. Women who are depressed may sleep more than usual, but their sleep isn't restful. Some of the antidepressants meant to counteract depression, particularly SSRIs, can also interfere with sleep.

Solution: See your primary care doctor, psychologist, psychiatrist, or therapist for help, which may include medications, talk therapy, or both. If your antidepressant seems to be keeping you awake, ask your doctor to switch you to another drug.

7. Stress

It's impossible to sleep when the weight of the day is pressing on you. Finding a sense of calm before bed isn't easy, especially when you can't unplug from the demands of your day.

Solution: Establish wind-down time. Do a quiet, relaxing activity before bed that doesn't involve a screen. Talk to a friend or family member, sew, or read a real book--not one on a backlit tablet device.

"Just allow yourself to have quiet time," Dr. Edelman adds. And don't sleep with your smartphone on your bedside table.

8. Poor sleep habits

Sometimes insomnia stems from long-ingrained behaviors, like staying up too late or engaging in stimulating activities before bed.

Solution: Follow a few basic sleep hygiene strategies. Go to bed and wake up at the same times each day. Keep your bedroom cool, dark, and comfortable. Use your bed for sleep and sex only. If you can't fall asleep within 15 minutes, get up and leave the bedroom. Read or do another quiet activity for 15 to 20 minutes until you get sleepy.

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Pediatric migraines may be caused by environment

Different environmental factors, such as sleep deprivation, diet, and school, could play a role in pediatric migraines.

Environmental stressors play a large role in triggering migraines in children, according to Dr. Eric Pearlman.

"Migraine is definitely a pediatric disorder. It peaks in young adulthood, but it definitely occurs in kids," Dr. Pearlman, chair of the department of pediatrics at Mercer University in Savannah, Ga., said at the annual meeting of the American Academy of Pediatrics.

Epidemiologic data suggest that migraine occurs in 10.5% of 10- to 15-year-old children and 3% of 7-year-olds, and that headaches – possibly including migraines – occur in 4% of 3-year-olds. By about 13 years of age, the prevalence of migraines starts reaching adult levels of about 6% in males, and 18% in females.

Environmental factors such as sleep deprivation, dehydration, dietary factors, school stressors, hidden stressors (like peers), and hormonal fluctuations represent triggers that can be particularly pronounced in children, he noted.

With International Classification of Headache Disorders, third edition (ICHD-III) criteria, migraines can be differentiated from acute, acute recurrent, and chronic progressive or chronic nonprogressive headaches if a child has experienced at least five attacks lasting up to 72 hours (whether untreated or unsuccessfully treated), if nausea and/or vomiting or photophobia and phonophobia are present, and if the child has at least two of four characteristics, including unilateral location, pulsating quality, moderate to severe intensity, and a tendency to be aggravated by – or avoid – routine physical activity.

In children, photophobia and phonophobia can be inferred (if they report having to lie down in a dark, quiet room, for example), as many have difficulty describing or understanding these symptoms

Unilateral headaches are rare in children, Dr. Pearlman noted.

If a diagnosis of migraine is established, it is important to make the diagnosis known to the child, and to educate the child about the condition and treatments.

Consider providing handouts and referring to websites (such as theAmerican Headache Society or the National Headache Foundationsites), to help educate patients and to manage their expectations, as they need to understand you cannot cure their migraine, he advised.

Involving both the patient and their parents in decision making can improve compliance with treatment recommendations, he said.

Pharmacologic interventions can include nonspecific short-term therapies, migraine-specific therapies, and preventive treatment.

Nonspecific short-term therapies may include acetaminophen, nonsteroidal anti-inflammatory drugs, or combination drugs. Migraine-specific therapies include ergotamine and dihydroergotamine, and the "triptans."

Seven triptans are available, including two that are approved for use in children; rizitriptan (Maxalt) is approved for children older than age 6 years, and almitriptan (Axert) is approved for those aged 12-17 years.

Maxalt comes in both an oral and orally disintegrating form, and is available as a generic drug. Generic sumitriptan (Imitrex) also is available.

"There are good data for most of the triptans for adolescents aged 12 and older," Dr. Pearlman said.

Rescue medications for those who have an inadequate response to short-term therapy can include a combination of an analgesic like a nonsteroidal and an antiemetic, or an opiate and an antiemetic if the patient used a nonsteroidal initially. Rescue medications may be needed "because nothing is going to work 100% of the time," he said.

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Children eat more when they lose sleep

A new study from Pediatrics looks specifically at what effects adding and losing hours of sleep have on children, specifically regarding their caloric intake. In short, they found that the less sleep a child gets, the more they eat.

Many studies have shown that kids and adults who sleep less are more likely to be overweight or obese. This correlation doesn't prove that sleeplessness causes obesity: Obesity can lead to sleep problems, and lack of sleep might be associated with socioeconomic factors, less organized homes and other factors that affect weight gain.

But a new experimental sleep study, reported in Pediatrics, actually looked at what adding and subtracting sleep does to weight and caloric intake in kids, and its findings suggest that just changing sleep duration may impact kids' waistlines.

The less you sleep, the more you eat

The researchers asked 37 kids, aged 8-11 years, 27 percent of them overweight or obese, to sleep as usual for the first week of the study. During the second and third weeks the kids alternated between sleeping 1.5 hour more and 1.5 hour less per night for an entire week. Sleep duration was verified by an actigraph -- a device that is placed on the wrist and monitors activity level. On average, the actual sleep difference between the week with increased and decreased sleep was about 2.5 hours.

So what can 2.5 hours do? During the week the kids slept more they reported eating 134 fewer calories per day compared to their intake during the reduced sleep condition, and their measured weight was about half a pound less.

While you may frown upon the 134-calorie decrease, if such a reduction is maintained over a long period of time -- something further studies that last longer than three weeks will need to prove -- this would be enormous. Weight is usually gained slowly, by eating just a little more than necessary over long periods of time. The energy gap is the daily discrepancy between energy intake and energy expenditure, and for American kids, the average energy gap estimate is just 64 calories a day. Eliminating calories in just the double digits daily could prevent further weight gain and doing that in your sleep could be sweet!

The exact mechanism in which sleep affects weight is unclear. After a good night's sleep we might be more active and burn more calories, we might have reduced appetites, and craving for high-calorie foods might be curbed.

Getting a good night's sleep

Getting enough sleep helps kids grow, concentrate in school, feel good, and -- as this study further suggests -- keep a healthy weight.

And while getting enough sleep isn't always easy, one of the factors that affect sleep is in our hands. TV before bed has been shown time and time again to result in kids sleeping later, and having a screen in the bedroom not only reduces sleep -- it is correlates independently with overweight.

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Food purchasing is increased after sleep deprivation

A study links sleep deprivation to purchasing more food the following day which could influence weight gain and obesity over time.

People who were deprived of one night's sleep purchased more calories and grams of food in a mock supermarket on the following day in a new study published in the journal Obesity, the official journal of The Obesity Society. Sleep deprivation also led to increased blood levels of ghrelin, a hormone that increases hunger, on the following morning; however, there was no correlation between individual ghrelin levels and food purchasing, suggesting that other mechanisms -- such as impulsive decision making -- may be more responsible for increased purchasing.

Researchers in Sweden were curious as to whether sleep deprivation may impair or alter an individual's food purchasing choices based on its established tendency to impair higher-level thinking and to increase hunger.

"We hypothesized that sleep deprivation's impact on hunger and decision making would make for the 'perfect storm' with regard to shopping and food purchasing -- leaving individuals hungrier and less capable of employing self-control and higher-level decision-making processes to avoid making impulsive, calorie-driven purchases," said first author Colin Chapman, MSc, of Uppsala University.

On the morning after one night of total sleep deprivation, as well as after one night of sleep, Chapman, along with Christian Benedict, PhD, and their colleagues, gave 14 normal-weight men a fixed budget (approximately $50). The men were instructed to purchase as much as they could out of a possible 40 items, including 20 high-caloric foods and 20 low-calorie foods. The prices of the high-caloric foods were then varied to determine if total sleep deprivation affects the flexibility of food purchasing. Before the task, participants received a standardized breakfast to minimize the effect of hunger on their purchases.

Sleep-deprived men purchased significantly more calories (+9%) and grams (+18%) of food than they did after one night of sleep. The researchers also measured blood levels of ghrelin, finding that the hormone's concentrations were higher after total sleep deprivation; however, this increase did not correlate with food purchasing behavior.

"Our finding provides a strong rationale for suggesting that patients with concerns regarding caloric intake and weight gain maintain a healthy, normal sleep schedule," said Chapman.

Follow up studies are needed to address whether these sleep deprivation-induced changes in food purchasing behavior also exist under partial sleep deprivation, though. Additional research should also look into sleep deprivation's potential impact on purchasing behavior in general, as it may lead to impaired or impulsive purchasing in a variety of other contexts.

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Healthy diet and sleep help children learn

For children, success at school is influenced by a healthy diet and getting enough sleep.

Backing what many parents already believe, experts say that healthy eating and good sleep habits can help youngsters do well at school.

"Your brain can't work if you're not consuming enough calories, and in general that's not a problem," Krista Casazza, an assistant professor in the nutrition sciences department at the University of Alabama at Birmingham, said in a university news release. "But when kids go to school without eating breakfast, their [thinking and learning skills] can be affected."

Children should start the day with fruits, proteins and whole grains. They should avoid sugary cereals because they cause a sugar high followed by a crash.

"A balanced breakfast will fuel the body for a long period and help sustain their attention level through lunch, when they need to eat well again," Casazza said. "This will hold them until dinner, and they won't snack ravenously after school."

If their kids do need to eat something before dinner, parents can offer healthy choices such as yogurt, fruits and vegetables. Baked chips, in moderation, can be an option if children want "kid stuff." For a drink, give them water instead of soda.

Sleep is another important part of success at school.

"Children need a good night's sleep for their overall school performance," Kristin Avis, an associate professor in the pulmonary and sleep medicine division in the pediatrics department at UAB, said in the news release.

"Lack of sleep can lead to problems with attention and memory in the classroom, affect impulse control and mood regulation [and] lead to anxiety and even depression," she explained.

Children aged 6 to 12 should get nine hours sleep per night, as should teens aged 13 to 18. However, they typically average little more than seven hours per night, Avis said.

"Often parents think one night of sleep loss won't matter, but that's all it takes to affect them the next day," she said. "If they are chronically deprived, it can snowball and make matters worse."

Trying to catch up on lost sleep on the weekend can compound the problem.

"If kids sleep in Saturday, they have a hard time going to bed Saturday night; so they sleep in Sunday and have a hard time going to bed Sunday night. Monday morning they are tired, and it's hard to wake up for school. They struggle to get back on a good sleep schedule," Avis said.

Children and teens need a consistent bedtime seven days a week.

"It keeps their clock set so they can go to bed at a certain time, sleep well through night and wake up well rested the next morning," Avis said.

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Sleep deprivation results in poor dietary choices in teenagers

Teenagers who get less sleep make poor dietary choices as opposed to teenagers who get enough sleep.

Well-rested teenagers tend to make more healthful food choices than their sleep-deprived peers, according to a study led by Lauren Hale, PhD, Associate Professor of Preventive Medicine at Stony Brook University School of Medicine. The finding, presented at SLEEP 2013, the annual meeting of the Associated Professional Sleep Societies, may be key to understanding the link between sleep and obesity.

"Not only do sleepy teens on average eat more food that's bad for them, they also eat less food that is good for them," said Dr. Hale, speaking about the study results. "While we already know that sleep duration is associated with a range of health consequences, this study speaks to some of the mechanisms, i.e., nutrition and decision making, through which health outcomes are affected."

The study, which was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, examined the association between sleep duration and food choices in a national representative sample of 13,284 teenagers in the second wave of the National Longitudinal Study of Adolescent Health. The data were collected in 1996 when the interview subjects had a mean age of 16 years.

The authors found that those teens who reported sleeping fewer than seven hours per night -- 18 percent of respondents -- were more likely to consume fast food two or more times per week and less likely to eat healthful food such as fruits and vegetables. The results took into account factors such as age, gender, race and ethnicity, socioeconomic status, physical activity and family structure, and found that short sleep duration had an independent effect on both healthy and unhealthy food choices.

The respondents fell into one of three categories: short sleepers, who received fewer than seven hours per night; mid-range sleepers, who had seven to eight hours per night; and recommended sleepers, who received more than eight hours per night. The American Academy of Pediatrics currently recommends that adolescents get between nine and 10 hours of sleep per night.

"We are interested in the association between sleep duration and food choices in teenagers because adolescence is a critical developmental period between childhood and adulthood," said the first author of the study, Allison Kruger, MPH, a community health worker at Stony Brook University Hospital. "Teenagers have a fair amount of control over their food and sleep, and the habits they form in adolescence can strongly impact their habits as adults."

The research team -- which included co-authors Eric N. Reither, PhD, Utah State University; Patrick Krueger, PhD, University of Colorado at Denver; and Paul E. Peppard, PhD, University of Wisconsin-Madison -- concluded that addressing sleep deficiency may be a novel and effective way to improve obesity prevention and health promotion interventions.

Dr. Hale said that one of the next steps in the research will be to explore whether the association between sleep duration and food choices is causal.

"If we determine that there is a causal link between chronic sleep and poor dietary choices, then we need to start thinking about how to more actively incorporate sleep hygiene education into obesity prevention and health promotion interventions," she said.

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