The Health Impact of Lack of Sleep

Sleep on this: a combination of poor sleep and unlimited access to food leads to increased calorie intake plus fat accumulation, particularly unhealthy belly fat.The study was conducted at the Mayo Clinic by Naima Covassin, PhD and cardiovascular researcher. It found that lack of sleep led to a 9% increase in total abdominal fat and an 11% bump in abdominal visceral fat when compared to controlled sleep. Fat that’s deposited deep inside the abdomen surrounding internal organs is strongly correlated with heart disease and metabolic illnesses. The study, funded by the National Heart, Lung, and Blood Institute, was published in the Journal of the American College of Cardiology.Insufficient sleep is frequently a behavioral choice, and it is growing increasingly common. Over a third of US adults routinely miss sleep, partly due to shift work, use of electronic devices, and social media when they should be sleeping. In addition, people often eat more in longer waking hours but don’t necessarily increase physical activity. "Our findings show that shortened sleep, even in young, healthy, and relatively lean subjects, is associated with an increase in calorie intake, a very small increase in weight, and a significant increase in fat accumulation inside the belly," says Virend Somers, M.D., Ph.D., the Alice Sheets Marriott Professor of Cardiovascular Medicine, and principal investigator of the study."Normally, fat is preferentially deposited subcutaneously or under the skin. However, inadequate sleep appears to redirect fat to the more dangerous visceral compartment. Importantly, although during recovery sleep there was a decrease in calorie intake and weight, visceral fat continued to increase. The study suggests that poor sleep is a precipitating factor for the deposition of visceral fat. Catch-up sleep (through napping or sleeping in), in the short term, doesn’t reverse the accumulation of visceral fat. Long term, this data suggests that lack of sleep may contribute to the rising cases of obesity, cardiovascular disease, and metabolic diseases, according to Dr. Somers. The small study included 12 healthy, non-obese adults who spent two, 21-day sessions in an inpatient setting. Subjects were assigned randomly to the control (normal sleep) group or restricted sleep group in one session and switched in the next session after a 3-month washout period. Both groups had unlimited access to food throughout the trial. Energy intake, energy expense, body weight, body composition, fat distribution (including visceral fat), and circulating appetite biomarkers were monitored and measured by the researchers.An acclimation period was used in the first 4 days, where subjects were granted nine hours in bed to sleep. In the next two weeks, the sleep-restricted group was allowed four hours of sleep, and the control group maintained nine hours of sleep. Afterward, three days and three nights of recovery were allowed with nine hours of bedtime for each group. During the sleep-restricted time, subjects ate over 300 additional calories per day, accounting for roughly 13% more protein and 17% more fat, compared to the acclimation stage. The bump in nutrient consumption was the highest in the early trial of sleep deprivation, then waned to starting levels in the recovery period. Calorie expenditure remained relatively stable throughout. The accumulation of visceral fat was caught by CT scan and would likely not have been noticed as the increase in weight was only about a pound, per Dr. Covassin. "Measures of weight alone would be falsely reassuring in terms of the health consequences of inadequate sleep. Also concerning are the potential effects of repeated periods of inadequate sleep, in terms of progressive and cumulative increases in visceral fat over several years."In individuals who cannot control sleep disruption, such as shift workers, Dr. Somers suggests increased physical activity and better food choices to combat fat gain. Further study is indicated to evaluate how this study impacts higher-risk individuals with obesity, diabetes, or metabolic syndrome. Need tips to get your clients to sleep? Here you go!

• Encourage regular exercise most days of the week. Physical activity is linked with better sleep and reduced body fat.
• Limit caffeine, especially after 2 PM. Coffee, tea, energy drinks, and chocolate each contain caffeine.
• Turn off the tube. Watching TV late at night (especially disturbing shows or the news) is associated with poor sleep.
• Get up and go to bed at the same time each day. Consistent sleep and wake cycles can help ensure adequate sleep.
• Don’t use smartphones, tablets, or other devices a few hours before bed. Blue light impacts the ability to fall asleep and stay asleep.
• Limit alcohol. Alcohol may help you fall asleep, but it's a known sleep disrupter. 

By Lisa Andrews, MEd, RD, LDJournal References:

1. Naima Covassin, Prachi Singh, Shelly K. McCrady-Spitzer, Erik K. St Louis, Andrew D. Calvin, James A. Levine, Virend K. Somers. Effects of Experimental Sleep Restriction on Energy Intake, Energy Expenditure, and Visceral Obesity. Journal of the American College of Cardiology, 2022; 79 (13): 1254 DOI: 10.1016/j.jacc.2022.01.038
2. Rubio-Arias JÁ, Marín-Cascales E, Ramos-Campo DJ, Hernandez AV, Pérez-López FR. Effect of exercise on sleep quality and insomnia in middle-aged women: A systematic review and meta-analysis of randomized controlled trials. Maturitas. 2017 Jun;100:49-56. 
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4. Sehn AP, Gaya AR, Brand C, Dias AF, Kelishadi R, Franke SIR, Renner JDP, Reuter CP. Combination of sleep duration, TV time and body mass index is associated with cardiometabolic risk moderated by age in youth. J Pediatr Endocrinol Metab. 2020 Nov 16;34(1):51-58.
5. Chaput JP, Dutil C, Featherstone R, Ross R, Giangregorio L, Saunders TJ, Janssen I, Poitras VJ, Kho ME, Ross-White A, Zankar S, Carrier J. Sleep timing, sleep consistency, and health in adults: a systematic review. Appl Physiol Nutr Metab. 2020 Oct;45(10 (Suppl. 2)):S232-S247.