Tuesday, April 05, 2016

"...we sort of self medicate in order to not feel tired and when we do that, we actually erode our sleep quality."

I really need to get my sleep worked out.  Great podcast ep.  Robb Wolf - Paleo Solution Podcast - Episode 314 - Sarah Ballantyne - Sleep: "...when you look at the impact of that sleep has on the central nervous system, on the immune system, on our hormones, on our metabolism, it's so fundamental and if you think of anyone of those systems being out of whack, you're not going to be healthy...

We're missing this linchpin that is holding everything together, which by the way, when you get enough sleep, your hunger is regulated. You don't have cravings. You naturally want to eat more fruits and vegetables and you naturally feel more motivated to move.

 Here's one of my favorite statistics. Sleeping less than 6 hours per night which about 35% of Americans do increases risks of all cost mortality by 12%. So that's a really general measure that looks at both health and longevity when you look at all cost mortality. Being morbidly obese increases risks of all cost mortality by 18%. For every hour of sedentary time that you're placed with physical activity, you reduce all cost mortality by 16% and for every serving, daily serving of vegetables up to 5 servings, reduce risks of all cost mortality by 5%, which means we're talking about sleep being in the same ballpark in terms of health risks as being obese, being inactive and not eating vegetables...  and sleep is the first thing that people are willing to give up for everything else in their life.

We put work and play before sleep. On average, we are sleeping an hour and a half to 2 hours less per night than we were 50 years ago and when you have -- this is fundamental, but how much time that is total per year. So most of the scientist of sleep is actually looking at metabolic syndromes. They're looking at diabetes, cardiovascular disease risk factor and obesity or one piece of that pie, but within those studies, there is some really interesting insights.

So for example, it looks like it's really important for our sleep time to be synced with the sun. So if you look at hunter gatherers, the sun goes down and they kind of have their quiet more intimate time. They tend to fall asleep about 2 hours after the sun goes down. They tend to wake up around sunrise or an hour before sunrise depending on the time of year. So they're actually spending typically about 9 hours in bed, a little bit longer in the winter, and then when you subtract off sleep latency time, that's adding up to about 7 hours of sleep. It's not just time in bed...

So you turn out the light at 10. You're alarm went off at 6, but you really only slept 6 and a half hours in that period of time and that's really important I think for most of us to understand that we tend to statistically speaking, we over estimate how much we sleep by about 48 minutes. But the less that you sleep, the more you overestimate how much you're sleeping. So if you're sleeping 5 hours a night, you tend to overestimate by an hour and 20 minutes whereas if you sleep 7 hours a night, you're only on average overestimating your sleep by 20 minutes.

So that's like the first thing to keep in mind here is that we're talking about adults having a bed time, which I realize this is supposed to be one of the rites of passage of becoming adults that we no longer have to go to bed at a certain time.

Robb Wolf: You have the right to completely metabolically derange yourself. You have the right to eat an entire box of coco puffs as well. 

So keep that in mind that there are certain things that we grow up with like having a healthy breakfast that are pretty good patterns to maintain through adulthood and having a bed time is one of them. So what we know is that having a very regular sleep patterns so one of the things that increases risks of obesity is variability in terms of what time we go to bed, what time we wake up and how long we sleep.

So if you have that very typical pattern of 'I go to bed a little bit earlier because I have to wake up early on weeknights and then on the weekend, I'm going to stay up late, but I'm going to sleep in' that can increase risks of obesity by as much as 14%. But if your variability and how long you sleep varies by more than about an hour standard deviation, so I go to bed at 10 on weeknights, but I stay up till 1 on Saturday night, that increases risks of obesity by 63%.

So having a really consistent bed time ideally, the time shouldn't vary by more than about 30 minutes and a really consistent wake time and we should never need to sleep to catch for our sleep. We should never have a sleep debt. We know from studies looking at sleep in the immune system that inadequate sleep, so getting short sleep, not necessarily is inflammatory and it stimulates all components of the immune system that are up to shenanigans in autoimmune disease and when you go to recovery from sleep, you go to sleep in over the weekend, that's not sufficient time to fully regulate the immune system.

So there are aspects of the immune system like TH17 cells that remain over stimulated even after 2 days of getting enough sleep and paying down that sleep debt.  So we know that we need consistency in bed time. We know that we want total fleet to equal that 7 hours, but for most people is 8 and a half to 9 hours in bed and so I was recommending, what time do you have to get up in the morning and we have responsibilities. We have jobs. Most of us have things that get us up in the morning if it's not young kids or both the kids and the job. So what time do you have to get up in the morning? So my alarm personally set for 6:30 in the morning. So if I calculate back 9 hours, that means that I have to turn out my light at 9:30 and I think that this is really the number 1 barrier that most people face to getting enough sleep is taking their bodies, putting them into their beds early enough that they actually have enough time to get enough sleep, turning out the light, turning off the TV and closing their eyes.

There are lots of things that we can do to support sleep quality from there like managing stress and then transient circadian rhythms and being in a dark environment in the evenings and being outside in bright 18 light during the day, not eating sugar in the evenings, right. There are lots of things that we can do to support sleep quality, but the number one thing that we are just not doing is putting sleep high up enough up on the to-do list that we are actually getting it.

Robb Wolf: Got yeah, got yeah. Just a little bit on the -- you mentioned sugar in the evening. It seems like I've seen is much material on evening carbohydrates either improving or making sleep worse. What are your thoughts on that, like since now, it's just like, oh you just have to play with and see, like what do you think is going on there? 

Sarah Balantyne: There's a very big difference in terms of the hormonal response to sugar versus starchy carbs, right, and so what we seen in studies that actually differentiate between those is that having a good serving of a starchy vegetables at dinner and the optimal time frame is 4 to 5 hours before bed dramatically improves sleep quality. So there is this 2-hour window before bed where eating anything whether it's carbohydrates, whether it's protein, eating anything within 2 hours before bed basically gets your metabolism roughed up, gets your growth hormone spiking and those are things that are going to erode sleep quality. So there is this optimal window of eating about 4 to 5 hours before bed depending on schedule.

I mean, sciences are so cut and dried that there is a reason why pushing it to 2 hours before bed if that fits with people's schedules would be inappropriate, but then there is this whole separate side of things looking at added sugars. They're looking at high fructose corn syrup and sugary drinks and this very, very different quality of carbohydrate and showing that consuming sugars, any simple sugars, things like sucrose and glucose and fructose from mid afternoon on basically starts you on that wonderful insulin roller coaster that will erode sleep quality.

So my general recommendation is to include a serving of starchy carbs to blood sugar regulation levels. So for each of us, it's a little bit different, right. Some people can do -- typically people could do 30 to 45 grams of carbohydrates with dinner and be okay, that sort of like the American Diabetes Association guidelines for maximum carbohydrates within a meal for regulating blood sugars even in diabetics. Some people can handle more.

So starchy carbs to blood sugar regulation with dinner and then don't eat. I think a lot of us eat to stay awake at night. It’s one of my like worst food habits is 7 to 8 o'clock rolls around and I’m like what can I snack on.  Really, I should just go to bed. It’s such a common thing that we mistaken fatigue for hunger and then we end up again, right, so then we end up eating which erodes sleep quality and it becomes another crap. So some people reach for caffeine and some people reach for sugar, and I mean, I reach for both. I'm going to put myself in that category. I like my caffeine in the morning and my sugar in the evening.

...but that's such a common thing that we sort of self medicate in order to not feel tired and when we do that, we actually erode our sleep quality, which then sets us up for just a snowball of bad."

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