Sleep More, Stress Less to Achieve Your Weight Loss Goals

Weight Watchers and Jenny Craig should get with the program. Neither of the weight loss leaders integrates sleep education and sleep diaries. And the companies are making a big mistake, new research suggests. Popular approaches used by groups like Weight Watchers use a diary to keep track of food and exercise. Adding an extra column in the diary for hours slept would be a minor change that could make a significant impact.

A new study in the International Journal of Obesity found that adequate sleep increases your chances of success during weight loss efforts. People trying to lose at least 10 pounds more often reached their goal if they had six to eight hours of sleep per night. Stress reduction also helps with weight loss, the study reports.

A group of 500 study participants were instructed to lose 10 pounds over a six month period. All participants attended weekly weigh-in and educational meetings. Instructors at the meetings encouraged the participants to consume 500 fewer calories per day, adopt a healthy low-fat, low-sugar diet and exercise for at least 180 minutes a week. Participants were required to keep record of how long they slept, stress levels and mood. The class instructors encouraged participants to keep a food diary as well.

Nearly three-quarters of the people who slept more than six hours and kept a low-stress lifestyle were successful in losing 10 pounds or more and were twice as likely to meet their goals compared to those who get six or fewer hours of sleep.

Sleep loss tends to lead to weight gain or undermine dietary weight loss because it changes the body’s hormone levels. Lower leptin and higher ghrelin can lead to a slower metabolism but a bigger appetite for junk food.

Whether you are trying to lose weight or stay trim for swimsuit season, prioritizing sleep is always a good idea. The American Academy of Sleep Medicine recommends adults get at least seven hours of sleep. Don’t underestimate the power of diet and exercise. Weight loss programs like Weight Watchers work for many people because they educate people to make the right choices and encourage them to hold themselves accountable for their health.

Inadequate Sleep Undermines Dietary Fat Loss

Dieting sometimes just doesn’t work out as hoped, despite your best intentions. Before you reexamine your exercise routine or diet, consider your sleeping habits.

A small study conducted at the University of Chicago suggests sleep is the third vital element in the battle to shed fat. Exercise and dietary efforts may be less effective without a regular 7-8 hours of shuteye.

Dieters in the study shed the same amount of weight with less sleep, however when they had adequate sleep they burned off more body fat. An abstract is available on the website of the journal Annals of Internal Medicine.

A group of 10 overweight study participants with an average BMI of 27.4 adopted a diet with 90 percent of calories required to maintain weight without exercise. The volunteers dieted in two 14-day intervals. One involved sleep restriction with only 5.5 hours per night compared to 8.5 hours in the control portion of the study.

The subjects lost an average of 6.6 lbs during each 14-day dieting period. Half of the weight lost was body fat with adequate sleep. In the sleep restriction condition, the dieters lost only 1.3 lbs of fat and 5.3 lbs of lean body mass.

They also felt hungrier. The “hunger hormone” Ghrelin increased during sleep loss, causing a spike in appetites. Ghrelin also promotes the retention of fat, the study authors report.

"If your goal is to lose fat, skipping sleep is like poking sticks in your bicycle wheels," said Plamen Penev, MD, PhD, the study’s principal investigator. “One should not ignore the way they sleep when going on a diet.”

The authors intend to further investigate how sleep loss affects diet results. They plan on conducting similar, lengthier studies with larger samples of dieters.

A Low-Energy Diet & Sleep Apnea

A new study examined the effect of weight loss on obstructive sleep apnea in obese men. The results were published online in the British Medical Journal.

The Swedish study involved 63 obese men with an average weight of 248 pounds. Their average age was 49 years. Sleep apnea was measured using a home sleep test.

All of the men had moderate to severe OSA and were being treated with CPAP therapy. They had an average apnea-hypopnea index of 37 breathing pauses per hour of sleep. An AHI of more than 30 is considered “severe” OSA.

Thirty men were assigned to the treatment group. The other 33 men acted as a control group.

The men in the treatment group were put on the Cambridge Diet for seven weeks. This is a very low-energy, liquid diet. It uses a powder that is mixed with water to replace every meal of the day.

After the seven-week diet normal foods were gradually introduced for two weeks. Treatment also involved group sessions for support and motivation.

Results show that men in the treatment group lost an average of 41 pounds. Twenty-two of the 30 men were no longer obese.

This weight loss produced an improvement in sleep apnea severity. The mean AHI of the treatment group dropped from 37 to 12.

Seventeen percent of the men no longer had sleep apnea. Fifty percent had mild sleep apnea with an AHI of less than 15. Men who initially had severe OSA showed the greatest improvement in AHI.

In a press release the authors noted that a very low-energy diet is not a general solution to weight problems. Typically it is used in the first phase of a long-term treatment program.

They also wrote that the main limitation of the study was its short duration. Weight regain is common after weight loss. Evaluating the long-term effectiveness of weight loss would require at least one year.

The study was funded in part by Cambridge Manufacturing Company Limited, which markets the Cambridge Diet.

The AASM recommends dietary weight loss as one treatment strategy for people who are obese and have sleep apnea. But weight loss should be combined with another treatment such as CPAP or an oral appliance.

In October the Sleep Education Blog reported on another study involving a low-energy diet and OSA. Read more about weight loss and sleep apnea.

Image by Becky Lai

Sleep May Help You Eat Healthier

A new study examined the relationships between sleep, job strain and food choices.

The Harvard study involved 542 men; their average age was 49 years. They were all motor freight workers who often work long hours and have irregular shifts.

Results show that 51 percent reported getting adequate sleep. Almost 88 percent were satisfied with their job; about 30 percent reported job strain.

Statistical analysis found that adequate sleep was associated with lack of job strain and healthful eating choices. Work experiences also were related to healthful food choices; but the effect was no longer significant when adequate sleep was included in the model.

The authors concluded that adequate sleep is associated with more healthful food choices; sleep also may mediate the effects of workplace experiences. As a result workplace health programs should be responsive to workers' sleep patterns.

“Our findings suggest that sleep adequacy, by enhancing helpful dietary choices, is one means by which workplace factors may influence chronic disease risk,” they wrote.

In September the Sleep Education Blog reported that eating when you should be sleeping may lead to weight gain.

Other studies also have found that how long you sleep may affect how you eat. You may crave more high-calorie, high-carbohydrate foods when you are tired.

What about you – do you eat healthier foods when you are well rested?

Image by barbarina

Sleep Apnea in Women: Diet, Exercise & Weight Loss

A new study from Australia tested the effectiveness of a 16-week exercise and diet program for people with obstructive sleep apnea. The results were published today in the Journal of Clinical Sleep Medicine.

The study involved 12 people with an average age of 42 years; nine of the participants were women. They had an average body mass index of 36.1; a BMI of 30 or higher is considered “obese.”

They also had an average apnea-hypopnea index of 24.6 breathing pauses per hour of sleep; an AHI of 15 to 30 is considered “moderate” sleep apnea.

The program used Optifast, a very low-energy diet. Participants also followed a supervised exercise schedule; this included both aerobic and resistance training.

Results show that participants lost an average of about 27 pounds. Some typical OSA symptoms also improved; these included snoring, daytime sleepiness and mood.

But weight loss did not cure OSA. It did reduce the average AHI by 25 percent; but participants still had moderate sleep apnea with an average AHI of 18.3

“Although there was some improvement in sleep disordered breathing, it was not seen in all patients and was not proportional to the degree of weight loss,” lead author Dr. Maree Barnes told the AASM.

Follow-up at 12 months showed that all but one person who completed the program had regained some weight. But half of the participants were able to maintain weight loss of at least seven percent.

The AASM recommends dietary weight loss as one treatment strategy for people who are obese and have sleep apnea. But weight loss should be combined with another treatment such as CPAP or an oral appliance.

Read more about weight loss and sleep apnea. Learn more about women and sleep apnea risk.

You should talk to your doctor to develop a healthy weight-loss plan that is right for you. For help with sleep apnea you should contact an AASM-accredited sleep disorders center in your area.

Insomnia and Weight Gain

A new study examined the link between insomnia and weight gain.

The study involved 14 men with primary insomnia and 24 healthy controls. It measured their levels of the “hunger hormones” leptin and ghrelin three times during one night of sleep.

Results show that men with insomnia had less total sleep time than controls. Leptin levels were similar between the two groups. Leptin helps to suppress your appetite and increase your metabolism.

But ghrelin levels were about 30 percent lower in men with insomnia. Ghrelin stimulates appetite.

So it would seem that insomnia lowers your risk of weight gain. Less ghrelin means you would be less hungry.

But this may not be the case. Lead author Sarosh Motivala of UCLA thinks that a change may occur during the day to increase appetite. Other studies show that sleep loss decreases leptin and increases ghrelin.

What is clear is that insomnia disrupts how the body regulates appetite.

"The current study shows that insomnia patients have a dysregulation in energy balance that could explain why these patients gain weight over time," Motivala said in a UCLA statement. “"This is an exciting finding because it highlights how diverse behaviors like sleep and eating are connected.”

Most people with insomnia have “secondary” insomnia. It occurs along with another medical problem, mental illness or sleep disorder. It also may result from the use of a medication or substance.

The men in this study had “primary insomnia.” This kind of insomnia is unrelated to another health problem. It is estimated that about 25 percent of people with insomnia have primary insomnia.

A 2008 study in the journal Sleep linked primary insomnia to low levels of a brain chemical. Results show that GABA levels are reduced by 30 percent in adults with chronic primary insomnia.

Learn more about the link between sleep and weight.

Losing Weight: Which Diet is Best?

If you are obese, weight loss is one strategy to reduce the severity of obstructive sleep apnea. It is unlikely to cure sleep apnea, but it can help. And losing weight can produce many other benefits for your health and well-being.

But where do you begin? There are so many types of diets. Each one has its supporters. And it’s easy to be lured in by an advertisement – many of which make false claims.

Should you focus on a high-protein diet? High fat, low carb? High carb, low fat? How do you know?

A new, long-term study provides some helpful insight. It involved 811 adults. They had an average age of 51 and an average body mass index (BMI) of 33.

Each person was assigned to one of four types of diets. The diets allowed differing portions of fat, protein and carbs. All of the diets had the same goals for reducing calories. The diets also were heart healthy: low in saturated fat and cholesterol, high in fiber.

Each diet plan included group counseling sessions two to three times per month. Individual sessions were held every two months. The common goal for activity was to get 90 minutes of moderate exercise per week.

Which diet was the winner? It was a tie. The amount of weight loss after two years was similar for all four diets. On each diet plan, participants lost an average of eight to 10 pounds. They also reduced their waistlines by one to three inches. Most of the weight loss - an average of 13 pounds - occurred in the first six months.

Maintaining the weight loss was harder. The majority of people slowly regained some weight after 12 months. About 23 percent of people continued to lose weight from six months to two years.

Eighty percent of people completed the two-year study. For each diet about 31 to 37 percent of people lost at least 5 percent of their body weight. Fourteen to 15 percent lost at least 10 percent of their body weight.

Dramatic weight loss was rare. Only two to four percent of people in each diet group lost 44 pounds or more.

Attendance at counseling sessions was related to weight loss. People who attended two-thirds of the sessions lost almost 20 pounds over two years.

So which should it be - high protein? High carbs? The results suggest that any type of heart-healthy, low-calorie diet can be effective. For long-term success the authors recommend choosing a diet that fits your personal preferences.

Weight loss is not a quick fix. So it is important to continue CPAP therapy for sleep apnea while on any diet program.

Get tips for setting goals for weight loss and choosing a weight-loss program from the Federal Trade Commission.

Can a “Sleep Diet” Really Help You Lose Weight?

Research has linked your risk of obesity to how long you normally sleep. So can you lose weight by getting more sleep?

Seven women decided to take the challenge. Their story is told in Glamour magazine and on the Today show.

They practiced a specially designed “Sleep Diet” for 10 weeks. They were told to refrain from making any other changes to their eating or exercise habits.

The results? Six of the seven women stuck to the sleep plan and lost weight; one woman was unable to follow the plan because of her work schedule. The women lost six to 15 pounds each.

Here’s the sleep plan they followed:

1. Get at least 7.5 hours of sleep each night.
2. Go to sleep and wake up at the same times every day. A one or two-hour change was allowed on weekends, as long as they still slept for at least 7.5 hours.
3. No caffeine after 2:30 p.m. No alcohol within three hours of bedtime.
4. Find your ideal sleep time. You may need more than 7.5 hours of sleep each night if you depend on an alarm to wake up in the morning. Go to bed about 15 minutes earlier each night until you are able to wake on your own, feeling fully rested.

That’s it. The women did face some challenges. For some it was hard to go to bed earlier than they had in the past.

But there were other benefits in addition to the weight loss. Some of the women reported having much more energy than before.

So what do you think? Is the “Sleep Diet” a good way to lose weight and maintain a healthy weight?

Which would be harder for you: giving up some foods to go on a diet or giving up some free time to get more sleep?

Learn more about healthy sleep habits. Read a list of sleep tips for women.

Weight Loss & Sleep Apnea

Obstructive sleep apnea is common in people who are overweight or obese. So is weight loss an effective way to treat sleep apnea?

A new study from Finland shows that people with mild sleep apnea may benefit from weight loss. Participants were put on a very low calorie diet. They also received supervised lifestyle modification.

The treatment led to an average weight loss of 10.7 kg, which is almost 24 pounds. It also led to a significant reduction in sleep apnea severity.

All common sleep apnea symptoms improved. The treatment benefits remained at the one-year follow up.

The AASM recommends dietary weight loss as one treatment strategy for people who are obese and have sleep apnea. But weight loss should be combined with another treatment such as CPAP or an oral appliance.

Why? There are three main reasons. First, weight loss takes time. Sleep apnea is a serious health problem that requires immediate treatment to normalize your breathing during sleep.

Second, weight loss is difficult to maintain. Often there is a trend toward regaining weight over time.

Finally, although it may reduce the severity of sleep apnea, weight loss rarely cures sleep apnea. Breathing pauses during sleep are still likely to occur.

Talk to your doctor before starting a diet or a weight-loss plan. Contact an AASM-accredited sleep center for help with sleep apnea.

You Eat How You Sleep?

A new study adds to the evidence linking sleep duration with the risk of obesity. It finds that how long you sleep may affect how you eat.

The small study at the University of Chicago involved 11 healthy volunteers. Each participant stayed at a sleep laboratory two times for 14 days each time. During one stay they spent 8.5 hours in bed each night. During the other stay they spent only 5.5 hours in bed each night.

They had easy access to food during both stays in the lab. The study measured their intake of calories from meals and snacks.

Results show that they ate similar meals during both sleep conditions. But they consumed more calories from snacks when their sleep was restricted. Their snacks during sleep restriction also had a higher content of carbohydrates. Snacking increased the most between 7 p.m. and 7 a.m.

This was similar to a previous study that linked sleep restriction to the levels of the appetite-regulating hormones leptin and ghrelin. Other studies also have linked sleep duration to obesity and diabetes.

What about you – do you snack more when you sleep less?