Sleep Matters for Obesity
Written by Editor   
Sunday, January 10, 2016 12:00 AM

Healthy sleep and water consumption are two components for consideration in obesity.

When most people think about the behavioral therapy of obesity, they mostly focus on eating habits (personalized caloric restriction) and physical activity.

The idea that we must alter patients’ homeostasis and energy balance in favor of fat loss needs consideration as well. Obesity is extremely complex with many factors contributing to an imbalance, with other behavioral components involved as well. One of those is sleep, which is crucial and is perhaps an unsung hero of behavioral therapy.

The study that caught the attention of the media was a canine model of sleep deprivation and the results were billed with the catchy message that “one night of poor sleep could equal six months on a high-fat diet."  Eight male dogs were evaluated by glucose tolerance test following both a night of habitual sleep and a night of sleep deprivation at baseline and after 6 months on a "high-fat diet." Sleep deprivation alone caused a 33% drop in insulin sensitivity compared with 21% with the high-fat feeding alone. 

Sleep deprivation and metabolic disease has been studied extensively recently with reviews showing glucose tolerance decreasing in healthy young adults after just a night of sleep deprivation. It has also been shown that shorter sleep duration has an association with weight gain as revealed in several recent studies, this report lists, and it was found that 86% of patients with obesity and type 2 diabetes suffer from obstructive sleep apnea (OSA). This obviously contributes very detrimentally to poor sleep and expansive metabolic complications including obesity. 

In another study researchers took subjects with obesity and overweight, all who drank diet beverages, and advised half of the group to switch their lunchtime diet beverage to water and the other group to continue drinking a lunch time diet beverage. All participants were on an otherwise structured hypocaloric diet. After 24 weeks, those who were advised to drink water lost more weight (7.6 kg in the diet beverage group and 8.8 kg in the water group) and also had better insulin sensitivity improvements. This confirms our recommendations of sticking to water when possible, although you can still have diet beverages and lose weight.

Healthy sleep is a critical component of well-being and is often the underlying issue in many ailments from general fatigue and psychiatric health to obesity and metabolic complications. There needs to be a consistent focus on addressing sleep hygiene and awareness of sleep apnea so that lifestyle can be optimized.

Sugar-sweetened beverages (SSBs) provide an excessive load of empty calories potentially contributing to obesity, type 2 diabetes, and cardiovascular disease. Replacing SSBs with diet versions seems like a reasonable consideration, but perhaps the goal should still be to guide patients into drinking more water instead.