The Insomnia Blog by Sleep Doctor Michael Breus, Ph.D.

Women Watch Out: Poor Sleep Could Be Worse for You

No more excuses, please. Seriously. A new study that just came out, which I read about in an online article from an industry magazine, is bad news for women who don’t sleep well. I think it’s bad news for all of us.

Researchers at Duke University Medical Center have discovered that poor sleep is linked to greater psychological distress (no surprise there) and higher levels of biomarkers that increase your risk for heart disease and type 2 diabetes. No surprise there, either, because it’s long been reported that sleep deprivation can have tremendous health consequences.

But here’s the surprising part about the study. These associations are discriminating—they are much stronger in women than in men. So it’s riskier to be a sleepless woman than a sleep-deprived man.

Warm Milk, True or False?

I just love it when some old piece of advice proves totally absurd, false, or, in the case of drinking a glass of warm milk before bed as a sleep inducer, TRUE!

Last month New York Times writer Anahad O’Connor settled the claim about milk as a sleeping aid in a great, short article that put to bed some old assertions about milk… with a twist.

YES, warm milk can help you get to sleep. But it’s not because it contains the enzyme tryptophan, which urban legend has it will lull you to sleep (and which is often the talk at Thanksgiving when people drop like flies after a large meal heavy in tryptophan-rich turkey).

When Life Gets “Crazy-busy,” Even a Little SLEEP Goes a Long Way

Everyone loves a good confession. They are typically much more fun to listen to than someone’s boring, unrealistic New Year’s resolution. Catherine Lloyd Burns’s had an entertaining write-up for Self magazine last week, available here. Her piece is titled “Confessions of a Lapsed Exerciser,” with the subtitle, “When life gets crazy-busy, even a little exercise goes a long way.”

Burns, an avid exerciser in years past, chronicles how life gets in the way of her ability to take regular time to exercise, and how she struggled to get back on track by joining a local gym. She writes, “My life, it seems, is a balancing act perpetually on the verge of tipping over. Exercise is one of the items on the scale, along with work, chores, eating and making contact with other humans; all of these things threaten to throw everything off kilter. What’s changed is that now I accept this idea. My foray back to the gym has made me more flexible, physically and mentally.”

Sound familiar?

What Do Sleep and Baseball Have in Common this Week?

Aside from the exciting Sox vs. Cardinal baseball that went on last week leading up to the World Series, the drama surrounding Cleveland Indians pitcher Paul Byrd caught my attention in particular. Byrd acknowledged using human growth hormone for a medical condition, but what got my eye wasn’t related to the fact HGH is a banned drug in professional baseball (since 2005) without a doctor’s prescription. It’s about something else I read that I bet most people didn’t stop to think about.

Is There an Anti-Age Doctor in the House?

I don’t have to give you a ton of statistics to prove how hard we try to stay young, energetic, and beautiful. Just consider the number of energy drinks on store shelves, the popularity of Starbucks (which, just this week announced plans to add new drinks or drink sizes that better meet the needs of kids or teens), dramas like Nip/Tuck, and reality TV shows like Extreme Makeover and the newer Dr. 90210, which definitely fulfills a few stereotypes about women seeking the perfect, buxom body in a city like L.A.

In a new book I scanned last week called Microtrends by Mark J. Penn, I read some incredible reports on the extent of plastic surgery going on today. The author devotes an entire chapter to “Surgery Lovers,” claiming that “Cosmetic procedures, both invasive and noninvasive, have become so popular in America lately that between liposuction, Lasik, nose jobs, and tummy tucks—and the latest favorite, eyelash transplant surgery [what is that?!]—it seems like it’s the rare American who hasn’t volunteered to go under the knife.”

Well, I’m happy to report that I keep the carving knives on my food plate and am not one of the one million men who seek the help of a surgeon. Ten years ago, a man wouldn’t be caught dead sitting in the waiting room of a cosmetic surgeon for purely vanity reasons. But today, the tides apparently have changed. Penn predicts a boom in so-called Aesthetic Medicine, as well as some mighty turf wars among doctors who want to practice it.

I wish the same could be said for Sleep Medicine. I’d welcome the turf war and more opportunities to expound the benefits of sleep—that free asset we all have an opportunity to capture every night sans the sharp edges and bruising. Let me repeat: it’s free; there are no risks involved; and it can potentially benefit you in more ways than one. Clearly, a breast augmentation targets one area; sleep can cover an array of areas by virtue of the hormones it releases to repair and rejuvenate the entire body.

Ask the Sleep Doctor: Cortisol and Early Morning Awakenings

This question from a reader came in recently:

Q:

Not sure if this is the right way to ask a sleep-related question (as mentioned on your blog) or if this will be an appropriate question but thought I'd send it anyway.

A little background in case there is a better way to phrase my question. Pre-steroid treatment (for hypoadrenal function), I regularly would wake up between 3am and 4am and be unable to fall back asleep. With steroid treatment, this stopped. However, when I taper my dose, this happens again until I acclimatise to the new dose.

So the question is... Is there any connection between cortisol and early morning (3-4am) awakening?

A:

The answer is YES, but it's quite complicated.

Looking at natural cortisol hormone curves over a 2 day period, we see a natural circadian rhythm, meaning that there are natural ebbs and flows of this hormone with spikes occurring at between 4-6 a.m. each morning.

What I do not know is if administration of cortisol at particular times of day would indeed produce an awakening; but if, at the height of normal cortisol levels, many people are waking up for the day, it would make sense that the changes in dosage are hitting a peak and waking someone up.

Sleep, Testosterone, Baldness and Libido

In a recent issue of the Journal Sleep, there was a fascinating new study, once again showing the importance of sleep in all areas of health.  This time it was referring to men’s health -- specifically testosterone levels.

We have known for a while that men’s levels of testosterone vary with age and usually decline. Some men seem to have higher levels of testosterone well into their 80s. High levels of testosterone have been thought to be linked to hair loss, while low levels have been linked to lack of energy and libido. There is now evidence to suggest that these testosterone variations may be linked to sleep.

Researchers found that the amount of sleep that older men in their study got was significantly related to the amount of testosterone in their a.m. blood samples. More sleep lead to higher levels of testosterone.

What does this mean? It is really hard to say.

First, the results may need to be re-confirmed. Next, we would want to look not just at the total minutes of sleep, but also at the actual quality of the sleep these men are getting.

But what is quality sleep? Is it more delta sleep or slow wave sleep (that "wake up and feel great" sleep!)?

Another good question, but I would say that since we know that the elderly have lower wave amplitude (meaning that their brainwaves do not have as much power to the punch as they may have had when younger... but again we do not yet know what this may mean), we would want to see if those with higher testosterone at 80 have not only more minutes, but also higher amplitude.

How can this study have any effect on our real world thinking?

Here is how I see it:  the more sleep you get at 80, the less hair you may have, but the more sexual drive is likely to stay with you.

So ask yourself:  do you want to be bald and hot to trot, or do you want to have a head full of hair but not be that interested?

Sleep Article Roundup, 4/2/07

On the sleep-friendly foods front:

Newsweek continues its Up Close and Edible series by shining a light on peanut butter. It turns out that peanut butter can lower triglycerides and help reduce the risk of heart disease.   Peanut butter, like sleep, can also help with waistline management. Says Newsweek:

Penn State researchers found that peanut eaters had lower body mass indexes (BMIs), compared to non-peanut eaters. The higher your BMI (25 and lower is considered optimal), the greater your risk of obesity-related problems like heart disease or diabetes.

But don't fall prey to eating too much of a good thing. Peanut butter is high in calories. A single serving, or two tablespoons of low-fat or regular peanut butter, has about 190 calories. "The point is not to go through the whole jar in one sitting," says Dr. Penny Kris-Etherton, distinguished professor of nutrition at Penn State. She recommends peanut butter as a snack alternative or as a meal, such as a PB&J on whole-wheat bread. Good news for those of us who like our foods comfortable and sticky.

This is also good news for people searching for an ideal pre-bedtime snack: peanut butter and jelly on whole wheat is a high-glycemic snack that may help one fall asleep faster.

Regarding women and sleep:

Over at the Chicago Tribune, Julie's Health Club shares tips for overcoming insomnia. (She likes Yoga Nidra.)

Will Tryptophan Really Help Me Sleep?

In honor of the holiday, here's a Thanksgiving-related food fact, taken from Good Night:

Myth: 
Turkey will put you to sleep because of the enzymes it contains, which promote sleep.

Reality: 
Sleep-friendly foods, such as turkey, may help you relax and fall asleep, but don't view them as "sleeping pills".  You'd have to eat about forty pounds of turkey to get enough of the enzyme tryptophan to make you sleepy. 

Since the average grocery store turkey weighs about 15 pounds, that's 3.5 turkeys, all to yourself. That's a lot, even for the heartiest diner. 

So if you're looking to get a good night's sleep after your meal, remember, overdoing it on the turkey won't help you. In fact, if anything, it may hurt, because the body has to work extra hard while you're asleep to digest all the extra food.

So dine in moderation this holiday, and try and stay away from that late-night turkey sandwich if you're hungry right before bed -- a high-protein meal without accompanying carbs can actually keep you awake. (Bring on the dinner rolls! And while you're at it, throw in a glass of milk or egg nog too.  Calcium helps the brain convert tryptophan to melatonin, which will help you sleep.)

Enjoy a happy and restful holiday!