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Why Poor Sleep Makes Weight Loss So Much Harder · Doctor Turned Health Coach

• 0:22
  Today, we're going to do a bit of a deep dive into sleep.
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  Now, I know everyone knows how much sleep they have to get, how important it is, etc., etc.
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  But it's fascinating to me that after so many years of doing family medicine,
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  two decades, and over five years of doing health coaching with high achievers,
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  people who are intelligent,
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  they know how to manage their lives.
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  Every single time, sleep comes up.
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  And sleep is something we constantly have to work on with every one of these
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  clients. They think their sleep is perfect. They think their sleep is optimal.
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  And once I get the data, once we really do a deep dive, we see lots of problems.
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  So now imagine a person, completely healthy, no blood sugar problems,
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  no insulin problems, and you just cut two hours of sleep from them every single night.
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  After maybe like a week, after just a few days, their blood sugar is going to
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  be very similar to somebody who is early stage diabetic.
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  That's really scary when you think about it. And when you think about a diabetic
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  person, what comes to mind? This is somebody who, because of their insulin levels
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  and their blood sugar levels, is going to gain a lot of weight.
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  They're going to have a lot of joint problems. They're going to be super tired.
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  They're going to get a lot of infections and unfortunately have higher risk
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  of cancers and all these other things.
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  And I think the myth out there is that, oh, one night sleep that's bad is not
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  really going to affect me. And a little bit of coffee will get me through the day.
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  But they don't realize that this sleep debt that you accrue after age 30 is
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  not something you can make up.
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  And the acute metabolic crisis, honestly, the metabolic crisis that ensues after
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  this poor sleep is not something you can outrun in the gym.
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  It's not something that you can out eat in your fridge or in the grocery store. And that's the myth.
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  I'm not saying every single night has to be perfect sleep. Of course,
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  that's ridiculous. But the fact that somebody says, oh, it's okay,
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  it's just one night, is what creates a lot of these problems.
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  It is why I exist as a health coach, to help people rebuild and reset their lives.
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  And so we have lots of data on this.
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  I think one of the fascinating ones is a 1999 Spiegel study in The Lancet.
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  And it proved that sleep debt directly damages the endocrine system and the
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  metabolic function of the body.
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  And I think that 1999 study, Spiegel et al., is probably one of the most important
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  studies, a landmark study of its kind, and there's many, many more like it.
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  So what is the biology of this? Let's quickly go over this.
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  We're going to go over the cortisol spikes, we're going to go over the sympathetic
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  drive, and we're going to go over the cellular problems when you're not getting enough sleep.
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  And I'm talking about just missing a couple of hours here and there is enough
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  to really create this. The cortisol, most of you probably know this already.
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  When you are under stress, when you don't get adequate sleep,
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  your cortisol level remains high throughout the day.
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  And that's going to increase your insulin levels. And it's going to increase
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  the amount of blood sugar in your bloodstream, creating a lot of damage in your
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  joints, in your cells, in your brain, increasing the risk of dementia,
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  brain fog, mood problems, depression, anxiety.
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  That's number one, that's the cortisol spike. The sympathetic overdrive is something
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  we see when somebody has that lack of adequate rest and recovery from sleep.
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  And so their sympathetic tone actually increases over their parasympathetic
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  tone. You know, this fight or flight thing that we always talk about.
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  And this creates a lot of inflammation in the pancreas, which,
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  prevents it from being able to secrete insulin now when that happens you are
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  going to have a really hard time with weight loss you're really going to have
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  a hard time maintaining your weight loss maintaining your appetite and we're
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  going to get into appetite in a minute with the ghrelin hormones.
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  And the last one is really the cellular problem of something we call the GLUT4 glucose transporter.
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  So when now you have all this extra blood sugar in your blood and all this extra
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  insulin because of lack of sleep, unfortunately, your muscles,
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  which are the number one way that you,
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  take up excess blood sugar from the body, won't function.
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  Those are the GLUT4 transporters on the muscle cells, and they won't function
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  the same way. So your blood sugar will go up, which will make you hungry,
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  which will make you crash, which will make you gain weight because you're going
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  to eat more. You're going to snack more, unfortunately.
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  Now, there are two other things that I think are worth mentioning,
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  which is the leptin hormone and the ghrelin hormone.
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  And the only reason I think these are important is ghrelin now is actually getting
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  a lot of press because of some of the newer weight loss medications that actually
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  affect the ghrelin pathway.
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  Gwellyn is the hormone that triggers hunger.
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  And leptin is the hormone that tells you you're full.
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  Unfortunately, with lack of sleep, you're going to throw these hormones off.
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  And it takes only a little bit.
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  Sleep in the beginning stage, the first half is going to be a lot of deep sleep.
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  And the second half is going to be a lot of REM sleep. REM is really good for
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  your mood, your mind, cognition.
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  But deep sleep, that beginning stage, is that restful sleep.
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  If you eat heavy at night, if you're under a lot of stress, if you're on your
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  phone the entire time right before going to bed, it's likely that your deep
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  sleep won't be quite as deep and it's likely that it's going to get shortened.
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  And all of this happens in the amygdala.
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  I guess, I don't know, I don't think we need to get into it,
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  but it all creates this terrible cycle of cravings, more sugar intake, more carb intake,
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  higher insulin, higher stress, poor sleep, more insulin, more sugar and that's how it all unwinds so.
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  So one of the main things that my diabetic patients, when I used to take care
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  of diabetic patients, one of the main problems they had is a lot of visceral fat.
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  And the number one way to put on visceral fat, so if you have an animal and
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  you want to make it nice and fat, you limit its activity and you feed it a lot
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  of dense or calorie-dense foods.
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  For humans, it's eating a lot of saturated fat, it's eating a lot of meat,
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  a lot of eggs, a lot of dairy, and just not moving a lot. And that's how you
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  get visceral fat. But that's the same thing.
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  You can achieve the same thing by just restricting somebody's sleep.
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  As long as you feed them enough, restricting their sleep is unfortunately going
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  to cause the same metabolic terrain, which is not favorable.
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  So what are some actionable takeaways? What are some things that you could actually do?
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  Number one, when you wake up in the morning, try to go out for a walk.
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  Get some sunlight early. there are some really good studies to show that this
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  early sunlight will lower your cortisol and increase your melatonin because you need a spike in your.
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  Melatonin levels before you can actually get good sleep at night.
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  So you don't want to suppress your melatonin. And the way you suppress it is
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  by, you know, getting a lot of sunlight later in the day or too much light,
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  artificial light, or just being really stressed at the end of the day.
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  So get your early morning sunlight, The second one is this diet.
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  So, yeah, the diet thing is always complicated, but I'm going to briefly go over it here.
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  If you eat late at night, your deep sleep is going to be disrupted because of
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  the way your body temperature is affected. If you eat a high sugar meal,
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  you're going to be kind of amped up and unfortunately, it's going to affect your sleep at night.
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  So you really need that fine balance. You want to get the majority of calories
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  early in the day. You don't want to eat something too heavy towards the end of the night.
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  And this takes us to number three, which is the caffeine thing.
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  Caffeine, some people will have it at 1 p.m. And by 4 p.m., it's out of their system.
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  Other people will have it at 8 a.m.
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  And by 10 p.m., they still have caffeine in their system. Which means if you
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  have any sleep issues, if you have any weight problems, in my humble opinion,
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  caffeine is something you kind of have to cut out.
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  And later we can introduce it back in. But with a lot of my health coaching
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  clients, it's something we cut out until we fix the underlying.
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  Problems because it really does affect your REM.
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  And in the early stages, it does affect your deep sleep because you could fall
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  asleep with caffeine in your system.
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  But what's the point if you wake up and you're groggy and you feel like you
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  need more caffeine to get going?
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  And the last one is this temperature drop, which I briefly mentioned.
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  You need to keep your bedroom cool, even if you feel cold. There are ways around
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  that, but the bedroom, the environment should be cold.
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  And so can put blankets around you. It's kind of like camping, right?
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  But your body temperature has to drop in order for your metabolic activities to fully restore.
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  So those are the ways that I think about it. And I know there's no perfection here,
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  but if you're over the age of 30 and you are dealing with any health problems
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  whatsoever of any kind, the most important thing you can do for yourself is
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  to just go back to the basics of sleep.
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  Think about a baby that goes to sleep whenever it wants, or an infant or a toddler.
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  They go to bed whenever they're tired and they'll nap and they'll sleep and then they wake up.
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  And you know, if you've had a kid or have taken care of kids,
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  that when they really exhaust themselves, they'll get more sleep.
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  They'll make sure that they get enough sleep to recover. But we don't do that as adults.
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  When we have a really crazy day, crazy week, we get the same amount of sleep
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  as the previous week. It doesn't make any sense.
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  The more you do, the more sleep you need. The more you use your brain,
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  the more sleep you need, the more exercise you do, the more sleep you need.