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Chronic sleep deprivation and seasonality: Implications for the obesity epidemic
Sleep duration has progressively fallen over the last 100 years while obesity has increased in the past 30 years. Several studies have reported an association between chronic sleep deprivation and long-term weight gain. Increased energy intake due to sleep loss has been listed as the main mechanism. The consequences of chronic sleep deprivation on energy expenditure have not been fully explored. Sleep, body weight, mood and behavior are subjected to circannual changes. However, in our modern environment seasonal changes in light and ambient temperature are attenuated. Seasonality, defined as cyclic changes in mood and behavior, is a stable personality trait with a strong genetic component. We hypothesize that the attenuation in seasonal changes in the environment may produce negative consequences, especially in individuals more predisposed to seasonality, such as women. Seasonal affective disorder, a condition more common in women and characterized by depressed mood, hypersomnia, weight gain, and carbohydrate craving during the winter, represents an extreme example of seasonality. One of the postulated functions of sleep is energy preservation. Hibernation, a phenomenon characterized by decreased energy expenditure and changes in the state of arousal, may offer useful insight into the mechanisms behind energy preservation during sleep. The goals of this article are to: a) consider the contribution of changes in energy expenditure to the weight gain due to sleep loss; b) review the phenomena of seasonality, hibernation, and their neuroendocrine mechanisms as they relate to sleep, energy expenditure, and body weight regulation.
Hypnotics’ association with mortality or cancer: a matched cohort study
ObjectivesAn estimated 6%–10% of US adults took a hypnotic drug for poor sleep in 2010. This study extends previous reports associating hypnotics with excess mortality.SettingA large integrated health system in the USA.DesignLongitudinal electronic medical records were extracted for a one-to-two matched cohort survival analysis.SubjectsSubjects (mean age 54 years) were 10 529 patients who received hypnotic prescriptions and 23 676 matched controls with no hypnotic prescriptions, followed for an average of 2.5 years between January 2002 and January 2007.Main outcome measuresData were adjusted for age, gender, smoking, body mass index, ethnicity, marital status, alcohol use and prior cancer. Hazard ratios (HRs) for death were computed from Cox proportional hazards models controlled for risk factors and using up to 116 strata, which exactly matched cases and controls by 12 classes of comorbidity.ResultsAs predicted, patients prescribed any hypnotic had substantially elevated hazards of dying compared to those prescribed no hypnotics. For groups prescribed 0.4–18, 18–132 and >132 doses/year, HRs (95% CIs) were 3.60 (2.92 to 4.44), 4.43 (3.67 to 5.36) and 5.32 (4.50 to 6.30), respectively, demonstrating a dose–response association. HRs were elevated in separate analyses for several common hypnotics, including zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates and sedative antihistamines. Hypnotic use in the upper third was associated with a significant elevation of incident cancer; HR=1.35 (95% CI 1.18 to 1.55). Results were robust within groups suffering each comorbidity, indicating that the death and cancer hazards associated with hypnotic drugs were not attributable to pre-existing disease.ConclusionsReceiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality.
See: Obesity raises death risk tied to sleeping pills (EurekAlert!)
Annual Sleep in America Poll Exploring Connections with Communications Technology Use and Sleep
Annual Sleep in America Poll Exploring Connections with Communications Technology Use and Sleep
Source: National Sleep Foundation
The 2011 Sleep in America® poll released today by the National Sleep Foundation (NSF) finds pervasive use of communications technology in the hour before bed. It also finds that a significant number of Americans aren’t getting the sleep they say they need and are searching for ways to cope.
The poll found that 43% of Americans between the ages of 13 and 64 say they rarely or never get a good night’s sleep on weeknights. More than half (60%) say that they experience a sleep problem every night or almost every night (i.e., snoring, waking in the night, waking up too early, or feeling un-refreshed when they get up in the morning.)
About two-thirds (63%) of Americans say their sleep needs are not being met during the week. Most say they need about seven and a half hours of sleep to feel their best, but report getting about six hours and 55 minutes of sleep on average weeknights. About 15% of adults between 19 and 64 and 7% of 13-18 year olds say they sleep less than six hours on weeknights.
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Americans report very active technology use in the hour before trying to sleep. Almost everyone surveyed, 95%, uses some type of electronics like a television, computer, video game or cell phone at least a few nights a week within the hour before bed. However, baby boomers (46-64 year olds), generation X’ers (30-45 year olds), generation Y’ers (19-29 year olds) and generation Z’ers (13-18 year olds) report very different technology preferences.About two-thirds of baby boomers (67%) and generation X’ers (63%) and half of generation Z’ers (50%) and generation Y’ers (49%) watch television every night or almost every night within the hour before going to sleep.
“Artificial light exposure between dusk and the time we go to bed at night suppresses release of the sleep-promoting hormone melatonin, enhances alertness and shifts circadian rhythms to a later hour—making it more difficult to fall asleep,” says Charles Czeisler, PhD, MD, Harvard Medical School and Brigham and Women’s Hospital. “This study reveals that light-emitting screens are in heavy use within the pivotal hour before sleep. Invasion of such alerting technologies into the bedroom may contribute to the high proportion of respondents who reported that they routinely get less sleep than they need.”
+ Survey results (PDF)
