Hormonal Connection Between Sleep & Metabolism
You are probably aware that the hormone melatonin helps modulate sleep cycles, but did you know that hormones related to metabolism are also intricately linked with sleep? Sleep is a critical regulator for many of the body homeostatic mechanisms, as it is a key player in the body’s stress response system, known as the hypothalamic pituitary adrenal (HPA) axis.
The HPA is a dynamic communication interface between the hormonal or endocrine system and the central nervous system. It is often regarded as the body’s stress system because it controls cortisol and a number of other stress-related hormones. Under normal, non-stress conditions, levels of cortisol in the bloodstream follow a circadian rhythm. Most simply, highest levels occur in the morning, and ideally are responsible for stimulating us to wake up. Cortisol levels should decrease over the course of the day, hitting the lowest point around midnight. When the body’s internal clock is not properly synchronized, or when we are subjected to excess stressors, the regular pattern of this daily cortisol wave is disrupted, and can have a ripple effect on related factors, including sleep (Joseph & Golden, 2013) and weight gain (Hirotsu et al., 2015).
Even a little bit of sleep deprivation can challenge the waistline, particularly if it happens routinely. Studies have shown that regular sleep duration of fewer than 7.7 hours is associated with increased sensation of hunger and correlations with increased BMI (Taheri et al., 2004). Sleep restriction has also been shown to cause a decrease in the hormone leptin, which is responsible for the sensation of satiety or fullness, and increases in ghrelin, which stimulates hunger (Spiegel et al., 2004). These effects can impact the day’s appetite even after just a single, sleep-deprived night (Schmid et al., 2008). Short sleep not only makes us want to eat more, it also significantly reduces insulin sensitivity and glucose tolerance (Wilms et al., 2019; Spiegel et al., 2004). Chronically reduced insulin sensitivity commonly leads to insulin resistance, which is closely associated with health issues such as metabolic syndrome, type 2 diabetes, and polycystic ovary syndrome.
If you are noticing circular relationships here, then you are right. Poor sleep can increase stress and disrupt blood sugar management, and high stress can make sleep more difficult (Lucassen & Cizza, 2012). The good news is that you can escape from this vicious cycle! There are a number of ways to destress and cultivate good sleep habits. Regular exercise along with a good schedule for bedtimes and meals is a great place to start. Other helpful habits include limiting caffeine and making space to unwind during the hours before bedtime.
Even when they are ultimately beneficial, developing new habits can be challenging. At Naturna, we help you transition more smoothly by sharing what we have seen work for others, and by providing supportive health care. Acupuncture is shown to be an effective modality for shifting hormonal imbalances toward a more stable state of homeostasis (Liang & Koya, 2010). In addition, acupuncture can reduce insomnia and improve overall sleep quality (Guo et al., 2013). Most importantly, the holistic nature of Chinese medicine means your acupuncturist will consider multiple variables in developing a treatment plan to best address your unique patterns and circumstance.
References
Guo, J., Wang, L. P., Liu, C. Z., Zhang, J., Wang, G. L., Yi, J. H., & Cheng, J. L. (2013). Efficacy of acupuncture for primary insomnia: a randomized controlled clinical trial. Evidence-based complementary and alternative medicine: eCAM, 2013, 163850. doi:10.1155/2013/163850
Hirotsu, C., Tufik, S., & Andersen, M.L. (2015). Interactions between sleep, stress, and metabolism: from physiological to pathological conditions. Sleep science (Sao Paulo, Brazil), 8(3), 143–152. doi:10.1016/j.slsci.2015.09.002
Joseph, J. J., & Golden, S. H. (2017). Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Annals of the New York Academy of Sciences, 1391(1), 20–34. doi:10.1111/nyas.13217
Liang, F. & Koya, D. (2010). Acupuncture: is it effective for treatment of insulin resistance? Diabetes, Obesity and Metabolism, 12, 555–569.
Lucassen, E. A., & Cizza, G. (2012). The hypothalamic-pituitary-adrenal axis, obesity, and chronic stress exposure: sleep and the HPA axis in obesity. Current obesity reports, 1(4), 208–215. doi:10.1007/s13679-012-0028-5
Schmid, S.M., Hallschmid, M., Jauch-Chara, K., Born, J. & Schultes, B. (2008). A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. Journal of Sleep Research, 17(3), 331–334. doi:10.1111/j.1365-2869.2008.00662.x
Spiegel, K., Leproult, R., L’Hermite-Baleriaux, M., Copinschi, G., Penev, P.D., & VanCauter, E. (2004). Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and tryptophan. The Journal of Clinical Endocrinology & Metabolism, 89(11), 5762–5771. doi:10.1210/jc.2004-1003
Taheri, S., Lin, L., Austin, D., Young, T., & Mignot, E. (2004). Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS medicine, 1(3), e62. doi:10.1371/journal.pmed.0010062
Wilms, B., Chamorro, R., Hallschmid, M., Trost, D., Forck, N., Schultes, B., Mölle, M., Sayk, F., Lehnert, H., & Schmid, S.M. (2019). Timing modulates the effect of sleep loss on glucose homeostasis, The Journal of Clinical Endocrinology & Metabolism, 104(7), 2801–2808. doi:10.1210/jc.2018-02636
