In case you didn't notice, it’s November, and in the Northern Hemisphere at least, that means Fall. Good food, holidays and merry-making await, but so does the specter of dramatically shorter days. So what, you may be saying, WE live in the post-modern information age! Flatscreen Television, computers, all night restaurants, SciFi channel and the other accoutrements that make (modern) life worth living… or at least bearable.

Well, the only problem with the post-industrial age and all the perks we may enjoy is that we are still biological entities that are tied to the planet, food, and indeed the ebb and flow of the seasons. If you have followed my drivel at all, you have likely heard me recommend a book Lights Out! Sleep, Sugar and Survival. This is, by a very narrow margin, my second favorite book on nutrition and health. It is perhaps not ironic that the folks who wrote my favorite book, Protein Power: LifePlan by Drs Michael R. and Marry Dan Eades, originally recommended Lights Out on the Protein Power Message Board. These two books cover so much important material: Probiotics, autoimmunity, depression, bio-identical hormone replacement, ketosis, even leaky gut syndrome. If you have not read these books, several times, you are doing yourself a disservice.

Lights Out deals largely with sleep deprivation and photo-toxicity. It manages to wrap in some quantum mechanics, and reasons for choosing a low carb diet, but the main theme, SLEEP, is lost on virtually everyone in health and medicine. I’m not sure what this stems from. Our Puritanical work ethic that shames us into a sense of bravado at how little sleep we can “get by on”? When is ANYTHING of quality or worth achieved under the circumstances: “Whew!! I managed to just get by on that project”?

The project I’m talking about is our LIFE, and we seem to miss the point that cutting into our sleep is, in the words of Lights Out authors T.S. Wiley and Bent Formby, “saving us minutes while costing us years.” Formby, with a PhD in Biophysics, and Wiley, a medical anthropologist, postulate that our heritage as hunter-gatherers, and the environment we evolved in, LIKELY influences our health (and disease) today. I know, I know… show me the study that proves their hypothesis. Well, clinically we have observed a handful of clients who have been stalled with fat loss efforts. Zone diet, check. CrossFit champs, check. Fish-oil, check. Fat Loss: no-bueno. Thorough questioning uncovers an average nightly sleep allotment of 5-6 hours. Approximately 50-60% of the minimum 9.5 hrs of darkness Lights Out recommends for most of the year. Fixing this problem (ya know, sleeping) can induce a 5% shift in scale weight in only a day or two (water loss due to decreased insulin and cortisol levels) and an immediate reduction in umbilical adiposity (belly fat = insulin resistance). Still don’t believe me? Here is an account from Dan John (http://danjohn.org/question.html) from several years ago. But hey, what does he know? National champion in a few sports and still competing in athletics at age 47; I’m sure nothing to learn there.

I want to delve into the contents of Lights Out just a bit and touch on some newer research that further validates the contention that we need to sleep more and eat in accordance with the seasons if we are to achieve optimum performance, health and longevity. PLEASE do not take this as a substitute for reading the two recommended books. I receive emails daily with the generic message: "This exercise and nutrition stuff is sooo complex. I’m confused about what to do." It’s not confusing when, in the words of Loren Cordain, "you know the answer… reverse engineering the question is easy." More often than not, it’s not confusion about WHAT to do, but rather resistance to life-ways that are as old as time. Whether we like it or not, the world our ancestors thrived in is quite different than that in which we live.


She blinded me with Science

We, our species, are the most adaptable and successful (in Darwinian terms) critters on planet Earth. We can survive and reproduce in virtually any environment imaginable as evidenced by many of the participants of the Jerry Springer Show (http://www.jerryspringertv.com/) and everything Emo (http://www.dobi.nu/emo/). Hardwired into this adaptability is in essence a blueprint for what environmental factors we as a species have faced in the past. We have an ability to remold our skeletons to a remarkable degree, which indicates a plasticity to meet the needs of various environments. Related to this is an ability to build not insignificant amounts of muscle to propel our activities; however, we also have a built-in brake in the form of the Myostatin gene (http://www.medterms.com/script/main/art.asp?articlekey=33546), which exerts an ever greater down regulation of hypertrophy. Gain a little muscle and it’s harder to gain more. It is apparent from the skeletal remains of our ancestors that they built an impressive level of muscularity and strength, but it is also evident that a control mechanism was necessary to prevent this process from going awry.

These are examples of innate control mechanisms that help us to cope with or optimize our existence. Despite our adaptability there are limits. Certain situations introduce stressors for which we have little or no adaptive capacity. One of these is fat gain, particularly fat gain associated with hyperinsulinism. Unlike the situation with the myostatin gene, fat gain is a feed-forward mechanism that can accelerate ever faster. Gain a little fat and it’s easier to gain more. Sleep, or more specifically, sleep-deficit, is similar to fat gain in that we have little ability to adapt to its effects. Sleep loss is also similar to (and actually an element of, as we will soon see) fat gain in that once our sleep has been disturbed, it is often difficult to achieve any quality sleep. Let’s take a closer look at the effects of sleep loss and perhaps I’ll convince you to go to bed a little earlier and stay there a little later.


Sweet Dreams

Everyone with the exception of the ever clueless Vegan Avenger, Dr. McDougall, seems to be up-to-date with the fact that excessive carbohydrate intake, particularly of a refined nature, can lead to very serious problems. People (some, anyway) have increased the lean proteins in their diet, added veggies and fruit and deleted grains and legumes. It’s a step in the right direction, but for many the results with respect to body composition shifts, amelioration of autoimmunity and the ability to control blood glucose levels have not been impressive. The one stone left unturned appears to be a silly little lifestyle component: sleep.

The link between sleep deprivation and impaired glucose metabolism/insulin resistance has been known for decades and the amount of research concerning sleep and hormonal dysregulation is quite extensive, however this timely information has yet to percolate to the surface of mainstream medicine. Sleep deprivation affects many hormonal and endocrine systems but perhaps the most pronounced effect is the increase in circulating cortisol levels1. Even modest sleep deprivation (2-3 hrs for 1-2 nights) can dramatically increase total daily cortisol release; however, the greatest impact appears to be an increase in cortisol in the late afternoon and evening, when cortisol should be declining. Normally the decreasing cortisol levels create a hormonal environment conducive to sleep. Sleep deprivation flips our body-clock to a low cortisol level in the AM and high levels in the PM. In the immortal words of my old Capoeira instructor, Mestre Curisco (http://www.qdoq.com/eng/photos/misc/h_capoeira-4.jpg.html), this situation is "No so good."

It is also important to note that elevated cortisol levels negatively affect appetite via actions on the ghrelin/leptin ratio. Not surprisingly, hunger appears to be focused on carbohydrate in these situations, with no increased desire for protein rich foods1. I think it’s telling how potent the effects of sleep deprivation are in that there is little contradictory information or conflict among sleep researchers as to hormonal derangement. Simple test protocols in which individuals are allowed to sleep for up to 12 hrs vs 4 hrs produce immediate, marked increases in cortisol, inflammatory markers and impaired glucose tollerance2. Even the young suffer the ill effects of sleep deprivation. The news flash is that sedentism, stress and inadequate sleep (in a dose-response fashion) appear to correlate quite nicely with childhood obesity.

I’d love to see the bio-ethics request to keep a bunch of brats up late, feed them crap and have them watch TV and play video games. That would likely get turned down as “unethical” yet that is typical home life for most children these days. Misanthropy anyone? I don’t want to beat this to death but I think its vitally important that you realize you can have your nutrition dialed, you can CrossFit like a champ… and you can still be ten gallons of screwed if you are chronically sleep deprived. I’ve had an ongoing conversation with a few of you about this very topic (you know who you are). If you do not fix your sleep, your sleep may fix you… perfect lead in for the next topic: chemical castration via sleep loss!


Dude, Where’s my androgens?

When we think about youth a common term is used: Raging Hormones. One of the key measures of aging is in fact a decline in or departure from a “youthful” hormonal profile. It appears however that a decline in testosterone in men and an alteration of the estrogen/progesterone ratio in women might be tied to lifestyle factors that assail youthful levels. Although the data is limited, it appears hunter-gatherers do not suffer the age related decline in androgens commonly seen in westerners3, until dietary and lifestyle practices leave the ancestral life way. Our favorite stud paleo-scientist, Arthur DeVany, appears to have amazing testosterone levels.

But how convincing is a burly Economics professor and a study looking at T levels of !Kung San hunters? Glad you asked. The literature is quite convincing in the argument that sleep deprivation, especially when combined with stressful situations, can leave one with a predilection towards break-up movies and pastel bath-towels. In simple terms even mild sleep deprivation can shift one towards a markedly catabolic state4. Not surprisingly, some of the people most impacted by this phenomena happen to be our guardians of health and wellness: doctors5. You’ve just got to love a system that creates a work environment that can reduce a man to the equivalent of a castrate and make otherwise youthful women infertile. What is the typical lifestyle of our modern physician? Long hours, sporadic sleep, crappy food, stress and golf as the main form of exercise.


A Few Good Men

This may not come as a surprise to our readers who are in the military, but you folks have some of the most stressful, difficult jobs around. Apparently loads of physical activity, dicey food and people trying to kill you induce a pretty potent stressor6. You folks in particular need to sleep when you can and keep your food as consistent as possible to mitigate an already difficult situation. Now if the females out there are feeling left out, don’t you worry! Sleep deprivation is a bugger for you as well7. Decreased testosterone and estrogen are just a few sleep-deprived nights away.

You may be thinking, “So what if guys end up with low testosterone levels and women have both low T and estrogen”? Well… a thorough treatment of endocrinology is beyond the scope of this paper but just keep in mind that YOUTHFUL levels and ratios of hormones are both correlative and causative of health. Men with low T levels are both depressed and depressing (http://www.hno.harvard.edu/gazette/2003/01.09/01-testosterone.html). Libido (http://www.medicalnewstoday.com/medicalnews.php?newsid=3865) in women appears to be tightly tied to T-levels as well. The main take home lesson here is even mild sleep deprivation can dramatically alter androgen levels for the worse. OK, I know all that was a bummer so here is a little something to lighten things up—check out this study:

Addict Biol. 2002 Jul;7(3):285-90. “Does Paradoxical Sleep Deprivation And Cocaine Induce Penile Erection And Ejaculation In Old Rats?”

I’m NOT making this up! When you search pubmed for the lead author you get this response. Loads of studies on rats both young and old, ecstasy, cocaine and penile function. I love science. I’m at a loss for something witty to follow up the penis-cocaine-ecstasy link, so let's just move this car wreck along to sleep and autoimmunity.


Know Thy Self

We have several elements that constitute our immune system. Innate, cell mediated immunity works concurrently with antibody production and a myriad of cytokines8 to control how we respond to a cold, heal from a strained hamstring or how/when/if we develop Parkinsons and Alzheimers. Immunology is in my opinion, THE most fascinating area of biology. Immune cells possess a massive information processing and storage system that rivals the brain in its complexity and computational power. The immune system is Bad-Ass and well endowed with AKP. Like anything smart, powerful and crafty, however, the immune system can, when not properly cared for, turn on the very entity it was meant to serve, making life miserable or, in some instances, impossible.

What are some ways to piss off the immune system? Feed yourself crap like wheat and beans, exercise excessively, or just come up short on your sleep allowance. That last one, friends, will work like a charm. Here is a little experiment. The next time you have some kind of allergy really pay attention to how much (or little) sleep you had the night(s) before. Now try sleeping at least 9 hours for a few days. Notice a difference? You will be much less sneazy, stuffy and red faced with a good night's sleep because your immune system will not be in over-drive. What exactly is occurring here is not well understood but involves a dynamic equilibrium between your immune system, largely located in the gut in structures called Peyer’s Patches, and the intestinal microflora. Microflora proliferate during the day, and under normal (optimal) conditions the immune system prunes some of the biomass back at night. Sleep deprivation compromises the integrity of this dynamic system and allows for, in essence, a bacterial bloom. It’s as nasty as it sounds. These bacteria shed molecules called endotoxin-lipo-polysaccharides that play a key role in a healthy immune system. Overgrowth of the bacterial mass, however, can derange immune function and set the stage for autoimmune conditions such as Lupus, Rehumatoid arthritis, chronic fatigue and fibromyalgia.

Somewhat related to autoimmunity is the catch-all term “Irritable Bowel Syndrome” or IBS for those in the know. This condition is as much fun as a Chernobyl type accident in the middle of a Rib Cook Off. Lots and lots of bad. IBS is characterized by alternating bouts of constipation and diarrhea, gas, bloating cramps… Did I mention lots of bad? IBS has many environmental triggers such as wheat and alcoho,l but sleep deprivation kicks the colon while it’s down by disturbing the normal vagal nerve activity that governs peristaltic action AND it feeds the aforementioned microflora extravaganza. In essence, IBS is a condition in which an agitated nervous system is paired with an intestine in the middle of a China Syndrome Meltdown from microflora bloom9. Did I mention this is bad? I think it’s also important to note that autoimmunity and gut health are somewhat chicken and egg. Irritate your gut lining by consuming wheat, legumes and other nasty foods and you may open the door to autoimmunity. Neglect your sleep, derange your immune system and cause a microflora overgrowth… and again, you can open the door to autoimmunity. If you’re not convinced that IBS is of the suck, just eat a load of wheat and stay up late for a while. Fun times await!


Aging

Before laying out a simple prescriptive piece, I’d like to touch on aging and sleep deprivation. It is telling that many of the papers I reviewed for this article included statements such as “…Sleep deprivation appears to create acutely, elements of the aging process…” Said another way, missing sleep makes you feel how you will feel when you are old. All of the elements I’ve touched on (and several I did not) are what we typically associate with aging. Impaired glucose metabolism, obesity, decreased physical capacity, androgen derangement, depression, and digestive issues. It is interesting that hunter-gatherers have been observed to live into advanced age with little if any of these effects. It is perhaps a stretch to say that aging IS sleep deprivation… but not much of one. To delve more deeply into the topic of aging I would simply revisit the above topics. Do me a favor and re-read those pieces with an eye not only towards the symptomatic condition I’m discussing, but also with an eye towards aging and longevity. Then read Lights Out and put their recommendations into action. Some elements may not be easy, the authors point out, “Yes, getting 9.5 hours of sleep per night may impact your social life… but then again so will cancer…” For many of you, this is the last chink in the armor. Your nutrition is sound and you are smart with your training. It would just be a bummer to never know that a little more sleep (or a lot) could have made everything all the better.


Things to Tinker With

1. Get 9.5 hours per night of sleep/time in COMPLETE DARKNESS. If you need to cover your bedroom windows with foil and take on the elements of an Oroville Trailer Park, do it. No light. You cannot see your hand wave in front of your face… no alarm clock light, LEDs from thermostats, etc. Go to bed as early as is reasonable. This may be the only way to get in the 9.5 hrs.

2. Go to bed the SAME time every day. Weekends, holidays and government overthrows included. This consistency establishes a pattern that lends itself to deeper sleep and an easier waking.

3. 1,000 mg of buffered Vitamin C in the form of magnesium and zinc ascorbates can help to reduce cortisol levels. Take this about an hour before bed.

4. A contrast shower can really help to knock you out! One to two minutes hot, 30 seconds cold, alternated a few times. If you can handle it, finish with a cold rinse… then jump in bed! One of the characteristics of sleep is a reduced body temp. The contrast shower with the cold finish can aid this process. If you are cold sensitive, finish on a hot rinse.

5. Think about dropping your daily carb intake to the 30-60 gram range. You may not be able to be a CrossFit rock-star on this carb level, but you can shore up weaknesses in your strength base while keeping a modicum of metabolic conditioning in your line up. The lights out authors are emphatic that a period of ketosis is absolutely essential to maintain health. With what we have learned about intermittent fasting and Metabolic Control Analysis, this seems a wise recommendation.

What the heck are you waiting around for! Go to bed!


Notes:
1- Essent Psychopharmacol. 2005;6(6):341-7 Metabolic and endocrine effects of sleep deprivation. Copinsshi G.
2- Ann N Y Acad Sci. 1999;896:254-61 Sleep as a mediator of the relationship between socioeconomic status and health: a hypothesis. Vancouter E., Spiegel K.
3- Psychoneruoendocrinology. Vol 12, No 6, pp. 449-458, 1987 Testosterone Levels Change With Subsistence Hunting Effort In !Kung San Men. Carol M. Worthman And Melvin J. Konner
4- Arch Androl. 1989;22(3):203-7 Sleep deprivation and adaptive hormonal responses of healthy men.
5- Steroids. 1992 Feb;57(2):86-9 Subnormal serum testosterone levels in male internal medicine residents.
6- Mil Med. 2003 Dec;168(12):1034-8. Immune and hormonal changes following intense military training.
7- Horm Behav. 2006 Apr;49(4):433-40. Epub 2005 Nov 14 The effects of paradoxical sleep deprivation on estrous cycles of the female rats.
8- Neuroimmunomodulation. 2005;12(5):255-69 Cytokine dysregulation, inflammation and well-being.
9- Dig Dis Sci. 2000 May;45(5):952-9. Sleep disturbance influences gastrointestinal symptoms in women with irritable bowel syndrome.