Finding time to Sleep is crucial for youthful skin, health and beauty.

WOMEN At Least 3 Sleep Challenges

FACE

Contents

Beauty & Sleep 2

3 5 6 7  10 12 14 17 18 19

About Dr. Breus

Women, Hormones & Havoc

PMS & Your Biological Clock

Sleep Loss & Fat

Sleep Loss & Increased Appetite

Sleep Deprivation, Skin Hair

Sleep Apnea, or Look Young?

Skin and Sleep

Sleep Loss & Weight Gain

Sleep Loss & Fat

ABOUT DR. BREUS Michael J. Breus, Ph.D., is a Clinical Psychologist and both a Diplomat of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine. He was one of the youngest people to have passed the Board at age 31 and, with a specialty in Clinical Sleep Disorders, is one of only 160 psychologists in the world with his credentials and distinction. In addition to his private practice, he not only treats athletes and celebrities, Dr. Breus also trains other sleep doctors and consults with major airlines, hotel chains, mattress manufacturers and retailers to provide the optimum sleep experience for their customers. For over 14 years, Dr. Breus has served as the Sleep Expert for WebMD which includes a monthly column called “Sleep Matters”. Dr. Breus also writes The Insomnia Blog and is a regular contributor to The Huffington Post, Psychology Today, MedPedia, Organized Wisdom, and Furniture Today. With more than a dozen appearances on The Dr. Oz Show, Dr. Breus has been dubbed his “Sleep Expert” and holds a seat on his Clinical Advisory Board. Additionally, Dr. Breus’ audio relaxation CD, created for Crown Plaza Hotels, helps millions of people fall asleep each year.

Further ReadingBooks By Dr, Breus

The Sleep Doctor's Diet Plan: Lose Weight through Better Sleep

Good Night: The Sleep Doctor's 4-Week Program to Better Sleep and Better Health Also available in Spanish & Japanese

Tune in for Dr. Breus’Secrets to Sleep Success Podcast

Secretstosleepsuccess.com

Good Night with the Sleep Doctor

Don’t Miss the PBS Documentary

1Beauty Sleep 4

Women have more problems sleeping than men do for two primary reasons:

hormones and aging.

5 Beauty Sleep

Hormones Wreak Havoc Women have more problems falling asleep and staying asleep than men do and are also more likely to have daytime sleepiness. Women have more sleep disruptions during the premenstrual and menstrual times of the month—including difficulty getting to sleep, nighttime awakenings, sleep disturbances, and vivid dreams. But why do these sleep disruptions occur? Your hormones. While the hormone estrogen, which is present in both sexes but more abundant in women, increases REM sleep, the female hormone progesterone, which rises at midcycle, after ovulation, causes feelings of fatigue and drowsiness. When menstruation begins and the progesterone level begins to fall, women have greater difficulties falling asleep and often experience poor sleep quality for a few days. As a woman’s cycle begins again, normal sleep (if not good sleep) usually returns. Other consequences women must contend with include:

Changes in the rhythm of body temperature throughout the men- strual cycle that affect sleep. Your sleep pattern seems to closely follow changes in your body temperature. In fact, daily body tem- perature increases right after ovulation, thus minimizing the nor- mal decline in body temperature that occurs with sleep.6 Lower production of the natural sleep hormone melatonin during the luteal phase, the second half of the menstrual cycle after ovulation,7 which makes it harder to stay asleep at night and leaves you feeling sleepy the next day. Pregnancy and child rearing both take heavy tolls on a woman’s sleep. One study revealed that women lose hundreds of hours of sleep during the first year of a child’s life.8 (And when their teen- agers start driving, I’m sure worrying makes them lose hundreds of hours of sleep again!)

The susceptibility to hormone-related sleep problems waxes and wanes throughout a woman’s life; sleep problems first surface during pregnancy and flare up again at perimenopause and menopause. Along with female-specific sex hormones, imbalances of other sub- stances in the body that affect mood, inflammation, and insulin balance can also contribute to poor sleep in women. Examples of these substances include the amino acid tryptophan and the sleep hormone melatonin. Tryptophan is necessary for the formation of serotonin, the neurotrans- mitter that has a calming influence in the brain.9 Melatonin helps to regu- late sleep cycles and sets the brain’s biological clock. When levels of any or all of these substances fluctuate, the result can be a miserable night’s sleep.

6 Beauty Sleep

Why Women Can’t Sleep: The Menstrual Cycle According to a poll by the National Sleep Foundation, about 70 percent of menstruating women say their sleep is disrupted during their periods by symptoms like breast tenderness, bloating, cramps, and headaches.10 The menstrual cycle is divided into four phases: § Menstrual phase—Between the onset of your period (day 1 of your cycle) and its end § Follicular phase—From the end of your period until ovulation at about day 14 § Early luteal phase—The week after ovulation (days 15 to 21) § Late luteal phase—The time until menstruation starts again (days 22 to 28 or so) At the start of your menstrual phase (when your period starts), there’s a decline in estrogen (and a slowing of your metabolism) and you get sleepy. We now know that the drop in estrogen leads to less REM sleep, which is when dreams usually occur. Also, having a heavy period can lead to anemia from the lower iron level, which is a primary cause of restless legs syndrome—that uncomfortable creepy, crawly feeling you may get in your legs when you lie down that forces you to keep moving your legs or walking around. During the follicular phase, in the first half of your menstrual cycle, the brain signals the pituitary gland to make follicle-stimulating hor- mone, which triggers a rise in estrogen. Thus, you no longer feel sleepy—to the contrary, you may feel overly stimulated and have insomnia. During the follicular phase, women tend to have more light or poor-quality sleep (Stage 2) and an increase in REM sleep, often at the end of the night, which may make it difficult to wake up in the morn- ing. So, it’s both hard to fall asleep and hard to wake up during this menstrual phase leading to ovulation. During the early luteal phase, the week after ovulation, the hormone progesterone is on the rise again. This will increase sleepiness and body temperature. Your circadian rhythm (which is controlled by melatonin) is affected. You will feel sleepy and want to go to bed earlier, but you will also wake up earlier. Your metabolism speeds up during this phase, so you will feel hungrier and eat more. Sleep will be lighter or of poorer quality. In the final phase that leads up to menstruation—the late luteal phase, which is when many women experience PMS—estrogen and progesterone levels begin to fall back to “normal,” increasing awaken- ings and decreasing the amount of deep, restorative sleep you get and crave the most.

To add to the trouble, it is thought that PMS also affects your biological clock by throwing off the timing of sleep, just as jet lag does. Normally, melatonin is low during the day and higher at night. However, in women dealing with PMS, melatonin is thought to be higher during the day, making them feel sleepy at the wrong time. While in the throes of PMS, some women say they feel fatigued no matter how long they stay in bed. In addition, a study showed that women who experienced PMS rated their alertness as significantly lower during both menstrual phases studied (the follicular phase and the late luteal, premenstrual phase).12 It may be that the lower level of alertness is due to a tendency toward poorer sleep in women with PMS. Studies show that women have more awakenings, sleep distur- bances, and vivid dreams with PMS than they do during the rest of the month. PMS tends to occur more often in women from ages 26 to 42 who have had at least one child and have a family history of depression and/ or a past medical history of postpartum depression or a mood disorder.13 Women with severe PMS (also called “premenstrual dysphoric disor- der,” or PMDD) report even more sleep-related complaints, including having trouble falling and staying asleep, fatigue, sluggishness, and dif- ficulty concentrating. In fact, sleep disturbance—either being sleepy all the time or having trouble getting to sleep or staying asleep—is one of the defining criteria for a diagnosis of PMDD. .

PMS  Throws  Off  Your  Biological  Clock    

7

��� We all know that sleep often becomes more difficult as we age. Some of us who’ve accumulated a certain number of birthday cards know this first hand! We also know that our circadian “clocks”—an internal mechanism that keeps us on a 24-hour, night-day cycle—function less well with age, and this contributes to sleep problems that can plague older adults, including: Difficulty falling asleep Trouble staying asleep Problems with daytime alertness In addition to difficulty with nightly sleep, as we age we’re less likely to be able to cope with disruptions to our night-day routines, including difficulty adapting to time-zone changes, or working non-traditional hours, late at night or early in the morning. Sleep is a critical factor in our long-term health and well being: studies show that it can play an important role in extending health and longevity and lack of sleep, in turn, can poseserious health consequences as we age. Women face particular challenges to sleep throughout their lives. Research shows they are more likely than men to experience difficulty sleeping. Evidence also suggests that over time, sleeplessness can have a more serious impact on women’s overall health than on men’s. Some of the sleep challenges for women are a matter of physiology, and others can be a matter of the many roles and responsibilities that women so often take on, particularly as mothers. Hormonal changes throughout a woman’s monthly menstrual cycle—primarily fluctuations of estrogen and progesterone—can make falling asleep and staying asleep more difficult. Menopause and peri-menopause bring their own set of hormone-related sleep challenges: insomnia is a common—and often overlooked—problem for women experiencing menopause. While raising young children, everyone in the family is likely to be sleep-deprived at times, but women with young children are more likely to be deprived of sleep than men. Understanding how the aging process affects sleep can help us find better ways to treat disordered sleep. That’s why this news is significant: a recent study may provide new information about why our circadian clocks may become less effective as we age.

Beauty Sleep

Women, Sleep and Age Researchers focused on a small area of the brain responsible for regulating the body’s circadian clock, which controls our sleep-wake cycle. To study the effects that aging has on the circadian clock, researchers compared young mice and middle-aged mice, looking for differences between them. What did they find? A dramatic difference in the amount of electrical activity in the area of the brain that controls the sleep-wake cycle (circadian clock) of younger mice versus older mice. In the younger mice, the researchers found very active brain waves during the day, and very little electrical activity at night. In middle-aged mice, the researchers found that the brain was not as active during day, and even more interestingly, it wasn’t as quiet at night. It’s as if as we age, the clock that regulates our sleeping and wakefulness ticks more and more quietly. A less effective circadian clock means less—and lower quality—sleep. The more we know about why our circadian clock deteriorates with age, the better able we’ll be to develop effective treatments for age-related sleep problems. Here’s some good news: you don’t need to wait for science to make new breakthroughs to improve your sleep by paying attention to the way your circadian clock works. You can reinforce your body’s own circadian rhythm—and strengthen your sleep-wake cycle—by adopting these habits: Exercise early in the day. Morning exercise can help stimulate your mind and body to a more alert, wakeful state, and sends the get-up-and-go message to your circadian brain. Get outside. Exposure to sunlight stimulates the brain’s SCN. Turn your coffee break into a quick walk around the block, and you’ll also be helping strengthen your circadian clock. Routine, routine. Our minds and bodies love—and respond to—routines. Setting regular bedtimes and rising times, eating and exercising at the same times during the day, are calming to the mind and help reinforce the body’s inner circadian rhythms. With their particular challenges to sleep, women may find paying special attention to circadian-boosting habits a natural and effective way to sleep well, no matter what number shows up on that next birthday card.

8 Beauty Sleep

NATURAL SLEEP TIPS FOR PMS AND YOUR PERIOD Increase your intake of liquids to help flush out excess sodium that causes water retention and bloating just before and during your period. This will help decrease any feelings of discomfort that make sleep difficult. Take extra calcium. In a study commissioned by the manufacturer of Tums (an OTC antacid medication containing calcium carbonate), taking 1,200 milligrams (mg) calcium daily resulted in a 50 percent decrease in PMS symptoms. Bloating was reduced by 36 percent, food cravings by 54 percent, and psychological symptoms by 46 percent. In addition, calcium has sedating properties, which can improve sleep quality.14 Take 400 mg magnesium. Studies show that magnesium affects mood by boosting the level of serotonin, the calming neurotransmitter in the brain. When combined with calcium, magnesium is a good muscle relaxant.15 Of course, being relaxed is important to falling asleep easily. Take 100 mg vitamin B6, which also helps you produce serotonin. But be careful: In some people, B6 can have an energizing effect. Starting at 2:00 p.m., eliminate all caffeine. Caffeine is a stimulant that can trigger anxiety, making it difficult to fall asleep. Exercise in the early morning sunlight. Remember, do not exercise within 4 hours of bedtime. Exercising close to bedtime can key you up and make it more difficult to fall asleep. However, getting outside in the natural sunlight can increase your melatonin level in the evening. In addition, getting sunlight each day is vital to keeping your serum vitamin D level adequate. We now know that sufficient vitamin D is important for producing leptin (the STOP hormone that tells you to quit eating). I will explain more about this in Chapter 6. Don’t drink alcohol within 3 hours of bedtime. PMS can cause your blood level of alcohol to get higher than at other times of the month. While drinking alcohol may make you feel sleepier, alcohol also keeps you out of the deep stages of sleep, which are important for feeling refreshed when you awaken.

News You Can Use

2Beauty Sleep 9

DIET: Sleep loss leads to either an increase in calories taken in or a decrease in calories

burned off.

10 Beauty Sleep

Lack of Sleep Makes you Fatter In the Nurses’ Health Study, 70,026 women were studied to see whether not sleeping enough increased the risk of future weight gain and even obesity. Researchers concluded that self-reported sleep restriction impacts your ability to burn calories and increases the risk of weight gain. In fact, they reported that women in the study who slept 7 to 8 hours per night had the lowest risk for major weight gain. Similar stud- ies suggest that those who sleep less than 7 hours per night are more likely to be obese.24 In a study of middle-aged women, researchers concluded that weight gain was directly correlated with the amount of sleep the subjects received each night. This study started about 20 years ago and included more than 68,000 women who were asked every 2 years about their sleep patterns as well as their weight. After 16 years, the findings revealed that those women who slept 5 hours or less each night weighed 5.4 pounds more than the women who slept 7 hours. In addition, women who slept 5 or fewer hours per night were 15 percent more likely to become obese than women who slept 7 hours each night. Another sleep study reported that losing just 16 minutes of sleep per night increased the risk of obesity.

Moodiness and Depression Poor sleep can cause you to have mood swings and increased anxiety, and it can even lead to depression in some women. Between 65 and 75 percent of the patients I see in clinics have either anxiety or depression as both a cause and a result of their sleep problems. It’s not uncommon for patients with sleep deprivation to report bad moods, irritability, fatigue, decreased sex drive, and other signs of psychological dysfunc- tion. The good news is that many of these symptoms usually lessen in severity or even disappear when they establish good sleep habits again.

11 Beauty Sleep

Lack of Sleep Makes you Eat More Carbs and Snacks In a revealing study, scientists at the University of Chicago allowed people to sleep 5.5 hours on one night and 8.5 on another and then measured how many free snacks they downed the next day.27 The participants ate an average of 221 calories more when sleepy—an amount that could translate into almost a pound gained in 2 weeks! In another study that reviewed short sleep (less than 6 hours) in young adults, researchers concluded that after poor sleep, the increase in appetite for foods with high carbohydrate content was particularly strong. It was as if the sleep-deprived brain craved its primary fuel, glucose, which your body produces from carbs.28 In addition, not getting enough sleep affects the amounts and types of food you eat. Some studies show that sleeping for a shorter time and spending waking hours in an environment where people tend to overeat can cause you to engage in excessive snacking—and I don’t mean on fresh fruits and vegetables.

Bedtime Snacks: Truth or Hype? The trick to eating the ideal bedtime snack is to stick with foods that are high in carbohydrates and calcium and medium to low in protein, but to avoid heavy carbs that you’re bound to overeat, like pasta and rice. Also, watch your portion size before bedtime. Bedtime Snacks  ︎Whole grain cereal with fat-free milk (steer clear of high-sugar cereals) ︎ Nuts (a handful) ︎ Low-fat oatmeal raisin cookie and milk ︎ Peanut butter on whole wheat bread ︎ Fruit and cottage cheese or yogurt ︎ Whole grain toast topped with 1 small slice of reduced-fat cheese or nut butter ︎ Whole wheat crackers topped with mild cheese  Banana with 1 teaspoon peanut butter

12 Title of the book

The Connection Between Sleep and Appetite

Title of the book 12

Eating and sleeping are two of the most basic human functions, both essential to survival. They are also two biological processes that are deeply entwined, as science is increasingly discovering. There are foods that promote sleep (including potassium-rich fruits and dark leafy greens) and foods that can interfere with sleep (think high-fat snacks). Too much or too little sleep alters appetite and wreaks havoc with hunger-related hormones. Going without enough sleep makes junk food look more tempting, and increases desire for fatty and high-calorie foods. Staying up late at night often leads to greater overall calorie consumption and makes us more prone to putting on weight. On the other hand, high-quality, restful sleep in moderate amounts (not too little, not too much) has a positive influence on long-term weight control. Junk food New research gives us a glimpse of just how deeply connected sleeping and eating may be. Scientists have discovered in fruit flies that a brain molecule already known to regulate appetite may also play an important role in sleep regulation. Researchers at Brandeis University found that a neuropeptide in the fruit fly brain, already recognized as a regulator of eating, also can dramatically influence sleep and activity levels. Neuropeptides are molecules that enable communication among cells in the brain, and are involved in regulating a number of important physiological processes, including appetite and metabolism. Researchers examined the possible role in sleep regulation of a particular neuropeptide, known as sNPF, that is already known to regulate food intake and metabolic function. Researchers manipulated the sNPF neuropeptide in fruit flies to see what effects this had on sleep and activity levels. They found that altering the activity of sNPF had a dramatic, sleep-inducing effect on the flies: When sNPF was activated above normal levels, fruit flies fell asleep almost immediately. Flies slept excessively and activity levels dropped dramatically after sNPF activation. The flies woke from sleep in order to eat or to locate a new food source and then fell back asleep. When sNPF levels were returned to normal, the fruit flies’ sleep habits changed and the flies returned to normal sleeping patterns and activity levels. The activation of sNPF that changed sleep patterns and activity levels in the fruit flies did not alter feeding behavior in the short term. What does this discovery mean? It provides new window into the neurological connection between sleeping and eating. These findings on their own don’t explain how the physiological mechanisms behind sleeping and eating are related or influenced by one another. But the identification of a shared signal that regulates both eating and sleeping establishes an important and very tangible neurological connection between the two functions. Other recent research also has explored the brain-based connections between sleeping and eating, and the possible implications for weight control:

13 Title of the book

Researchers at University of California, Berkeley investigated the effects of sleep deprivation on brain functions related to food choices. Using MRI scans, scientists observed the neurological activity of sleep-deprived and well-rested people as they viewed pictures of a range of healthful and unhealthful foods. The scans revealed that the reward center of the brain responded more strongly to images of high-calorie foods among the sleep-deprived group than the well-rested group. The MRI scans also showed that sleep deprivation decreased activity in the area of the brain that regulates behavior control. This study suggests that insufficient sleep has a two-fold effect on eating—not sleeping enough makes us more inclined to eat poorly, and at the same time less able to exert control over our impulses to eat those not-good-for-us foods. Scientists at St. Luke’s-Roosevelt Hospital Center and Columbia University also examined the effects of sleep deprivation on neurological responses to food. Researchers used MRI scans to observe brain activity among two groups of healthy-weight adults—one group had received several full nights’ of sleep, and the other group had been limited to no more than 4 hours of sleep per night for 5 nights. The sleep-restricted group demonstrated greater activity in the reward center of the brain when looking at pictures of junk food. MRI scans showed the reward centers of sleep-restricted subjects did not react to the sight of healthful foods this way. The well-rested group did not display this heightened reward-center response to images of junk food. Both sleep problems and metabolic problems associated with overeating pose significant challenges to long-term health. Disrupted and insufficient sleep has become an increasingly common problem over the past several decades, contributing to the risk of a number of serious diseases, including cardiovascular disease, some types of cancer, and diabetes. Obesity is a significant public health problem in the United States. The rise in the rate of obesity is slowing somewhat after decades of sharp growth. Still, by 2030, projections suggest that more than 40% of U.S. adults will be obese. Understanding the relationship of sleep to food consumption, weight regulation, and metabolism is critical work. Identifying a single neurological molecule that helps regulate both sleeping and eating is a significant development in that understanding. There is much more to learn about the relationship between sleeping and eating—and how we can use that relationship to foster weight loss and improve overall health. But this latest discovery could be one important piece of the sleep-weight puzzle.

14

Sleep is a powerful tool for weight management. Getting sufficient sleep—for most of us that means 7-8 hours a night—can help keep your appetite in check, curb cravings, and reduce late-night noshing. The problem is that many of us just aren’t getting that much sleep on a regular basis. And sleep deficiency can make controlling weight much more difficult. A comprehensive new review of research related to sleep and weight gives us some perspective on what we’ve learned about the complicated relationship between the two. Researchers examined studies from the past 15 years on the possible influence of partial sleep deprivation and weight control. They emerged with a broad consensus: partial sleep deprivation appears to have a significant impact on weight—how easily it is gained, lost, and maintained. Partial sleep deprivation, in this case, is defined as sleeping fewer than six hours per night. The Centers for Disease Control estimates that nearly one-third of working adults in the U.S. are sleeping no more than 6 hours per night, an indication of just how broadly lack of sleep may be contributing to our culture’s problems with weight. This review revealed consensus among multiple studies about some of the ways that sleep can influence weight. Partial sleep deprivation disrupts the normal levels of two hormones that are critical to regulating hunger and appetite: ghrelin and leptin. I’ve written before about the role that these hormones play in the sleep-weight connection. Studies show that even mild and short-term sleep deprivation can result in imbalances to these hormones that govern appetite. Ghrelin is a fast-acting hormone, produced in cells of the stomach, which spurs appetite and drives us to eat. Ghrelin may particularly increase appetite for high-calorie foods. There’s evidence that ghrelin may also direct fat towards the midsection of the body, where it is most dangerous to health. When the body is deprived of sleep, production of ghrelin increases. Research shows that even a single night of sleep deprivation can elevate ghrelin levels—and appetite. Leptin is a hormone that suppresses appetite by communicating to receptors in the brain that the body has the energy it needs to function, and doesn’t need to take on more. Leptin is produced in white fat cells throughout the body. The amount of fat in the body, then, influences the amount of leptin produced.

When leptin levels are lower than normal, we’re less likely to feel full after eating. Food also appears more enticing to people with low leptin levels, according to research. Low sleep suppresses leptin production, making us more likely to feel ongoing pangs of hunger. Even short-term sleep deprivation has been shown to reduce leptin levels. With these hormonal imbalances at work, it’s little surprise that sleep-deprived people are more likely to gain weight, and to have difficulty maintaining a healthy weight. More than a third of adults in the US are obese, as are 17 percent of children, according to the Centers for Disease Control. Obesity, with its increased risks for many serious health problems—including diabetes, heart disease, stroke, and some types of cancer—is arguably our nation’s leading public health problem. A recent study by the CDC projects that half of all adults in the US will be obese by the year 2030. Our collective weight problem endangers millions of lives and costs billions of dollars. Researchers found that many studies conducted over the past 15 years reached similar conclusions about the influence of sleep on appetite hormones, and the consequences for weight. Their findings also suggest other areas of sleep-weight study that merit additional investigation: The influence of sleep deprivation on energy expenditure: Does sleep deprivation diminish the effectiveness of our body to burn calories? The effect of sleep deprivation on the quality of weight loss: Does sleep deprivation have an effect on the type of weight we lose? Does going without sufficient sleep make us more inclined to hang on to fat and shed non-fat soft tissue, like muscle? One thing is certain: with the numbers of people currently overweight and obese—and the millions more expected to join their ranks in the coming years—we can’t afford to overlook any treatment or lifestyle adjustment that could make a difference in our battle against the bulge. Getting enough sleep on a regular basis continues to prove a challenge for millions of people. Millions, too, are struggling to lose weight or to maintain a healthy weight. In order to make a real difference in the fight against obesity, we’re going have to get a lot more serious about improving our sleep. So when you’re strategizing to keep the pounds off through the holidays, why not make 8 hours of sleep a night part of your plan?

Beauty Sleep

Partial Sleep Deprivation Hinders Weight Control

15 Beauty Sleep

News You Can Use

3 KEYS TO LOSING WEIGHT WITH THE SLEEP DOCTOR’S DIET PLAN 1. Eat small meals that are high in protein and fiber every 3 to 4 hours up until 7:00 p.m. The protein–fiber combination will help stabilize your blood sugar and you won’t find yourself starving at dinner time or bingeing on late-night snacks like you would with fewer meals per day. 2. Eliminate calorie-laden sodas and juices from your diet. These calories definitely add up. Substitute mineral water or herbal teas for these drinks. Try flavored water or add a twist of a citrus fruit or cucumber slices to plain water. Even zero-calorie soda is not advised because the carbonation will give you gas and keep you awake or in a light-sleep stage. 3. Use an olive oil cooking spray instead of butter or margarine. Using this cooking spray can cut hundreds of calories from each dish you prepare.

Beauty & Sleep 16

3Your skin looks pasty, your eyes get puffy, and poor hydration makes your under-eye circles

more pronounced. Sleep Deprivation

Beauty & Sleep 17

Good Sleep Is Essential For Health & Beauty

Poor Complexion and Bad Hair Poor sleep can make you look older. You can see the effects of sleep loss when you look in your bathroom mirror in the morning. Lack of sleep can make your skin look swollen and ashen and can accentuate the deep reddish blue color under your eyes (dark circles). In addition, because sleep deprivation leads to poor circulation (which is how hair and skin get their nutrients), poor sleep is linked to facial wrinkles and thinning hair or even total hair loss. In a study reported in the Journal of Investigative Dermatology, researchers tested sleep-deprived women and found that their skin was more susceptible to outside allergens and bacteria.1 For some women, lack of sleep can worsen acne, rosacea, and dermatitis. Other studies have shown that poor sleep ultimately reduces immunity and results in skin that is dehydrated, wrinkled, pale, and unable to repair itself quickly.

You know that even occasional sleep problems make a normal day more stressful and less productive. That’s because your body and mind need consistent, restful sleep to function optimally. Remember, sleep is not a luxury or a treat, like splurging on dessert. Sleep is a necessary physiological function that keeps you alive. Let’s take a look at how missing just 1 night of shut-eye affects your looks, your mind, and your health. Your prefrontal cortex shuts down. This is the part of your brain that controls logical reasoning and the “fight or flight” response. You instantly become a poor decision maker. As a result, your choices of foods lean toward comfort foods (i.e., high carbs and high fat) to increase your level of serotonin (the calming hormone) and you’re apt to skip the gym because of fatigue. Your insulin production increases and your body starts to store fat more easily. Over time, this can lead to serious illnesses such as obesity, hypertension, and type 2 diabetes. You have problems completing tasks, whether simple or complex. Your ability to speak and remember diminishes as your brain is depleted of its ability to consolidate memories. You become irritable, possibly even irrational. You have difficulty focusing and concentrating. Your muscles ache, making movement difficult. Chances are, you recognize most of these symptoms. But now imagine weeks to months of poor sleep and how this can lead to premature aging, weight gain, and even a larger abdomen. I see the following problems almost daily in my female patients.

18

Sleeping Beauty may have had the ultimate secret to looking great and maintaining that soft, dewy skin of a twenty something. The Los Angeles Times reported on the “best skincare treatment,” readers might have been surprised to learn that it wasn’t a new cosmeceutical or $500-per-ounce skin cream. It doesn’t get any cheaper or more universally accessible than this: sleep. The article pointed out a few good facts that few people bear in mind: As we age, lack of sleep affects us more deeply and shows up more prominently on our faces (which explains why dark circles, fine lines, and pallid complexions aren’t a problem in our twenties despite the late nights, but can be later on). Sleep induces the production of collagen, a key ingredient in firm, youthful skin. The skin’s capacity to hold water is enhanced by sleep, thereby keeping skin moisturized and supple. Sleep deprivation can sting the immune system, leaving one vulnerable to rashes and skin-related problems. Growth hormone peaks during deep sleep, and this hormone plays a central role in initiating cellular repair. This can be tough medicine to swallow, though, for the millions of people who just can’t get six to eight hours of uninterrupted sleep. No wonder the multi-billion dollar cosmetic industry is in high demand. It’s true that when skin benefits from enough sleep, products and treatments work more effectively to provide better results. I concur with how Dr. Howard Murad, a dermatologist quoted in the article, puts it: “You cannot treat the skin as an isolated organ, you treat the whole person. Imagine your window frame needs to be replaced. You can just replace the frame or you can find out what damaged it in the first place, say termites or bad plumbing. Similarly, when the skin looks gray and sallow and you have dark circles around your eyes, you can use cold compresses and makeup as a temporary fix or address the underlying issues, such as sleep deprivation.” Unfortunately, temporary fixes can seem easier than getting a good night’s sleep. But imagine all the money you’d save if you just took this advice to heart— or, to bed. You’d do more for yourself than just enhance your looks. You’d feel better, too, from the inside out.

Beauty Rest Is Real

There’s no shortage of reasons to treat obstructive sleep apnea, including your overall health, your ability to function well during the daytime, and even your sex life. Here’s another: treating your sleep apnea will likely improve your appearance. New research indicates that effectively treating sleep apnea with CPAP therapy results in patients looking younger and more attractive.Attractive good sleepe and cpap compliant Researchers at the University of Michigan examined the impact of CPAP therapy for obstructive sleep apnea on patients’ facial appearance, and found noticeable—and measurable—improvements after consistent use of CPAP. The study included 20 adults, 14 men and 6 women, all of whom had obstructive sleep apnea. Researchers took highly detailed 3-dimensional images of participants’ faces, both before CPAP treatment began and again after 2 months of regular use of CPAP. Researchers then asked a group of 22 volunteers to assess both the before and after-treatment images. For each sleep apnea patient, volunteers were asked to identify what they believed was the post-treatment image, as well as to compare and rate the before and after pictures for alertness, youthfulness, and attractiveness. Researchers also used 3-D imaging to measure several aspects of appearance, including facial redness and forehead surface volume. They found significant differences to appearance after treatment, according both to volunteers’ impressions and objective measurements: In a significant majority of instances, volunteers were able to correctly identify the post-treatment images of sleep apnea patients Volunteers also were 2 times as likely to rate the post-treatment images as more youthful, more attractive, and more alert looking

Image analysis showed that after 2 months of CPAP treatment, facial redness around the eyes and cheeks had diminished Forehead surface area had also decreased after 2 months of CPAP, a finding that researchers suggested may be attributed to changes in fluid circulation at night. These results illustrate what most of us already know from looking in the mirror, or at the faces of those familiar to us: when we sleep well, we look better. Other recent research has also explored the relationship between sleeping well and looking good, with similar findings: Scientists at the University of Stockholm studied the impact of sleep deprivation on facial appearance. They found sleep-deprived people were observed to have redder and more swollen eyes, hanging eyelids, and darker circles under the eyes, as well as more wrinkles and paler skin. According to the study’s findings, sleep-deprived people also looked sadder than those who were well rested. An earlier Swedish study by some of the same research team also found sleep-deprived people to be perceived by others as less healthy and less attractive than well-rested people. A study commissioned by the cosmetics manufacturer Estée Lauder and conducted by scientists at Cleveland’s University Hospital’s Case Medical Center found that people who slept poorly showed greater signs of skin aging, including more fine lines, uneven pigmentation, and diminished skin elasticity. Poor sleepers also took longer to recover from sunburns and other environmental and stress-related skin damage. Sufficient amounts of high-quality sleep are critical for cell rejuvenation as well as for healthy immune function, so it’s not surprising that we’re seeing the effects of poor sleep in aging skin and less youthful

appearances. One important way that sleep promotes cell restoration and provides boost to the immune system is through the release of the body’s own natural growth hormones. During phases of deep sleep, levels of human growth hormone in the body rise. These hormones play a powerful role in stimulating the immune system and in promoting cellular repair as well as new cell growth. Poor sleep, and sleep disorders such as obstructive sleep apnea, diminish both sleep quantity and sleep quality, and can interfere with the body’s ability to rejuvenate cells and bolster immune function. This can result in a less attractive, less youthful appearance. But the most serious consequences of poor sleep and untreated sleep disorders are more than skin deep. Obstructive sleep apnea, left untreated, is associated with significant risks for cardiovascular disease, including high blood pressure, heart attack and congestive heart failure. Sleep apnea is also linked to type 2 diabetes and to greater incidence of depression. Patients with sleep apnea are at greater risk for accident and injury. CPAP therapy is effective in diminishing and even eliminating sleep apnea symptoms, decreasing these health risks significantly. But many patients who are prescribed CPAP don’t always use the device consistently. For people who are reluctant to use CPAP therapy on a regular basis, these results provide yet another incentive to stick with the treatment. You won’t just feel a difference in your sleep—you’ll see a difference in the way you look. Beauty Sleep

Treat your sleep apnea and look younger

20 Title of the book

TRY THE GLAMOUR SLEEP CHALLENGE Recently, to test my sleep diet hypothesis, another doctor and I worked with Glamour magazine and recruited women to help us investigate the link between sleep and weight loss. In the Glamour Sleep Challenge, we gave the participants some simple instructions.

•  Get 7.5 hours of sleep on the same schedule each night. •  Start a bedtime routine. •  Watch your caffeine and alcohol intake if they are high. •  Experiment with exactly how much sleep you need. •  Continue with your normal eating habits and exercise routine. The women agreed to follow these strategies and to ensure that they were sleeping at least 7.5 hours each night. That’s it. We didn’t ask them to make any changes to their eating habits or exercise routine. And the results were clear: Longer sleep allowed them to lose weight.

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21 Beauty Sleep

Our appearance is in so many ways a reflection of our general health and well-being. Sleeping well, and following recommendations made by our doctors for treating sleep disorders can help us look good and feel good.

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