I’ve been thinking about health promotion and identity lately. See my posts on gender and sunscreen (Men, gender roles, and skin cancer risk), as well as on women and wine (see Women, wine, and the gendered marketing of alcohol.)

On the one hand, we might want to change the world and undo lots of the damage caused by gender roles. On the other hand. we want to save lives. Maybe when we’re out to promote health we do best with existing identities and motivations.

What got me thinking about this this week were two very different headlines about sleep in my newsfeed, obviously aimed at different demographics. The first, Go to Bed to Find Your Six Pack  is about the role of sleep in body fat reduction. It looks to be aimed pretty squarely at my son, for example. There’s no other argument about lack of sleep that would work, I think. It’s not that the fat reduction claims aren’t true. But do you lead with them?

(An actually, an aside: I do worry about health tips that rely on weight loss as a motivation, particularly for exercise. Suppose you don’t lose weight–that’s the most likely outcome–and you stop exercising. But it’s good for all sorts of things besides weight loss….)

Surprisingly, though, as a nutritionist who works with a lot of athletes, Mohning considers neither nutrition nor exercise to be the prime weapons in the fight against a tubby tummy. Instead, she points to sleep and stress.

“I would say Number 1 is sleep, Number 2 is stress, followed by nutrition and then exercise,” she says. “If you’re exhausted, it’s better to sleep the extra 30 to 40 minutes than to exercise.”

(The most effective anti-smoking ads for teenager girls, for example, don’t mention lung cancer. They mention your complexion as a smoker and the horror of wrinkles.)

This piece in After 50, called more sensibly and comprehensively The Risks of Insufficient Sleep, instead rtalks about cognitive decline, memory loss, and declining quality of life.

A small study published this March in Nature Neuroscience explored the relationship of poor-quality sleep with changes in the brain’s prefrontal cortex (where long-term memories are stored) associated with aging, which both led to reduced slow-wave activity during non-REM sleep.

Researchers concluded that the lack of deep sleep in older adults combined with these structural brain changes is linked to impaired memory and age-related cognitive decline but couldn’t establish a direct, causal connection.

All true. Sleep is super good for you. But different health messages reach different people.

It’s the second week of daylight savings time and I don’t know about you, but my friends are all still talking about sleep. Mostly they’re all talking about how little they get. “Sleep is the new sex,” etc etc.

There’s also a lot of media attention because it’s World Sleep Day.

In an earlier blog post I argued that sleep is a feminist issue. Women get less sleep than men, even though there’s some evidence we actually need more. Why do we get less sleep? The answers are sadly familiar. They are the same reasons women also get less time for sports and other leisure activities. Women as a group shoulder a greater percentage of dependent care responsibilities and housework. It’s part of the larger picture of the unfair division of work in the home. Something had to give and that thing is sleep.

Being well rested it turns out tracks power and privilege. Surprised? I’m not really.

Men, on balance, get more sleep than women, on balance. (Of course some women get lots of sleep and some men get nearly none. It’s the big picture we’re talking about here.) But sex isn’t the only relevant factor when it comes to power and privilege. In the case of sleep it may not even be the most important one. Race and income matter too. Here’s a report on sleep and the numbers.

A study of the sleep characteristics of 669 middle-aged adults found that people sleep much less than they should, and even less than they think. Published in the July issue in the American Journal of Epidemiology, the study also found that blacks sleep less than whites, men sleep less than women, and the poor sleep less than the wealthy.

It’s not just a little bit less sleep either. Black Americans get a lot less sleep than white Americans. In fact, the difference in sleep quantity between the two groups may be enough to explain the difference in life expectancy between the two groups.

“The racial inequalities in the US are stark, but none are more damaging than the health gap between blacks and whites. On average, blacks die at a significantly younger age than whites.”

Here is a recent report on sleep differences between black and white Americans, Nobody Sleeps Better Than White People, Says Study

Thursday we learned something truly astonishing: White people, unburdened by racism, sleep pretty damn well.

According to a new report from the Centers for Disease Control and Prevention, about 65 percent of Americans polled said they usually get at least seven hours of sleep per night, the benchmark recommendation. It’s self-reported data, not confirmed with any kind of tracking, but it’s fairly consistent with other estimates, the CDC says.

When the responses were broken down by race, they found that non-Hispanic whites had the highest rate of healthy sleep duration, at 66.8 percent. Close to 66 percent of Hispanics got seven-plus hours, as did 62.5 percent of Asians and 59.6 percent of Native Americans. Black people were at 54.2 percent, and multiracial people were at the bottom, with 53.6 percent. Overall, people who were employed and college-educated slept better, too.

Of course, most the media images of the underslept North American worker are of white, professional people. It’s reminding me of all the studies on stress which typically make their way into the media with images of men in suits attached. Stress is pictured as a disease of over achievers.

But the reality is quite different. Jobs that come without a lot of control are actually much more stressful. I’m reminded of my term serving as head of my academic department. Everyone asked if I found it stressful. The truth was that being in charge was much less stressful than being a regular colleague.

When I was a regular colleague I worried about decisions the Department Chair might make. When I was Chair, I didn’t worry about that all.

So as with stress, so goes sleep. It’s not the over-achieving powerful people who suffer the most. When it comes to sleep, black women get less sleep than white women and black men. It’s all about intersectionality. What’s that?

From the Geek Feminist Wiki, “Intersectionality is a concept often used in critical theories to describe the ways in which oppressive institutions (racism, sexism, homophobia, transphobia, ableism, xenophobia, classism, etc.) are interconnected and cannot be examined separately from one another.”

See also:

The Racial Inequality of Sleep

How Well You Sleep May Hinge on Race

Now, blessings light on him that first invented sleep! It covers a man all over, thoughts and all, like a cloak; it is meat for the hungry, drink for the thirsty, heat for the cold, and cold for the hot. It is the current coin that purchases all the pleasures of the world cheap, and the balance that sets the king and the shepherd, the fool and the wise man, even. ~Miguel de Cervantes, Don Quixote, 1605

Lots of recent fuss over getting enough sleep concerns links between lack of sleep and weight gain.  As sleep goes down, weight goes up. If you’re not interested in weight or body composition, look away. Nothing to see here. I’m not interested in dieting but I am interested in changes we can make that have an effect on nutrition, metabolism, and ultimately weight and body composition.

First, the correlation: Is lack of sleep making me fat?

With an ever-increasing number of studies finding a direct connection between sleep deprivation and weight gain, it’s difficult to deny the cause-and-effect relationship. People who get at least seven hours of sleep per night tend to have less body fat than people who don’t. There are, of course, other factors involved in determining who becomes overweight and who doesn’t, like food intake, exercise and genes. But sleep is a more integral of the process than most people realize. In a study involving 9,000 people between 1982 and 1984 (NHANES I), researchers found that people who averaged six hours of sleep per night were 27 percent more likely to be overweight than their seven-to-nine hour counterparts; and those averaging five hours of sleep per night were 73 percent more likely to be overweight.

Second, it’s not just weight, also fat versus muscle:  Lack Of Sleep Can Make Dieters Lose Muscle Instead Of Fat

People who are on a low-calorie diet will lose the same amount of weight whether they sleep an average of 8.5 hours or 5.5 hours each night. However, those on 8.5 hours will lose much more fat, while those on 5.5 hours lose mainly muscle, instead of fat, according to an article published in the peer-reviewed journal Annals of Internal Medicine. The researchers, from the University of Chicago stress that adequate sleep is a key contributor to managing body weight.

 

Third, what’s the causal mechanism?:  Insufficient sleep affects appetite and satiety hormones as well as fat cells, according to the nation’s top sleep experts.

Most people know they should cut calories and exercise more to trim down, but there’s now significant scientific evidence that another critical component to weight control is avoiding sleep deprivation, sleep scientists say. “There is no doubt that insufficient sleep promotes hunger and appetite, which can cause excessive food intake resulting in weight gain,” says Eve Van Cauter, director of the Sleep, Metabolism and Health Center at the University of Chicago. She has spent 15 years studying the topic. Sleep deprivation probably affects every process in the body, she says. “Our body is not wired for sleep deprivation. The human is the only mammal that does this.” Her research and that of others may help explain why so many people who are chronically sleep-deprived also are overweight, and it could be part of the reason sleepy college students, new parents and shift workers pack on pounds.

Fourth, and this fascinated me, we’re the only animals who do this:

“The human is unique in sleep depriving itself.” According to Van Cauter, the only times that animals lose sleep is either when there is a shortage of food or a stressful situation.  Such behavior can also be seen in humans, though much more frequently.“Our biology is wired to interpret sleep deprivation as either corresponding to a lack of food or corresponding to major stress,” Van Cauter says. Such behavior explains why the late-night bowl of ice cream can seem so appealing.

Hormones play a significant role in regulating the body’s food intake, and Van Cauter says that regulation of the hormones that control hunger and appetite starts in the brain, specifically the hypothalamus.  In the hypothalamus are orexin neurons, which maintain wakefulness and become hyperactive when the body is sleep deprived.  When the orexin neurons are more active, they stimulate production of hormones that are associated with increased hunger and appetite. When more of these hormones are created, humans tend to crave sugary and fatty foods.  Van Cauter says the reason for such a dietary phenomenon is that the brain is fueled primarily by sugars and fats, and needs those to stay alert. Because of sleep’s profound impact on diet, Van Cauter says the success of any weight loss plan is dependent largely on the amount of sleep that the individual gets.

Many people may experience difficulty getting the proper amount of sleep and may be inclined to look for other ways to keep the weight off.  Studies have shown that the hormone lepton can reduce appetite, but its use in overweight subjects is limited because they have a resistance to the hormone.

While I was away at a conference this past weekend, I thought I’d try out the android sleep tracker. I confess I’ve been curious for awhile about how much deep sleep I got. With a king size bed all to myself, I slept like a rock star. Eight hours, eleven minutes. 75% of that in deep sleep. Woo hoo.

(By the way, I’m doing well on this week’s resolution. So far, no snoozing. It works well having the alarm go off in a light sleep period, I think, though it’s hard to get used to the random awakening times. Ah, 5:22. You again.)

On a regular weeknight, my sleep is not so luxurious. Usually I get seven hours and change. And I get less deep sleep.

I share my bed with my partner, when he’s not in Toronto, and with our cuddly labradoodle (that’s a guess, she’s a rescue puppy) Olivia. Sometimes, also, the cat.

Behind us are the days of multiple babies and toddlers in the bed. It was a futon then, king size, with lots of room for extras.

Sharing a bed isn’t just about sleep quality though. There’s also sex, conversation, cuddling, and companionship to consider.

Strictly from the sleep quality point of view, it turns too there’s no clear consensus on whether alone or together is better. I’d heard three of these arguments before, better alone, better together and in opposite sex couples, worse for women, better for men. The new one was worse for men, better for women.

Better for everyone
Sleeping together improves health

Couples sleeping on the same bed may live longer and be in better health that people who sleep by themselves, experts say.

In fact, some researchers believe that sleeping with a partner may be a major reason why people in intimate relationships tend to be in better health.

Worse for everyone
Why It Might Be Healthier to Sleep Alone
From the marriage sucks file: The couple that snoozes together, loses together. scientists say sleeping together ruins your health.

The study reports that if you’re shacked up and sharing a bed, you experience 50% more sleep troubles than singletons. Sleeping together is downright unhealthy. So weird – I’m not married for this exact reason! Strategic brilliance from Ost, yet again.

Better for women, worse for men:

Bed sharing ‘drains men’s brains’

Sharing a bed with someone could temporarily reduce your brain power – at least if you are a man – Austrian scientists suggest.
When men spend the night with a bed mate their sleep is disturbed, whether they make love or not, and this impairs their mental ability the next day.

The lack of sleep also increases a man’s stress hormone levels.

According to the New Scientist study, women who share a bed fare better because they sleep more deeply.

Better for men, worse for women

http://www.nbcnews.com/id/21091112/ns/health-sleep/t/men-sleep-better-beside-mate-women-worse/

Taylor’s trouble getting a good night’s rest next to her husband isn’t unusual.Women sleep less soundly when they share a bed with a romantic partner, a study published this month in Sleep and Biological Rhythms found. Surprisingly, men actually sleep better when they sleep next to a woman.

There are a lot more couples sleeping separately than you might guess, says Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center in Minneapolis and a professor of neurology at the University of Minnesota Medical School. An estimated 23 percent of American couples sleep apart, according to a survey by the National Sleep Foundation. A Canadian study reported that 34 percent of couples hit the sack separately.