Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

The impact of sleep is both immediate and intimate

David L. Katz, MD
Conditions and Diseases
November 27, 2013
Share
Tweet
Share

We have long known that sleep is of profound importance to health. It is a requirement for living, much like breathing, but with awake and asleep playing out over longer spans and to slower rhythms than inhalation and exhalation. Sleep is essential. We must turn off if we are to go on.

Unlike many of the factors that affect health profoundly, the impact of sleep is both immediate and intimate. You have no need of me, or clinical trials, to tell you that sleep matters. All of us have, at some time, slept well — and awakened to feel the invigoration of having done so. All of us have, and most of us, alas, too often do, sleep poorly or too little — and thus know all too well that feeling of a head stuffed overfull with cotton and far too heavy for our necks.

While we need no science to tell us sleep matters, science can enhance our understanding of all the reasons why. Over recent years, no doubt due largely to our preoccupation with the epidemic obesity we keep choosing to lament rather than fix, the links between sleep and weight have received particular attention.

Relevant research consistently associates sleep deprivation with obesity risk, and invokes a number of potential mechanisms. Some are fairly self-evident. For instance, lack of sleep tends to mean lack of energy, which is apt to discourage exercise. Sleep deficiency also tends to produce irritability, and all the wrong foods tend to provide, albeit briefly, all the right comfort to dull this pain.

Some mechanisms are less apparent, and likely more important. The quantity, quality and timing of our sleep are tethered to our endocrine system. The circadian rhythms of our hormones influence our capacity to sleep and wake, and are in turn influenced by them. Disruptions in sleep patterns inevitably disturb hormonal balance, which in turn reverberates through the endocrine system like ripples in a pond. Cortisol levels are perturbed, unbalancing levels of insulin, and subsequently, appetite-regulating hormones such as leptin and ghrelin. Brain neurotransmitters, several of which double as hormones, are affected as well, including norepinephrine and serotonin. The stress of sleep deficiency stimulates epinephrine release. The result in general is increased appetite, an increased tendency to store calories as fat around the middle where it does the most harm, increased inflammation and the initial steps toward insulin resistance.

We knew all of this from a large and growing body of research addressing sleep. But relatively little of that research is of the direct cause-and-effect variety in people, because it’s challenging to randomize people to different sleep patterns for extended periods.

A new study in Pediatrics is something of an elegant exception, and all the more so for being carried out in children. While most of us adults would likely welcome more and better sleep, kids tend to go the other way — so they lack our bias. For research purposes, that’s a good thing — even if it’s not so good when it makes bed time a battle. I’ve got five kids. I know that gig.

In the new study, researchers assessed appetite, hormone levels, weight and food intake in a group of roughly forty children ages 8 to 11. They randomized the kids to a sequence of different number of hours in bed within a reasonable range, and monitored brain waves to tally hours actually slept. In one assignment, the kids had an extra 90 minutes in bed for a week. In the other, they lost 90 minutes. The result, measured by EEG, was an average of more than two hour differences in sleep time between assignments.

The effects on all measures of interest were clear and compelling. Two hours less sleep, even without rising to the definition of sleep “deprivation” was still enough to disrupt hormone levels, increase hunger and appetite, and increase daily calorie intake. In the sleep reduction phase of the trial, fasting leptin (a hunger suppressing hormone) levels were lower; reported food intake was higher; and weight increased slightly. And again, this was in kids — who may if anything be less prone to treat sleep-related irritabilities with food than we are.

The new study doesn’t change what we thought we knew, but it certainly lends emphasis. The physiologic effects of even moderate changes in nightly sleep time are rather potent, directly relevant to the prevailing health problems of our time, and nearly immediate.

Sleep has long been on my short list of top priorities for health, even if I’m slightly less good at it than I am with all the others. If it isn’t on yours, I certainly think it should be. Any parent or grandparent concerned about weight gain or diabetes risk in a child they love now has cause to make it a priority for those children, too. As a society subject to epidemic obesity and diabetes in children and adults alike, we may have new reasons to cultivate the respect for sleep it clearly deserves.

Action items begin there, with respecting sleep as much more than down time. Busy people may feel they don’t have time to sleep. However, for sustained productivity, let alone health, the truth is that none of us has time not to sleep.

At times, sorting out sleep problems may require assistance — such as undergoing polysomnography to identify sleep apnea. But often, the problem is behavioral and under our own control. There is a simple skill set for optimizing sleep hygiene, which any of us can learn and practice to good effect.

ADVERTISEMENT

Finally, there is an important argument here for approaching our health holistically. Perhaps you want to lose weight or avoid diabetes — you could decide, reasonably, to focus on diet and exercise. But if you ignore other aspects of your health, such as sleep, your own daily routine may conspire against your objectives. A culture widely prone to both obesity and sleep deprivation may be a quintessential case of meeting the enemy, and finding it is us.

I have seen just such patterns in my practice over the years, and a holistic view of health, orchestrating into a logical sequence of tweaks, can be just the fix. Often, with the requisite insights and skillpower, you can oversee just such troubleshooting on your own — no docs or drugs required.

We can’t be too busy to get the sleep we need, unless we are also too busy to get the health and weight control we want. If you remain unconvinced, I can only think to suggest you sleep on it.

David L. Katz is the founding director, Yale-Griffin Prevention Research Center. He is the author of Disease-Proof: The Remarkable Truth About What Makes Us Well.

Prev

Who do you want reading your EKG?

November 27, 2013 Kevin 17
…
Next

Emergency medicine is a public service

November 27, 2013 Kevin 4
…

Tagged as: Pediatrics

< Previous Post
Who do you want reading your EKG?
Next Post >
Emergency medicine is a public service

 

ADVERTISEMENT

More by David L. Katz, MD

  • There are only 3 ways to allocate health care resources

    David L. Katz, MD
  • Dr. Oz: I have met the enemy. It is us.

    David L. Katz, MD
  • a desk with keyboard and ipad with the kevinmd logo

    The dietary guidelines are for which Americans, exactly?

    David L. Katz, MD

More in Conditions and Diseases

  • Shift work and circadian rhythms shape the 24/7 workplace

    Deepak Gupta, MD
  • Telehealth and postpartum psychosis defy simple blame

    Rabia Cheema, MD
  • Underage online gambling needs more than a checkbox

    Kayvan Haddadan, MD
  • Why must fourth trimester care begin after delivery?

    Allison P. Boyle, DPA, PA-C
  • Nutrition during cancer treatment is more than calories

    Dr. Manjari Chandra
  • Why witnessing death outside the hospital felt different

    Denise Moulton, RN
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...