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	<title>Comments on: When It Comes to Sleep, Average is Best</title>
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	<description>Serving up health and fitness insights (daily, of course) with a side of irreverence.</description>
	<pubDate>Fri, 04 Jul 2008 06:47:49 +0000</pubDate>
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		<title>By: Heather</title>
		<link>http://www.marksdailyapple.com/sleep-weight-gain/#comment-44239</link>
		<dc:creator>Heather</dc:creator>
		<pubDate>Tue, 08 Apr 2008 02:10:09 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/sleep-weight-gain/#comment-44239</guid>
		<description>Thank you, Anna. Your last line is exactly how I feel. In the past I've felt like I was being "bad" somehow or should feel guilty for sleeping a lot, like there was something wrong with me or I didn't deserve to waste time sleeping.

Since living with my husband (9 years now) I've gotten over that because he's never acted like my sleeping is a bad thing, and encourages me not to feel bad about it. He'll even tell me to take a nap if he can tell that I'm in a bad mood or have a headache. 

I'm really grateful for his understanding &#38; accepting attitude, even though he rarely sleeps more than six hours a night. I'm sure your husband is as grateful as I am. =)</description>
		<content:encoded><![CDATA[<p>Thank you, Anna. Your last line is exactly how I feel. In the past I&#8217;ve felt like I was being &#8220;bad&#8221; somehow or should feel guilty for sleeping a lot, like there was something wrong with me or I didn&#8217;t deserve to waste time sleeping.</p>
<p>Since living with my husband (9 years now) I&#8217;ve gotten over that because he&#8217;s never acted like my sleeping is a bad thing, and encourages me not to feel bad about it. He&#8217;ll even tell me to take a nap if he can tell that I&#8217;m in a bad mood or have a headache. </p>
<p>I&#8217;m really grateful for his understanding &amp; accepting attitude, even though he rarely sleeps more than six hours a night. I&#8217;m sure your husband is as grateful as I am. =)</p>
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		<title>By: Anna</title>
		<link>http://www.marksdailyapple.com/sleep-weight-gain/#comment-43961</link>
		<dc:creator>Anna</dc:creator>
		<pubDate>Mon, 07 Apr 2008 20:29:54 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/sleep-weight-gain/#comment-43961</guid>
		<description>Heather, 

I think you make some great points.  I sometimes will lay down and rest my eyes, but rarely can nap (if I do it messes with my night sleep, too).  

My husband is like you; he will sleep a lot if he can arrange it in his schedule.   He is pretty much his own boss; he goes into work late several times a week to have a little nap in the morning and also on weekends.  His work is such that he can do a lot at home, too.  That was hard for me to adjust to at first, but denying my husband a nap a few times a week and trying to keep him on a conventional work schedule just made both of us cranky and annoyed.  

Sleeping isn't a moral thing.  It's responding to and respecting individual needs.</description>
		<content:encoded><![CDATA[<p>Heather, </p>
<p>I think you make some great points.  I sometimes will lay down and rest my eyes, but rarely can nap (if I do it messes with my night sleep, too).  </p>
<p>My husband is like you; he will sleep a lot if he can arrange it in his schedule.   He is pretty much his own boss; he goes into work late several times a week to have a little nap in the morning and also on weekends.  His work is such that he can do a lot at home, too.  That was hard for me to adjust to at first, but denying my husband a nap a few times a week and trying to keep him on a conventional work schedule just made both of us cranky and annoyed.  </p>
<p>Sleeping isn&#8217;t a moral thing.  It&#8217;s responding to and respecting individual needs.</p>
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		<title>By: Heather</title>
		<link>http://www.marksdailyapple.com/sleep-weight-gain/#comment-43955</link>
		<dc:creator>Heather</dc:creator>
		<pubDate>Mon, 07 Apr 2008 20:19:17 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/sleep-weight-gain/#comment-43955</guid>
		<description>I'm a 9-10 hour person (since I was little), sometimes I'll go longer if I feel like it. I do have the kind of lifestyle that allows me to sleep as long as I want to, mostly because I've chosen that kind of lifestyle intentionally. I have few responsibilities beyond the basic bill-paying &#38; house-cleaning (and a part time job), so I happily indulge in sleeping as much as I want to. So there are people who are not "seriously ill" and do have time to sleep that much.

I would argue that many of the people who think they don't have time to sleep simply aren't choosing to sleep. Time spent watching TV &#38; reading blogs could be spent sleeping, but most people would rather stay up so they don't "miss anything". I know there are people who are truly busy, but most of us have more of a choice to sleep than we think. I know how much I love to sleep, so I make choices that accommodate that desire. 

I don't think sleeping so much is detrimental to my life at all. I find I eat way less when I sleep more for a few reasons. I feel rested &#38; emotionally stable, so I don't eat junk because I'm cranky. I plain just can't eat while asleep, and I have less hours in the day to eat. This also leads to unintentional IF-ing  because by the time I'm showered &#38; ready it's nearly lunchtime, might as well wait &#38; just eat lunch in an hour or two. 

Lots of sleep = laziness = poor food choices doesn't ring true for me. The more I sleep, the better my food choices are. Not everyone who sleeps a lot is just lazy or bored. And for that matter, some of the laziest people I know don't get much sleep, and I wonder if they're lazy because they're tired all the time.

Overall I figure that if my body didn't wake up naturally then obviously I needed to sleep. Forcing myself to wake up early has only led to crankiness &#38; muscle soreness. There's nothing wrong with sleeping a lot &#38; enjoying it, provided other areas of life don't suffer for it. Some people act like it's a sin to sleep until noon, but I think it's far worse to neglect your body because there's some societal rule saying "sleep = lazy" and no one wants to be seen as lazy.</description>
		<content:encoded><![CDATA[<p>I&#8217;m a 9-10 hour person (since I was little), sometimes I&#8217;ll go longer if I feel like it. I do have the kind of lifestyle that allows me to sleep as long as I want to, mostly because I&#8217;ve chosen that kind of lifestyle intentionally. I have few responsibilities beyond the basic bill-paying &amp; house-cleaning (and a part time job), so I happily indulge in sleeping as much as I want to. So there are people who are not &#8220;seriously ill&#8221; and do have time to sleep that much.</p>
<p>I would argue that many of the people who think they don&#8217;t have time to sleep simply aren&#8217;t choosing to sleep. Time spent watching TV &amp; reading blogs could be spent sleeping, but most people would rather stay up so they don&#8217;t &#8220;miss anything&#8221;. I know there are people who are truly busy, but most of us have more of a choice to sleep than we think. I know how much I love to sleep, so I make choices that accommodate that desire. </p>
<p>I don&#8217;t think sleeping so much is detrimental to my life at all. I find I eat way less when I sleep more for a few reasons. I feel rested &amp; emotionally stable, so I don&#8217;t eat junk because I&#8217;m cranky. I plain just can&#8217;t eat while asleep, and I have less hours in the day to eat. This also leads to unintentional IF-ing  because by the time I&#8217;m showered &amp; ready it&#8217;s nearly lunchtime, might as well wait &amp; just eat lunch in an hour or two. </p>
<p>Lots of sleep = laziness = poor food choices doesn&#8217;t ring true for me. The more I sleep, the better my food choices are. Not everyone who sleeps a lot is just lazy or bored. And for that matter, some of the laziest people I know don&#8217;t get much sleep, and I wonder if they&#8217;re lazy because they&#8217;re tired all the time.</p>
<p>Overall I figure that if my body didn&#8217;t wake up naturally then obviously I needed to sleep. Forcing myself to wake up early has only led to crankiness &amp; muscle soreness. There&#8217;s nothing wrong with sleeping a lot &amp; enjoying it, provided other areas of life don&#8217;t suffer for it. Some people act like it&#8217;s a sin to sleep until noon, but I think it&#8217;s far worse to neglect your body because there&#8217;s some societal rule saying &#8220;sleep = lazy&#8221; and no one wants to be seen as lazy.</p>
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		<title>By: primalman</title>
		<link>http://www.marksdailyapple.com/sleep-weight-gain/#comment-43931</link>
		<dc:creator>primalman</dc:creator>
		<pubDate>Mon, 07 Apr 2008 19:06:21 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/sleep-weight-gain/#comment-43931</guid>
		<description>There is probably more than just correlation here and the results are not silly.  

Sleep deprivation (even mild deprivation) leads to increases in the hormone gherlin which is responsible for increases in appetite. At the same time, levels of leptin decrease following sleep disruption. Leptin is a hormone that leads to satiety.  Disruption of sleep of otherwise normal sleeping adults has been shown to create the “munchies” often resulting in 500 kcal increase in consumption following day.  Even 60-90 minutes of disruption can lead to this increase and people tend to go for salty, processed carbs.  The hormones appear to be largely responsible.

Not sure about the biological cause of over-sleeping as it relates to weight gain. 

 I will say that over-sleeping for one person may be under sleeping for another.  The “average” person does need about 8 hours of sleep.  However, approximately 15% of the population has an optimal sleep need of only about 6 hours. Eight hours is over-sleeping for these people.  On the side of the bell curve, there is about 15% of the population who has a sleep need of 9-10 hours, optimally speaking.  Sleeping 8 hours for these people will lead to mild, chronic sleep deprivation.  I do not see where this study accounts for this natural variation.

Last, sleep quality does have a lot to do with the equation.  It may be that many people who sleep more than 9 hours due to depression, boredom or just plain old fatigue may not be getting enough stage 3 and 4 sleep.  Many people try to compensate for poor quality by increasing sleep time, but it does not work very well.  Decreases in time spent in stages 3 and 4 may very well lead to the hormone disruptions noted above.</description>
		<content:encoded><![CDATA[<p>There is probably more than just correlation here and the results are not silly.  </p>
<p>Sleep deprivation (even mild deprivation) leads to increases in the hormone gherlin which is responsible for increases in appetite. At the same time, levels of leptin decrease following sleep disruption. Leptin is a hormone that leads to satiety.  Disruption of sleep of otherwise normal sleeping adults has been shown to create the “munchies” often resulting in 500 kcal increase in consumption following day.  Even 60-90 minutes of disruption can lead to this increase and people tend to go for salty, processed carbs.  The hormones appear to be largely responsible.</p>
<p>Not sure about the biological cause of over-sleeping as it relates to weight gain. </p>
<p> I will say that over-sleeping for one person may be under sleeping for another.  The “average” person does need about 8 hours of sleep.  However, approximately 15% of the population has an optimal sleep need of only about 6 hours. Eight hours is over-sleeping for these people.  On the side of the bell curve, there is about 15% of the population who has a sleep need of 9-10 hours, optimally speaking.  Sleeping 8 hours for these people will lead to mild, chronic sleep deprivation.  I do not see where this study accounts for this natural variation.</p>
<p>Last, sleep quality does have a lot to do with the equation.  It may be that many people who sleep more than 9 hours due to depression, boredom or just plain old fatigue may not be getting enough stage 3 and 4 sleep.  Many people try to compensate for poor quality by increasing sleep time, but it does not work very well.  Decreases in time spent in stages 3 and 4 may very well lead to the hormone disruptions noted above.</p>
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		<title>By: Anna</title>
		<link>http://www.marksdailyapple.com/sleep-weight-gain/#comment-43921</link>
		<dc:creator>Anna</dc:creator>
		<pubDate>Mon, 07 Apr 2008 18:41:20 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/sleep-weight-gain/#comment-43921</guid>
		<description>For about a decade (to age 44), increasingly I would wake in the night for no apparent reason and not be able to get back to sleep, which exhausted me during the day to the point that I dropped any responsibility &#38; chore that wasn't absolutely essential.  I absolutely wasn't burning the candle at both ends, but I felt like I was.

I also used to wake suddenly and sit bolt upright with repeated violent "coughing fits" (I didn't have any major allergies or respiratory infections), which would then keep me - and my husband- awake for hours.  Sleeping in a semi-upright position sometimes was effective, but the sleep quality wasn't ever very good.  Dealing with the dust, allergen coverings for bedding, and nasal steroids didn't help, because that wasn't the problem.  So we lived with it.

Everyone is different, of course, but my sleep quality and duration improved nearly 100% when I got on an appropriate dose of thyroid hormone treatment almost two years ago.   After a lot of reading and keeping a symptom diary, I perservered and finally found patient and informed practitioners who didn't write Rx just to mask symptoms.  I'm finally sleeping well nearly every night, which makes everything better in the day (and without resorting to sleeping pills, anti-depressants, and various other drugs my former internist wanted to prescribe).  

I had at least 10 or more years of undiagnosed mild hypothyroidism, but during that time, I never imagined anything systemic like that.  I just noticed an increasing number of very annoying but seemingly unrelated changes in all sorts of things minor and major, that my (former) internist attributed to "getting old".  She told me to get used to getting old because the body wasn't designed to thrive past age 50 (I had just turned 44 - I'm not into age-denial and anti-aging, but that attitude is such BS!).   

It took trying several doctors over several months to get treated in a way that produced both "good" lab results and me feeling better, finally going outside my HMO network to a recommended doctor and paying out of pocket.  Too many doctors treat the lab results and not the patient.  When some symptoms do not resolve even when the "labs look great", out come the anti-depressant samples and the Rx pad.   Finding the right care was difficult, lengthy, and not covered by my HMO insurance plan, and frankly, the search was more depressing than the hypothyroidism itself.  But two years later, I know my tenacity was well worth it.  My increasing fatigue had been taking a high toll on my family.  

My husband was the first to notice that I no longer woke up coughing after my hypothyroidism was stabilized.  I take T4 along with with a small dose of compounded natural thyroid extract for small dose of T3 - about a 98% T4 to 2% T3 ratio.  Now I realize I was probably experiencing sleep apnea (though I do not fit the typical sleep apnea profile in any way, except for hypothyroidism, which isn't a well known cause).  The coughing problem has returned sporadically each fall for the last two years (some other symptoms also return around that time) so my doctor raises my dose a bit for the fall-winter season then reduces it in the late spring.  That takes care of it.   He has noticed the seasonal/declining light connection in other patients, too. 

I also noticed a bit more sleep improvement when I started on bioidentical progresterone about a year ago (I'm now 46) in the luteal phase of my cycle.  But mostly I use progesterone for other not-serious-but still-annoying peri-menopause symptoms, like cycles that had shortened to 20 days on average, luteal phase itching and rashes,  and worsening pre-menstrual breast pain.  I now see a great gynecology Nurse-Practioner who is well-versed in bio-identicals and compounding. I wish I had found her years ago.  

The symptoms women experience often are so common and overlap with so many conditions; it is not always easy to determine the exact cause or combination of causes.  Not enough practitioners are interested in doing more than manage symptoms instead of determining the root cause.  Thyroid issues are more common in women (though men sometimes have a hard time getting thyroid problems diagnosed because of this), and typically occur during periods of reproductive hormone changes, such as the teenage years, post-childbirth, but especially pre-and post-menopause, which can last for many years.  And being the "master hormone", when the thyroid hormones are not working properly, the other reproductive hormones may not function properly, either.  

Plus, some hormones naturally decline with age, but they don't always decline smoothly and predictably.  I don't have some of the typical pre-menopausal symptoms, like hot flashes (in fact I was so chronically cold for so many years I would have gladly welcomed a hot flash) plus I know from two rounds of complete hormone testing in my 30s that my estrogen levels weren't ever going very high and roller-coastering down (the rapid, steep estrogen fluctuations cause hot flashes); increasing an-ovulatory cycles and low progesterone  production were much likely to be my problem.  

What helped me might not solve every woman's sleep disturbances, but with so many friends in their 30s and 40s also experiencing debilitating sleep disturbances, thyroid and hormone levels would be first things that should be thoroughly investigated. Doesn't mean every hormone shift or imbalance needs treating, either, but it's useful to know what is and isn't happening so the right decisions for treatment (or no treatment) are considered.  For instance, I would probably would have created more problems for myself if I had been trying the popular OTC estrogen-boosting supplements.  And long-term untreated hypothyroidism can be serious, with increased risk of heart disease and other conditions.</description>
		<content:encoded><![CDATA[<p>For about a decade (to age 44), increasingly I would wake in the night for no apparent reason and not be able to get back to sleep, which exhausted me during the day to the point that I dropped any responsibility &amp; chore that wasn&#8217;t absolutely essential.  I absolutely wasn&#8217;t burning the candle at both ends, but I felt like I was.</p>
<p>I also used to wake suddenly and sit bolt upright with repeated violent &#8220;coughing fits&#8221; (I didn&#8217;t have any major allergies or respiratory infections), which would then keep me - and my husband- awake for hours.  Sleeping in a semi-upright position sometimes was effective, but the sleep quality wasn&#8217;t ever very good.  Dealing with the dust, allergen coverings for bedding, and nasal steroids didn&#8217;t help, because that wasn&#8217;t the problem.  So we lived with it.</p>
<p>Everyone is different, of course, but my sleep quality and duration improved nearly 100% when I got on an appropriate dose of thyroid hormone treatment almost two years ago.   After a lot of reading and keeping a symptom diary, I perservered and finally found patient and informed practitioners who didn&#8217;t write Rx just to mask symptoms.  I&#8217;m finally sleeping well nearly every night, which makes everything better in the day (and without resorting to sleeping pills, anti-depressants, and various other drugs my former internist wanted to prescribe).  </p>
<p>I had at least 10 or more years of undiagnosed mild hypothyroidism, but during that time, I never imagined anything systemic like that.  I just noticed an increasing number of very annoying but seemingly unrelated changes in all sorts of things minor and major, that my (former) internist attributed to &#8220;getting old&#8221;.  She told me to get used to getting old because the body wasn&#8217;t designed to thrive past age 50 (I had just turned 44 - I&#8217;m not into age-denial and anti-aging, but that attitude is such BS!).   </p>
<p>It took trying several doctors over several months to get treated in a way that produced both &#8220;good&#8221; lab results and me feeling better, finally going outside my HMO network to a recommended doctor and paying out of pocket.  Too many doctors treat the lab results and not the patient.  When some symptoms do not resolve even when the &#8220;labs look great&#8221;, out come the anti-depressant samples and the Rx pad.   Finding the right care was difficult, lengthy, and not covered by my HMO insurance plan, and frankly, the search was more depressing than the hypothyroidism itself.  But two years later, I know my tenacity was well worth it.  My increasing fatigue had been taking a high toll on my family.  </p>
<p>My husband was the first to notice that I no longer woke up coughing after my hypothyroidism was stabilized.  I take T4 along with with a small dose of compounded natural thyroid extract for small dose of T3 - about a 98% T4 to 2% T3 ratio.  Now I realize I was probably experiencing sleep apnea (though I do not fit the typical sleep apnea profile in any way, except for hypothyroidism, which isn&#8217;t a well known cause).  The coughing problem has returned sporadically each fall for the last two years (some other symptoms also return around that time) so my doctor raises my dose a bit for the fall-winter season then reduces it in the late spring.  That takes care of it.   He has noticed the seasonal/declining light connection in other patients, too. </p>
<p>I also noticed a bit more sleep improvement when I started on bioidentical progresterone about a year ago (I&#8217;m now 46) in the luteal phase of my cycle.  But mostly I use progesterone for other not-serious-but still-annoying peri-menopause symptoms, like cycles that had shortened to 20 days on average, luteal phase itching and rashes,  and worsening pre-menstrual breast pain.  I now see a great gynecology Nurse-Practioner who is well-versed in bio-identicals and compounding. I wish I had found her years ago.  </p>
<p>The symptoms women experience often are so common and overlap with so many conditions; it is not always easy to determine the exact cause or combination of causes.  Not enough practitioners are interested in doing more than manage symptoms instead of determining the root cause.  Thyroid issues are more common in women (though men sometimes have a hard time getting thyroid problems diagnosed because of this), and typically occur during periods of reproductive hormone changes, such as the teenage years, post-childbirth, but especially pre-and post-menopause, which can last for many years.  And being the &#8220;master hormone&#8221;, when the thyroid hormones are not working properly, the other reproductive hormones may not function properly, either.  </p>
<p>Plus, some hormones naturally decline with age, but they don&#8217;t always decline smoothly and predictably.  I don&#8217;t have some of the typical pre-menopausal symptoms, like hot flashes (in fact I was so chronically cold for so many years I would have gladly welcomed a hot flash) plus I know from two rounds of complete hormone testing in my 30s that my estrogen levels weren&#8217;t ever going very high and roller-coastering down (the rapid, steep estrogen fluctuations cause hot flashes); increasing an-ovulatory cycles and low progesterone  production were much likely to be my problem.  </p>
<p>What helped me might not solve every woman&#8217;s sleep disturbances, but with so many friends in their 30s and 40s also experiencing debilitating sleep disturbances, thyroid and hormone levels would be first things that should be thoroughly investigated. Doesn&#8217;t mean every hormone shift or imbalance needs treating, either, but it&#8217;s useful to know what is and isn&#8217;t happening so the right decisions for treatment (or no treatment) are considered.  For instance, I would probably would have created more problems for myself if I had been trying the popular OTC estrogen-boosting supplements.  And long-term untreated hypothyroidism can be serious, with increased risk of heart disease and other conditions.</p>
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		<title>By: Migraineur</title>
		<link>http://www.marksdailyapple.com/sleep-weight-gain/#comment-43913</link>
		<dc:creator>Migraineur</dc:creator>
		<pubDate>Mon, 07 Apr 2008 18:23:43 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/sleep-weight-gain/#comment-43913</guid>
		<description>Correlation is not cause.  Taubes has a plausible hypothesis that fatigue, excessive hunger, and obesity are symptoms of celluar starvation that stocks the fat cells at the expense of other body cells.  So it makes sense that people whose body cells are starving would need more sleep.

I don't have much to say about the correlation between less sleep and weight gain, other than to note that medications, clinical depression, and other factors might affect both insulin (the primary weight gain hormone) and sleep.</description>
		<content:encoded><![CDATA[<p>Correlation is not cause.  Taubes has a plausible hypothesis that fatigue, excessive hunger, and obesity are symptoms of celluar starvation that stocks the fat cells at the expense of other body cells.  So it makes sense that people whose body cells are starving would need more sleep.</p>
<p>I don&#8217;t have much to say about the correlation between less sleep and weight gain, other than to note that medications, clinical depression, and other factors might affect both insulin (the primary weight gain hormone) and sleep.</p>
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