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Sleep and Be Fertile

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a blog by Marta Montenegro, May 5, 2014

We’ve been told that to lose weight, we’d better have a healthy, balanced diet, eat fewer calories than we burn, and exercise regularly. And somewhere we read something about also managing stress to keep the pounds from piling up. However, other than the standard recommendations, not many people connect losing stubborn pounds with sleep habits. Indeed, you can be doing everything you are supposed to do, but still don’t see the scale balance in your favor. If this is the case for you, read and learn from my patient Mary.

BMI, IVF and Sleep: What do they have in common?

Mary, a patient evaluating fertility treatment options, ate clean and worked out four times a week, but began to notice, little by little, that her pants got tighter. Since she was doing the right things in terms of her health, she thought her weight gain was caused by a hormonal problem. “It must be my thyroid,” she said. After her physician ran all the proper tests, she came to me for overall dietary, exercise and other health-related lifestyle counseling.

By reviewing Mary’s lifestyle, I found she had begun to get up at midnight to make sure her husband was home safe from his night job. So, with this nightly interruption, Mary was getting only about six total hours of sleep a night. Not terrible, but the problem was that her sleep time and quality was being disrupted. And this disturbance she was messing up her metabolism. Translation: she didn’t know why she was hungry all the time or why she was craving sugary food throughout the day. These symptoms were something that she didn’t have before.

Mary’s body mass index (BMI) – a measure of weight-height relationship classification – was now over 25, when it used to be 23. This put Mary in the overweight category. The fact that Mary now was overweight increased not only her pant size, but also her risked her fertility and overall health. In fact, a recent study, in which more than 47,000 treatment cycles were included, found that raised BMI (>25) is associated with adverse pregnancy outcome in women undergoing IVF with ICSI treatment, including lower live birth rates. (Reproductive Biomedicine Online, 2011.)

Unfortunately, Mary could now be part of this statistic. How are sleep deprivation or erratic sleep patters linked to weight increase? In a study published in the international journal Psychoneruendocrinology, sleep-deprived people selected greater portion sizes of energy-dense food snacks – high in sugar and fat –and meals than they do after one night of normal sleep. Another study published in Journal of Clinical Endocrinology & Metabolism shows that even with subjects of healthy weight, when they experienced just a single night of sleep loss, the part of the brain related to the desire to eat experienced a greater activation than when they slept their regular number of hours.

Experts explain that lack of sleep or sleep disruption, throws off important hormones that control appetite and satiety: ghrelin and leptin. When these two hormones are out of whack, hunger increases while satiety is slow to kick in. This affects other hormones that also impact the metabolism, such as insulin and cortisol. So, basically, your energy goes down and neither your body nor mind processes that you’ve already eaten, therefore you feel hungry all day, and your energy stays low. All this makes it harder for you to do the two things that can best control your weight: making nutritious food choices and exercising.

Even when you do manage to control your diet, in a study in which subjects on a diet slept 8.5 hours or 5.5 hours, they lost the same amount of weight, but the ones who slept the 8.5 hours lost more body fat and less lean muscle than those who slept less.

The takeaway message: we know how important is to maintain a healthy weight during fertility treatments; one more thing to evaluate if you’re fighting the pounds is your sleep pattern.

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