At Least 3 Sleep Challenges

WOMEN
FACE

Finding time to Sleep is crucial for youthful skin, health and beauty.
 Contents
About Dr. Breus 3
Women, Hormones & Havoc 5
PMS & Your Biological Clock 6
Sleep Loss & Fat 7  
Sleep Loss & Fat 10
Sleep Loss & Increased Appetite 12
Sleep Loss & Weight Gain 14
Sleep Deprivation, Skin Hair 17
Skin and Sleep 18
Sleep Apnea, or Look Young? 19

2 Beauty & Sleep

Further Reading
ABOUT DR. BREUS
Books By Dr, Breus
Michael J. Breus, Ph.D., is a Clinical Psychologist and
both a Diplomat of the American Board of Sleep
The Sleep Doctor's Medicine and a Fellow of The American Academy of
Diet Plan: Lose Sleep Medicine. He was one of the
Weight through
Better Sleep
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.

Good Night: The Sleep In addition to his private practice, he not only treats
Doctor's 4-Week
athletes and celebrities, Dr. Breus also trains other
Program to Better
Sleep and Better sleep doctors and consults with major airlines, hotel
Health chains, mattress manufacturers and retailers to provide
the optimum sleep experience for their customers.
Also available in
Spanish & Japanese 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
Don’t Miss the PBS Insomnia Blog and is a regular contributor to The
Documentary Huffington Post, Psychology Today, MedPedia,
Organized Wisdom, and Furniture Today.

With more than a dozen appearances on The Dr. Oz

Good Night with Show, Dr. Breus has been dubbed his “Sleep Expert”
the Sleep Doctor 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.

Tune in for Dr. Breus’

Secrets to Sleep Success
Podcast

Secretstosleepsuccess.com
 1
Women have more problems sleeping than men
do for two primary reasons:
hormones and aging.

4 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.

Beauty Sleep 5
 PMS  Throws  Off  Your  
Biological  Clock    
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
Why Women Can’t Sleep: The Menstrual Cycle the day and higher at night.
However, in women dealing with
According to a poll by the National Sleep Foundation, about 70 percent of PMS, melatonin is thought to be
menstruating women say their sleep is disrupted during their periods by symptoms like higher during the day, making them
breast tenderness, bloating, cramps, and headaches.10 The menstrual cycle is divided feel sleepy at the wrong time.
into four phases:
While in the throes of PMS, some
women say they feel fatigued no
§ Menstrual phase—Between the onset of your period (day 1 of your cycle) and its matter how long they stay in bed. In
end addition, a study showed that
§ Follicular phase—From the end of your period until ovulation at about day 14 women who experienced PMS
§ Early luteal phase—The week after ovulation (days 15 to 21) rated their alertness as significantly
§ Late luteal phase—The time until menstruation starts again (days 22 to 28 or so) lower during both menstrual phases
studied (the follicular phase and the
At the start of your menstrual phase (when your period starts), there’s a decline in late luteal, premenstrual phase).12
estrogen (and a slowing of your metabolism) and you get sleepy. We now know that It may be that the lower level of
alertness is due to a tendency
the drop in estrogen leads to less REM sleep, which is when dreams usually occur.
toward poorer sleep in women with
Also, having a heavy period can lead to anemia from the lower iron level, which is a PMS. Studies show that women
primary cause of restless legs syndrome—that uncomfortable creepy, crawly feeling have more awakenings, sleep
you may get in your legs when you lie down that forces you to keep moving your legs distur- bances, and vivid dreams
or walking around. with PMS than they do during the
rest of the month.
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 PMS tends to occur more often in
estrogen. Thus, you no longer feel sleepy—to the contrary, you may feel overly women from ages 26 to 42 who
have had at least one child and
stimulated and have insomnia. During the follicular phase, women tend to have more
have a family history of depression
light or poor-quality sleep (Stage 2) and an increase in REM sleep, often at the end of and/ or a past medical history of
the night, which may make it difficult to wake up in the morn- ing. So, it’s both hard to postpartum depression or a mood
fall asleep and hard to wake up during this menstrual phase leading to ovulation. disorder.13

During the early luteal phase, the week after ovulation, the hormone progesterone is Women with severe PMS (also
on the rise again. This will increase sleepiness and body temperature. Your circadian called “premenstrual dysphoric
rhythm (which is controlled by melatonin) is affected. You will feel sleepy and want to disor- der,” or PMDD) report even
go to bed earlier, but you will also wake up earlier. Your metabolism speeds up during more sleep-related complaints,
including having trouble falling and
this phase, so you will feel hungrier and eat more. Sleep will be lighter or of poorer
staying asleep, fatigue,
quality. sluggishness, and dif- ficulty
concentrating. In fact, sleep
In the final phase that leads up to menstruation—the late luteal phase, which is when disturbance—either being sleepy all
many women experience PMS—estrogen and progesterone levels begin to fall back to the time or having trouble getting to
“normal,” increasing awaken- ings and decreasing the amount of deep, restorative sleep or staying asleep—is one of
sleep you get and crave the most. the defining criteria for a diagnosis
of PMDD.
.
6
Beauty Sleep
 Women, Sleep and Age

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
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.
7
 News You Can Use
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.

Beauty Sleep 8
 2
DIET: Sleep loss leads to either an increase in
calories taken in or a decrease in calories
burned off.

9 Beauty Sleep

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.
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.
10
Lack of Sleep Makes you Eat More Bedtime Snacks: Truth
Carbs and Snacks or Hype?

In a revealing study, scientists at the University of The trick to eating the ideal
Chicago allowed people to sleep 5.5 hours on one night bedtime snack is to stick with
and 8.5 on another and then measured how many free foods that are high in
snacks they downed the next day.27 The participants carbohydrates and calcium and
ate an average of 221 calories more when sleepy—an medium to low in protein, but to
amount that could translate into almost a pound gained avoid heavy carbs that you’re
in 2 weeks! bound to overeat, like pasta and
rice. Also, watch your portion size
In another study that reviewed short sleep (less than 6 before bedtime.
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 Bedtime Snacks
the sleep-deprived brain craved its primary fuel, ︎
 Whole grain cereal with fat-free milk
glucose, which your body produces from carbs.28
(steer clear of high-sugar cereals)
︎ Nuts (a handful)
In addition, not getting enough sleep affects the ︎ Low-fat oatmeal raisin cookie and
amounts and types of food you eat. Some studies show milk
that sleeping for a shorter time and spending waking ︎ Peanut butter on whole wheat bread
hours in an environment where people tend to overeat ︎ Fruit and cottage cheese or yogurt
can cause you to engage in excessive snacking—and I ︎ Whole grain toast topped with 1
don’t mean on fresh fruits and vegetables. small slice of reduced-fat cheese
or nut butter
︎ Whole wheat crackers topped with
mild cheese
 Banana with 1 teaspoon peanut
butter
11
Beauty Sleep
 The Connection Between Sleep and Appetite

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:

12 Title of the book 12

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.
Title of the book 13
Partial Sleep Deprivation Hinders Weight Control
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.
Beauty Sleep
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?
14
 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 15
 3
Your skin looks pasty, your eyes get puffy, and
poor hydration makes your under-eye circles
more pronounced. Sleep Deprivation

16 Beauty & Sleep

 Poor Complexion
and Bad Hair
Good Sleep Is Essential For Health Poor sleep can make you
& Beauty look older. You can see the
effects of sleep loss when
You know that even occasional sleep problems make a normal day you look in your bathroom
more stressful and less productive. That’s because your body and mind mirror in the morning. Lack
need consistent, restful sleep to function optimally. Remember, sleep is of sleep can make your skin
not a luxury or a treat, like splurging on dessert. Sleep is a necessary look swollen and ashen and
physiological function that keeps you alive. Let’s take a look at how can accentuate the deep
missing just 1 night of shut-eye affects your looks, your mind, and your reddish blue color under
health. your eyes (dark circles). In
addition, because sleep
Your prefrontal cortex shuts down. This is the part of your brain that deprivation leads to poor
controls logical reasoning and the “fight or flight” response. You instantly circulation (which is how
become a poor decision maker. As a result, your choices of foods lean hair and skin get their
toward comfort foods (i.e., high carbs and high fat) to increase your nutrients), poor sleep is
level of serotonin (the calming hormone) and you’re apt to skip the gym linked to facial wrinkles and
because of fatigue. thinning hair or even total
hair loss.
Your insulin production increases and your body starts to store fat more
easily. Over time, this can lead to serious illnesses such as obesity, In a study reported in the
hypertension, and type 2 diabetes. Journal of Investigative
Dermatology, researchers
You have problems completing tasks, whether simple or complex. tested sleep-deprived
women and found that their
Your ability to speak and remember diminishes as your brain is skin was more susceptible
depleted of its ability to consolidate memories. to outside allergens and
bacteria.1 For some women,
You become irritable, possibly even irrational. lack of sleep can worsen
acne, rosacea, and
You have difficulty focusing and concentrating. dermatitis. Other studies
have shown that poor sleep
Your muscles ache, making movement difficult. ultimately reduces immunity
and results in skin that is
Chances are, you recognize most of these symptoms. But now imagine dehydrated, wrinkled, pale,
weeks to months of poor sleep and how this can lead to premature and unable to repair itself
aging, weight gain, and even a larger abdomen. I see the following quickly.
problems almost daily in my female patients.

17
Beauty & Sleep
Beauty Rest Is Real
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.

18
Treat your sleep apnea and look younger
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
Beauty Sleep
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.
 News You Can Use

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.

Title of the book 20

 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.

Beauty Sleep 21
 Thank You!

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