One of the problems that we will all have to face as we get older is loss of muscle. The $10 word for this problem is sarcopenia. But no matter what word you use, loss of muscle is not good, and ultimately leads to fatigue and frailty. The obvious things we can do to prevent sarcopenia are resistance exercise and hormone replacement. But a recent review study is pointing out how important sleep is for muscle maintenance.
The authors point out that the known causes of sarcopenia are inflammatory factors, poor nutritional habits, low physical activity, and hormone deficiencies. But then they go on to explain why getting enough sleep might also be a big factor.
The first thing they note is that studies have shown that decreases in the length and quality of sleep, combined with the other things that happen with aging, promote muscle breakdown, pot bellies, and insulin resistance. All of these are associated with sarcopenia. Studies also show that generalized frailty in older people increases as their sleep patterns worsen. Still other studies show that treating certain sleep disorders, such as age-related slow-wave sleep decline, abnormal sleep patterns (circadian rhythm disruptions), and obstructive sleep apnea decreases the rate of muscle loss compared to those who are not treated. And sleep problems also change the way the body uses hormones.
The most important hormones for muscle maintenance are growth hormone, IGF-1 (insulin-like growth factor-1), testosterone, insulin, and cortisol. The first four hormones act to increase muscle mass. But cortisol is different. Its action is to break down muscle mass. And here's the point. Research is showing that age-related sleep problems interfere with the muscle-building actions of the first four, while at the same time enhancing the negative effects of cortisol. Not a good combination! Here's what the authors have to say after having reviewed all the research on sleep and sarcopenia, "Therapeutic approaches targeting sleep disturbances to normalize circadian rhythms and sleep homeostasis may represent a novel strategy to preserve or recover muscle health in older adults."
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Now you know one more reason why it's so important to have healthy sleep habits. But before you get too excited, let me just say this. In terms of the complaints my patients have, sleep problems are secondary only to fatigue. And, of course, the two are closely related. So this is a huge issue. And I can tell you that it's not always easy to fix. Why? Because unhealthy sleep habits are often long imbedded and hard to break. That said, here are some ideas. Do this for at least six weeks before you say it isn't working.
1. Diet: eliminate processed foods, especially sweets, alcohol, and caffeine.
2. Exercise: every day do 15 minutes of aerobic interval training followed by 15 minutes of resistance training.
3. Get to bed with lights out no later than 10:00 p.m.
4. Do not do any business or discuss anything controversial within two hours of lights out.
5. Do not go to sleep with a radio, TV, etc.
6. Get out of bed and start your day no more than eight hours after lights out — no matter what kind of night you had.
7. If you wake up in the night, do not turn on any lights.
8. Take up to 20 mg of melatonin about 30 minutes before lights out.
9. Take three Advanced Sleep Formula tablets about 30 minutes before lights out.
10. Don't take naps.
There are definitely other things you and your doctor can do to improve your sleep besides these. But these changes form the basis for everything else. So get them established before you add on any other remedies.
Yours for better health,
Frank Shallenberger, MD
Piovezan RD, 1Abucham J, et al. The impact of sleep on age-related sarcopenia: possible connections and clinical implications. Ageing Res Rev. 2015 July 24.