Posts Tagged ‘melatonin’

Sleep: The (Undeserved) Least Respected Piece of a Healthy Lifestyle

October 13, 2018

Andrew Siegel MD  10/13/2018


Photo above: my two daughters in peaceful repose (quite a few years ago!)


Exercise is king. Nutrition is queen. Put them together and you’ve got a kingdom.
Jack Lalanne

In addition to Lalanne’s emphasis on exercise and healthy eating as the key pieces to a healthy lifestyle, modern science supports adequate quality and quantity of sleep as a third component of equal importance.  More than one- third of Americans suffer with chronic sleep deprivation and today’s entry explores the consequences and solutions to  this.

Nature has not intended mankind to work from 8 in the morning to midnight without the refreshment of blessed oblivion which, even if it only lasts 20 minutes, is sufficient to renew all the vital forces.

Winston Churchill

What’s Obvious

That adequate quantity and quality of sleep is vital to our well-being and optimal functioning is readily apparent. We have all enjoyed the blissful experience of a great night’s sleep, awakening well-rested, energetic, optimistic and ready to approach the new day with vigor. Conversely, we have all experienced a poor night’s sleep, awakening feeling physically exhausted, mentally spent, lids heavy, dark circles under our eyes, and often in a disassociated “zombie” state, totally unmotivated and unenthusiastic about facing the new day (a situation not unlike jet lag).

The amount of sleep one needs is biologically determined and different for each person. Some can make do with five hours of sleep while others require ten hours, but as a general rule, seven to eight hours is recommended.  Regardless, sleeping has an essential restorative function as our brains and bodies require this important down time for optimal functioning.

What’s not so obvious

Good quality sleep is an important component of overall health, wellness, and fitness with potential dire consequences to the chronically deprived. Sleep disruption or deprivation has numerous negative mental and physical effects including disturbed cognitive, endocrine, metabolic, cardiovascular, gastrointestinal and immune function. While sleeping, there is an increased rate of anabolism (cellular growth and synthesis) and a decreased rate of catabolism (cellular breakdown), processes that are disrupted by sleep deprivation. Chronic sleep issues can result in making one feel ill and appearing much older than they are chronologically.

Sleep disruption results in decreased levels of leptin (a chemical appetite suppressant), increased ghrelin levels (a chemical appetite stimulant), increased corticosteroids (stress hormones) and increased glucose levels (higher amounts of sugar in the bloodstream). As a result, chronic sleep deprivation commonly gives rise to increased appetite, increased caloric intake and the disassociated “zombie” state lends itself to dysfunctional eating patterns and consumption of unhealthy foods, and as such, weight gain is a predictable consequence.  Compounding the issue, a chronically-fatigued state impairs one’s ability to exercise properly, if at all.

Chronic sleep deficits results in irritability, impaired cognitive function and poor judgment.  The inability to be attentive and focused interferes with work and school performance and causes increased injuries (such as falls) and motor vehicle accidents.

Fact: Shift work sleep disorder.   Non-standard shift workers (health professionals, emergency workers, airline pilots, plant and manufacturing operators, etc.) make up nearly 20% of the U.S. work force. Their irregular working hours are often associated with disturbance of circadian rhythms and resultant insomnia and poor quality and quantity of sleep.  Scientific evidence shows an increased risk of developing diabetes, high blood pressure, high cholesterol, cardiovascular disease, peptic ulcer disease and depression.

What to do

The good news is that sleep deprivation is a modifiable risk factor, with a variety of ways to facilitate a good night’s sleep.

Sensible measures to help ensure a good night’s sleep:

  • Lead an active lifestyle with abundant exercise and stimulation.
  • Whether you are an early riser or a night owl, try to be consistent with respect to wake-up and bedtimes on both weekdays and weekends; if these times vary greatly it is a setup for sleep problems by disturbing your internal body clock.
  • Maintain a comfortable sleeping environment—a good quality supportive bed, comfortable pillows, a dark room, cool temperature and, if you like, “white noise” (I find that the monotonous sound of the sea produced by a sound machine, coupled with the gentle whirring of an overhead fan, is an instant relaxer).
  • Avoid caffeinated beverages—coffee, tea, cola, etc.—particularly after 6:00 p.m.  On the other hand, herbal teas, e.g., chamomile, can be soothing and relaxing.
  • Avoid consuming a large meal at dinner or eating very late at night.
  • Avoid imbibing too much alcohol.
  • Avoid exercising late in the evening.
  • Minimize the stress in your life, as much as is conceivable. Engage in a de-stressing activity immediately before sleep—reading, watching a movie or television show, crossword puzzle, sudoku, sex—whatever helps relax you and bring upon sleepiness.
  • Try to minimize evening exposure to the bright light (“blue light”) of cell phones, tablets and computers that inhibits production of the sleep-promoting hormone melatonin, levels of which under normal circumstances rise coincident with darkness. If possible, dim the light settings on electronic devices that are used at night.
  • Supplemental melatonin seems to help some people, but is ineffective for many others (including myself), but may be worth a try 

Wishing you the best of health,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health


PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

New video on female pelvic floor exercises:  Learn about your pelvic floor



S.A.D. (Seasonal Affective Disorder) Makes Me F.A.T.

December 10, 2011

If we had no winter, the spring would not be so pleasant; if we did not sometimes taste adversity, prosperity would not be so welcome.

Anne Bradstreet (17th century poet)

Like many others, I adore the spring and summer—relishing the sunshine, the vibrant blues and greens that dominate the outside palette, and the long hours of summer daylight.  One of the greatest thrills I have ever experienced was to be in Northern Europe in June where it stayed light until near midnight.  I feel most alive when exposed to sunlight, warmth, vibrant natural colors, scents such as honeysuckle and lilacs, and the background white noise of cicadas.  How delightful it is to be outdoors scantily clad in shorts and a short-sleeved shirt—cycling, playing tennis or golf, or just throwing a Frisbee for my English Springer Spaniel, Charley Morgan.

Light profoundly affects my mood.  Sitting in my living room on one of those days when the sun is in and out behind a cover of clouds, I am made acutely aware of how a sudden darkening of my environment makes me gloomy and a sudden lightening makes me happy.  I can virtually dial up my mood when the brightness of the lighting in my basement or living room is controlled with a rheostat.

I am among the 5-10% of the population that suffer with an affliction known as Seasonal Affective Disorder (S.A.D.). The prevalence of S.A.D. is highest towards the north and south poles and lowest at the equator.  It is quite common in the Scandinavian countries, where light is in limited supply during the winter.  Due to the very short winter days, these winter blues are characterized by variable degrees of melancholy brought on by the dark, cold and colorless external environment. The feelings of hibernation and stagnancy are distinctly unpleasant for any of us who are afflicted with S.A.D.  I am fortunate to be affected in only a mild way, much less so than many who suffer with depression, concentration issues, loss of energy and sexual drive, sleep disturbances, exhaustion, and withdrawal from friends, family and social activities. Various theories have been proposed to explain S.A.D., including a biochemical basis involving the chemicals serotonin and melatonin, but the jury is still out on the precise underlying basis.

Cold weather and darkness also directly affect our eating behaviors; they seem to conspire against healthy and disciplined consumption patterns and beg for relief by means of comfort foods.  For many of us, winter fosters a type of foraging activity that causes us to satisfy carbohydrate cravings and seek solace in rich, heavy foods including stews, creamy soups and starches.  Additionally, being more housebound in the winter leaves abundant opportunities for “boredom” eating, providing fewer distractions from eating that are possible in the warmer times of the year. The sleep disturbance that many with S.A.D. experience can lead to “fatigue” eating. During winter, outdoor exercise/activities dramatically decline; at the same time, there is less availability of healthy fresh fruits and vegetables that are abundant in summer.  There is less opportunity for grilling, a healthier form of cooking than many other alternatives. Unfortunately, all of the forces discussed above can work together and lead to winter weight gain.

So what to do to cope with S.A.D. causing the winter doldrums and the potential for unhealthy weight gain?  Options include melatonin supplements (a naturally-occurring hormone that maintains our circadian rhythms); anti-depressant medications; and cognitive-behavioral therapy or occupational therapy (both of which can help S.A.D. sufferers function at more optimal levels during their “dark” times).  My preference is to use exercise as an effective means of keeping the blues at bay.  It nudges the pharmacy within to release a cocktail of “happy” chemicals including serotonin (which modulates mood, emotion, sleep and appetite). A daily dose of exercise will not only help release the natural anti-depressants within, but will burn calories and help prevent the weight gain.  I wholeheartedly recommend tapping into our own pharmacy within before reaching for the products of Big Pharma.

If you can swing it, a winter vacation to a nice sun-drenched Caribbean island can be just what the doctor ordered.  If this is not feasible, a therapeutic bright light box is an alternative that can provide the much-needed daily dose of light.  Another tonic to soothe the blues is music, capable of producing a steep rise in a listener’s serotonin levels.  Ultimately, having purpose and remaining busy, productive and engaged in meaningful activities is one of the best means of staying focused and keeping the effects of S.A.D. at bay.  So whatever it is you choose to do to chase those blues away, do it with passion and gusto.

 In the depth of winter, I finally learned that within me there lay an invincible summer.

Albert Camus

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship With Food

Available at; e-book available on Amazon.