Ghrelin and Leptin and Sleep, Oh My!

One of the most interesting classes I have taken at Green Mountain at Fox Run was one that discussed the "hunger hormones" and how they intereact with insulin and what we eat to regulate hunger, satiety and, ultimately, body weight.  I had naturally heard a great deal about insulin over the years, with the threat of diabetes always hovering in my background, but leptin and ghrelin, the two primary hormones that govern hunger and satiety, were totally new to me. 

Basically,ghrelin is produced in the stomach and tells the brain that more food is needed, while leptin, which is produced in fat cells, sends the signal that we are full and all is well.  When you have too many fat cells, you have too much leptin, which seems to make the receptors insensitive to the signal to stop eating, especially if you have too much insulin floating around and the whole system gets out of balance.  (Apologies for gross oversimplification!)

The simplest and most obvious way to regulate this important hormone system is by making sure to eat regularly and include a good balance of foods, especially fiber, fat and protein, at every meal. But quite a lot of recent research has suggested that getting adequate sleep is a huge factor in maintaining hormonal equilibrium.  This may be the mechanism by which sleep disorders contribute to obesity.

This week, I experienced strong anecdotal evidence in support of that theory.

A couple of months ago, I started feeling as though the quality of my sleep was getting worse; I was feeling tired again despite spending adequate hours in bed, and felt sluggish and sleepy throughout the day.  I wondered whether my CPAP mask was leaking, but I didn't notice anything, at least when I was awake and checking.  Yet I had a feeling that the seal of the nasal pillows in my nostrils wasn't as good as it had been and suspected that that might be the source of the problem.  I tried using the second set of slightly larger nasal pillows that had come with my mask, and that seemed to help with the sleepiness, but they were too big for my face and I was waking up with a very sore nose.  So I contacted my sleep center and asked them to send me a new set of nasal pillows (evidently insurance will pay for a new one every three months, even though my respiratory therapist had assured me that every six months should be fine).

The new mask arrived on Friday, and when I went to swap out the old parts, I noticed that indeed, the slightest pressure against the side of the nasal pillows pushed it out of the tubing, thus creating a huge leak.  This was actually very exciting to me, as it gave me evidence that I hadn't been imagining the change in sleep status and offered the promise of good sleep again. And for the past three nights I have indeed enjoyed much better sleep, waking earlier and feeling ready to get moving right away.

One of the other problems I've been experiencing this winter has been an evident inability to eat mindfully.  While I have managed very well at continuing to eat only those foods that sit well with my body, I've been unable to stop eating, most of the time, at the moment when I first feel satisfied, which is usually also the moment when the food stops actually tasting good.  I thought I was just facing another instance of a previously established "corner of the blanket" flapping up as another was dealt with, and wondered what was going on.  Was it emotional eating?  Was I stuffing down some other deep-seated emotional morass?  It was perplexing.

Then, on Saturday, I noticed that I didn't eat everything on my dinner plate, for the first time in a very long time.  I thought that was strange, but figured maybe the additional meditating I was doing was having a calming effect.  Sunday, the same thing happened, twice.  Moreover, when I couldn't fall asleep that night (due to physical discomfort), I felt hunger, ate a small snack, and then stopped eating, which is exactly what I had not been able to do during the previous couple of months.

Suddenly, a light bulb went off -- surely it was no coincidence that the return of my ability to respond to internal signals about hunger and fullness came at exactly the same time as the return of undisrupted sleep.

This realization felt huge.  First, it gave me incredibly convincing evidence that I am, in fact, very much in tune with my body and its signals to me.  If I wasn't getting the message to stop eating, that was because it wasn't being sent.  Second, it meant that my difficulty with eating was not due to some sort of moral failure -- it was simply my body being out of whack.  Once the balance was reestablished, I could (and can) make sensible and healthy choices without even thinking about it. 

If I hadn't been a total believer in CPAP before, I would surely be now. 

A hui hou.