Not getting enough sleep has immediate consequences-you feel more tired, less focused, and run down the next day. Many people try to fix this by sleeping in on weekends or whenever they can. But consistently missing sleep, or keeping an irregular sleep schedule, can affect more than just how you feel day to day. Lack of adequate sleep can have a negative impact on metabolic health and make weight management more challenging for people living with overweight or obesity.
Sleep is essential, but often overlooked. So, what defines good sleep?1
Lack of adequate sleep can result in metabolic changes such as reduced sensitivity to insulin, changes in hormones that regulate appetite, and increased levels of the hormone cortisol.2,3 These changes can increase your risk of high blood pressure, stroke, heart disease, as well as obesity and type 2 diabetes.3 People who don't get enough sleep may experience more anxiety, have difficulty regulating their emotions, and may be more likely to be affected by stress and symptoms of depression.3
Metabolic syndrome (MetS) is defined by high triglycerides (a type of body fat), high fasting blood sugar, low HDL cholesterol, high blood pressure, and high waist circumference (abdominal obesity). It can increase the risk of type 2 diabetes, heart attack, and stroke.4 Too little sleep can lead to increased body weight, which can affect how the body uses glucose (sugar). In a large study, it was found that people 40 years of age and older who were diagnosed with MetS were more likely to have poor sleep quality or sleep less than six hours per day. Regardless of age, people who slept for shorter periods and had lower sleep quality scores were more likely to have abdominal obesity (measured by waist circumference 90 cm or more in males and 85 cm or higher in females) and a high body mass index (BMI).5
Having excess body fat is a risk factor for a type of sleep-related breathing disorder called obstructive sleep apnea (OSA). The likelihood of having OSA increases as BMI increases.6 OSA occurs when a person has regular episodes during sleep where the upper airways are blocked. This leads to reduced air flow and disrupted sleep.7 A person with OSA may be more tired the next day and less likely to be physically active, and they can also experience changes in appetite regulation.7 Obesity has been linked to other sleep disorders such as restless legs syndrome and insomnia. When these conditions are not treated, weight can increase, and metabolic health can decline.7
Sleep deficit can affect behaviours such as food choices, stress and emotional eating, and physical activity. Let's take a closer look.
Lack of sleep alters the circulating levels of appetite-regulating hormones leptin and ghrelin and increases secretion of the hormone cortisol. A decrease in leptin leads to greater appetite and an increase in ghrelin increases the hunger sensation.8 These hormonal changes make a person not only consume more food, but also choose high-calorie, high-fat, carbohydrate-rich, and salty foods.7,8
When we sleep less, there are more opportunities to eat, and hormonal changes mean greater need for food "rewards."9 Emotional eating is defined as the need to overeat when one is not able to cope with difficult emotional situations.9 A person may be more likely to tie eating to emotions if they have a lack of sleep, and this has been linked to obesity, especially in women.9
Physical activity is an important part of a weight management plan, and sleep can have an impact on how active you are during the day. In a study of middle-aged and older adults, people who slept more than nine hours per night and those who slept less than seven hours per night were less likely to be physically active and more likely to spend time watching television, sitting, and reading than those who slept between seven and nine hours.10
The components of a weight management plan include dietary changes, physical activity, and sometimes medication therapy. These factors can also help to improve sleep-related health problems, such as obstructive sleep apnea (OSA). Decreasing the number of calories that a person consumes consistently causes weight loss and has been shown to improve oxygen intake by people with OSA.11 Physical activity increase may also help to reduce symptoms of OSA, and people who are regularly physically active are less likely to develop sleep-related breathing disorders such as OSA, regardless of their weight.11
Glucagon-like peptide-1 receptor agonists (GLP-1 medications) such as semaglutide and liraglutide, and the combination GIP/GLP-1 agonist, tirzepatide, are effective treatments for obesity. Some research shows that they may also improve symptoms of OSA.11,12 Also, sleep duration may affect how well a person responds to medication for obesity. A study that looked at weight loss and sleep duration showed that in a group of people who lost weight by incorporating a low-calorie diet with or without the GLP-1 medication liraglutide and exercise, those who slept less than six hours per night regained more weight and lost less body fat compared to those who slept longer.13
It is important to make better sleep one of your goals for your weight management plan. Here are some tips from Mysleepwell.ca that you can use to improve your sleep.14
Sleep isn't optional-it's foundational. Prioritizing sleep can improve metabolic health, regulate appetite, support mood and physical activity, and play a key role in long-term weight management. Set a clear sleep goal and make it a core part of your weight management strategy, not an afterthought. For personalized guidance on both medication and nondrug approaches to support sleep and weight management, speak with your doctor or Rexall pharmacist.
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