VISIONS OF SUGARPLUMS || Sleep Hygiene Tip of the Week: 10 foods to avoid eating right before bed

If you are going to eat late at night, such as at a party or for a midnight snack, you could do better by avoiding the following 10 foods. Consuming these could lead to problems with overstimulation, repeated trips to the bathroom at night, gastroesophageal reflux disease (GERD) or heartburn and/or low metabolism leading to weight gain and potential obesity. 

1. Bacon and other smoked meats contain high levels of the amino acid tyramine; consuming these triggers the release of norepinephrine in the brain, leading to wakefulness rather than sleepiness. 
2. Celery is a natural diuretic. What this means is, if you eat a bunch of celery at bedtime, you may need to get up to use the bathroom as your body processes it. 
3. Chocolate has caffeine in it and this will, naturally, stimulate your brain and keep you awake. Studies also show that candy bars right before bed can lead to nightmares. 
4. Cheese before bedtime is going to be a troublesome gut bomb. Just because it is dairy doesn't mean it will be good for you like a glass of warm milk will be. 
5. Citrus fruits are high in acid, which is not the best thing to consume right before going to bed, especially if you also consume something that is high in fat. Fat and acid in the stomach while you sleep do not mix well and can lead to troublesome reflux. 
6. Fatty meats like hamburger and steak may have good quantities of sleep-promoting properties like tryptophan, but the fat and general texture of these foods will slow down digestion and lead to indigestion and heartburn if eaten too close to bedtime. 
7. Ice Cream's high fat is harder to digest, will relax the esophageal sphincter, leading to potential reflux, and the sugar bomb will keep you awake before leading to a hypoglycemic crash. On top of that, the sugar will not be burned off as energy; the body will convert it to fat as a result. You can't win.
8. Nuts may consist of healthy fats, but they are fats, nonetheless and will be harder to digest and potentially lead to heartburn. 
   
9. Pizza's combination of high acid and high fat products is practically a guarantee of heartburn at bedtime, and many people overeat this highly popular food. Best to save your pizza cravings for earlier in the day.
10. Spicy foods do a couple of things to the body: first, they stimulate all kinds of processes, which can disrupt sleep, and second, they inspire the body to generate a higher temperature. Your body, when getting ready for sleep, actually wants to cool down, so this late-night thermal boost can make it hard to sleep.

Sleep Hygiene Tip of the Week || What about those sugarplums anyway? Will eating sugar hurt my sleep?

"Sugarplums," artist unknown.

Sugarplums are actually not fairies, as commonly assumed by fans of the ballet. They are a kind of confection made either of dried fruit (plum) and sugar, or a sugary gelatin confection shaped like a plum and colored purple.

They are an old-fashioned treat that probably isn't consumed as much anymore as was done in the old days. But sugarplums are also a more generalized reference to all things sugary and sweet and enjoyed at the holidays. This can include candy canes, butterscotches, ribbon candies, Turkish delight, pralines, penuche, divinity fudge, white almond bark... ANY candy, really, that is not made of chocolate.

Okay, so it's the holidays, and that means these foods enter into our diets more frequently for a temporary (let's hope!) time in our lives as part of the festivities. And that's okay. But consuming lots of sugary treats will have an impact on your ability to sleep well, so it's a good idea to know what to expect before you launch into a bowl of eggnog taffy or those leftover gumdrops from last night's gingerbread house party right before you go to bed.

What goes up must come down 
Sugary foods eaten right before bedtime can drastically increase, then decrease your blood glucose levels, as your body is forced to release hormones to establish balances between blood sugar and insulin. This swing in hormone release can impair sleep, which is a body process that relies upon, among other things, a balance in your blood chemistry. You may find you have early-night insomnia, for instance, or you wake up an hour or so after falling asleep; this can be due to glucose regulation and even the "crash" (or withdrawal) that comes after consuming a lot of sugar. (This also holds for alcohol "nightcaps.")

This is not the same thing as being "hyperactive." Remember the old days when people said kids who were hyperactive at bedtime probably just ate a bunch of sugar? Not really true. Sugary foods will spike your energy levels briefly but what follows is a downward spiral of energy leading to sleepiness. Here's a great article at Slumberwise which illustrates the sugar-sleep paradox.

Carbo loading
Sugary foods, by the way, are carbohydrate in nature. Other carbohydrates that aren't sugary include foods like rice, bananas, bread, pasta and warm milk, which could actually make you feel more sleepy afterward than straight-up sugary foods might. The body processes these kinds of carbs more slowly than pure sugar (and its cousins, honey, corn syrup, and the like), so you may only feel the hypoglycemic (blood sugar crash) after-effect and not the initial rise in energy (hyperglycemia, or blood sugar high) like you might after eating a candy cane. These carbs inspire your brain to send messages to your digestive system to slow down for the purpose of starting the sleeping process. If you want to sleep, this is not really a problem; however, if you're working the night shift, then you might want to avoid these foods in order to stay alert on the job.

Nighttime bathroom breaks
One of the things that happens when your blood sugar is out of whack is that your body will try to eliminate the excess sugar. Dr. Lynn Maarouf, RD and diabetes education director at the Stark Diabetes Center in Galveston points out that “any time your blood sugar is really high, your kidneys try to get rid of it by urinating, so you are probably getting up and going to bathroom all night long -- and not sleeping well.” This isn't true only for diabetics, but for prediabetics and healthy individuals who have consumed a large amount of sugar in one sitting. That is what the body's filtration system does: it kicks out the excess waste products through urination and/or bowel movement, both which should be more active processes during the day, but not so much at night.

If you are needing to use the restroom all night, you should probably mention this to your primary care physician so they can look for reasons as to why this is happening. It could just be a temporary imbalance in processes brought on by increased sugar intake, but it could also be a sign of metabolic dysfunction or something else entirely, like sleep apnea, which causes the body to frequently arouse due to lack of oxygen, which sends signals to the bladder to be emptied upon awakening.

Here's a great article on sugar intake and sleep quality worth checking out if you are concerned about the possibility of developing or aggravating a diabetic condition.

How to achieve sweet dream
So what does one do with all these wonderful sugarplums winking at us at our neighborhood party, the office kitchen or the family gathering by candlelight? If you already have a known metabolic condition, you know the answer is to stick to the healthy stuff. But if you don't, and you need to get a good night's sleep after the party is over, try to limit yourself to a few sugary treats and break up the sugar infusion with some crudite or a small protein bite in between to keep your blood sugar on an even keel. Drinking water in between also helps you to avoid the sugar-insulin rollercoaster ride by helping you to avoid dehydration, which concentrates your blood sugar and makes you hyperglycemic.

Whatever you do, be prepared. If all else fails, you might not get all your winks that night, and remember, if you're a believer in the fat man... Santa does see you when you're sleeping, and he knows when you're awake...

VISIONS OF SUGARPLUMS || Sleep Hygiene Tip of the Week: How overeating at bedtime affects sleep

You might think that eating a big meal right before bedtime would help make you more sleepy. Initially, it might. Studies do suggest that eating large meals in general can have a hypnotic or tranquilizing effect on the body, and a high carbohydrate meal will have an impact on sugar-insulin balances which can result in sleepiness.

But the relationship between sleep and digestion is far more intricate, and going to bed sleepy after a big meal does not mean you are going to sleep well. Here's some basic biology about digestion as it relates to sleep.

Your digestive system tends to also "go to sleep" when your body and brain begin to send out sleep signals. This means the muscular work that the bowel does slows down, you generate less saliva and swallow less, and stomach acid remains in the system longer, peaking in quantity at around midnight. This is due to a "digestive" clock in the brainstem which syncs with other clock signals in the brain related to sleep stages.

Photo courtesy Health.com

This is the reason why you are not up all night having bowel movements after large meals. Your brain communicates to the digestive system organs to take a few hours off and finish up digestion when the body reawakens.

However, if you have a very large meal late in the evening, just as your body and brain are closing down shop for the night, the digestive system gets confused or doesn't function properly.

With less swallowing and less saliva comes less opportunity for the body to clear away the stomach acid after it has done its job. Acid secretions that remain in the stomach after digestion can potentially travel out of the stomach, back up into the esophagus while you sleep, leading to the common problem of gastroesophageal reflux disease or GERD, which is marked by heartburn and indigestion. You wake up with a nasty acid taste in your mouth and a burning sensation in your throat and it can make it very hard to return to sleep. If you've ever had heartburn, you may have also noticed how the salivary glands can suddenly produce a lot of saliva that you swallow; this is the body's way to move the process along and clear out that acid.

But you aren't consciously thinking about swallowing while you are asleep, right?

When your body goes into REM sleep, all muscles below the chin paralyze, making it impossible to swallow against a rising flow of reflux (stomach acid that is still digesting your meal). What's more, you run the risk of actually inhaling some of this flow if it rises high enough in the throat to access your airway.

So what happens to your sleep quality on a night when you've eaten a large meal late? Either your body wakes from much-needed REM sleep to participate in some emergency swallowing, or you sleep through acid erosion in your throat, unaware that over time, this can create a lot of damage to the mucous membranes and the muscles that are meant to keep the stomach acid from reentering the esophagus, meaning the damage can be permanent.

It gets even worse for people who have asthma. They may actually inhale this acidic matter into their lungs, which is dangerous to their already compromised pulmonary system.

And what about the bowel? It's suddenly full of matter that needs to be moved out of the body precisely when the body's muscular system isn't primed to do the work. The unprocessed food waste waits there, as if in a traffic jam, and this can lead to trapped gas, constipation and pain.

There may be a link between Irritable Bowel Syndrome and late-night eating habits because the usual mechanisms for digestion simply aren't "awake" to do their job in regulating waste. People who awaken in the early morning hours with gastrointestinal pain may also be more likely to develop ulcers.

Going back to that original blood sugar-insulin imbalance described earlier, it's important to note that the body generally is meant to "fast" overnight rather than spend its time digesting things. (This is where the term "breakfast" comes from... in the morning, you "break" your "fast.") If you eat a large meal, then go to bed, this interrupts the normal fasting process and leads to dysregulation of glucose, insulin and other appetite-related hormones. If one falls into the habit of eating large meals late most of the time, they may find themselves battling with any number of metabolic disorders, including obesity and diabetes, as the body no longer can effectively process "energy" (calories) the way it is meant to process them.

'Tis the season to celebrate, often late into the evening and inside a food-laden landscape. Going to a feast after midnight mass on Christmas Eve won't automatically lead to all of these problems, so don't worry so much about a rare late meal. But if you find yourself turning to over-the-counter digestive aids like Tums or Gas-X or Pepto Bismol frequently during the holidays, you may want to reconsider your eating habits and how they might interact with your sleep, because if they have a negative impact on your sleeping life, they can eventually lead to systemic health problems down the line.

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Sources: 

"Gastrointestinal Physiology in Relation to Sleep." Orr, W. and "Gastrointestinal Disorders." Orr, W. from Principles and Practice of Sleep Medicine, 5th Edition, eds. Kryger, Roth and Dement.