The effect of acute fasting on sleep and the sleep-growth hormone response

REM Sleep Loss-Induced Elevated Noradrenaline Plays a Significant Role in Neurodegeneration: Synthesis of Findings to Propose a Possible Mechanism of Action from Molecule to Patho-Physiological Changes

Wear and tear are natural processes for all living and non-living bodies. All living cells and organisms are metabolically active to generate energy for their routine needs, including for survival. In the process, the cells are exposed to oxidative load, metabolic waste, and bye-products. In an organ, the living non-neuronal cells divide and replenish the lost or damaged cells; however, as neuronal cells normally do not divide, they need special feature(s) for their protection, survival, and sustenance for normal functioning of the brain. The neurons grow and branch as axons and dendrites, which contribute to the formation of synapses with near and far neurons, the basic scaffold for complex brain functions. It is necessary that one or more basic and instinct physiological process(es) (functions) is likely to contribute to the protection of the neurons and maintenance of the synapses. It is known that rapid eye movement sleep (REMS), an autonomic instinct behavior, maintains brain functioning including learning and memory and its loss causes dysfunctions. In this review we correlate the role of REMS and its loss in synaptogenesis, memory consolidation, and neuronal degeneration. Further, as a mechanism of action, we will show that REMS maintains noradrenaline (NA) at a low level, which protects neurons from oxidative damage and maintains neuronal growth and synaptogenesis. However, upon REMS loss, the level of NA increases, which withdraws protection and causes apoptosis and loss of synapses and neurons. We propose that the latter possibly causes REMS loss associated neurodegenerative diseases and associated symptoms.

A ketogenic diet containing medium-chain triglycerides reduces REM sleep duration without significant influence on mouse circadian phenotypes

Ketogenic diets (KDs) affect the circadian rhythms of behavior and clock gene expression in experimental animals. However, these diets were designed to simulate a fasting state; thus, whether these effects are caused by diet-induced ketogenesis or persistent starvation is difficult to distinguish. The present study aimed to define the effects of a KD containing medium-chain triglycerides (MCT-KD) that increase blood ketone levels without inducing carbohydrate starvation, on circadian rhythms and sleep regulation. Mice were fed with a normal diet (CTRL) or MCT-KD for 2 weeks. Blood β-hydroxybutyrate levels were significantly increased up to 2 mM by the MCT-KD, whereas body weight gain and blood glucose levels were identical between the groups, suggesting that ketosis accumulated without carbohydrate starvation in the MCT-KD mice. Circadian rhythms of wheel-running activity and core body temperature were almost identical, although wheel-running was slightly reduced in the MCT-KD mice. The circadian expression of the core clock genes, Per1, Per2, Bmal1, and Dbp in the hypothalamus, heart, liver, epididymal adipose tissues, and skeletal muscle were almost identical between the CTRL and MCT-KD mice, whereas the amplitude of hepatic Per2 and adipose Per1 expression was increased in MCT-KD mice. The MCT-KD reduced the duration of rapid-eye-movement (REM) sleep without affecting the duration of non-REM sleep and the duration of wakefulness. These findings suggested that the impact of ketone bodies on circadian systems are limited, although they might reduce locomotor activity and REM sleep duration.

Many faces of sleep regulation: beyond the time of day and prior wake time

The two-process model of sleep regulation posits two main processes regulating sleep: the circadian process controlled by the circadian clock and the homeostatic process that depends on the history of sleep and wakefulness. The model has provided a dominant conceptual framework for sleep research since its publication ~ 40 years ago. The time of day and prior wake time are the primary factors affecting the circadian and homeostatic processes, respectively. However, it is critical to consider other factors influencing sleep. Since sleep is incompatible with other behaviors, it is affected by the need for essential behaviors such as eating, foraging, mating, caring for offspring, and avoiding predators. Sleep is also affected by sensory inputs, sickness, increased need for memory consolidation after learning, and other factors. Here, we review multiple factors influencing sleep and discuss recent insights into the mechanisms balancing competing needs.

Diet and sleep health: a scoping review of intervention studies in adults

BACKGROUND

Recent research has demonstrated an association between dietary intake and sleep health that can influence chronic disease risk factors. A scoping review of research studies investigating dietary intake and sleep was undertaken to determine the extent and scope of research in laboratory-based, free-living and mixed settings. Additionally, this review determines how well subpopulations and geographical locations are represented and the methodologies used to assess outcome measures.

METHODS

Five online databases were used to identify papers published between 1970 and 2017. Included studies were those conducted in adults and reported both outcomes of interest: (i) sleep health, including sleep restriction and sleep hygiene and (ii) dietary outcomes, including altered nutrients, dietary patterns and supplements.

RESULTS

In total, 129 publications were included with the majority being dietary interventions investigating sleep outcomes (n = 109) with fewer being sleep interventions investigating and reporting dietary outcomes (n = 20). Dietary interventions were most often carried out in free-living environments, in contrast to sleep interventions that were most often carried out in laboratory-based environments. The majority of dietary interventions investigated use of a supplement (n = 66 studies), which was predominantly caffeine (n = 49). Sleep interventions investigated sleep duration only, with the majority (n = 17) investigating the effect of partial sleep restriction under 5.5 h per night on dietary intake, while three studies investigating total sleep deprivation.

CONCLUSIONS

Investigating broader aspects of dietary such as overall diet quality and dietary patterns and other components of sleep health such as quality,  timing and sleep hygiene are important aspects for future research.

Effects of Diet on Sleep Quality

There is much emerging information surrounding the impact of sleep duration and quality on food choice and consumption in both children and adults. However, less attention has been paid to the effects of dietary patterns and specific foods on nighttime sleep. Early studies have shown that certain dietary patterns may affect not only daytime alertness but also nighttime sleep. In this review, we surveyed the literature to describe the role of food consumption on sleep. Research has focused on the effects of mixed meal patterns, such as high-carbohydrate plus low-fat or low-carbohydrate diets, over the short term on sleep. Such studies highlight a potential effect of macronutrient intakes on sleep variables, particularly alterations in slow wave sleep and rapid eye movement sleep with changes in carbohydrate and fat intakes. Other studies instead examined the intake of specific foods, consumed at a fixed time relative to sleep, on sleep architecture and quality. Those foods, specifically milk, fatty fish, tart cherry juice, and kiwifruit, are reviewed here. Studies provide some evidence for a role of certain dietary patterns and foods in the promotion of high-quality sleep, but more studies are necessary to confirm those preliminary findings.

Sleep changes in fasting rats after chronic glycerol feeding

Species which do not enter torpor during fasting and which were efficiently able to spare their body proteins during the first two phases of fasting (which are commonly comprised of 3 successive phases) also increase their daily amount of slow-wave sleep (SWS) during the first two phases. Since in fasting animals the ability to spare proteins was reported to be improved when they were previously fed with a diet enriched with glycerol, it was supposed that, after such a diet, food-deprived rats would increase their daily quota of SWS. In addition, the tolerance to food deprivation, defined as the time elapsed to reach the end of phase II, should also be improved since this tolerance is known to be critically modulated by protein utilization. The daily proportions of wakefulness (W), SWS and paradoxical sleep (PS) were thus studied in Wistar rats after 16 weeks of feeding (i.e., when they were 27 weeks old) with an enriched glycerol diet. These daily W and sleep state proportions were then evaluated until the middle of fasting phase II (MII), i.e., when protein catabolism in the rat appears to be at its lowest level. The rats were able to tolerate more than 5 weeks of food deprivation, which represented an increase of 123% of the fasting tolerance previously reported in rats of the same age but which were fed normally before fasting onset. At MII the daily proportion of SWS was significantly (vs. fed state, p less than 0.01) increased (due to an increase in the daily mean episode duration), at the expense of W (due to a lowering in the daily occurrence of W episodes).(ABSTRACT TRUNCATED AT 250 WORDS)

Sleep changes in fasting rats

The proportion and the distribution of wakefulness (W) slow-wave sleep (SWS) and paradoxical sleep (PS) were studied in 27-week-old rats over 24 hr periods, both in the fed state and after having been deprived of food for 2 to 3 weeks. In these rodents, prolonged fasting has been characterized by 3 successive metabolic phases which have been found to correspond to changes in protein metabolism. Sleep-waking changes were not studied during the first phase which was often of short duration (24 hr). During the second phase, i.e., when proteins were spared, the 24 hr proportions of W and sleep states remained unchanged. There were, however, profound changes in the daily mean episodic characteristics of each vigilance state (duration and frequency) except in the case of PS. During the phase II, the differences in the day/night proportions observed in each vigilance state were less than in the fed state. This reflected a lowering in the amplitude of their daily rhythms. In contrast, when protein use rose (phase III), W was increased sharply at the expense of SWS and PS, the latter being almost completely suppressed. During this last phase, which was also of short duration (by mean 3 days) alertness was greatly enhanced and the rats, which were typically nocturnal when fed, became diurnal. The changes in sleep and wakefulness were examined in relation to their effects on the homeostatic and cyclic components of sleep mechanisms and adaptive strategy to food deprivation in rat.

Hypothalamic control of GH secretion: pathophysiology and clinical implications

GH is secreted episodically. Its pattern is regulated by the interplay of a releasing and a release-inhibiting hormone of hypothalamic origin. Modulation occurs by metabolic factors (glucose, free fatty acids, ketone bodies, amino acids). Altered GH secretion has been observed in states of metabolic derangement such as diabetes mellitus, malnutrition and obesity. Further modulation occurs by extrahypothalamic CNS structures. In man--but not in animals, including subhuman primates--sleep has an important effect on GH secretion. A defective GH secretory pattern has been found to occur in several states of sleep disturbance, such as sleep deprivation, narcolepsy, severe psychosocial derangement, the apallic syndrome. Other CNS influences on GH secretion are related to stress, emotional changes and psychiatric disturbances. The exact mechanisms by which most of these influences are relayed to the GH secretory apparatus of the hypothalamus remain yet to be investigated.

Sleep related growth hormone and prolactin secretion in children during constant rate enteral nutrition

The aim of this study was to investigate the nocturnal secretion of growth hormone and prolactin in a particular model where nutrients are delivered continuously. Six children with severe intestinal diseases undergoing total constant rate enteral nutrition for 1.5 to 8 months have been studied; all children had a normal nutritional status at the time of the recording. Sleep patterns were studied by the usual polygraphic methods from 10 p.m. to 8 a.m. Blood samples were taken every 20 min through an indwelling catheter for growth hormone and prolactin plasma level determination. Several growth hormone peaks were observed with a peak always secreted in connection with stage III-IV of the first cycle. This early peak was significantly higher than the following ones. Nocturnal patterns of prolactin secretion showed individual differences characterized by a series of episodic releases which consisted of a few long rises (4 patients) and several small fluctuations; no correlation was found with the sleep patterns; no increase in the level throughout the night was observed. Loss of the rhythmicity of alimentation does not alter the secretion of growth hormone during sleep.

Sleep in the rat during food deprivation and subsequent restitution of food

Continuous telemetric EEG recordings served to determine the vigilance states of the rat during 2 control days, 80 h of food deprivation and 64 h following restitution of food. The recordings were supplemented by measurements of food intake, water intake and motor activity. The following 3 sleep parameters were not significantly changed by food deprivation: the daily amount of the vigilance states, the light-dark distribution of sleep and waking, and the 10 min paradoxical sleep (PS) cycle. During food deprivation, PS was depressed in the dark phase of the diurnal cycle and increased in the light phase. The sleep parameter that was most affected by food deprivation was the duration of sleep episodes. Episodes of slow-wave sleep (SWS) and PS were shortened only in the dark phase of the deprivation days, whereas total sleep episodes were progressively decreased in both diurnal phases. After restitution of food, the episodes of SWS and total sleep were immediately lengthened and tended to exceed the control level. The duration of feeding episodes and meal size were significantly increased in comparison to pre-deprivation values, whereas feeding frequency was decreased. Long episodes of continuous motor activity occurred during the dark phase of the refeeding period, while a fragmented activity pattern was typical for the deprivation nights. It is proposed that the adjustment of the length of behavioral episodes may constitute an important adaptive mechanism for the rat.

Isocaloric diet changes and electroencephalographic sleep

Electroencephalographic (E.E.G.) sleep changes were studied in eight young healthy male subjects who were given a normal balanced diet or a high-carbohydrate/low-fat or low-carbohydrate/high-fat isocaloric diet, according to an experimental design. Significantly less slow-wave sleep (S.W.S.) was found after consuming a high-carbohydrate/low-fat diet than after consuming a normal balanced diet or a low-carbohydrate/high-fat diet. The latter two diets did not differ in terms of the amounts of S.W.S. Both high-carbohydrate/low-fat and low-carbohydrate/high-fat isocaloric diets, especially the former, were associated with significantly more rapid-eye-movement (R.E.M.) sleep than was the normal balanced diet. These findings emphasise the importance of daily diet for the following night's sleep.