DORMIMOS MAL POR QUE ALIMENTAMOS MAL NUESTROS MICROBIOS INTESTINALES?
Y QUE TIENE QUE VER LA MICROBIOTA CON EL SUEÑO?
Los trastornos del sueño son un problema frecuente y constituyen un motivo usual de consulta en la atención primaria, ya que se asocian a un deterioro significativo
de la calidad de vida. El insomnio es el trastorno del sueño más frecuente y se ha estimado una prevalencia total en adultos de 19,1%, de los cuales un 85% corresponde a insomnio crónico, el que a su vez se relaciona estrechamente
con trastornos psiquiátricos y ha sido descrito como marcador de episodio depresivo.
El insomnio es sin duda el trastorno del sueño más frecuente
y consiste en la dificultad para iniciar o mantener éste de malestar personal significativo y deterioro social, laboral odurante al menos un mes, asociado a fatiga diurna, sensación
de otras áreas importantes de la actividad personal.
Tiene una mayor frecuencia en mujeres (1,5:1), siendo más prevalente en la población anciana, donde aparece como un problema serio en 25-35% de la población.
En Latinoamérica, existen pocos datos sobre la prevalencia
de los trastornos del sueño. El primer esfuerzo por realizar este tipo de investigación fue llevado a cabo el año 2000 al interior de Brasil, donde los principales objetivos fueron determinar los patrones de sueño y prevalencia de insomnio en la población adulta (>18 años) de la ciudad de Bambuí, Minas Gerais (15.000 habitantes). Para esto, fueron seleccionados en forma aleatoria simple 1.221 adultos. La
prevalencia de insomnio fue del 35,4% y mayor en el género
femenino (47%). Además, el 48% del total de quejas de insomnio tenían una duración superior a un año.
De acuerdo a las características del insomnio podemos distinguir, el “Insomnio primario” sin una causa identificada
y el “Insomnio secundario” que dentro de sus etiologías más
frecuentes se encuentran las afecciones psiquiátricas (depresión y trastornos de ansiedad principalmente), neuroló-gicas y médicas.
Es un hecho conocido, que alrededor del 80% de los pacientes con depresión se quejan de cambios en su patrón de sueño y que la mayoría de estos tiene un despertar precoz.
Por su parte, los trastornos del sueño más frecuentemente asociados con el perfil de los pacientes con trastorno de ansiedad generalizada (TAG) son la dificultad para iniciar el
sueño o insomnio inicial y el insomnio de mantenimiento.
Pero, ¿y si nuestros intestinos fueran en realidad las culpables de nuestro insomnio?
¿Qué pasaría si los trillones de microbios que se encuentran en nuestro intestino delgado, conocidos colectivamente como el microbioma o la microbiota, realmente estuvieran afectando nuestro estado de ánimo, la digestión, la salud en general y la capacidad de dormir al menos 8 horas seguidas?
Los científicos comienzan a sospechar que existe un vínculo fuerte, aunque aún no probado, entre la salud intestinal (la diversidad y el bienestar de las bacterias en el estómago, el intestino delgado y grueso) y la salud del sueño.
Este es un campo embrionario en este momento en los anales de la investigación del sueño ", dice Matt Walker, autor de Why We Sleep y director del Centro de Ciencias del Sueño Humano de la Universidad de California, Berkeley. "Conocemos enormemente la relación entre la falta de sueño y apetito, la obesidad y el aumento de peso, así como los aspectos de la resistencia a la insulina y la regulación de la glucosa. Lo que aún no comprendemos del todo es el papel del microbioma en el sueño ".
Sabemos que la falta de sueño aumenta nuestras posibilidades de obesidad y afecta la forma en que controlamos la ingesta de alimentos. La falta de sueño produce una disminución de la leptina, la hormona que nos hace sentir llenos, y un aumento de la grelina, lo que nos impide sentirnos satisfechos con los alimentos que comemos. Eso significa que seguimos comiendo, a veces tanto como 300 calorías adicionales al día.
La falta de sueño también afecta las partes de nuestro cerebro responsables del control de los impulsos, dejándonos con muy pocas posibilidades de comer saludablemente y de cuidar ese ecosistema intestinal. Un sueño pobre, entonces, ciertamente puede afectar nuestro intestino.
La pregunta es, ¿podría nuestro intestino afectar nuestro sueño?
¿Mejorar la salud intestinal es una nueva terapia del sueño?
El Dr. Michael Breus, psicólogo clínico y miembro de la Academia Estadounidense de Medicina del Sueño, está de acuerdo en que esta es una posibilidad que vale la pena seguir.
"No hay dudas en mi mente de que la salud intestinal está relacionada con la salud del sueño, aunque todavía no tenemos los estudios para demostrarlo.
Científicos que investigan la relación entre el sueño y el microbioma descubren que el ecosistema microbiano puede afectar el sueño y las funciones fisiológicas relacionadas con el sueño de diferentes maneras: cambiando los ritmos circadianos, alterando el ciclo sueño-vigilia del cuerpo, afectando las hormonas que regulan el sueño y la vigilia . "
Mientras esperamos la ciencia definitiva, Breus sugiere tomar probióticos (un tipo de bacteria viva) y prebióticos (carbohidratos no digeribles, principalmente fibra) para alimentar las buenas bacterias de nuestro intestino.
Los beneficios de los probióticos para el intestino están bien documentados.
Un estudio reciente de científicos de la Universidad de Colorado, publicado en Frontiers of Behavioral Neuroscience, sugiere que los prebióticos podrían tener un efecto significativo en la calidad del sueño REM y NO REM.
El Dr. Michael Mosley probó con cierto éxito en un documental reciente de la BBC: tomó prebióticos durante cinco días y observó mejoras en su sueño. El día antes del experimento, Mosley pasó el 21% de su tiempo en la cama despierto; para el último día, eso había bajado al 8%. Esto es, por supuesto, anecdótico, pero no obstante interesante.
Tim Spector, profesor de epidemiología genética en el King's College de Londres y autor de The Diet Myth, está de acuerdo en que un intestino sano podría promover un buen sueño. Al igual que Walker y Breus, también cree que la salud intestinal está relacionada con nuestros estados de ánimo. Eso es particularmente interesante para alguien como yo, que sufre de depresión e insomnio. Yo vivo con trastorno bipolar; mis estados de ánimo afectan mi sueño y, tradicionalmente, esperaría que mi cerebro estuviera a cargo de eso. Pero resulta que no es tan simple.
Sabemos que las personas que viven con depresión y las personas que duermen mal tienen microbios anormales en el intestino, lo que sugeriría que hay una conexión muy real entre los tres ", dice Spector. "Siempre he descubierto que si ayudas a alguien a dormir, mejora su depresión, y viceversa. Si también podemos cuidar el intestino, esto puede tener un impacto tanto en las alteraciones del sueño como en los trastornos del estado de ánimo. "Se sabe desde hace mucho tiempo que existe una relación recíproca entre la depresión y el sueño, la mayoría de las personas deprimidas duermen mal y muchas personas insomnes tienen síntomas depresivos.
Spector está convencido de que puedes mejorar la alteración del sueño con la dieta. "si comemos mal, dormimos mal",
Si quieres mejorar tu sueño, podrías intentar un régimen de intestino sano al comer una dieta amplia e inclusiva con alimentos reales, no procesados. Todos van a ser diferentes. Podrías tratar de ser vegetariano durante un mes y ver si te ayuda.
Duplica tu consumo de fibra y come alimentos fermentados todos los días, como yogur griego y quesos de buena calidad. Aumenta la variedad de alimentos en tu dieta. Come bayas, té verde, chocolate negro (70% cacao), café descafeinado, nueces y semillas.
No comas justo antes de ir a la cama, pero igualmente, no pases hambre. Evita comer bocadillos antes de acostarte.
En cuanto a la rutina a la hora de dormir, Christine Hansen, autora de Sleep Like a Boss, tiene algunos consejos adicionales.
"Mi consejo general es comer alimentos de bajo índice glicémico (IG) antes de dormir porque liberarán la energía más lentamente. Si comes alimentos con alto IG, como un postre o azúcar o algo refinado, combínalo con alguna proteína o fibra.
Por ejemplo, si tienes pan blanco, tómalo con queso crema y/ o huevos. Si quieres galletas, ve por cereales integrales.
Probablemente no deberías comer antes de irte a la cama una comida que sea difícil de digerir: comida frita o carnes pesadas, por ejemplo.
FUENTES:
https://www.theguardian.com/lifeandstyle/2018/mar/19/is-your-gut-keeping-you-awake-at-night
https://www.actaspsiquiatria.es/repositorio/11/68/ESP/11-68-ESP-358-364-867576.pdf
AND WHAT DOES THE MICROBIOTE HAVE TO SEE WITH THE DREAM?
Sleep disorders are a frequent problem and are a common reason for consultation in primary care, as they are associated with a significant deterioration
of the quality of life. Insomnia is the most frequent sleep disorder and a total prevalence in adults of 19.1% has been estimated, of which 85% corresponds to chronic insomnia, which in turn is closely related with psychiatric disorders and has been described as a marker of depressive episode.
Insomnia is undoubtedly the most frequent sleep disorder
and consists in the difficulty to initiate or maintain this one of significant personal discomfort and social, labor or
for at least a month, associated with daytime fatigue, sensation of other important areas of personal activity.
It has a higher frequency in women (1.5: 1), being more prevalent in the elderly population, where it appears as a serious problem in 25-35% of the population.
In Latin America, there are few data on prevalence
of sleep disorders. The first effort to carry out this type of research was carried out in 2000 in the interior of Brazil, where the main objectives were to determine sleep patterns and prevalence of insomnia in the adult population (> 18 years) of the city of Bambuí, Minas Gerais (15,000 inhabitants). For this, 1,221 adults were randomly selected. The
Insomnia prevalence was 35.4% and higher in the gender female (47%) In addition, 48% of all insomnia complaints lasted longer than one year.
According to the characteristics of insomnia we can distinguish, the "Primary Insomnia" without an identified cause and the "secondary insomnia" that within its etiologies more frequent are psychiatric conditions (depression and anxiety disorders mainly), neurological and medical.
It is a known fact that about 80% of patients with depression complain of changes in their sleep pattern and that most of these have an early awakening.
On the other hand, the sleep disorders most frequently associated with the profile of patients with generalized anxiety disorder (GAD) are the difficulty to initiate the sleep or initial insomnia and maintenance insomnia.
But, what if our intestines were actually the culprits of our insomnia?
What would happen if the trillions of microbes found in our small intestine, collectively known as the microbiome or microbiota, were actually affecting our mood, digestion, general health and the ability to sleep at least 8 hours in a row ?
Scientists begin to suspect that there is a strong link, although not yet proven, between intestinal health (the diversity and well-being of bacteria in the stomach, the small and large intestine) and the health of sleep.
This is an embryonic field at this time in the annals of sleep research, "says Matt Walker, author of Why We Sleep and director of the Human Sleep Science Center at the University of California, Berkeley. lack of sleep and appetite, obesity and weight gain, as well as aspects of insulin resistance and glucose regulation. What we do not yet fully understand is the role of the microbiome in the dream. "
We know that lack of sleep increases our chances of obesity and affects the way we control our food intake. The lack of sleep produces a decrease in leptin, the hormone that makes us feel full, and an increase in ghrelin, which prevents us from feeling satisfied with the food we eat. That means we continue to eat, sometimes as much as 300 extra calories a day.
The lack of sleep also affects the parts of our brain responsible for the control of impulses, leaving us with very little chance of eating healthy and caring for that intestinal ecosystem. A poor dream, then, can certainly affect our gut. The question is, could our gut affect our sleep? Is improving intestinal health a new sleep therapy? Dr. Michael Breus, clinical psychologist and member of the American Academy of Sleep Medicine, agrees that this is a possibility worth pursuing. "There is no doubt in my mind that intestinal health is related to the health of sleep, although we still do not have the studies to prove it.
Scientists investigating the relationship between sleep and the microbiome discover that the microbial ecosystem can affect sleep and physiological functions related to sleep in different ways: by changing circadian rhythms, altering the body's sleep-wake cycle, affecting hormones that regulate sleep and wakefulness. " While waiting for the definitive science, Breus suggests taking probiotics (a type of living bacteria) and prebiotics (non-digestible carbohydrates, mainly fiber) to feed the good bacteria in our intestines. The benefits of probiotics for the intestine are well documented. A recent study by scientists at the University of Colorado, published in Frontiers of Behavioral Neuroscience, suggests that prebiotics could have a significant effect on the quality of REM and non-REM sleep.
Dr. Michael Mosley tried with some success on a recent BBC documentary: he took prebiotics for five days and observed improvements in his sleep. The day before the experiment, Mosley spent 21% of his time in bed awake; for the last day, that had dropped to 8%. This is, of course, anecdotal, but nevertheless interesting.
Tim Spector, professor of genetic epidemiology at King's College London and author of The Diet Myth, agrees that a healthy intestine could promote good sleep. Like Walker and Breus, he also believes that intestinal health is related to our moods. That is particularly interesting for someone like me, who suffers from depression and insomnia. I live with bipolar disorder; my moods affect my sleep and, traditionally, I would expect my brain to be in charge of that. But it turns out that it is not so simple.
We know that people living with depression and people who sleep poorly have abnormal microbes in the intestine, which would suggest that there is a very real connection between the three, "says Spector." I've always found that if you help someone sleep, improves your depression, and vice versa. If we can also take care of the bowel, this can have an impact on both sleep disturbances and mood disorders. "It has been known for a long time that there is a reciprocal relationship between depression and sleep, most depressed people sleep badly and many sleepless people have depressive symptoms.
Spector is convinced that you can improve sleep disturbance with diet. "If we eat badly, we sleep badly"
If you want to improve your sleep, you could try a healthy bowel regime by eating a broad and inclusive diet with real, unprocessed foods. All are going to be different. You could try to be a vegetarian for a month and see if it helps.
Double your fiber intake and eat fermented foods every day, such as Greek yogurt and good quality cheeses. Increase the variety of foods in your diet. Eat berries, green tea, dark chocolate (70% cocoa), decaffeinated coffee, nuts and seeds.
Do not eat right before going to bed, but equally, do not go hungry. Avoid eating snacks before going to bed.
Regarding the routine at bedtime, Christine Hansen, author of Sleep Like a Boss, has some additional tips.
"My general advice is to eat low glycemic index (GI) foods before sleep because they will release energy more slowly, if you eat foods with a high GI, such as a dessert or sugar or something refined, combine it with some protein or fiber.
For example, if you have white bread, take it with cream cheese and / or eggs. If you want cookies, go for whole grains.
You probably should not eat before going to bed a meal that is difficult to digest: fried food or heavy meats, for example.
AND WHAT DOES THE MICROBIOTE HAVE TO SEE WITH THE DREAM?
Sleep disorders are a frequent problem and are a common reason for consultation in primary care, as they are associated with a significant deterioration
of the quality of life. Insomnia is the most frequent sleep disorder and a total prevalence in adults of 19.1% has been estimated, of which 85% corresponds to chronic insomnia, which in turn is closely related with psychiatric disorders and has been described as a marker of depressive episode.
Insomnia is undoubtedly the most frequent sleep disorder
and consists in the difficulty to initiate or maintain this one of significant personal discomfort and social, labor or
for at least a month, associated with daytime fatigue, sensation of other important areas of personal activity.
It has a higher frequency in women (1.5: 1), being more prevalent in the elderly population, where it appears as a serious problem in 25-35% of the population.
In Latin America, there are few data on prevalence
of sleep disorders. The first effort to carry out this type of research was carried out in 2000 in the interior of Brazil, where the main objectives were to determine sleep patterns and prevalence of insomnia in the adult population (> 18 years) of the city of Bambuí, Minas Gerais (15,000 inhabitants). For this, 1,221 adults were randomly selected. The
Insomnia prevalence was 35.4% and higher in the gender female (47%) In addition, 48% of all insomnia complaints lasted longer than one year.
According to the characteristics of insomnia we can distinguish, the "Primary Insomnia" without an identified cause and the "secondary insomnia" that within its etiologies more frequent are psychiatric conditions (depression and anxiety disorders mainly), neurological and medical.
It is a known fact that about 80% of patients with depression complain of changes in their sleep pattern and that most of these have an early awakening.
On the other hand, the sleep disorders most frequently associated with the profile of patients with generalized anxiety disorder (GAD) are the difficulty to initiate the sleep or initial insomnia and maintenance insomnia.
But, what if our intestines were actually the culprits of our insomnia?
What would happen if the trillions of microbes found in our small intestine, collectively known as the microbiome or microbiota, were actually affecting our mood, digestion, general health and the ability to sleep at least 8 hours in a row ?
Scientists begin to suspect that there is a strong link, although not yet proven, between intestinal health (the diversity and well-being of bacteria in the stomach, the small and large intestine) and the health of sleep.
This is an embryonic field at this time in the annals of sleep research, "says Matt Walker, author of Why We Sleep and director of the Human Sleep Science Center at the University of California, Berkeley. lack of sleep and appetite, obesity and weight gain, as well as aspects of insulin resistance and glucose regulation. What we do not yet fully understand is the role of the microbiome in the dream. "
We know that lack of sleep increases our chances of obesity and affects the way we control our food intake. The lack of sleep produces a decrease in leptin, the hormone that makes us feel full, and an increase in ghrelin, which prevents us from feeling satisfied with the food we eat. That means we continue to eat, sometimes as much as 300 extra calories a day.
The lack of sleep also affects the parts of our brain responsible for the control of impulses, leaving us with very little chance of eating healthy and caring for that intestinal ecosystem. A poor dream, then, can certainly affect our gut. The question is, could our gut affect our sleep? Is improving intestinal health a new sleep therapy? Dr. Michael Breus, clinical psychologist and member of the American Academy of Sleep Medicine, agrees that this is a possibility worth pursuing. "There is no doubt in my mind that intestinal health is related to the health of sleep, although we still do not have the studies to prove it.
Scientists investigating the relationship between sleep and the microbiome discover that the microbial ecosystem can affect sleep and physiological functions related to sleep in different ways: by changing circadian rhythms, altering the body's sleep-wake cycle, affecting hormones that regulate sleep and wakefulness. " While waiting for the definitive science, Breus suggests taking probiotics (a type of living bacteria) and prebiotics (non-digestible carbohydrates, mainly fiber) to feed the good bacteria in our intestines. The benefits of probiotics for the intestine are well documented. A recent study by scientists at the University of Colorado, published in Frontiers of Behavioral Neuroscience, suggests that prebiotics could have a significant effect on the quality of REM and non-REM sleep.
Dr. Michael Mosley tried with some success on a recent BBC documentary: he took prebiotics for five days and observed improvements in his sleep. The day before the experiment, Mosley spent 21% of his time in bed awake; for the last day, that had dropped to 8%. This is, of course, anecdotal, but nevertheless interesting.
Tim Spector, professor of genetic epidemiology at King's College London and author of The Diet Myth, agrees that a healthy intestine could promote good sleep. Like Walker and Breus, he also believes that intestinal health is related to our moods. That is particularly interesting for someone like me, who suffers from depression and insomnia. I live with bipolar disorder; my moods affect my sleep and, traditionally, I would expect my brain to be in charge of that. But it turns out that it is not so simple.
We know that people living with depression and people who sleep poorly have abnormal microbes in the intestine, which would suggest that there is a very real connection between the three, "says Spector." I've always found that if you help someone sleep, improves your depression, and vice versa. If we can also take care of the bowel, this can have an impact on both sleep disturbances and mood disorders. "It has been known for a long time that there is a reciprocal relationship between depression and sleep, most depressed people sleep badly and many sleepless people have depressive symptoms.
Spector is convinced that you can improve sleep disturbance with diet. "If we eat badly, we sleep badly"
If you want to improve your sleep, you could try a healthy bowel regime by eating a broad and inclusive diet with real, unprocessed foods. All are going to be different. You could try to be a vegetarian for a month and see if it helps.
Double your fiber intake and eat fermented foods every day, such as Greek yogurt and good quality cheeses. Increase the variety of foods in your diet. Eat berries, green tea, dark chocolate (70% cocoa), decaffeinated coffee, nuts and seeds.
Do not eat right before going to bed, but equally, do not go hungry. Avoid eating snacks before going to bed.
Regarding the routine at bedtime, Christine Hansen, author of Sleep Like a Boss, has some additional tips.
"My general advice is to eat low glycemic index (GI) foods before sleep because they will release energy more slowly, if you eat foods with a high GI, such as a dessert or sugar or something refined, combine it with some protein or fiber.
For example, if you have white bread, take it with cream cheese and / or eggs. If you want cookies, go for whole grains.
You probably should not eat before going to bed a meal that is difficult to digest: fried food or heavy meats, for example.
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