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Weight Cycling Linked to Insomnia in Women, Study Says

Woman with insomnia

Key Takeaways

  • Even one bout of weight loss and gain can increase the risk for sleep problems in women.
  • Researchers didn’t offer a reason for the correlation, but previous research suggests cardiovascular health may link sleep and weight changes.
  • To lower the risk of developing sleep problems when losing weight, experts suggest taking a slow, gradual approach that minimizes the chances of regaining weight.

Women who have a history of weight cycling—which means losing weight and then regaining that amount plus more—are more likely to experience sleep problems, even if they’ve had as little as one bout of losing and regaining ten pounds, according to a new study in the Journal of Cardiovascular Nursing.

Sleep issues and excess weight have both, independently, been associated with cardiovascular risk in previous research. To determine if there’s an overlap between those issues, researchers looked at data on just over 500 women who took part in a health-tracking study supported by the American Heart Association.

72% of the women reported one or more episodes of weight cycling, excluding pregnancy, and these participants showed a higher incidence of sleep problems, compared to those whose weight had not fluctuated.

That association became more dramatic with more episodes of weight cycling. Researchers noted that each additional episode of weight cycling was related to:

  • Shorter sleep duration
  • Poorer sleep quality
  • Greater insomnia severity
  • Longer time to fall asleep
  • More sleep disturbances
  • Lower sleep efficiency
  • Frequent use of sleep medication
  • Significant obstructive sleep apnea risk
  • Greater daytime sleepiness or dysfunction

“These results were true across various life stages,” says study co-author Brooke Aggarwal, EdD, of Columbia University Vagelos College of Physicians and Surgeons. “These results are in line with previous research we’ve done that found women with a history of weight cycling had increased chances of poor cardiovascular health. Sleep problems seem to be another variable in this issue.”

The Connection Between Weight, Sleep, and Heart Health

In findings presented at a 2019 American Heart Association meeting, Aggarwal and fellow researchers from Columbia University presented evidence that weight cycling has an effect on seven heart disease risk factors:

  • Smoking status
  • Weight
  • Diet
  • Physical activity
  • Cholesterol
  • Blood pressure
  • Blood glucose

Brooke Aggarwal, EdD

We think it’s possible that every time weight that’s been lost is regained, cardiovascular risk factors such as blood pressure, cholesterol, and glucose nudge higher, above the baseline level.

— Brooke Aggarwal, EdD

"Any of these [heart disease risk factors] could create a detrimental effect on sleep," says Aggarwal. For example, a study in BMC Public Health found that significantly more smokers than nonsmokers demonstrated poor sleep quality and sleep disturbances—an association that increased with more cigarettes per day.

Physical activity has long been connected to sleep and better cardiovascular health. A research review published in Advances in Preventive Medicine found that sleep and exercise affect one another, and that sedentary behavior and sleep deprivation can not only hurt your heart but also put you at higher risk for a range of physical and mental issues.

“We think it’s possible that every time weight that’s been lost is regained, cardiovascular risk factors such as blood pressure, cholesterol, and glucose nudge higher, above the baseline level,” she says. "Mainly, that's because when you lose weight, it's usually a combination of fat and some lean muscle tissue, but weight regained is all fat, particularly in the abdominal region."

That type of fat (abdominal fat) has been strongly associated with increased risk for cardiovascular disease, she adds—and as heart risks and weight go up, it appears sleep problems do, too.

Metabolism and Sleep

Weight cycling isn’t only tough on your heart, though. It can also create challenges when it comes to how your metabolism operates, and that may be another reason that sleep will be impacted, says Candice Seti, PsyD, who provides cognitive therapy for weight management, including insomnia treatment.

“When you lose weight, your metabolism can drop, particularly if you have lost weight quickly, because your body is trying to adjust to that change,” she says. If you start to regain that weight, the metabolism will continue to be negatively impacted. That can cause hormone issues related to stress—another factor that can sabotage sleep.

“This can become an ugly cycle,” says Seti. “The worse your sleep problems become, the more likely you are to store fat, particularly in the abdominal region as a stress reaction. Subsequently, that can impact your sleep even more.”

Preventing a Cascade Effect

To prevent the kind of ripple effect that can put you at higher risk for health issues, it’s helpful to focus on sustainable weight loss—and that means a very gradual, steady approach, according to Nicole Avena, PhD, assistant professor of neuroscience at Mount Sinai School of Medicine, and author of Why Diets Fail.

Nicole Avena, PhD

You don't have to change everything overnight. Start with one thing. When people go on diets that have a lot of rules, it can often be too much at once and they are set up for failure.

— Nicole Avena, PhD

A first step she suggests is to reframe the concept of “diet” and its role in weight loss. Rather than adopting a restrictive, short-term change, even as a “reset,” it’s better to start with a long-term view from the outset, Avena believes.

"Part of the problem in our diet culture is that diets are viewed as temporary when they should not be," she says. "You don't have to change everything overnight. Start with one thing. When people go on diets that have a lot of rules, it can often be too much at once and they are set up for failure."

Most of all, she suggests seeing weight loss as a side effect of healthier eating behavior, not an endpoint. That can increase the enjoyment of what you’re eating, which is a major factor for sticking with better choices.

What This Means For You

Losing and gaining weight, especially repeatedly, puts you at higher risk for serious health issues, including insomnia and cardiovascular issues. A better approach is to lose weight gradually and make weight loss a "side effect" of healthy eating.

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  1. Cao V, Makarem N, Maguire M, et al. History of weight cycling is prospectively associated with shorter and poorer-quality sleep and higher sleep apnea risk in diverse US women. J Cardiovasc Nurs. Published online April 30, 2021. doi:10.1097/JCN.0000000000000818

  2. American Heart Association. Yo-yo dieting may increase women’s heart disease risk. Published March 7, 2019.

  3. Liao Y, Xie L, Chen X, et al. Sleep quality in cigarette smokers and nonsmokers: findings from the general population in central China. BMC Public Health. 2019;19(1):808. doi:10.1186/s12889-019-6929-4

  4. Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB. Interrelationship between sleep and exercise: a systematic reviewAdv Prev Med. 2017;2017:1364387. doi:10.1155/2017/1364387