March Newsletter
March, 2022
Welcome to the March newsletter. This newsletter aims to provide information and analysis of timely topics from recent articles published in the medical literature. I hope you find this information useful and helpful in your health journey. If you have comments or questions, please let us know!

Sleep and shifts in sleep always come to the forefront in March with the change to daylight savings time. This year, a debate has been raging about staying permanently on daylight savings time and the Senate voted unanimously on March 15th to make daylight savings time permanent. While many of us enjoy the extra hour of daylight on summer nights, is it the best thing for our health? In 2020, the American Academy of Sleep Medicine released a position statement in the Journal of Clinical Sleep Medicine that recommended that the United States move to year-round standard time. Standard time is more aligned with humans’ circadian rhythms and natural light/dark cycles, the group wrote, and disrupting that rhythm has been linked to higher risks of heart disease, obesity, and depression. Laboratory and field experiments in humans and rodents have shown that circadian misalignment can lead to cognitive impairment, mood dysregulation, a reduction in glucose regulation and insulin sensitivity, and changes in satiety hormones such as leptin that can lead to increased food consumption and weight gain. Daylight saving time does not ‘save’ evening light at all, it simply steals it from the morning, where it is necessary to maintain our healthy biological rhythms, Permanent daylight saving time would lead to more dark mornings, which could be dangerous for kids going to school, adults driving to work (75-100 more dark morning commutes annually), and overall sleep cycles. This wouldn't be the first time we tried switching to permanent DST. In the 1970s, the U.S. adopted permanent DST in response to the oil embargo in order to save energy. It was reversed within a year primarily because of concerns when children, sadly, were killed waiting in the dark for their school buses. 

Most Americans don't want to switch clocks twice a year and although a majority prefer permanent daylight saving time, permanent standard time looks to be the best solution most in line with our circadian rhythms.

Since sleep is on our minds this month I decided to have a sleep-themed newsletter. The first article focuses on the type of fat that we gain when sleep-deprived and explains why I was so hungry when I was a resident on call losing a lot of sleep. The second article reviews what happens to our metabolism when exposed to light while sleeping. The third article looks at the effects of exercise on sleep and which type of exercise could be most beneficial to help us sleep. I hope you enjoy these articles!
I am happy to announce that I have one of the newest diagnostic tests available. The Galleri test is a blood test that can detect over 50 types of cancer before they are apparent through regular screening testing (and many cancers don't have a screening test). The test detects methylation patterns of cell-free DNA which can indicate cancer and thus has the potential to detect cancers at the earliest stages. If you are interested in learning more about this test please let us know. I'm constantly on the lookout for cutting-edge tests and procedures for my patients and I have a few more things on the horizon that I am evaluating.
fat belly
Lack of Sleep Belly
When we lose sleep, we often feel like our energy and alertness levels are the biggest problem. But what if there is something potentially more dangerous? What if chronic sleep loss is not only causing you to gain fat, but causing you to gain it in the most dangerous location? What are the dangers of gaining fat in this location? This study, from the Mayo Clinic, shows us how much of a problem chronic sleep deprivation could be for our metabolism.  

Lights On, Sleep Off
It can be hard to get a room completely dark to sleep in. We all probably have glowing clocks, phones, televisions, tablets, and other electronic devices in our bedroom. If we live in a city, we have streetlights and car lights streaming in our windows. What effect does nighttime light have on our bodies? What happens physiologically when we have increased light exposure during the night? How is the structure of our sleep affected by light exposure? What are the possible detrimental effects?  

Best Exercise For Sleep
It is well known that exercise improves sleep. But is there a type of exercise that is best to promote sleep? Is time on the elliptical better than pumping iron for a night of better sleep? Will I fall asleep faster if I do HIIT or does taking a walk lead to better rest? This study looked at the effects of 12 months of regular exercise on overall sleep duration, sleep efficiency (time sleeping vs time in bed), and sleep latency (time to fall asleep). If you are interested in improving sleep without resorting to medication, this study has some interesting suggestions.  

To Your Health...
Thank you for taking the time to read through this newsletter. We hope you have found this information useful. Feel free to pass this on to anyone you think would benefit from this newsletter.

Mark Niedfeldt, M.D.

Old-fashioned medicine with 21st Century convenience and technology