Sleeping Your Way to A Longer, Healthier Life

There’s an Irish proverb that goes, "A good laugh and a long sleep are the best cures in the doctor’s book." It turns out that there is some truth to that... at least the part about sleeping. That is, sleep has a profound effect on maintaining an individual’s health status. 

An alarming number of people around the world have trouble sleeping or don't get enough sleep. In fact, Kryger et al. (2017) found that over 36% of the world's population has trouble sleeping. In the US, about 50–70 million Americans have trouble sleeping regularly, which makes it hard for them to go about their daily lives and hurts their health and longevity (Institute of Medicine Committee on Sleep Medicine and Research, 2006).

How Does Poor Sleep Affect Your Health?

Lack of sleep moderates important biological reactions, including heightened cell stress, subpar immune responses and neural autonomic control, which controls involuntary physiological processes like heart rate, blood pressure, respiration, digestion and sexual arousal (Tobaldini et al., 2017). In recent studies, it was discovered that sleep quality is linked to skin aging, frailty, and mental health (Lo et al., 2014; Oyetakin-White et al., 2015; Carskadon et al., 2019; Sun et al., 2020), as well as cardiometabolic health and mortality (Karthikeyan et al., 2019; Fan et al., 2020).

Research on Sleep and Longevity

In 2021, there was a massive study put on by the UK Biobank examining the link between how well you sleep and how long you live based on a large prospective cohort (Sambou et al., 2021). This longitudinal cohort study enrolled 328,850 participants aged between 37 and 73 years from the UK Biobank to examine the associations between sleep quality and risk of terminated health span. They found that, compared with poor sleep quality, participants with healthy sleep quality had a 15% reduced risk of a healthspan-ending event. This study shows how important sleep quality is for reducing the risk of prematurely ending healthspan and suggests that healthy sleep behavior may extend healthspan.

NMN and Sleep

Recently, there have been several studies on nicotinamide mononucleotide (NMN) and sleep in humans. One study from 2021 looked at how giving NMN once a day for 12 weeks affected sleep and other factors in older people (Kim et al., 2022). The study showed that taking NMN in the afternoon helped older people feel less sleepy. However, no effects were seen on a questionnaire that reliably distinguishes between good and poor sleepers, called the Pittsburgh Sleep Quality Index (PSQI), in this study.

Another study from last year that looked at the effects of NMN on insomnia in middle-aged and older adults showed that NMN improves sleep (Zhao et al., 2022). In this study of 58 people with insomnia, half were treated with NMN for 12 weeks so that the effects on middle-aged and older adults could be seen and compared. The PSQI and smart bands that tracked sleep data were used to determine how well the NMN supplements worked. While PSQI scores decreased for both the untreated and treated groups, the total effectiveness rate was significantly higher in the NMN group (65.52%) than in the control group (27.59%). Also, the smart bands they wore while sleeping showed that people in the NMN group slept better.

How Can NMN Aid Sleep?

We don’t know exactly how NMN affects sleep. We do know that NMN is converted into a molecule called nicotinamide adenine dinucleotide (NAD+), which is required for many enzymes involved in cell health to function. Along these lines, nicotinamide phosphoribosyltransferase (NAMPT), the enzyme that turns NMN into NAD+, is turned on and off by the circadian clock, causing NAD+ production to change as you sleep and wake up (Tokizane & Imai 2021).

An area in the brain known as the hypothalamus—a critical center for the homeostatic regulation of energy and glucose metabolism, circadian rhythm and aging-related physiology—has been shown to be dependent on NAD+. According to recent research, the hypothalamus needs NAD+ oscillation in order to function properly, and poor NAD+ regulation in the hypothalamus' neurons is a major contributor to metabolic disorders and the disruption of the circadian rhythm brought on by diet and aging. Also, it was recently discovered that cells in the hypothalamus contain a transporter for NMN called Slc12a8. This transporter was shown to be important for regulating the metabolism of the whole body and the functions of skeletal muscles, and it sheds light on what causes frailty in older people (Ito et al., 2022).

In the future, researchers should look at how long these sleep improvements caused by NMN last and if they keep getting better over time.

References:

Institute of Medicine (US) Committee on Sleep Medicine and Research. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Colten HR, Altevogt BM, editors. Washington (DC): National Academies Press (US); 2006. PMID: 20669438.

Ito N, Takatsu A, Ito H, Koike Y, Yoshioka K, Kamei Y, Imai SI. Slc12a8 in the lateral hypothalamus maintains energy metabolism and skeletal muscle functions during aging. Cell Rep. 2022 Jul 26;40(4):111131. doi: 10.1016/j.celrep.2022.111131. PMID: 35905718.

Kim M, Seol J, Sato T, Fukamizu Y, Sakurai T, Okura T. Effect of 12-Week Intake of Nicotinamide Mononucleotide on Sleep Quality, Fatigue, and Physical Performance in Older Japanese Adults: A Randomized, Double-Blind Placebo-Controlled Study. Nutrients. 2022 Feb 11;14(4):755. doi: 10.3390/nu14040755. PMID: 35215405; PMCID: PMC8877443.

Kryger, Meir H., T. Roth, and William C. Dement. Principles and Practice of Sleep Medicine. Ed. Meir H. Kryger, T. (Tom) Roth, and William C. Dement. Sixth edition. Philadelphia, PA: Elsevier, 2017. Print.

Sambou ML, Zhao X, Hong T, Fan J, Basnet TB, Zhu M, Wang C, Hang D, Jiang Y, Dai J. Associations Between Sleep Quality and Health Span: A Prospective Cohort Study Based on 328,850 UK Biobank Participants. Front Genet. 2021 Jun 15;12:663449. doi: 10.3389/fgene.2021.663449. PMID: 34211497; PMCID: PMC8239359.

Tobaldini E, Costantino G, Solbiati M, Cogliati C, Kara T, Nobili L, Montano N. Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases. Neurosci Biobehav Rev. 2017 Mar;74(Pt B):321-329. doi: 10.1016/j.neubiorev.2016.07.004. Epub 2016 Jul 7. PMID: 27397854.

Tokizane K, Imai SI. NAD+ oscillation and hypothalamic neuronal functions. Fac Rev. 2021 Apr 27;10:42. doi: 10.12703/r/10-42. PMID: 34046646; PMCID: PMC8130408.

Zhao, B., Liu, C., Qiang, L., Liu, J., Qiu, Z., Zhang, Z., Zhang, J., Li, Y., & Zhang, M. (2022). Clinical observation of the effect of nicotinamide mononucleotide on the improvement of insomnia in middle-aged and old adults. American Journal of Translational Medicine, 6(4), 167–176.