Quelle est la relation entre le sommeil et le surpoids ? Un mauvais sommeil peut-il contribuer à un surpoids ? Aujourd'hui, je reçois un spécialiste du sommeil, le Dr Jonathan Taieb, directeur de l'Institut Médical du Sommeil. Nous allons parler nutrition et sommeil. Vous allez apprendre comment, avec l'alimentation, vous allez pouvoir vous mettre dans les meilleures conditions pour bien dormir. UN sommeil réparateur est important pour la régulation des émotions mais aussi pour la bonne production d'hormones qui régulent l'appétit et la satiété. Et beaucoup vont enfin comprendre pourquoi je mets des féculents le soir dans les menus de la méthode Cohen, eh oui, ça aide à l'endormissement ! Voici 6 conseils d'experts pour bien manger et dormir comme un bébé !
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00:00 Hi friends, today I'm with Jonathan Tailleb,
00:03 the head of the Sleep Institute.
00:06 He's also a doctor at the Hôtel Dieu hospital.
00:09 He's going to talk to us about sleep because it's a problem
00:11 that interests everyone who wants to lose weight
00:13 because we know there's a relationship between sleep, weight gain, weight loss.
00:16 Hello Jonathan.
00:17 Hello Jean-Michel, thank you for inviting me.
00:19 Welcome to the Jean-Michel Cohen channel,
00:21 the channel where we only talk about nutrition and where we never talk about salads.
00:25 Masterclass, personalized menu, individualized dietary follow-up,
00:30 visit the website doctor.jeanmichelcohen.fr
00:33 What is a good sleep?
00:35 A good sleep is already a sleep without complaints.
00:37 You don't wake up at night, you don't put several hours to sleep, several minutes,
00:41 and you wake up in the morning with a feeling of repairing sleep.
00:45 Repairing sleep on the physical level, without muscle fatigue,
00:48 and repairing sleep also on the psychological level,
00:50 ready to face the day with new emotions.
00:52 So if I have a good sleep, I'm in my body, in my head, in my skin?
00:56 Yes, we know that sleep has an important role in the reconstruction of one's deep being
01:00 on the physical and psychological level.
01:02 So you explained to me that we were today in an epidemic of sleep debt.
01:07 We went from 8 hours of sleep in the 19th century to 6 hours and 30 minutes of sleep today,
01:11 the fault, finally, of the arrival of artificial light,
01:14 which made it invade our homes, our streets, our offices.
01:18 We work more and more early, we finish our days more and more late,
01:20 we often go to the cafe, and then in the evening, it's a waste of sleep.
01:24 So we are in a world where sleep is poorly managed.
01:26 It's true that on the Internet, we often see "you have to sleep 8 hours to be in good shape".
01:29 It's false. In fact, there are people who need 6 hours, others who need 8 hours.
01:32 You have to have the feeling of repairing sleep.
01:35 You feel repaired on the physical level, repaired on the psychological level.
01:38 We are ready to face the day with emotions.
01:40 I don't know if you have this feeling, Jean-Michel,
01:42 you can be upset one night by a problem,
01:46 the next day, you wake up, you are a little less upset by what upset you.
01:50 Because sleep has gone through this, it's also the dilution of emotions,
01:54 and it's in a particular state of sleep that we call paradoxical sleep.
01:57 What do I do if I can't fall asleep?
01:59 If you can't fall asleep and it lasts a while,
02:02 you don't have to stay in bed, you can get up, go to another room,
02:06 and as soon as the signs of sleep reappear, heavy eyelids, you're drooling,
02:10 you feel like sleep is coming back, you can get back to your bed.
02:13 If it's chronic, and it happens overnight,
02:17 you can fall into chronic insomnia.
02:19 And at that point, you have to come and see me.
02:21 Suppose I wake up several times at night.
02:24 Is that a problem? It's not a problem. What do I do?
02:26 For nightly wake-ups, it is physiological to wake up in the middle of the night.
02:29 Between each sleep cycle, you wake up for a few seconds.
02:31 Now, if this wake-up starts to last a few minutes,
02:35 and it impacts your night, and there is a complaint,
02:37 and it affects the day of the next day,
02:39 in these cases, you have to consult better.
02:41 There are sleep pathologies that can be responsible,
02:43 especially sleep apnea.
02:45 The idea is really to know what sleeper you are.
02:47 Are you a sleeper who sleeps 6 hours a night?
02:51 So that's the short sleepers, 10% of the population.
02:53 Are you a long sleeper?
02:54 It's the sleepers who will sleep 9-10 hours.
02:56 And then, overall, 80% of the population, it will be between 7 and 8 hours.
02:59 And also, know your chronotype.
03:01 There are people who are late-night sleepers, late-night sleepers,
03:03 it's genetic.
03:05 We saw during the COVID period with the confinement
03:07 that there is the environment that can also take part and shake up genetics a little.
03:11 Do you also confirm that there is a link between weight gain and lack of sleep?
03:17 We know that it is this debt of sleep, and all scientific studies show it,
03:20 sleeping less than 6 hours chronically increases the emergence of cardiometabolic pathologies.
03:26 We know that there is an increase in the risk of arterial hypertension,
03:28 an increase in the risk of stroke, an increase in the risk of diabetes,
03:32 an increase in insulin resistance, but also weight gain.
03:36 There are several studies that only emerge between sleep and diet.
03:40 Our human body is a bit like an engine.
03:43 There is fuel, it is food.
03:46 There is maintenance, it is physical activity.
03:48 And then there is rest.
03:49 Sometimes you have to put your car to rest, it's sleep.
03:51 And so, all the different studies that are emerging,
03:53 from the great scientific journals,
03:55 address the theme and the intricacy of sleep and diet,
03:59 of food and physical activity,
04:01 and then sleep and physical activity.
04:03 Yes, I know that's your big credo.
04:05 Can you give me some advice, but really 7-8 tips,
04:08 for what you really need to do to have a good sleep?
04:11 When you eat a meal that is too copious, too heavy, or too close to bed,
04:14 you will increase the body temperature,
04:16 and to sleep well, Jean-Michel, you need to lower the body temperature.
04:19 So that's your first tip, that means eating...
04:21 Eating at the distance of the last meal, and then eating in a reasonable amount.
04:26 My grandmother always told me, "Excess at night."
04:29 So that's the quantitative aspect.
04:31 Then there is the qualitative aspect.
04:33 What you need to know is that the brain needs sugar.
04:36 It's very important because sleep is very energetic,
04:38 especially in the second part of the night, with paradoxical sleep,
04:41 which will consume 5 grams of glucose per hour.
04:44 Yes, but for us, it's fine, because if we consume sugar, we lose weight.
04:47 Exactly.
04:48 So you're going to tell me that you have to eat sugar before bed?
04:51 So, rather, slow sugars.
04:52 Slow sugars that will release a constant flow of sugar during the night.
04:56 So for me, that's all I take, Jean-Michel,
04:58 it's vegetables, it's lentils.
05:00 It always annoys people.
05:01 A bit like sports.
05:02 No, but it always annoys people when I tell them,
05:03 "You're going to take lentils at night."
05:05 And they say, "Lentils at night?"
05:06 And I tell them, "Yes, yes, it will help you fall asleep, calm you down."
05:09 Third tip is to reserve fast sugars for the evening and avoid them during the day,
05:15 because fast sugars will induce drowsiness.
05:19 You know, that little sweet, sweet...
05:21 No, but you're going to break my job.
05:23 That is, you are going to eat pasta at night,
05:25 and then you're going to end up with sweets and chocolate.
05:27 It's a bit like that, actually, Jean-Michel, it's true that...
05:29 Yes, I confirm.
05:30 Yes, I confirm.
05:31 In fact, that's why...
05:32 No, but it's true, because the elderly, for example,
05:35 they tell you that before going to bed,
05:37 they love to suck on a candy or take something with honey, you see?
05:42 So it's a bit true, it confirms.
05:43 It's a bit like that for me.
05:44 Before, when I was little, I used to take a glass of milk,
05:46 and now I take a little chocolate bar.
05:48 So I know there's a little bit of caffeine in the chocolate bar,
05:50 but this chocolate bar, Jean-Michel, is my little psychological sweetness.
05:55 OK, I'll let you like it.
05:56 So tell me, is it a myth or a reality, the glass of milk with the spoon of honey,
06:00 as we used to say before?
06:01 Three interesting points.
06:02 The first is that there are a lot of tryptophan, we've talked about it,
06:04 so it will stimulate the secretion of melatonin.
06:07 The second point is that the glass of milk has to be hot,
06:10 because it cools the body down by the thermal exchanges.
06:14 And finally, the last one, well, that's all, it reassures, it's psychological sweetness.
06:17 We are at the third tip.
06:18 There is a fourth tip.
06:20 Avoid alcoholic beverages as you approach bed.
06:22 It raises the central temperature because alcohol is only eliminated by heat.
06:26 Exactly, and on top of that, it's a false friend,
06:28 because it's true that alcohol makes you sleep easier.
06:30 Limit everything that is going to be exciting.
06:32 And when I talk about exciting, I'm talking about caffeine,
06:34 but I'm also talking about nicotine as you approach bed,
06:36 because we know that it makes sleep less deep, lighter,
06:39 and it can lead to an alteration in the quality of sleep.
06:42 Oh shit, I always take the little nicotine pills,
06:44 because I stopped smoking, but it's nicotine.
06:46 OK, great advice, I'm going to stop.
06:49 Sixth tip, Jean-Michel, incorporate food rich in tryptophan.
06:52 The tryptophan, Jean-Michel, is really interesting,
06:54 because it's an amino acid that is not secreted by the human body,
06:58 which is brought in by food,
07:00 which will have the specificity of passing the brain barrier in 30 minutes.
07:03 It will turn into 5-hydroxy-tryptophan.
07:05 The 5-hydroxy-tryptophan is serotonin.
07:08 Serotonin turns into melatonin, which is the sleep hormone.
07:11 So when you eat tryptophan,
07:13 it actually allows you to secrete melatonin.
07:16 It even prevents you from buying it at the pharmacy.
07:18 It's essentially cheese, meat and eggs,
07:21 fish and crustaceans, cereals and vegetables,
07:25 and also oleaginous grains.
07:27 Interestingly enough, it's the roast chicken with the skin first,
07:30 then you have the sesame seeds,
07:32 then you have the broken peas,
07:35 then you have the morue,
07:37 which we don't eat every day,
07:39 and then you have the parmesan.
07:40 It's easy to eat, because I just told you earlier
07:42 that you have to eat pasta at night,
07:44 pasta with parmesan is super good,
07:46 and you'll have a good meal afterwards, as he told you.
07:48 What foods should you avoid?
07:49 According to you, it's the excitants, you told me.
07:51 The excitants, but the excitants...
07:52 Coffee, tea, alcohol.
07:53 Coffee, tea, alcohol.
07:54 Maybe if you want a colorful drink,
07:56 maybe a herbal tea,
07:57 because it will have the effect of thermal exchange.
08:00 When you drink a hot drink,
08:01 you cool your body,
08:02 and you know that it's by cooling your body
08:04 that you promote sleep.
08:05 In addition to that, the effect of plants,
08:07 so there's chamomile, orange blossom,
08:09 it always relaxes,
08:10 and it's also a little bedtime ritual.
08:12 Are sleeping pills useful?
08:14 People generally take, from the simplest to the lightest,
08:17 there's the Donormy, the melatonin,
08:19 there are the very powerful things,
08:21 the Roxy, the hypnotics, the Imovane, etc.
08:25 The person who can't sleep,
08:27 does it happen that you give them that?
08:30 Look, Jean-Michel, it happens,
08:31 but always over a short period.
08:33 The idea is that we treat the symptom,
08:35 but we don't treat the cause.
08:36 And the cause is insomnia treatment,
08:38 reference treatment,
08:39 and behavioral cognitive therapy.
08:41 When I see that a patient has a quality of life
08:43 that is altered professionally,
08:44 he can't take it anymore,
08:45 it's complicated at work,
08:46 he can't sleep,
08:47 and it becomes really complicated
08:49 in terms of mood and in terms of physical condition,
08:51 we can put benzodiazepines.
08:52 But the idea is not to prolong the prescription for years,
08:55 because we know that these benzodiazepines
08:57 have an effect on sleep,
08:59 especially there's a habit,
09:01 so it's less effective,
09:02 but in addition to that, sleep is less repairing,
09:04 there's less deep sleep,
09:05 this deep sleep which is really very important
09:07 for the reconstruction of our deep being.
09:09 So, short duration of action on benzodiazepines,
09:12 we can prescribe it,
09:13 but the idea is to do a severing
09:15 with behavioral cognitive therapy.
09:18 Is the amelatonin in compressed or warm sheet useful or not?
09:21 The problem is that amelatonin is poorly prescribed,
09:23 it really has two indications.
09:24 First indication, chronobiotic action,
09:26 an action on the biological clock
09:28 that we would take 4 to 6 hours before,
09:30 on doses of 0.5 to 1 mg,
09:32 so it's medical doses prescribed by the doctor.
09:34 And then there's a soporific action
09:36 at more than 2-3 mg.
09:38 The periodicity of the clock is 3 weeks,
09:40 so amelatonin must be prescribed for 3 weeks maximum,
09:43 and the spray doesn't work.
09:44 At this point, it must be taken 4 to 6 hours before,
09:46 and take a very small amount,
09:48 that is, half a compressed or a quarter of a compressed.
09:51 Exactly, these are the recommendations
09:52 of the French Society of Research on Sleep Medicine.
09:54 Not bad, interesting.
09:55 The problem is that in pharmacies,
09:56 you are sold a lot of products with a lot of melatonin,
09:58 which are often combined,
09:59 there is no pure melatonin,
10:01 and there is a placebo effect, of course,
10:02 but in the long run, it's better to avoid.
10:04 A word on sleep apnea,
10:06 which is to be put relatively aside.
10:09 Yes, Jean-Michel, it's a very common pathology,
10:11 which affects 10% of the world population,
10:13 a bit like arterial hypertension,
10:15 and the main factor is overweight.
10:18 70% of patients with sleep apnea have overweight,
10:22 30% of which can be simply the morphology of the ORL pathways.
10:25 And one of the peculiarities is that
10:27 overweight will increase visceral fat,
10:29 will increase fat at the level of the muscles of the neck,
10:32 and therefore it will promote sleep apnea.
10:34 It will close at the level of the upper RNA pathways,
10:36 more oxygen for the heart,
10:38 increase cardiovascular pathologies,
10:40 more oxygen for the brain,
10:41 non-reparatory sleep sensations,
10:43 swelling, morning fatigue,
10:45 and you have patients who will have a quality of life
10:47 that will be totally altered.
10:49 You have all heard of the machine
10:52 at constant positive pressure
10:53 that will release air to open the voids
10:55 and treat sleep apnea.
10:56 Well, in some cases,
10:59 when you lose weight significantly,
11:01 I have some patients who have lost 20-15 kg,
11:03 who have also done the "know how to lose weight" program,
11:05 and who have finally
11:07 lowered their sleep apnea index
11:09 and who no longer need either orthoses
11:11 or sleep apnea devices.
11:13 Is it mandatory to have sleep apnea
11:16 when you are obese?
11:17 No, not necessarily.
11:18 I have some patients who are obese or overweight
11:20 and who do not have sleep apnea.
11:22 So there are several parameters that come into play.
11:24 The morphology of the upper RNA pathways,
11:26 sometimes the position in which we sleep.
11:29 We know that we increase sleep apnea
11:31 when we are in a dorsal position
11:32 because we increase the respiratory constraints,
11:34 but I have patients who are obese
11:37 and who do not have sleep apnea.
11:38 When you make someone who is obese lose weight
11:40 and who has sleep apnea,
11:42 do you always cure sleep apnea?
11:44 Not always.
11:45 We often do a polysomnography
11:47 or a polygraphy after a weight loss
11:49 that must be sustainable.
11:50 Because I often have patients who lose 20 kg,
11:52 I see them again two years later in the office
11:53 with 30 kg more,
11:55 the apnea is still there.
11:56 But it depends.
11:57 I have patients who go from 40 apnea per hour
11:59 to less than 5,
12:00 and so we no longer need treatment.
12:01 And others who will stay at 20, 25, 30
12:03 and who sometimes still need treatment.
12:05 We will thank Jonathan.
12:07 I remind you that he is the president
12:09 or director of the Institut Médical du Sommeil
12:11 who works with the National Institute of Sleep.
12:14 So you have all the advice for sleep.
12:16 Thank you very much Jonathan.
12:17 Thank you Jean-Pierre for the invitation.
12:18 I hope you enjoyed this video.
12:20 You like it, you share it, you subscribe,
12:22 you make comments, even criticisms if you need to.
12:24 You give me ideas or video suggestions.
12:27 And I'll see you soon, friends.
12:29 [Music]
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