Can a low-carb diet cause waking up in the middle of the night?
22 Comments


Lawrence Tam says, “I keep waking up in the
middle of the night and keep awoken for hours before I give up and get off my bed. Would low-carb, say 50 grams, make it worse? My blood glucose was 6 three days ago, which
was too high. I like to try low-carb,” and he clarifies
that that’s 100 milligrams per deciliter. “I keep waking up in the middle of the night
and stay awake for hours. Would low carb make it worse?” Lawrence, if you are in the chat, can you
just clarify whether you are already on the low-carb diet of 50 grams per day? So, yeah, it definitely could. So, look, if you’re on a ketogenic diet—okay,
first, let’s say you’re not on a ketogenic diet. Your brain will consume 120 grams of carbohydrate
every day, just your brain. There’s got to be another 30 grams or so that
would be used no matter what obligately by red blood cells, certain cells in the testes,
and the kidney, and the lens of the eye. And then the rest of your body, if you’re
eating not a ketogenic diet, the rest of your body is not really trying to be a fat burner,
so it’s going to burn through carbohydrate that could have been replaced by fat, but
it wasn’t because you had carbohydrate there. And so, your liver stores about 90 grams of
carbohydrate to be able to stabilize your blood sugar between meals, and overnight is
the biggest time where it has to do that because overnight is the longest period of time that
you go without meals. You add that up, you’re looking at like 250
grams of carbohydrate a day—we haven’t gotten to high-intensity exercise yet. You’re looking at, if you want to keep your
glycogen stores replete, you’re probably looking at 250 grams of carbs a day. Now, if you go on a ketogenic diet, what happens? Well, your brain glucose consumption goes
down from 120 grams a day to like 30 or 35 grams a day. You cannot and will not ever, ever, ever,
ever, ever go to zero. That’s one thing. You still have another 20, 30 grams of carbohydrate
that you’re burning through by cells that cannot burn anything else, like red blood
cells, certain cells in the kidneys, certain cells in the testes, certain cells in the
lens of the eye. So, you still have a minimum probably 60 or
70 grams of carbs per day that you need, even when you’re maximally keto-adapted. I’m not saying you need to eat those carbs. You’ll make them through gluconeogenesis if
you don’t eat them. But the rest of the body where the needs were
flexible has mostly shifted to burning fat for fuel on a long-term ketogenic diet. So, the real big problem is if you’re not
low-carb enough to be keto, but you’re way under 200, 250 grams of carbs a day. Like, probably 100 grams of carbs a day is
like, if it works for you, great, but if you have symptoms of low blood sugar at night,
you shouldn’t be spending a lot of time guessing why because you’re in this gray area where
you are not keto-adapted, your brain is still burning through 120 grams a day, your liver
still stores 90 grams a day, and the rest of your body still probably is preferentially
burning carbs for energy instead of storing them for the most part because the carbs are
there. So, your body is not deliberately, intensively
reorganizing to conserve the carbohydrate in that gray area. On 50 grams, I don’t know. How keto are you? It’s more interesting to me whether you’ve
had sustained like 2, 3, 4, 5 millimoles per liter ketones in your blood than how many
grams of carbs you’re eating. Because if you do have sustained full-on ketogenesis,
you’re probably, over many weeks, you’ll be very keto-adapted, but if you don’t, like
if you cycle between 0.5 and 1, I don’t think you’re going to be super keto-adapted. And so, I think you’re probably in that gray
area. Or if you’re 50 grams of carbs a day and you
don’t have ketones, you’re definitely in that gray area. So, waking up in the middle of the night and
staying up for hours, yeah, if you’re on low-carb, look at the carbs, definitely. Lawrence adds, “I’m not on the ketogenic diet.” Well, you might not be deliberately keto,
but unless you test your ketones, we don’t really know how ketogenic you are, so that’s
the big issue there. But again, you may have this problem on keto,
but keto is way safer than being in this, what Denise Minger calls, the macronutrient
swampland, where you’re like kind of low-carb, kind of high-fat, but you’re not really optimized
for one or the other. I think that’s probably the worst place to
be from this perspective. And I’m not saying there’s not other causes
of waking up in the middle of the night. I’m not saying that if you do have 50-100
grams of carbs, you will be in this place. I’m just saying, if you are eating 50 or 100
grams of carbs, and you are in this place, then you absolutely should connect the two
and see if increasing your carbs helps. Your blood glucose is a little high. Low-carb is not the best solution to high
fasting glucose. There’s a lot of people on low-carb who have
high fasting glucose. There’s a ton of people who go low-carb and
develop high fasting glucose. So, low-carb helps you—if you are glucose-intolerant,
you absolutely will not get high postprandial glucose spikes when you don’t eat carbs because
you didn’t eat the carbs, but your morning fasting glucose is like, only if your glucose
tolerance is ridiculously bad is that glucose left over from the carbs you ate last night. In most cases, it’s hormonally controlled,
and there’s nothing about low-carb that modulates the hormones in the way that prevents that. Low-carb modulates the hormones in the way
that spikes that because the hormones that raise your fasting glucose in the morning
are number one, glucagon, and then number two, compounded by adrenal hormones. And both of those are the early- and late-stage
adaptations to low glucose supply. You know what raises your morning fasting
glucose very acutely? Not sleeping well. Okay, so the case you’re making is one for
forgetting about the glucose and fixing your sleep, and what you’re reporting says to me,
definitely look at the carbs first in fixing the sleep.

22 thoughts on “Can a low-carb diet cause waking up in the middle of the night?

  1. An awesome vein diagram seems necessary here. Bad sleep? Ok follow this line on the diagram. It would be very detailed but who cares. As long as its accurate. Been listening to you for a while now Chris. Love your take on things. Keep it up. I think a book would be a good idea aswell. Happy t giving. 😊 Alex from Wa State.

  2. I found that going very low carb made me wake in the night, but eating around 70-100g / day usually keeps me in low-grade nutritional ketosis (~.5mmol) and fixed my sleep problems.

  3. Is Lawrence taking melatonine? Melatonine has a half-life of 30-50 minutes. In some people this causes sudden awakening 4-5 hours after taking it (because the body thinks sleep time is over). If this is the case, Lawrence should try reducing the dose to 250-300 micro grams (0.25 mg), or try taking time-release capsules.

  4. I have high zink level and I don't take any supplement since two years I don't now what is the problem I have many symptoms and the doctor told me I give you multivitamins supplement to hep you to be better because I am every time very tired, I don't accept I told him that I need something to reduce this zin and she told me there is nothing to reduce it
    Than if you can help me about this
    thank you for your videos

  5. I've been keto for a little over 4 years. Levels range from .5 to 1.9. I was waking up every night around 5 am. Glycine helped tremendously. 3 grams right at bedtime.

  6. Just went low carb last week. Since then, every night I have terrible insomnia, then waking in the night with panic and anxiety and now, just started my menses a week early (which has never happened) I think Chris is spot on. I'm wasn't doing Keto, just low carb so, I have messed up my blood sugar. Earlier this year, Chris talked about why some people may have adverse effects to GABA supps, and I am one of them. GABA gives me terrible anxiety/panic attacks. Blood sugar is key.

  7. I've been doing low carb over 1.5 years. Had a stroke 2013. Was becoming prediabetic, brain fog troubles. I lost 15 lbs as a side affect. (I'm only 5'4", wasn't fat).Brain generally clearer. However, I've never experienced the "wonderful" effects of keto. Maybe not low carb enough. I've always struggled with anxiety, but lately anxiety levels are very bad. Starting to eat more carbs again to see of that helps
    Not sure yet.

  8. Ever since I started eating animal organs I sleep really well without waking up in the middle, except when I don't have enough oxygen in the room (due to closing the door and all the windows in the room). I also eat some carb later in the day, but that was before the animal organs.

  9. On low carb diet the body does not need the same amount of sleep. You will sleep shorter and deeper.
    If I hit the bed at 10PM by 5AM I am already done with the sleep. Best sleep is between 10PM and 2-3AM.
    I never eat after 6PM. At least 4 hours before you go to bed. This is not a problem, it is a blessing, more time awake in this short life.

  10. A combination of true dark glasses, a set bedtime, an electronic fast for 1 hour before bed has dramatically reduced insomnia for me. I dream a lot more often.

  11. I’d say I stay around 200g-300/day of carb consumption. But you need to be quite clear that refined carbs are always a no-no! Raising your blood sugar fast and keeping that high sugar constant is a very dangerous recipe for disaster! Hernias all over the place like we have today! It’s messed me up!

  12. Almost any amount of refined carb foods causes me strange heart palpitations or feelings! Even some high carb whole foods (i.e. bananas, etc) do too, at times! I’m wondering if I have SIBO from a strange internal prolapse with hernia!

  13. Maybe this person is lacking some mineral or other nutrient, or just calories. 50-150g of carbs per day (versus <20 or >200), and the body can no longer function? I've done keto, low-ish carb, and higher carb for extended times with lots of high intensity exercise. Just put care into the food/nutrient choices. Also, when is this happening? …After two days of low carb, two months, a year?

  14. Quit guessing and start testing…it’s a bad trade off if you think you’re getting quality sleep(and aren’t), but are subjected to continual insulin damage. You can now easily test sleep quality and glucose/ ketones levels. Oura ring and Keto Mojo. Worth the investment…skip a few worthless gadgets this shopping season and get real ROI.

  15. "being between 0.5 – 1.0, I don't think you're keto adapted"

    This is incorrect.  

    For people on a long-term ketogenic diet, and without the use of exogenous ketones, you will rarely get above 1 unless your fasting.

    Remember, when you are fully keto-adapted and with proper body fat percentages you're metabolizing ketones rapidly. In fact, the definition of "in ketosis" for those following a ketogenic diet should start at 0.3.

    In addition, do you know what will wake you up in the middle of night…… having a carbohydrate bolus before you go to bed.

    The combination of a carb bolus, the rise in insulin, and your body's natural state of low blood glucose during sleep will cause a bit of hypoglycemia which is highly disrupting to your sleep cycle.

  16. I'm mostly carnivore, maybe 50g of carbs per day. My sleep prior was 6 hrs, now i range from 4-5. I was concerned at first, but noticed my energy level is better. I feel if i got to 6, i would even gain more energy. Just started taking a magnesium supplememt and will start sole water today.

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