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Creatine and sleep

Creatine and Sleep: Does Creatine Make You Sleep Less?

Wouldn’t it be great if you could take a supplement that reduced how much sleep you need without any negative effects? If such a compound existed, surely everyone would know about it already, right? Perhaps. But maybe there’s already a widely-used supplement that has this very profile. And what if this compound is safe, has health benefits, and is even inexpensive? This sounds too good to be true, but findings from a recent study suggest that creatine monohydrate, a supplement that has been used by strength and power athletes for decades, may fit all of these criteria. So, in this post I’m going to explore what we know about creatine and sleep.

 

What is creatine?

This simple peptide comprises three amino acids (arginine, glycine, and methionine), and we all consume creatine in our diets each day – often several grams of it. By increasing muscle stores of phosphocreatine – high-energy phosphate stores used to fuel brief, powerful muscle actions – many users soon surpass their previous best performances. To this day, the strength and power performance-enhancing effects of creatine monohydrate (1, 2) are probably unsurpassed by other legal supplements.

Better yet, scientists continue to identify more creatine use cases. One of these is brain health optimization, for creatine supplementation can increase brain energy stores and typically has antidepressant effects in females with depression that does not improve on taking commonly-prescribed antidepressants (3). Vegans and vegetarians may particularly benefit from supplementing creatine, for they typically consume less dietary creatine. As a result, these people tend to experience improved memory and cognitive function after creatine supplementation (4).

 

Side effects: creatine and sleep loss

Now, a small proportion of people who supplement with creatine monohydrate are “non-responders”. These people don’t experience large increases in cellular energy stores after creatine supplementation and therefore don’t reap the performance benefits either. But the only side effect that has otherwise been well documented is weight gain resulting from an increase in lean body mass…

… or is this the only side effect?

Speak to enough long-term creatine users, and one response may be so common as to leave you scratching your head, contemplating whether there’s more to the story:

I like creatine. I’m convinced I gain muscle and strength faster while using it. But I’m also sure that I don’t sleep as well when I take it.”

Those of you familiar with the basics of sleep regulation can probably come up with a hypothesis about why this might be the case, but scientists have only recently started to lose sleep (forgive me) over questions about creatine and sleep. 

The results?

Well, there’s more to the story!

 

Creatine and sleep: the two-process model of sleep regulation

Before I directly address creatine and sleep, we must first consider how sleep is regulated. The most widely used model of sleep regulation (5) has two processes. To describe the model simply:

  1. The longer you’ve been awake, the sleepier you generally are. This is sleep homeostasis (sometimes called Process S), and it determines sleep intensity. There are multiple biological correlates of sleep homeostasis, but the main one is the concentration of adenosine outside the cells in your brain. During wakefulness, your brain cells’ energy reserves are turned over, and some adenosine triphosphate (ATP – the primary energy currency of the cell) is released into the space between brain cells. This ATP can act on cells named astrocytes, raising the levels of some small proteins named cytokines (IL-1B and TNF-a, specifically) that increase the activity of sleep-promoting (GABAergic) neurons. Other ATP is broken down. In the first step of ATP degradation, ATP loses a phosphate, resulting in adenosine diphosphate (ADP) formation. In the next step, another phosphate is lost, producing adenosine monophosphate (AMP). One more step and AMP is degraded to adenosine. Adenosine then not only activates sleep-promoting neurons but also inhibits wake-promoting (cholinergic) neurons in the front of the brain (the basal forebrain). So, during wakefulness, extracellular adenosine and ATP accumulate in the brain and act on receptors in the brain to promote sleep. With more time awake comes more pressure to sleep.
  2. Even if you’ve been awake for a while, at certain times of day you find it hard to sleep. I bet you find it hard to nap in the late afternoon, for example. This wake drive (sometimes called Process C) is regulated by your circadian system – the biological clock that programs your daily patterns of biology and behavior.

Okay, so the main contributors to sleep homeostasis are extracellular adenosine and ATP concentrations. And this is key: When you consume creatine, you increase brain phosphocreatine stores and therefore the total pool of high-energy phosphates in your brain. (Recall that ATP is adenosine tri-phosphate). By doing so, and you buffer changes in brain energy stores during extended wakefulness. This should then counter increases in sleep homeostasis, the results of which might be reduced sleepiness and decreased sleep intensity.

Last year a group of scientists published work (6) that finally made sense of anecdotes about creatine and sleep.

 

Creatine and sleep regulation: creatine alters sleep homeostasis

To study creatine and sleep, Markus Dworak and his colleagues added creatine monohydrate to the chow consumed by rats for 4 weeks.

The results?

Creatine reduced total sleep time. But creatine also changed the structure of sleep.

Sleep is a cyclical phenomenon in which we pass through several stages. Each stage of sleep serves unique and important roles, and all are necessary to optimize our daytime function. One stage is REM sleep – that often-fun stage in which we enter our very own cinemas as we dream. The other stages fall into the category of non-REM sleep, the deepest stage of which is slow-wave sleep.

Sleep intensity is assessed by measuring a particular band of electrical activity in the brain during slow-wave sleep. Specifically, sleep intensity corresponds to brain waves that synchronously massage the brain 0.5 to 4 times each second. After we lose sleep and hence establish a sleep debt, repayment of this stage of sleep is prioritized at our first chance to sleep.

Interestingly, the rats consuming creatine had both less non-REM sleep as well as less intense non-REM sleep after sleep loss. This is not surprising, as creatine reduced the rise in extracellular adenosine in the rats’ brains after sleep loss. (Recall that the main determinant of sleep intensity is extracellular adenosine.) Such a loss of deep sleep is often seen during aging, as Dan discussed with Bryce Mander in one of my favorite episodes of humanOS Radio

This is interesting, but are these changes after creatine consumption actually bad for health?

 

Creatine and sleep: friend or foe?

When we consider the broader context of existing scientific literature on creatine, this work becomes especially intriguing.

A key study finding was that creatine shortened sleep. If you deliberately restrict sleep and non-REM sleep by waking people from their dozing prematurely, you reliably impair their health in many ways. For example, insufficient sleep:

  1. Predisposes people to obesity (7).
  2. Increases skeletal muscle loss in people on weight loss diets (8).
  3. Impairs some exercise performance metrics (9).
  4. Produces widespread impairments in cognitive function, including worsened memory and mood (10).

So, if creatine shortens sleep then you might expect creatine consumption to produce much the same effects as those listed above.

Yet what does creatine supplementation generally produce?

  1. Enhanced body composition and performance changes in response to exercise (11).
  2. Sharper cognitive function in some, including improved mood (3) and memory (4).

So, many of the benefits of creatine perfectly contrast the detriments of sleep loss!

Better still, it seems that creatine can be used acutely to offset the negative consequences of sleep loss.

As one example, researchers compared how well elite rugby players executed a sport-specific skill task following either sufficient sleep or just 3 to 5 hours of sleep. After ingestion of a placebo, players’ performance deteriorated. But when players consumed 50 or 100 mg creatine per kg bodyweight (so 5 or 10 g for a 100kg athlete – a typical dose), they performed as well as when well rested. After sleep loss, consuming the higher creatine dose also tended to produce higher testosterone levels versus consuming the placebo (12). 

During sleep deprivation, creatine also seems to offset deterioration in people’s abilities to plan, carry out, and monitor goal-directed tasks (13). What’s more, creatine has also been shown to counter negative effects of extended wakefulness on things like mood, balance, and reaction time (14), although not all studies have found this.

The type-A, “I’ll sleep when I die” types among us have long dreamed of something to let us get by on less sleep. By my reckoning, creatine might be the best readily-available compound there is in the pursuit of squeezing more hours into the waking day.

But before getting carried away and concluding that creatine is the answer this conundrum, let’s keep some things in mind:

  1. The Dworak study was done in rats. My strong suspicion is that the findings would be largely similar in us primates, but this work needs doing.
  2. Could there be detrimental effects of very long-term creatine use? The jury’s out, but there’s no evidence of this, to my knowledge.
Might creatine supplementation reduce how much sleep you need? If so, is this a good thing or a bad thing? Click To Tweet

 

Creatine and sleep: an anecdote

Take my anecdotal experience with a pinch of salt. Or three.

I’ve used creatine monohydrate on and off for about 12 years without any ill effects. While taking it, I feel sharp mentally and I seem to gain muscle size and strength a little faster. My sleep is noticeably less deep, however, and I’m convinced I awake more often at night. I suspect I sleep a little less too – half an hour to an hour each night, perhaps. When I stop taking it, my sleep seems to deepen and lengthen, and I feel a little sluggish initially during the day. Fragmented sleep while taking creatine isn’t as much fun as consolidated sleep when not taking it, but I don’t think sleep disruption affects my waking performance negatively. And with a little more time awake each day while taking creatine, the trade-off seems worth it.

So, if these effects are real, does creatine use reduce my sleep need? Or does it just help me feel and function well on less sleep?

This distinction is important regarding how to interpret this topic. Reducing sleep need while fulfilling all the requirements of healthy sleep would be a panacea: I’d get more time in my waking life without repercussions. Yet if creatine helps me feel better with less sleep without allowing me all the sleep I need, the long-term consequences could be dire. My guess is that the former is more likely to be accurate… but it is nothing more than a guess.

I’m very interested in your experiences too, so please do comment below with these!

 

Creatine and sleep: implications for users

There is some evidence that it is better to consume creatine after exercise than before if you wish to maximize how much muscle and strength you gain (15), although this finding needs replicating. I have no reservations recommending this approach if you train early in your waking day. But if you train late in your waking day and struggle to sleep afterwards, you might want to try consuming creatine earlier. I generally recommend taking creatine with your first meal, as things like carbohydrate and protein consumption aid creatine uptake. About 3 g of creatine monohydrate per day is usually about right, and there’s no need to ‘load’ creatine by taking higher doses initially. If you take it, get micronized Creapure® powder. The purity is higher and it’s still very cheap.

 

Key Takeaways

  1. Many people feel creatine monohydrate supplementation alters their sleep.
  2. Creatine ingestion shortens total and deep sleep in rats, probably by affecting sleep homeostasis.
  3. Despite shortening sleep, creatine often produces numerous beneficial health effects.
  4. Creatine ingestion may acutely offset some of the adverse effects of sleep loss. So while most people use creatine daily for several weeks to enhance exercise performance, you might also consider using creatine acutely as an alternative to stimulants like caffeine.
  5. If you take creatine and it messes with your sleep, you may want to take it in the morning. If you feel the sleep disruption impairs your health and performance, you should probably stop taking it.
  6. There isn’t really a strong rationale to cycle creatine, but effects on sleep might be one reason to use it intermittently. (I typically use creatine for about 12 weeks and then go without it for a few weeks.)

 

References

  1. Lanhers C, Pereira B, Naughton G, Trousselard M, Lesage FX, Dutheil F. Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses. Sports Med. 2015;45(9):1285-94.
  2. Lanhers C, Pereira B, Naughton G, Trousselard M, Lesage FX, Dutheil F. Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis. Sports Med. 2017;47(1):163-73.
  3. Kondo DG, Forrest LN, Shi X, Sung YH, Hellem TL, Huber RS, et al. Creatine target engagement with brain bioenergetics: a dose-ranging phosphorus-31 magnetic resonance spectroscopy study of adolescent females with SSRI-resistant depression. Amino Acids. 2016;48(8):1941-54.
  4. Rae C, Digney AL, McEwan SR, Bates TC. Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial. Proc Biol Sci. 2003;270(1529):2147-50.
  5. Borbely AA, Daan S, Wirz-Justice A, Deboer T. The two-process model of sleep regulation: a reappraisal. J Sleep Res. 2016;25(2):131-43.
  6. Dworak M, Kim T, McCarley RW, Basheer R. Creatine supplementation reduces sleep need and homeostatic sleep pressure in rats. J Sleep Res. 2017;26(3):377-85.
  7. Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep. 2008;31(5):619-26.
  8. Nedeltcheva AV, Kilkus JM, Imperial J, Schoeller DA, Penev PD. Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern Med. 2010;153(7):435-41.
  9. Fullagar HH, Skorski S, Duffield R, Hammes D, Coutts AJ, Meyer T. Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Med. 2015;45(2):161-86.
  10. Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2005;25(1):117-29.
  11. Tarnopolsky MA. Caffeine and creatine use in sport. Ann Nutr Metab. 2010;57 Suppl 2:1-8.
  12. Cook CJ, Crewther BT, Kilduff LP, Drawer S, Gaviglio CM. Skill execution and sleep deprivation: effects of acute caffeine or creatine supplementation – a randomized placebo-controlled trial. J Int Soc Sports Nutr. 2011;8:2.
  13. McMorris T, Harris RC, Howard AN, Langridge G, Hall B, Corbett J, Dicks M, Hodgson C. Creatine supplementation, sleep deprivation, cortisol, melatonin and behavior. Physiol Behav. 2007;90(1):21-8.
  14. McMorris T, Harris RC, Swain J, Corbett J, Collard K, Dyson RJ, Dye L, Hodgson C, Draper N. Effect of creatine supplementation and sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state, and plasma concentrations of catecholamines and cortisol. Psychopharmacology (Berl). 2006;185(1):93-103.
  15. Antonio J, Ciccone V. The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. J Int Soc Sports Nutr. 2013;10:36.