Expert: Adopted from SelfHacked
While aging, keeping your circadian rhythm is a key to health.
My Top 25 Tips For Sleeping Better
- Upon awakening, get outside and look at the sun, first thing in the morning for 15 minutes.
- Eat a protein-rich meal upon awakening.
- You need to be outside for 6 hours in the day, especially in the AM and afternoon.
- You need to have at least 1 hour of full body sun with either a bikini or boxers (start with 15 minutes), especially around noon for optimal vitamin D production.
- Starting at 7 PM (on average), cut out blue and green light at night. At the very least, cut out blue….Buy red glasses (block out blue and green light) or UVEX blue Blocking Glasses, for night time, especially when looking at computer or phone. Use Blue blocking light bulbs at night. Install F.lux as well. Make sure no stray light get to your eyes.
- In addition to cutting blue light out at night, you should dim ALL of your light to the lowest setting. It’s optimal to be in total darkness, but I don’t keep to this, because it’s too difficult.
- Stop eating by 7 PM (on average) – no midnight snacks.
- Stop wearing glasses or contacts when you’re outside. UV needs to directly hit your eyes.
- Go to bed at around the same time every night.
- Go to bed at 9PM instead of midnight. The more you are sleeping when it’s dark, the better.
- Be comfortably cool at night. Don’t sleep with really thick covers and in the summer make sure your room temperature is comfortably cool.
- Ensure an adequate intake of calories, especially protein, but also carbs and fat. Adequate seafood is also important. Protein increases metabolism and seafood has DHA.
- Make sure T3 and metabolism are normal. If not, then use cold and normalize your thyroid hormones.
- Exercise daily with walks and some high intensity, but all exercise should stop by 6 PM. You should be standing or doing yoga after 6 PM if you’re jittery.
- Use your brain in the day. If you’re not using your brain BDNF, will be lower and worsen your sleep.
- Don’t use your brain at night much. Don’t do stressful things at night. If you’re engaged in heavy mentally stimulating tasks, it will keep you from sleeping.
- Get your stress levels under control. If you’re stressed or your nervous system is overactive, you won’t go to sleep as well. This is where meditation, letting go, and mind-body techniques come in.
- Make sure you address underlying inflammation, because that will derail your circadian rhythm. Sometimes inflammation can be from food, which means you may need to stick to lectin avoidance diet. If you do have underlying inflammation, these tips should still help.
- Shut off the wifi at night.
- Buy a Silverell hoodie to protect against EMFs.
- Sleep in total darkness. Buy Curtains (Blackout) and Black tape.
- Don’t take any supplements after 3PM.
- If you’re still having trouble, then take upon awakening 6 capsNicotinamide riboside, 3 caps HMB, 1 tbsp liposomal resveratrol, 1 cap PQQ, 3 tbsp apple cider vinegar, 1 Nicotine and 3g Glycine after supper. These will help normalize your rhythm.
- If you’re still having issues, then try pot.
- If you still have issues, buy a Magnetico sleep pad…I use the “Super Sleep System”. You probably won’t get the results from the weaker versions. So if you do your own research and you decide to buy it you can use the code JC15 for 15% off.
While aging, keeping your circadian rhythm is a key to health.
- 1 The Circadian Rhythm In Pictures
- 2 About Your Circadian Rhythm
- 3 The Circadian Rhythm and Protein Recycling/Autophagy
- 4 Zeitgebers or Circadian Cues
- 5 1) Block Out Light at Night
- 6 2) Do Not Eat For Four Hours Before Bed
- 7 3) Getting Outside First Thing in the Morning
- 8 4) Getting As Much Sunlight In The Day
- 9 5) Going to Bed and Waking Up At The Same Time
- 10 5) Reduce Psychological Stress
- 11 6) Don’t Exercise a Few Hours Before Bed
- 12 7) Eat Most of Your Calories In the Morning and Afternoon
- 13 8) Go to Bed Early
- 14 8) Get Rid of Chronic Inflammation, Oxidative stress, Mitochondrial Dysfunction or Hypoxia
- 15 9) Be Cooler At Night
- 16 10) Block out EMFs.
- 17 11) Increase Cyclic AMP (cAMP) Right After Awakening
- 18 12) Make Sure You Have Enough of These
- 19 13) Take Most Supplements in the Morning
- 20 Other
- 21 Circadian Rhythm of Hormones
- 22 Circadian Rhythm of Disease
- 23 Circadian Rhythm, Metabolism and Oxidative Stress
- 24 Circadian Rhythm and Your Immune System
- 25 Circadian Rhythms and Weight Gain – Low CLOCK
- 26 Circadian Rhythms and Weight Loss- Low BMAL1
The Circadian Rhythm In Pictures
About Your Circadian Rhythm
Here’s a simple way to think about the circadian rhythm. The body has thousands of processes going on at any given moment. Many of these processes function better in concert with other processes – just like in a symphony, where different sounds work better with other sounds.
These processes have a certain rhythm or flow. The body conducts this orchestra with ‘clock genes’, which get activated in many cells in the body, in a synchronous way.
Research over the past few decades have recognized the importance of circadian biology in obesity.
Circadian biology has a massive influence on energy balance and metabolism. (R)
Many hormone receptors have been observed to exhibit circadian rhythms of expression. (R)
The daily timing of food intake has itself been shown to affect body weight regulation in mammals though the regulation of genes that control metabolism. (R)
Many variations in genes of the circadian rhythm raise the risk of diabetes. (R)
If your circadian rhythm is off, your sleep will be shit. The circadian rhythm is the key to health and weight loss. Hence, why this is more important than sleep.
The Circadian Rhythm and Protein Recycling/Autophagy
At the protein level, a healthy cell will progress through a daily cycle of alternating metabolic states directed by the circadian system, with proteins going through cycles of being synthesized and degraded (R).
During periods of fasting, cells release nutrients for re-cycling and remove damaged or unnecessary organelles (cellular structures). This is known as autophagy. In the liver and other tissues, this timely progression is controlled by your circadian clocks (R).
Part of circadian modulation of autophagy includes establishing particular phases of day or night when the neurons are more susceptible to aggregation and mitochondrial dysfunction, and potentially this would be exacerbated by circadian and/or sleep disturbance which would reduce the daily peak capacity for autophagy (autophagy works via circadian expression of the transcription factor C/EBPβ) (R).
Zeitgebers or Circadian Cues
A zeitgeber or time giver is a biological cue for the time of day. Our body needs these clues to know when synchronize different activities.
The most significant zeitgeber is the light-dark cycle. The environmental information goes through the retina and the retinohypothalamic tract to the Suprachiasmatic nucleus in the hypothalamus (R).
Other zeitgebers include temperature, tides, social contact and food availability, among others (R).
It’s important to realize that there is the central clock in your hypothalamus which has light as the predominant zeitgeber and there are peripheral clocks in cells outside your brain such as your liver.
Feeding/starving cycles are dominant zeitgebers for many peripheral clocks (R).
Food metabolites such as glucose and/or feeding-related hormones such as glucagon and insulin have been propose as likely candidates for phase setting of peripheral clocks (R).
Given the multitude of signals able to generate circadian rhythms in tissue culture cells, it is likely that a variety of different pathways are also used to synchronize peripheral clocks (R).
1) Block Out Light at Night
Getting rid of blue light at night is critical to your circadian rhythm. Green light has some melatonin blocking effects as well, so that’s why red glasses are ideal.
However, even red light at night increases alertness even though it doesn’t inhibit melatonin release like blue light, showing that melatonin suppression is not required for light-induced nighttime alertness (R).
The problem if you keep to these tips, people will think you’re a freak. You have to make a calculation if you’re health is worth it, and you can mitigate weirdness in various ways.
If your mate isn’t on board, it will be tough. I’m dating someone who is on board with this, because I know it’s difficult if this isn’t the case.
You must block out blue light after the sun goes down mostly.
I recommend the Orange Glasses to be worn when the sun starts going down. You can wear them starting in the afternoon if you wish when you’re indoors, but I only recommend that to the people who have more serious issues.
Blue light destroys the DHA in your eyes and dysrupts the signal to your hypothalamus (SCN).
I recommend you wear red glasses for at least 2 hours before bed.
You must turn off all artificial lighting and use these orange bulbs at night. If you get any kind of light at night that isn’t filtered, it will throw off your circadian rhythm. This includes the light bombs that come from outside.
I also use the popular f.lux program to block out blue light. I use f.lux program all day.
I use Twilight and Bluelight Filter for Android. Jail broken Iphones can have f.lux installed. Otherwise, I haven’t found programs in the IOS app store yet.
Use Red Sheets that block blue and green to cover ipad or other screens. I’ve actually put these on my windows to block out stray lights from outside, because in NYC light bombs are the norm.
If you need to go outside, you should wear red glasses and a hat/cap to block artificial lighting from above.
A mere 5 lux of light (a tiny amount) can dysrupt your circadian rhythm (R). Compare that to the bright light devices that are 10,000 lux and bright sunlight, which I believe is 50,000 lux.
This low level (5 lux) is present in your room even if you shut your lights off but have a night light, or if you are getting light from outside at night, which is the case if you live in a city. These low levels of light alters core circadian clock rhythms in the hypothalamus. These changes were associated with time alterations in eating and increased weight gain in mice. (R)
You need to be a Nazi about light at night.
People who had delayed phase sleep syndrome (and likely people who are just night owls) experienced lower melatonin levels in response to light at night (R). This means if you’ve got insomnia, you definitely need to follow this tip.
If you have light colored eyes (light-eyed caucasians), you will be more susceptible to melatonin suppression by blue light that if you had darker eyes (dark-eyed Asian) (R).
2) Do Not Eat For Four Hours Before Bed
Not eating a meal at least 3 hours before bed is critical and 4 hours is ideal.
If you feel hungry before bed or at night, you must increase your calories in the day.
In the beginning, if you’re getting hypoglycemic, you need to have some honey before bed. But if you are following the lectin avoidance diet and keeping to a circadian rhythm, that will disappear after a few weeks at most.
3) Getting Outside First Thing in the Morning
Getting outside first thing in the morning to get light and reset your rhythm is important. It’s also helpful to use a dawn simulator and also a bright light device if you aren’t getting bright light in the morning.
If you aren’t getting outside within 30 min of waking up, then you need a bright light device.
This Bright light device is large and it’s good to put at your work station if you use your computer first thing in the morning.
Again, if you can get outside within a half hour every day, then you don’t need this. You’re much better off getting outside.
4) Getting As Much Sunlight In The Day
Studies have found that melatonin is more easily suppressed in the winter than the summer by light in Japanese (R). This is presumably because not having enough bright light in the day predisposes you to increased circadian dysruption with light at night.
Night owls exposed only to natural sunlight had a more significant change in the time they went to sleep (they went to bed earlier) (R).
5) Going to Bed and Waking Up At The Same Time
I’m pretty bad when it comes to this, but going to bed at the same time can be useful for programming your circadian rhythm. I’m working on it.
5) Reduce Psychological Stress
Psychological stress will throw off your circadian rhythm.
Stress hormones (CRH, cortisol) have the effect of delaying the circadian rhythm. This is why night owls are more of an anxious phenotype.
And it’s not only psychological stress. Anything that activates your HPA axis or stress response is included. I made a list of dozens of HPA triggers.
6) Don’t Exercise a Few Hours Before Bed
Not exercising within 4 hours of going to bed is a good idea.
Exercising at ~5pm can sometimes be ideal for sleep, but don’t exercise at 9pm and go to sleep at 11pm.
7) Eat Most of Your Calories In the Morning and Afternoon
You want the vast majority of your calories and especially protein in the morning and afternoon.
Protein jumpstarts your metabolic rate and this is better close to the time you wake up.
You shouldn’t have your biggest meal for supper (last meal), as is common in the US.
People might have their largest meal for supper because they might not want to be fatigued in the day or more likely because they don’t have time to eat in the morning. I get it, but it’s time to change.
You should construct your meal size based on if you get hungry before bed or in middle of the night.
If you’re hungry before bed or you wake up in middle of the night because of hunger, it means you didn’t eat enough in your last meal or in the day in general.
Up your calories of lectin free foods and seafood, especially for breakfast. You will not get tired if you only eat 12 ounces of wild salmon and no carbs or oils (unless you have an allergy).
I usually fast for 12-14 hours a day because I will stop eating at about 7PM and eat breakfast at maybe 8AM. This fluctuates.
8) Go to Bed Early
You want to ideally go to sleep at 10 and wake up at 6. You don’t want to go to bed at 12 like I do.
I am working on this, with some limited success. I seem to be able to go to bed earlier, but the key for me is to do it EVERY DAY, not just most days.
I find I’m most successful when I aim to get in bed at 9 and then I end up getting in bed at 11. When I aim for 11, I get to bed at 1.
8) Get Rid of Chronic Inflammation, Oxidative stress, Mitochondrial Dysfunction or Hypoxia
If you have chronic oxidative stress, inflammation, hypoxia or mitochondrial issues, then fix it.
Each of these disturb your circadian rhythm and they are also increased by a disturbed circadian rhythm, creating a bad vortex.
For me, food lectins were most significant in giving me inflammation and dysrupting my circadian rhythm, but this was far from the only trigger.
Your mitochondria are supposed to be more active in the day and you’re supposed to utilize oxygen, which results in superoxide. Bursts of superoxide will hep you create new mitochondria.
When your mitochondria are working well, you will build up healthy levels of ATP and NAD+ levels, which are important for energy utilization and metabolism.
Healthy levels of these will allow you to be alert and energized in the day and tired by night fall.
The mitochondria creates ATP. ATP converts to cyclic AMP, which is a critical messenger molecule for so many cellular processes.
cAMP is needed for the regulation of glycogen, sugar, and lipid metabolism.
The phosphates from ATP activate proteins that act directly on the cell’s ion channels.
Through PKA/CREB, it leads to the production of gene products.
The following hormones also require adequate cAMP levels to function optimally: FSH, LH, ADH (V2=kidneys), TSH, CRH, hCG, ACTH, MSH, PTH, GHRH, Glucagon and Calcitonin.
Cyclic AMP turns on PKA, which converts ATP into AMP, which ends up converting to adenosine.
Adenosine builds up throughout the day and causes you to feel tired as the day goes on. Orexin also has a sharp drop off and you feel like you need to go to sleep.
If your mitochondria aren’t working, you don’t produce optimal levels of ATP, cyclic AMP, AMP and adenosine.
You need adequate oxygen for your mitochondria to work well.
Chronic inflammation and/or oxidative stress will cause your mitochondria to slow and you won’t utilize oxygen well. Low oxygen will lengthen your electron transport chain and cause increased superoxide per ATP produced (Kruse).
9) Be Cooler At Night
Some people like to have a thick blanket to snuggle on at night. This will make you warm and disturb your circadian rhythm. You’re supposed to be cooler at night and your body temperature should drop.
10) Block out EMFs.
non native EMFs are never good, but they’re particularly bad when you’re sleeping.
After experimenting with EMF blocking equipment, I found these to be the best:
- EMF Equipment (AMZN): Hoodie
- EMF Sheets (Aliex): Ksilver1#… I recommend you get 4 Square meters X2……one to cover the mattress and 4 square meter to cover yourself. I also use Ksilver32# (4 sq meters) to cover my head and also to protect against mosquitos in the summer.
- EMF Clothing (EBAY): Silver laced Pants, or Silverell clothing in general is good.
11) Increase Cyclic AMP (cAMP) Right After Awakening
cAMP resets the circadian rhythm. If you take forskolin, which could help you with weight loss, take it right when you wake up.
Exercise also increases cAMP, so it’s not a bad idea to wakeup and do some push-ups or take a quick sprint.
12) Make Sure You Have Enough of These
Selenium and proper methylation are important for circadian functioning.
- 1 cap every other day Selenium. Selenium is important for your circadian rhythm. (R)
- Vitamin A deficiency causes a circadian dysrhythm, which in turn results in cognitive disfunction. (R)
- Methyl groups – Take 1 capsule of Methyl Guard Plus (AMZN) orMethyl Guard Plus (IHERB)
- 1 cap SAM-e (AMZN) or SAM-e (IHERB)
13) Take Most Supplements in the Morning
Almost all herbal or other supplements should be taken in the morning or afternoon.
The exceptions are raw honey, magnesium, glycine, herbs meant to put you asleep (valerian, passion flower) and perhaps a few others. Unless you have a clear reason to use it at night, use it in the morning or afternoon.
I used to support some supplements to make you drowsy before bed, but I am now careful. I use them only when people suffer from insomnia.
Music and socializing are zeitgebers, which can indicate it’s daytime, so keep these to the earlier parts of the day (or restrict at night).
If you use an oxygen concentrator or hyperbaric machine, it should be done in the AM or afternoon.
Circadian Rhythm of Hormones
In the morning, light on the retinas signals the SCN to shut off melatonin (R).
GHRH spikes at about midnight and growth hormone gets released a bit later.
TRH spikes at 3-4AM, followed by TSH, T4 and T3.
Metabolism is lowest at about 4AM and this corresponds to our lowest body temperature.
Toward the end of the sleep phase, before early morning, the renin-angiotensin system kicks up. This increase causes aldosterone to also increase (before cortisol rises) (R).
Cortisol spikes at 6AM. CRH and ACTH precede the cortisol spike by an hour or so.
Aldosterone and cortisol both cause a blood pressure spike.
VIP is highest at 6 AM and lowest at 6 PM.
In lean people, ghrelin rises rapidly at midnight and peaks about 2:30AM, but not in obese people, where it stays flat (R).
This burst of ghrelin stimulates growth hormone.
Ghrelin continues to be high until the morning. Ghrelin stimulates NPY in the hypothalamus increasing our desire and ability to eat a lot more. Melatonin is known to acutely decrease ghrelin.
Light at night can disturb the ghrelin release (R).
Leptin rises as the day goes on and peaks at midnight and is at the lowest point between 9AM-12PM. The timing of your meals affect when you have a peak of leptin (R).
Leptin makes NPY decline normally, but if one is leptin resistant this does not occur and appetite is out of control at the brain level.
Testosterone secretion peaks at about 9AM. This is preceded by FSH and LH secreted at about 6AM.
At 6:30 PM we see our highest blood pressures due to changes in atrial natriuretic factor and antidiuretic hormone (ANF, ADH).
Circadian Rhythm of Disease
Heart attacks often occur in the morning. Epileptic seizures peak in the late afternoon. Asthma attacks get worse and more deadly between 11 p.m. and 3 a.m. (R).
In the morning, the immune system may be overactive, inflaming airways in asthma sufferers and swelling arthritic joints. (R).
Blood pressure and heart rate start increasing in the morning due to cortisol (R).
Heart attacks and strokes peak at around 9 a.m, partly because of the higher blood pressure (R).
Also, a substance called PAI-1, which makes blood clot more readily, peaks around 6:30 a.m. (R).
GERD may be higher at night. Stomach-acid production peaks between 10 p.m. and 2 a.m. (R).
Circadian Rhythm, Metabolism and Oxidative Stress
Metabolism/mitochondrial production of energy, sun and detoxification of food-derived toxins create free radicals in the daytime, which then elicit an antioxidant response in a cyclic manner throughout the day (but oxidative states are focused in the daytime and antioxidant response at night) (R).
In the late afternoon and on we see more antioxidant gene expression (R).
During daylight hours, we see increased Nrf2 gene expression, and at 6PM, we see a peak in NRF2 protein (R), which are your body’s core antioxidant defense system.
If your clock is broken, you will have higher levels of oxidative stress (R).
PPAR alpha and gamma, protein responsible for metabolism, are also active in the day and are controlled by CLOCK/BMAL1 (R).
When your cellular clock is dysrupted, it results in a deficiency of NAD+ because NAMPT, the enzyme that makes NAD, is controlled by clock proteins – BMAL1 is especially importnat for this (R). Less NAD+ leads to a reduction of SIRT3, which is necessary for metabolism and mitochondrial function (R).
Circadian Rhythm and Your Immune System
Some part of your immune system are elevated in the day and some at night. TNF, IL-1, IL-2, IL-6 and IFNy are elevated, in part because of melatonin (R).
TNF-α, IL-2 and IFN-γ likely work in part by inducing slow wave sleep, which makes us more resistant to infections (R).
T cell numbers and its reactivity were stable during daytime, whereas a significant increase was observed in the late evening and early morning hours (R).
This is why people with arthritis have a “morning stiffness of joints,” because these aspects of the immune system peak from midnight to early in the morning (R).
Cytokines, such as TNF, can change your circadian rhythm, so the effects are bidirectional (R).
Per2, which peaks toward the early evening, increases natural killer cell activity (R).
Circadian Rhythms and Weight Gain – Low CLOCK
Mice who eat at the wrong time (when it’s dark for humans) gained more weight, despite the absence of any significant differences in calorie intake or activity over the course of the experiment. (R) Obviously, their metabolism shifted.
A dysrupted circadian rhythm is why we see shift workers are at seriously increased risk of obesity. (R)
Mice deficient in the core circadian CLOCK gene develop obesity. These mice have reduced levels and a flat rhythm of orexin, a neurotransmitter that increases energy metabolism. (R)
Circadian Rhythms and Weight Loss- Low BMAL1
Mice deficient in another circadian gene (Bmal1) had defects in insulin secretion, both at base levels and in response to glucose stimulation. These mice were highly susceptible to diabetes. (R)
Fat cells also need BMAL1 to develop (R).
When mice were bread without BMAL1, they lost weight (R).
So a BMAL1 deficiency could cause weight loss as a result of less fat cell production and lower insulin secretion or weight gain.
I see both excessively thin and obese people having circadian rhythm problems. The obese people might have a problem with the CLOCK gene and the thin people might have an issue with BMAL1.
Adequate BMAL1 is needed for the production of vasopressin (R), which is something low in my clients.
A BMAL1 deficiency should also correlate with higher LDL cholesterol levels, because BMAL1 (and CLOCK) are needed to increase LDL receptor genes, which swallow up LDL (R).
Mice bred without BMAL1 are infertile, small in stature, age quickly, have progressive pains in joints and are more sleepy and less active (less overall locomotor activity) than normal mice (R).
BMAL1 (and CLOCK) increases gene production of NAMPT (R), which is crucial in converting covert niacin (also called nicotinamide) to NAD (R), which is what puts the pedal to the metal of metabolism. So less BMAL1 means less NAD+, slower metabolism and energy production (R).
Having too little BMAL1 will ruin your sleep, which many of my clients have sleep problems.
Histaminergic neurons are silent during sleep, and start firing after waking. Histamine, made by the enzyme histidine decarboxylase (HDC), enhances wakefulness.
Mice that don’t have BMAL1 in histamine cells, have more fragmented sleep, prolonged wakefulness at night, shallower sleep depth (Less SWS or N3), hindered recovery sleep after sleep deprivation, and impaired memory (R).
BMAL1 is lower in people with Bipolar. (R)
Overall, a BMAL1 deficiency fits with the thin phenotype client who has sleep problems and can’t gain weight.
BMAL1 inhibits mTOR (R)
BMAL1 increases hair growth. Mice deficient in BMAL1 had a delay in hair regrowth after shaving (R).
BMAL1 controls certain kinds of inflammatory monocyte (R).
BMAL1 increases the circadian genes Per1, Per2, Rev-erbα, and Dbp)
BMAL1 increases genes involved in hormone production, including Star, Cyp19a1, Cyp11a1, Hsd3b2, and Lhcgr (R).
Cyp11a1 makes a protein (Cholesterol side-chain cleavage enzyme) that converts cholesterol to pregnenolone (R).
Star is the rate limiting step for hormone production. It transports cholesterol to the inner mitochondrial membrane to be transformed into pregnenolone. Recently, it has been found to play a role in creating bile as well (R).
Hsd3b2 plays a crucial role in the synthesis of all classes of hormonal steroids. This gene is predominantly expressed in the adrenals, ovaries and the gonads (R). The HSD3B2 gene provides instructions for making the 3β-HSD enzyme, which is necessary for the production of progesterone, testosterone and ultimately cortisol, aldosterone and estrogens.
CYP19A1 is a gene that makes aromatase, the enzyme that transforms testosterone to estradiol.
In the male the LHCGR has been identified on the Leydig cells that are critical for testosterone production, and support sperm production. LHCGR is also important for female fertility as well (R).
BMAL1 (and CLOCK) is also important for GnRH receptors in the pituitary gland (R). This receptor receives the signal from the hypothalamus (GnRH) to produce LH and FSH.
BMAL1 increases the nerve growth factor receptor which can bind to NGF, BDNF, NT-3, and NT-4. This an mediate neuron cell survival.
BMAL1 plays an important role in adult hippocampal neurogenesis by regulating neural stem/progenitor cells (NSPCs). This ties various neurological/psychological disorders linked to adult neurogenesis and circadian rhythm (R).
BMAL1 (and CLOCK) represses glucocorticoid receptor NR3C1/GR-induced transcriptional activity by reducing the association of NR3C1/GR to glucocorticoid response elements (GREs) (R).
People with Gestational Diabetes have lower BMAL1 (R).