Sleep issues & Weight
Is There A Link Between Being Overweight And Having Problems Sleeping?
Does Lack Of Sleep Affect Your Ability To Lose Weight?
According to Arianna Huffington, author of The Sleep Revolution: Transforming Your Life, One Night at a Time, “Sleep is the underpinning of our entire well-being, necessary for us to fully recharge and be productive, creative and truly connect with ourselves and others during the day.”
According to a world-class study conducted by America’s National Sleep Foundation which took over two years to complete, adults between the ages of 26 and 64 ideally need seven to nine hours of sleep a night. Sleep is a vital indicator of overall health and well-being.
While there are a myriad of factors that can affect the quality of one’s sleep, the link between being overweight and the quality of sleep has always been a complex issue.
We asked Dr Kevin Rosman, a Specialist Neurologist at Morningside Sleep Centre in Johannesburg and an Associate Member of the World Sleep Medicine Association, about this very link.
“Sleep affects everything and everything happens when you sleep,” he says.
Dr Rosman estimates that at least 50% of people who snore also have sleep apnea, which is defined as a common and serious disorder in which breathing repeatedly stops for 10 seconds or more during sleep. He says that this occurs in a deep sleep when the muscles become paralyzed, which is our body’s way of preventing us from getting up from our sleep in response to our dreams.
Because the throat and tongue muscles are also more relaxed, this soft tissue can cause the airway to become blocked, which causes sufferers to experience interrupted sleep as they battle to breathe. People with obstructive sleep apnea might sleep lightly as their bodies try to keep their throat muscles tense enough to maintain airflow.
More than half of people with obstructive sleep apnea are either overweight or obese, which is defined as a body mass index (BMI) of between 25 and 29.9 or above 30, respectively. In adults, excess weight is the strongest risk factor associated with obstructive sleep apnea.
Dr Muller Smit, a general practitioner from Durbanville in Cape Town, believes that there could be as much as a 70-85% link between being overweight and experiencing sleep apnea, and that when someone loses weight, there will be an improvement in their sleeping patterns.
Alarmingly, research on this very association shows that with each unit increase in BMI, there is a14% increased risk of developing sleep apnea. A 10% weight gain can increase the odds of developing moderate or severe obstructive sleep apnea by six times. People who are obese have a sevenfold increased risk of developing obstructive sleep apnea, when compared with people of a normal weight.
While snoring and sleep apnea have links to being overweight, Dr Rosman emphasizes that these types of sleep issues are not only weight related and can happen to anyone at any age, not only overweight middle aged men as previously assumed. Dr Smit agrees and stresses the importance that we all need to adopt a ‘sleep hygiene’ schedule, such as avoiding stimulation two to three hours before bed time.
“Lack of sleep due to sleep apnea can have major health implications,” says Dr Rosman. “Decreased sleep causes a drop in Leptin and an increase in ghrelin, which in turn causes weight gain. People then eat to stay awake, are too tired to exercise, gain weight particularly around the neck which in turn causes increased snoring and sleep apnea,” he explains, saying that this becomes a vicious cycle.
Ghrelin signals your brain that it’s time to eat and when sleep-deprived, your body makes more of it.
On the other hand, Leptin cues your brain to realise when it is full. When someone is not getting enough sleep, leptin levels plummet, signalling your brain to eat more food, leading to weight gain.
“During the night (from around 22:00) is when your neural system recovers from daily activity damage. This allows for recovery of your immune system, muscular recovery, brain path recovery, allows for detox time of your organs. Melatonin is released at night to ensure these processes take place which is vital for overall internal functioning and health,” explains Dr Smit further.
So while the reason for snoring or sleep apnea might not always be weight related, the fact remains that sleep and weight are very interconnected.
Increased weight around a person’s neck, or bulky throat tissue, seems to be a common risk factor. Dr Rosman points out that body builders and rugby players who might not be clinically overweight at all, might also suffer from snoring and sleep apnea purely because of the increased weight around their necks.
People with sleep apnea, which Dr Rosman estimates is about 10-15% of the whole population, find it almost impossible to lose weight. Once the sleep apnea can be controlled with treatment, patients are in a much better position to lose weight by following a decent diet and exercise plan.
Dr Rosman says that for milder cases of sleep apnea, a mouth guard can be very beneficial, as it adjusts the jaw adequately to allow for better airflow. For more serious cases, continuous positive airway pressure (CPAP) therapy works best, by way of a fitted ventilator which is worn over the mouth and or nose during sleep.
A multi-pronged approach which is very patient specific is normally the best solution for sufferers. Dr Rosman says that surgery is an option but has not shown great success to date, although advances in surgery are coming, he says. “For the severely obese with sleep apnea, bariatric surgery is recommended as an option. This includes those people who are so severely sleep deprived that they fall asleep behind the wheel,” he says.
Dr Gary Hudson, a Johannesburg-based physician with a special interest in obesity and metabolic disorders, says that the negative effects on your sleep from being overweight are numerous. Apart from sleep apnea, he lists hypoventilation, reflux, sinusitis as well as obesity asthma, to name but a few.
Alarmingly, Dr Rosman says that 50% of people who have a heart attack also have sleep apnea, many of whom are undiagnosed.
The link between restless leg syndrome and being overweight is also of interest. “Type 2 diabetes patients can experience restless legs more regularly. Overweight patients experience a decrease in their peripheral circulation and that can lead to restless legs and muscular pain symptoms such as cramps,” Dr Smit explains.
Someone who knows just what some of the health advantages are of losing weight and improving sleep is 39 year old mother of two, Leanne from Johannesburg, who through a combination of prescription medication together with healthy eating and exercise, has lost over 24 kg within nine months and plans to lose another 16kg this year. Besides reversing her insulin resistance and no longer having sore knees, her sleep has improved dramatically, with both her snoring and restless leg syndrome being a thing of the past.
So it seems that to weigh less, you should sleep more….and to sleep more, you should weigh less!
Speak to your doctor about what weight loss options are most suitable for you, or go to www.ilivelite.co.za for more information.
DISCLAIMER: This editorial includes independent comment and opinion from an independent healthcare provider and is the opinion and experience of that particular healthcare provider and not necessarily that of iNova Pharmaceuticals.
References available on request