How Excess Weight Contributes To Sleep Apnea
Obstructive sleep apnea occurs when something physically blocks your airways during sleep, leading to short pauses in breathing. Usually, the obstruction is caused by the relaxation of your throat and neck muscles, and if youre overweight, excess fat deposits may further narrow your airway. Not everyone who has obstructive sleep apnea is overweight, but many, if not most, are.
Sleep Apnea And Visceral Fat
Visceral fat is closely associated with insulin resistance and insulin resistance is associated with sleep apnea independently of obesity. Waist circumference is a better predictor of OSA than BMI . In a study we examined whether sleep apnea correlates with visceral, subcutaneous or total fat by using computed tomographic scanning to asses body fat distribution . Male patients with OSA had a greater amount of CT-determined visceral adipose tissue into the abdomen than a group of BMI-matched men without SDB . Interestingly, BMI correlated significantly with total body fat and SC fat , but not with visceral fat. Importantly, visceral, but not SC fat, was significantly correlated with indices of sleep apnea . Our findings are consistent with reports that visceral fat accumulation is an important risk factor for OSA in obese subjects , and the AHI is significantly correlated with intra-abdominal fat but not with subcutaneous fat in the neck region or parapharyngeal fat .
Visceral fat significantly correlated with indexes of sleep apnoea. sleep apnoeics obese controls.
A model of the complex feed forward associations between visceral fat/insulin resistance, inflammatory cytokines, stress hormones, excessive daytime sleepiness and sleep apnoea.
Will Losing Weight Reduce Osa Symptoms
Without getting proper treatment for both your OSA and taking steps to maintain a healthy weight, a vicious cycle occurs. Weight gain can lead to sleep apnea, which can lead to weight gain, which makes sleep apnea worse, which leads to more weight gain and so on. And if youre balancing other health conditions at the same time, the cycle becomes harder to break.
On the positive side, this cycle can work both ways. Getting treatment for your OSA can improve your sleep quality, making it much easier to lose weight. And research has shown that losing even 10% of your weight can lead to a 20% drop in the severity of OSA symptoms.
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Can Sleep Apnoea Contribute To Weight Gain
The short answer to this question is a resounding yes. However, it is also a bit more complicated. Sleep apnoea can cause weight gain while weight gain can likewise increase the chances of developing sleep apnoea. Let us examine both sides of this coin in more detail.
We already mentioned that broken sleep can wreak havoc upon the ability of the body to repair itself and impact levels of hormones. Both of these scenarios will inevitably lead to feelings of lethargy throughout the day.
Thus, it is much more difficult for individuals to find the motivation to maintain a healthy lifestyle. Furthermore, they may also be tempted to eat foods high in sugar and so that they can obtain short bursts of energy. This will obviously increase the chances of gaining weight.
Also, those who are already obese are at a much higher risk of developing obstructive sleep apnoea. Although the discrete mechanics of OSA are not yet fully understood, it is a well-known fact that excess weight and this condition enjoy a hand-in-hand relationship. This may be due the fact that higher levels of fat around the neck and chest can cause the airways to narrow further exacerbating what might have otherwise been a rather mild case of OSA.
Cortisol The Stress Hormone
It is released by the brain at various times during the day and night. It is part of the fight-or-flight response that kept our early ancestors alive. If we are sleep deprived, cortisol release will make us feel hungry. It will raise insulin levels the effects of which were noted above. It also causes a lot of other problems like fluid retention, muscle weakness, memory loss and high blood pressure. If we are sleeping correctly, cortisol should peak in the early morning allowing us to start the day energized. But many of us have levels that are too high throughout the day and night and this causes us to sleep fitfully or wake often.
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Sleep Apnea And Insulin Resistance
Because of the association between inflammation and insulin resistance, a condition of increased insulin levels associated with normoglycemia , we examined whether OSA acts as an independent risk factor for insulin resistance. We evaluated 14 obese men with symptomatic sleep apnea versus 11 BMI- and age-matched, obese, non-apneic controls . Mean fasting blood glucose levels were higher in the apneics than in obese controls . Mean plasma insulin levels were also higher in sleep apneics than in obese controls .
Our findings were confirmed by three relatively large studies: 1) a sleep center population in Hong Kong 2) a community-based sample in the Baltimore area and 3) most recently, in a large sample from the Sleep Heart Health Study . Importantly, one study observed that the association between OSA and insulin resistance was present even in non obese subjects , whereas the other study reported insulin resistance even in mild forms of sleep apnea .
The Health Problems Created By Sleep Insufficiency
First and foremost, you can think of cortisol-induced sleep loss in terms of:
- Acute sleep debt, which is the amount of sleep you’ve missed out on in the past 14 days
- Chronic sleep deprivation, which refers to restricted sleep over a prolonged period of several months or years
In the short term, acute sleep debt downgrades every aspect of your life that matters, from your cognitive functioning to your immune system to your social relationships. Over time, acute sleep debt progresses to chronic sleep deprivation, in which a new host of health problems arrive, courtesy of your bodyâs persistently high cortisol levels. The long-term effects of sleep insufficiency are well-documented in scientific literature, particularly in the form of metabolic health issues such as:
- Type 2 diabetes
- Heart disease
As if the direct impacts of sleep loss itself aren’t distressing enough, you also have to contend with the additional health issues that too much cortisol instigates.
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Does Sleeping Help You Lose Weight: Sleep Schedule To Normalize Thyroid Function And Body Weight
The sleep hours required for a person can also vary depending on the health issues of a person. For example, a person suffering from a thyroid problem needs at least eight hours of sleep to maintain the wellness of the body. Similar is the case with pregnant ladies too. They are suggested to sleep for more time to maintain the normal health and wellness of the body.
Today, you can find hundreds of medicines in online stores to promote sleep quality and to maintain normal body weight. Always make sure to intake medicines of a reliable brand after consulting with a certified health practitioner.
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Will Treating Sleep Apnea Help You Lose Weight
Evidence suggests that OSA patients who effectively manage their sleep apnea may find it easier to lose weight. In one study, ghrelin levels were higher in OSA patients than in people without OSA of the same body mass but fell to comparable levels after two days of using CPAP treatment.
Conflictingly, long-term use of CPAP, the most effective sleep apnea treatment, has been associated with weight gain in some studies. However, the reasons for this association are unclear, and more research is needed. Given the complexity of weight and sleep apnea treatment, overweight patients should not solely rely on CPAP therapy or apnea treatments as their sole means of weight control.
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Physiology And Assessment Of The Hpa
Exposure to stress elicits a highly orchestrated series of physical reactions, mainly operated by the HPA-axis, the sympathetic nervous system, and the sympathoadrenal system . The body adapts to repeated and chronic stress via homeostatic mechanisms, adjusting physiological responses and behavior in order to maintain stability . The chronic wear and tear of this accommodation over the lifetime of an organism is referred to as the allostatic load . The parvocellular cells in the paraventricular nucleus of the hypothalamus secrete corticotrophin-releasing hormone in response to stressors, including physiological stressors such as fatigue or hunger, as well as stressors of psychological nature. CRH, in turn, stimulates the anterior pituitary gland to secrete adrenocorticotrophic hormone , which induces the synthesis and secretion of glucocorticoids, mineralocorticoids and androgenic steroids by the adrenal cortex. Cortisol, the main glucocorticoid in humans, suppresses the immune system and induces glycogenolysis, as well as insulin resistance . CRH and ACTH synthesis and release are inhibited by peripheral negative feedbacks mediated by cortisol . In addition, CRH activates the sympathetic locus coeruleus-norepinephrine system and cortisol enhances neuronal excitability to norepinephrine. In turn, norepinephrine activates hypothalamic CRH in reverberating circuits .
Proven Weight Loss Strategies For Sleep Apnea Sufferers
My wife just commented to me that just by eating dinner about one hour earlier than usual for the past few weeks, she’s automatically lost about 2-3 pounds. We normally eat about 3 hours before bedtime, but by the time we finish dinner and have fruit for dessert, it’s about two and a half hours before we go to bed at 10PM. Even our children now seem less tired and more alert during the day. Although we decided to make this change to increase our sleep quality, my wife’s weight loss was an unexpected side effect. So how does this apply to sleep apnea sufferers?
The Sleep Apnea Stereotype
At almost every sleep apnea lecture that I’ve seen in my career, the speaker almost always puts up a picture of Joe the fat boy from Dickens’ The Pickwick Papers. If you read any scientific study about obstructive sleep apnea, it almost always starts with, “typically seen in middle aged or older obese men who snore heavily with large necks.”
How Hormones Affect Your Appetite
You can imagine how once this process starts, it’s a vicious cycle: Poor sleep makes you more hungry, so you eat more or snack close to bedtime. More frequent obstructions causes your stomach juices to be suctioned up into your throat, causing more inflammation and swelling. These juices can then go into your nose and lungs, causing further inflammation and swelling. Weight gain then narrows your throat further, aggravating sleep apnea, which makes you sleep less efficiently. First Steps Toward Losing Weight
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Sleep: Your Bodys Best Friend
If you thought under-eye circles were the worst consequence of skimping on sleep, youre in for a shock. Sleep is important for pretty much every one of your physical systems, says Janet K. Kennedy, PhD, clinical psychologist and founder of NYC Sleep Doctor. Sleep deprivation leads to deficits in cognitive functioning, whether its reaction time, decision-making, or memory.
Sleep is essential for beyond just whats going on in your brain, too. Sleep is involved in the repair and restoration of the body. The rest that happens during sleep really rejuvenates your body for the next day, says Kennedy.
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Plus, you might be suffering from the symptoms of sleep deprivation, even if you think youre spending enough time in the sack. We used to think you needed a significant amount of sleep deprivation for it to have an effect on weight. It turns out thats not true, says Michael Breus, PhD, a sleep specialist and author of The Sleep Doctors Diet Plan: Lose Weight Through Better Sleep. Just 30 minutes of sleep loss could make you more likely to gain.
Avoid The Endless Trap Of Excess Cortisol And Sleep Loss
When you hear of cortisol, the first thing that comes to mind is its close association with stress, hence its moniker, “the stress hormone.” While cortisol may be a close companion when you’re rushing for a deadline or running to catch a bus, not many people realize its profound impacts on sleep. If you ever find yourself having difficulty falling asleep and sleeping through the night, thereâs a chance your body is too wound up with this stress hormone.
Be that as it may, we need cortisol for our day-to-day functioning. Aside from activating our fight-or-flight response, this hormone is also crucial for waking us up in the morning and lowering body inflammation . Itâs only when there is an ill-timed, chronic influx of cortisol circulating in your body that it spells trouble for your sleep patterns, as well as your health and wellbeing in the short and long term.
Below, we take an in-depth look at the stress hormone cortisol and how it relates to your sleep-wake cycle. You will discover why your body can produce too much cortisol, how that leads to sleep loss, and vice versa. Last but not least, you will learn how to lower cortisol levels to free yourself from this vicious cycle of surplus cortisol and sleep insufficiency.
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How Does My Body Control Cortisol Levels
Your body has an elaborate system to regulate your cortisol levels.
Your hypothalamus, a small area of your brain involved in hormonal regulation, and your pituitary gland, a tiny gland located below your brain, regulate the production of cortisol in your adrenal glands. When the levels of cortisol in your blood fall, your hypothalamus releases corticotropin-releasing hormone , which directs your pituitary gland to produce adrenocorticotropic hormone . ACTH then stimulates your adrenal glands to produce and release cortisol.
In order to have optimal levels of cortisol in your body, your hypothalamus, pituitary gland and adrenal glands must all be functioning properly.
Endocrine Regulation In The Link Osa
A growing body of epidemiological evidence supports an association between chronic sleep disorders and consequent chronic intermittent hypoxia, and the risk for obesity, insulin resistance, T2D, and many other endocrine-related diseases, showing a complex interaction between hormones and sleep disorders .
Figure 1. Common features and associated pathologies to obstructive sleep apnea and dysmetabolism. OSA and dysmetabolism are associated with many common dysfunctional parameters, namely body structure and composition and endocrine, peripheral nervous system, inflammatory and oxidative stress pathways. These shared patterns between OSA and dysmetabolism are also responsible for the development and progression of many cardiometabolic dysfunctions like cardiovascular disease, obesity, and type 2 diabetes .
All this literature leads to the conclusion that disruptions in insulin, leptin, and/or ghrelin pathways contribute to metabolic dysfunction in OSA, also pointing toward possible effects of these hormones, due to their central effects, on the promotion of increased caloric intake and weight gain in patients with OSA. Also, a positive correlation between AHI and orexin levels, a central nervous system appetite regulator, may potentially explain the tendency toward weight gain in patients with OSA .
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Sleep Deprivation Impacts Weight Loss
Sleep deprivation has very real consequences for weight management. For every hour of sleep you are deprived, it is estimated that people eat an additional 385 calories.
Poor sleep can result in emotional eating to manage tiredness and the mood changes that can occur. If youre noticing more emotional eating at night, dont miss my free guide to stop after dinner overeating.
How Cortisol Is Messing With Your Sleep
You may have heard of the stress hormone cortisol. This hormone driving the fight-or-flight response may be helpful for dodging scooters on the sidewalk, for example, but its not as useful when youre trying to fall asleep or feel ready for sleep.
Cortisol, which plays a variety of roles in the body to mobilize energy and promote alertness, may be affecting your sleep patterns. Cortisol levels are lowest at night and when we are sleeping. That said, sleep deprivation is known to elevate cortisol levels.
If youre wondering how to decrease your cortisol levels naturally to get better sleep then read on. Lets take a look at how cortisol works, its effects in the body, and the relationship between cortisol levels and sleep.
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Sleep Duration And Obesity Risk: Laboratories Studies
The relationship between sleep and obesity is likely mediated by multiple pathways. An upregulation of the activity of orexin neurons and changes in appetite-regulating hormones may affect food intake. It has been previously shown that ghrelin, a hormone promoting hunger, increases with sleep restriction, whereas leptin, a hormone contributing to satiety perception, decreases . More recently, Spiegel et al. analyzed the 24 h ghrelin profile in relation to meal and sleep in 14 healthy young men and showed an inhibitory effect of sleep on ghrelin secretion.
provides a schematic representation of the orexin system, which represents the link between sleep and feeding. Orexigenic neurons regulate the homeostatic feeding center in the hypothalamic arcuate nucleus, and concurrently affect hedonic feeding mediated by the âreward centersâ . Leptin and ghrelin are peripheral signals directly interacting with the arcuate nucleus, and ultimately modulating the orexin system activity to decrease and increase food intake, respectively. Their secretion is also modulated by the autonomic nervous system activity. A shift of the sympathovagal balance to higher sympathetic activity has been observed in studies of sleep deprivation .
Main pathways connecting sleepâwake regulation and feeding and possible mechanisms for the adverse impact of sleep loss on energy homeostasis