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Hypothyroidism in Pregnancy Goes Largely Undiagnosed

Researchers combed through 117,892 Quest Diagnsotics records and found that about 15% of women tested positive for gestational diabetes. Based on this finding, they estimate that as many as 483,000 women with gestational diabetes may go undiagnosed every year. Asian women had the highest rates of being tested and being positive for this condition, and older women and overweight women were much more likely to be tested during pregnancy. 

Hypothyroidism during pregnancy can lead to lower IQ scores in children after birth. 

I’ve written extensively before that pregnancy increases your chances of sleep-breathing problems, especially in light of significant weight gain that occurs. Gaining weight is a major risk factor for obstructive sleep apnea, which has been shown to significantly increase your risk or diabetes and hypertension. Any form of physiologic stress can has been shown to lower your thyroid levels as well. You don’t have to have obstructive sleep apnea to have significant breathing problems at night.

Having low thyroid levels can also promote weight gain. Poor sleep quality also promotes weight gain. Weight gain narrows your throat, causing more breathing problems. It’s a vicious cycle. Regardless of which comes first (sleep apnea or hypothyroidism), it’s a two-way street.

If you consider that our population as a whole is now heavier, and women are having babies at much later ages, then hypothyroidism is one of many conditions related to sleep-breathing problems and pregnancy that is expected to increase in numbers.

Sleep: The Missing Link in Weight Loss

Tara Parker-Pope, New York Times health columnist, wrote a great article in last week’s Times Magazine called, “The Fat Trap.” She details a poignant account of her personal struggles with obesity, and the various scientific studies that support the notion that there are a number of genetic, biochemical and environmental factors that prevent certain people from losing weight. 

But one thing that was clearly missing in her article was the importance of getting a good night’s sleep. There are a number of reasons why most modern Americans are not getting enough sleep.

A National Sleep Foundation poll in 2005 showed that Americans averaged 6.9 hours of sleep per night, which is about one hour less per night compared with 50 years ago. Furthermore, our sleep duration has dropped another 20 minutes since 2001. Invasion of technology has been blamed as one major factor, as cellphones, computers, and various media options are rampant in today’s society. The bad economy is also thought to create more insomnia and diminished total sleep times.

Not only has our sleep duration dropped, but the quality of our sleep is dropping even further. Obesity is a major risk factor for having obstructive sleep apnea. As obesity has reached epidemic proportions in the United States, it’s likely that rates of obstructive sleep apnea has increased as well. Untreated obstructive sleep apnea, by causing multiple breathing interruptions, prevents continuous, quality deep sleep. It also significantly increases your future risk of developing heart disease, heart attack, stroke and motor vehicle accidents.

A healthy diet, portion control, and regular exercise are cornerstones of most diets or weight loss programs. But without good quality sleep, your chances of losing a significant amount of weight and keeping is off is relatively low. One major reason for this is that poor sleep promotes weight gain. It’s been shown that hormonally and metabolically, one tends to either gain weight, or has difficulty losing weight, no matter how much you diet or exercise.

One great example was reported by Glamour Magazine in 2009: Seven women of varying weights were told to sleep at least 7.5 hours every night. After 10 weeks, 6 of the 7 women lost anywhere from 6 to 15 pounds, without any changes in their eating or exercise habits. The one woman that didn’t lose any weight did lose 2.5 inches off her waist, bust and hips.

This just goes to show that unless you can optimize sleep, losing weight through dieting and/or exercise won’t work as well, or last.

If you’re currently dieting, have you incorporated an optimal sleep program into your weight loss regimen?

Teens & Sleep Deprivation: An Epidemic

Everyone knows that teens are under intense pressure to not only produce stellar grades, but also excel in numerous extracurricular activities as well. The problem is that there’s only 24 hours in a day. Add to this 4-6 hours of homework in the most competitive private and public high schools, and the first thing to get sacrificed is sleep. 

In this New York Times article on the stresses of too much homework in independent schools, one student newspaper at a prestigious private school published an article last year showing that upper school students slept an average of 6.5 hours per night. I was shocked to see this.  You may think that this is not too bad, but consider this: A teenager should be sleeping 9 to 10 hours per night. 

There are tomes of research showing what chronic long-term sleep deprivation does for people in general, but these negative effects are even more magnified in developing teens’ brains and bodies. It’s not surprising that rate of anxiety and depression are are at already too high levels, and a lot of students are just burning out (mentally and physically). Many of these problems will ultimately manifest when they get to college, where sleep deprivation and poor eating and sleep habits become even worse. This is why the incidence of depression peaks in the college years. 

I realize there’s no easy solution to this problem, but someone has to take a stand and say enough is enough. What do you think about this issue?

Depression Ups Your Stroke Risk

A recent study revealed that having depression was found to increase the risk of having a stroke by 45% in people who were followed from 2 to 29 years. Your risk of dying from a stroke also increases by 55%. The article talks about people with depression being more overweight. What else can being overweight cause?

We know that having insomnia significantly increases your risk of developing depression later on in life. Having untreated severe obstructive sleep apnea also significantly increases your chances of having a stroke. Not sleeping well from any reason (insomnia or sleep apnea) can cause major biochemical and structural changes in your brain. Do you see the connection? 

How Being Fat Can Cause Dementia

Being overweight has been associated with a number of medical problems, including diabetes, heart disease, and even cancer. Now a new study shows that being overweight in midlife significantly increases your chances of developing dementia later in life. You can read a summary of the study here.

The researchers are unclear about the reason for this observation, but do suggest the possibility that inflammation from being overweight, or diabetes and cardiovascular complications, can damage brain cells. What they’re majorly missing is the fact that the more overweight you are, the more likely you’ll have obstructive sleep apnea. Obstructive sleep apnea is a major cause of hypoxia and brain injury. I’ve written numerous times in the past that sleep apnea has be shown to directly cause brain tissue injury, especially in areas that control memory, executive function, and even autonomic nervous system center that control breathing and heart rate.

What’s your take on this article?

Higher Pregnancy Complications In Obese Women

A new study published this week in the Journal Human Reproduction found that obese pregnant women have a much higher chance of miscarriage or suffering from their child dying before the first birthday. Not too surprisingly, pre-eclampsia was the most common reason for these obesity-related deaths. Gestational diabetes increased as well.

We know that any significant weight gain can lead to obstructive sleep apnea. Then why is it that pregnant women don’t develop sleep apnea? One possible reason why this may not happen as often is that progesterone increases significantly during pregnancy. Progesterone is an upper airway muscle stimulant, increasing tongue muscle tone significantly. This is one way it protects against apnea-promoting effects of weight gain.

However, if you gain too much weight, or if there are other stresses in your life that hormonally diminishes the protective effects of progesterone, then you’ll have more problems breathing at night, leading to or aggravating various pregnancy complications. High blood pressure (seen in pre-eclampsia), and diabetes are more likely in people with sleep apnea.

What’s just as important is what happens after delivery: Progesterone drops, but you’re left with all that weight. By definition, your sleep quality will drop significantly. This is one mechanism that can aggravate post-partum depression. Imagine how much worse it may be if you also lose your child.

If you’re a woman and are overweight and have sleep apnea, did you suffer any miscarriages or pregnancy complications in the past?

Are Ear Infections Linked to Childhood Obesity?

Here’s another interesting connection with an explanation that may surprise you. Researchers in South Korea found that children with chronic otitis media had measurable taste changes that could explain why these same children tended to be more overweight. This link between chronic otitis media and obesity has been made before, but this is the first time researchers showed what was suspected as a possible culprit: That chronic inflammation of the middle ear can adversely affect the taste-sensing chord tympani nerve, which travels through the middle ear. They showed that children with chronic otitis media had reduced taste capacity to sense sweet and salty flavors, and that this could make children eat more.

The problem with this study is that it doesn’t prove that having fluid in the middle ear causes obesity. It only shows a relationship. What’s more plausible is that these children have significant sleep-breathing problems that can lead to both ear infections and increased weight. We know that obstructive sleep apnea can lead to pharyngeal and nasal inflammation, which can prevent proper eustachian tube function. Poor sleep from poor breathing also promotes weight gain by increasing one’s appetite for sugary, fatty foods.

 

 

Expert Interview: Healthy Eating For Sleep Apnea With Maria Alexandra Bella

In this Expert Interview, dietician Maria Alexandra Bella will talk to us about Good Nutrition for Sleep Apnea. We’ll discuss:

1.Ways to avoid becoming hungry if you stop eating  within 3-4 hours of bedtime.

2. Why is it important to eat a good breakfast?

3. Some common myths and misconceptions about food choices and nutrition

4. Practical tips on choosing healthy ingredients without paying too much?

5. Nutritional pitfalls to avoid during the holiday season.

Please enter your information below to access your free mp3 recording:

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Does Your Doctor Have Sleep Apnea?

Assuming that doctors are also human, it’s safe to say that doctors are susceptible to obstructive sleep apnea at the same rate compared to the general public. Considering that about 1/4 of all men have untreated obstructive sleep apnea, 1 out of every four male doctors that you see will likely have obstructive sleep apnea. In addition, the older your doctor, or the more overweight he is, there’s an even higher chance of having this condition. For women physicians, it’s about 1/10, but if you look at post-menopausal doctors, the rates for sleep apnea are going to be much higher.

Knowing that doctors make the worst patients, and most likely to be in denial, all these numbers mentioned above may be a lot higher. So let’s say, on average, one out of every 3 doctors that you see has untreated obstructive sleep apnea. It’s known that it can cause impairment in memory, judgement, executive functioning, and motor skills. How does that make you feel?

Actually, you can say the same thing about anybody in any profession. Every time I see an overweight bus driver, I wonder if he or she’s being treated for sleep apnea. I look at people in elevators, subway trains, sidewalks. I analyze faces of young, thin people, wondering if they have upper airway resistance syndrome, only to turn into obstructive sleep apnea after they gain weight later in life.

One of the main points that I make in my book, Sleep, Interrupted, is that all of us, to various degrees have sleep-breathing problems. Sometimes they’re temporary (such as in pregnancy), or more permanent (in obesity or menopause). You can’t escape it if you’re human and can talk.

How many of your doctors do you think have obstructive sleep apnea?

Sleep Apnea and the Stroke Belt

A new report on stroke mortality confirms that seven southern states continue to told the title of having this highest stroke risk in the country, up to 50% higher in some states compared to the rest of the country. These states are: Alabama, Arkansas, Georgia, Mississippi, North Carolina, South Carolina, and Tennessee. The study authors also added, "Our results cannot pinpoint a specific explanation, but they are consistent with other research suggesting that the roots of stroke risk begin in childhood or even infancy,"

 

If you’ve been following this blog or read my book, Sleep, Interrupted, you’ll remember that having obstructive sleep apnea increases your risk of stroke by 50% or more. I’ve also stated that sleep apnea is not something that suddenly develops when you’re in your 60s and 70s. The risk factors for sleep apnea begin when you’re an infant. Your upper airway anatomy determines your risk for sleep apnea later in life. This is also when cardiovascular risk factors are first established. 

 

If you look at obesity rates in the deep south, they’re some of the highest in the country. So is depression and ADHD, which all happen to be strongly linked with obstructive sleep apnea. If you were born in one of these states and eventually move to another state later in life, your stroke risk remains increased.

 

Interestingly, residency in these states had little association with conventional stroke risk factors, social resources, or access to medical care.

 

What’s your take on this interesting finding? Please enter your thoughts in the comments box below.

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