March 19, 2013
It’s long been known in sleep medicine that lack of sleep can cause you to gain weight. But it works the other way around as well: Being overweight gain aggravate obstructive sleep apnea, leading to lack of quality sleep. Here’s an article in the NY Times that summarizes a study showing that even mild degrees of sleep deprivation can cause metabolic changes that promotes weight gain. This article emphasizes sleep deprivation only, but knowing that a huge segment of the population has undiagnosed obstructive sleep apnea, it’s safe to say that lack of quality sleep can also promote weight gain.
Many of you (whether or not you have obstructive sleep apnea) don’t get enough hours of sleep in general. The ideal number of hours is 7 to 8, but everyone has different needs. This is assuming you’re able to breathe normally at night. It’s also been shown that short sleepers (less than 6) or long sleepers (longer than 9) have much higher risk of developing diabetes, depression, heart disease, and even death.
If you’re a short sleeper, I challenge you to sleep one hour longer for the next month. Just by making this one change alone, you’re more likely to lose some weight.
March 1, 2013
Conventional thinking states that your genes don’t change, but here’s a revealing study that shows how sleep can significantly affect levels of gene expression. In this study, even mild levels of sleep deprivation or circadian rhythm disruption were found to increase or decrease expression of up to 711 genes, based on a technique called transcriptome analysis.
Biological areas affected included the following: gene-expression regulation, chromatin modification, macromolecular metabolism, and inflammatory, immune and stress responses.
What this means is that poor sleep, whether it’s due to insufficient sleep, insomnia, or sleep apnea, can have a negative effect on your hormones, metabolism, immune system, and your stress response.
September 27, 2012
Here’s a small study which showed how important deep sleep is to the onset of puberty in teens. They found that teens had multiple surges of lutenizing hormone, mostly during the deep stage of sleep (non-REM, N3).
Lack of deep sleep from either sleep deprivation or sleep apnea can definitely affect your child’s ability to develop and mature at normal rates. It’s also important to note that growth hormone is also produced during deep sleep.
Does your teen have sleep problems?
April 7, 2012
Look for my quote in More Magazine about the effects of alcohol on sleep (under #3).
March 16, 2012
In celebration of World Sleep Day, let’s give others the gift of sleep. If you have a loved one, a friend, or even a colleague that snores heavily or has problems sleeping, refer that person to a sleep medicine doctor. Most common sleep conditions are easily treatable. Here’s a press release by the World Sleep Federation describing their mission.
January 1, 2012
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?
October 28, 2011
After months of studying, I finally took my sleep medicine board examination yesterday. I felt well-prepared for this 4-part, 8 hour test. But one thing that always seems to happen to me before every major exam is that I suffer from severe insomnia. The same thing happened to me before my SAT, MCAT, and otolaryngology board exams.
The night before this test, I went to bed at my normal 10:30 PM time, but was unable to fall asleep unto about 4AM! What made it worse was that my mind was filled with thoughts of studies showing memory loss and poor recall in sleep-deprived individuals. Imagine a sleep doctor having major sleep problems before a major sleep test. This temporary, stress-induced insomnia is called adjustment (or acute) insomnia as defined by the International Classification of Sleep Disorders (Second Edition). Fortunately, it goes away once the stressor resolves.
I got a refreshing 8 hours of sleep last night, and now with the test over, I can get back to a normal life again.
October 21, 2011
April 27, 2011
Common sleep medicine dogma states that chronic insomnia is a completely separate disorder from obstructive sleep apnea (OSA). But just like other seemingly disparate medical conditions, there’s increasing evidence that there may be a certain degree of overlap between these two conditions. It’s been shown that anywhere from 39 to 58% of patients with OSA also have insomnia. Conversely, up to 43% of older people with chronic insomnia were found to have undiagnosed sleep apnea.
It’s been stated that chronic insomnia and sleep apnea can co-exist together, but very few studies are saying the one could cause the other. To challenge this assumption, Dr. Barry Krakow and the Sleep and Human Health Institute is looking at the provocative theory that a large percentage of people with chronic insomnia have undiagnosed breathing problems during sleep.
I wrote in my book, Sleep, Interrupted, that almost every patient that I see with chronic insomnia has significantly narrow upper airways, and one or both parents snore heavily. Most chronic insomniacs prefer not to or absolutely can’t sleep on their backs, due to the tongue taking up relatively too much space within the confines of smaller jaws. When in deep sleep, especially when on their backs, the tongue can fall back due to gravity, and because of additional muscle relaxation, causes breathing pauses and an inability to stay asleep.
It’s also not surprising that most people with sleep maintenance insomnia keep waking up at various 90-120 minute intervals, usually around the same times. This makes sense since at the end of one sleep cycle, your muscles will be most relaxed. Not sleeping deeply can lead to chronic sleep deprivation, which causes adrenaline overload and a hyperactive nervous system, which you can’t shut down when you’re ready to go to sleep. This process can explain sleep onset insomnia. One recent study showed that sleep deprivation can even cause a kind of euphoria, which can lead to poor judgement and even addictive behaviors.
Maybe this is why cognitive behavioral therapy (CBT) for insomnia works very well, but not for everyone. There are numerous studies and personal experiences that confirm that treating the underlying sleep-breathing problem can fix the insomnia issues.
Granted, even if only 50% of people with chronic insomnia have obstructive sleep apnea, it’s likely that another 30 to 40% will have upper airway resistance syndrome (or UARS), which is a huge topic that has been discussed elsewhere.
What do you think about my suspicion?
March 3, 2011
Colon cancer is usually thought to be due to hereditary causes, along with your diet and lifestyle factors, but a new study revealed that sleeping less than 6 hours per night increases your chances of getting colon cancer by 50%, compared with sleeping 7 hours per night. The study authors speculate that perhaps melatonin may be involved, but no plausible explanation was given.
Here’s my take on it: Lack of sleep of poor quality sleep causes a physiologic state of stress. Your adrenaline levels are constantly increased. Since digestion is your last priority (especially when you’re running from a tiger), blood flow and nervous system activity are shut down when you’re under stress. Now imagine if you place food in your bowel, and your gut is not able to digest properly, or clear toxins appropriately. Hypoxia (low oxygen) causes local tissue damage (causing inflammation) and what’s called neo-vascularization, where new blood vessels are created to try to bring in more nutrients. Chronic over-stimulation of tissues in a state of low oxygen levels can create a perfect storm for cancer development. This process can also be applied to reproductive organs such as breast or prostate.
If you have or had colon cancer, how many hours of sleep do you normally get?