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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."

Although described 30 or so years ago in these stereotypical men, now we know that it can occur even in young, thin women who don't snore. But many overweight people, especially as they get older, will snore or have obstructive sleep apnea. It's estimated that overall, about 24% of men and 9% of women will have it, but by the time you reach your 70 to 80s, the incidence about 55%. Being overweight is still a major risk factor for development of obstructive sleep apnea. If you're overweight and have sleep apnea, then it's much harder to lose weight than if you didn't have sleep apnea. Let me explain why.

How Hormones Affect Your Appetite

It's been proven that poor sleep (quality or quantity) can promote weight gain through various mechanisms. Leptin is one major hormone that provides information about energy status to your brain—essentially, it tells your brain that you have enough energy. Low levels of leptin causes hunger. Normally, leptin increases after you eat, but sleep deprivation lowers this hormone, making you hungry. As leptin drops, your cortisol levels will also increase. As I've mentioned numerous times in my book, Sleep, Interrupted, poor sleep efficiency cause a low-grade physiologic stress reaction that increases your cortisol levels. This hormone also makes you more hungry. Other studies have shown that not only will you be more hungry, you'll tend to crave fattier, sugary, high carb foods.

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

So what can you do if you have sleep apnea and are overweight? Is it hopeless?

Fortunately, there are steps that you can take that if followed properly, can not only help most people lose pounds, but also sleep better in the process. The first and most important thing is to eat as early as possible before bedtime. I know I keep repeating this, but you'll be surprised by how many people continue to eat late or snack just before bedtime. Three to four hours is the general recommendation to avoid eating before going to bed. The only thing you can have is water within this timeframe. The same goes for any kind of alcohol, since alcohol relaxes your throat muscles, aggravating obstructions and arousals.

The second most important thing to do is to make sure that you can breathe well through your nose. If your nose is stuffy, the challenge is in figuring out what's causing your nasal congestion, since there are a number of different reasons. In many cases, there's more than one reason. This is a huge topic that I cover in my Ask Dr. Park teleseminar called Un-Stuff Your Stuffy Nose. I also have various articles and blogs about this issue on my website at doctorstevenpark.com.

Needless to say, you also have to eat healthy and exercise regularly. I'll leave the specific recommendations for other respective experts in this area. One thing to point out, though, is that if you lift weights or engage in any activity that bulks up your upper chest and neck muscles, remember that your upper airway is unprotected, and that that any degree of neck muscle enlargement and press in on your upper airway. This is why many bodybuilders and weightlifters snore.

Eating earlier helps to reduce inflammation and swelling in your throat, and better nasal breathing lessens the vacuum effect that's created in the throat when you breathe in while sleeping. These two steps alone (along with eating healthy and regular exercise) will help many people, but to various degrees. For some, making these conservative changes alone may be enough, but with others, they will need some form of formal treatment for their obstructive sleep apnea. I won't get into the treatment options for sleep apnea since that's a HUGE topic in itself. For more information about sleep apnea treatment, I have lots of practical information on my website or you can find one comprehensive resource by reading my book, Sleep. Interrupted.

Sleep More, Lose Weight

Lastly, most people in general are sleep deprived. Lack of sleep, in addition to inefficient sleep due to sleep-breathing problems, can also cause similar weight promoting issues. A great example is when Glamour magazine asked women volunteers to try to get consistently 7.5 hours of sleep every night for 10 weeks. Many women lost anywhere from 6 to 15 pounds, all just by sleeping more. Studies have shown that lack of sleep (5 hours or less) per night is a major risk factor for significant weight gain.

So whether or not you are overweight, the recommendations outlined above will help you to breathe better and sleep better. Even if you are thin and don't have obstructive sleep apnea, following these recommendations can the onset of sleep-breathing problems and ultimately lessen the risks that can go along with obstructive sleep apnea. If you are overweight, this is the first step toward losing unwanted pounds.

Why Sleep Loss Can Make You Gain Belly Fat

Dieting and weight loss has surpassed baseball as America's national pastime. It's estimated that 2/3 of all Americans are officially overweight, and 1/3 are obese. Besides the routine bulges that you see on the outside, the presence of visceral fat (or belly fat)—not the flabby fat under the skin that you can grab—but the fat deep within your abdomen that's attached to your intestines, is thought to increase your risk of heart disease, diabetes, metabolic syndrome, high blood pressure, colon cancer, and in women, breast cancer.

With all the news about the importance of belly fat as a risk factor for heart disease and other medical conditions, it's almost gotten to the point where the press and the lay public perceive belly fat as a cause of all these various medical condition, rather than just an association. The real question is, what causes belly fat to begin with?

The Link Between Stress and Belly Fat

Any type of stress, whether physiologic, or external, can cause dramatic changes in your physiology. The sympathetic nervous system, or the classic fight or flight response, is activated when you're under stress. This in turn diverts blood flow away from less essential body parts and organs, such as your gastrointestinal system, your reproductive organs, your skin and distant extremities. It’s like if you were being chased by a lion—every nerve and fiber of your being will be focused on getting away, not on digesting what you had for lunch.

Although you’re probably not being chased by a lion, any type of prolonged periods of stress which results in low blood flow to the intestines causes biochemical changes that lead to accumulation of belly fat. It's also thought that increased estrogens created by belly fat further suppress the natural progesterone levels in both men and in women, aggravating the vicious cycle even more.

Poor Circulation Can Cause Belly Fat

You don't need a serious medical condition to cause these rapid changes in intestinal blood flow. Even your emotional state, and the various life stresses that you experience every day can significantly affect the rate of blood flow to your stomach and your intestines.

Researchers have found that periods of low oxygen in the intestines can cause biochemical changes that lead to fat accumulation. Is this low oxygen level the result of the standard atherosclerosis that's seen with cardiovascular disease as we get older, or can there be something else? Is there anything else that can cause intestinal hypoxia?

How Your Jaw Size Can Affect Your Waist Size

As I describe in my sleep-breathing paradigm, modern humans have difficulty breathing properly while sleeping at night, especially when on our backs and when in deep sleep, due to muscle relaxation. This is from a slow but significant narrowing of our jaws, due to a major change in our diets and with the addition of other feeding tools, like infant bottles and pacifiers.

The smaller the jaws, the less room there is for the tongue, and the more likely it'll fall back during deep sleep, especially when lying flat and in deep sleep. Depending on how often this tongue collapse obstructs our breathing at night, we all fall somewhere along this continuum, where the end extreme is officially called obstructive sleep apnea. It's not surprising that periods of interrupted breathing, whether very brief or pauses of 10 to 30 seconds (apneas), is known to cause physiologic states of stress.

And this sustained form of stress can in turn, slow down our metabolic rate making it difficult to lose weight if not gain it.

Hormones and Weight Gain

In women, there is yet another major variable that can cause you to gain weight as you get older, and that's the role of diminishing progesterone, which begins during the late 30s and early 40s.

Progesterone is a major upper airway muscles stimulant, which essentially tenses or stiffens the tongue, especially when in deep sleep. This is why as the levels of progesterone diminish during perimenopausal age, women begin not to sleep as well as they did before the onset of menopause. A relative change in a woman's sleep-breathing status can then lead to neurologic symptoms, such as night sweats, hot flashes, weight gain, mood swings, and irritability. Not too surprisingly, these same symptoms can be seen even in young men who are moving up the sleep-breathing continuum. Lack of deep or efficient sleep is a major cause of physiologic stress.

Sleep Your Way to Weight Loss

A recent article in Glamour magazine profiled 7 women who where all slightly overweight, and asked them to do one thing for 4 weeks: sleep more. Without making any other changes, they all loss anywhere from 7 to 21 pounds. Sleeping longer is one way to restore health in our sleep deprived culture, but increasing sleep efficiency while you sleep is another way to increase your energy levels, improve your health, and lose weight more easily.

Not Only Your Breathing Problem

Not being able to breathe well at night while sleeping, and not sleeping long enough are important factors to address, but there are many other factors that also prevent you from achieving the quality sleep that you need: Eating late close to bedtime is a common modern ritual that occurs for a variety of different reasons. Gastric juices still lingering from your last meal (or snack) can be suctioned up into the throat, causing more swelling and inflammation, causing more obstructions and arousals. Drinking alcohol close to bedtime causes your throat muscles to relax more, leading to more frequent obstructions and arousals, as well as louder and more frequent snoring.

The Right Way to Lose Weight

Before you begin that new diet plan, or take advantage of your new gym membership, make sure that you're able to breathe properly at night. If your nose is stuffy for whatever reasons, do everything possible to straighten it out first. If you've had a stuffy nose for years or decades, you may not realize that your nasal breathing is compromised. Proper sleep and lowering your stress levels is critical to getting rid of that excess belly fat.

The Most Overlooked Solution for Weight Loss

Can Losing Weight Cure Sleep Apnea?

Your Most Overlooked Solution To Losing Weight

Here’s what you need to do to lose weight…

If you struggle with weight loss be sure to register for my upcoming Expert Interview 

with premiere fitness consultant and personal trainer Ms. Tara Marie Segundo to learn:

The Most Overlooked Solution for Losing Weight

Wednesday, October 14th @ 8:00 PM Eastern Time

Register here: https://jodevpress.infusionsoft.com/link/581c04d20/325aa0

Can’t make it? Anyone who registers will get a time limited (available for 7 days) access to the MP3 downloadable recording of the call a few days after the event.

Former personal trainer at many of the exclusive health clubs in New York Çity, Tara Marie Segundo has shared her expertise on CBS, NBC, The Fox Sports Network and frequently contributes to American Health, Best Body and Natural Body Building & Fitness magazines.

 During this 60 minute call you will learn:

=> Why many traditional weight loss systems don’t work unless it has this one key component

=> How to overcome even the biggest obstacles to excercise and weight loss

=> THE insider secret to losing weight and for keeping it off  

 And like all of my Expert Interview teleseminars, you’ll get much, much more.

===========

Be sure to register and get your exclusive access to the MP3 download.

https://jodevpress.infusionsoft.com/link/581c04d20/325aa0

The Most Overlooked Solution for Losing Weight

Here’s what’s missing from your weight loss routine… Many of you who suffer from sleep apnea or even upper airway resistance syndrome have told me that you’d love to lose weight but don’t have the time, energy or motivation to do so. Well, here’s something that can help you change all that. If you’ve ever struggled to lose weight or have lost the weight but kept gaining it back, join me on my next Expert Interview titled: The Most Overlooked Solution for Losing Weight I’ll be interviewing personal trainer and fitness consultant, Tara Marie Segundo, M.A. on: Wednesday, October 14th @ 8:00-9:00 PM Eastern Time Tara will be sharing loads of information you won’t get elsewhere. She has been a top notch personal trainer at prestigious health clubs including Club La Racquette, New York Sports Club, and New York Health & Racquet Club. She has also appeared on CBS, NBC, The Fox Sports Network and frequently contributes to American Health, Best Body and Natural Body Building & Fitness magazines. Can’t make it to the LIVE session? Register anyways. Anyone who registers will get a time limited access to the MP3 downloadable recording of the call a few days after the event. That way you can listen to the recording afterward. Here’s what you’ll learn during this 60 minute call: – Why many traditional weight loss systems are a waste of your time and money unless you change this one key component first – How to overcome even the biggest obstacles to maintaining your diet and excercise routine – THE insider secret to losing weight and keeping it off And like all of Dr. Park’s Expert Interview teleseminars you’ll learn much, much more. =========== Be sure to register and get exclusive access to the complimentary MP3 download (good for 7 days). https://jodevpress.infusionsoft.com/link/5555573a0/325aa0 =========== Sign up now! The deadline to register is 10/15. I’ll talk to you next Wednesday night. Dedicated to helping you Breathe Better, Sleep Better, Live Better, Dr. Park P.S. Don’t forget – telephone bridge line space is limited and my teleseminars fill up quickly.

 

Sleep More, Lose Weight

Health care reform is making big news now,  and from what I’ve gleaned from the press, it’s a mess. I’m not too optimistic about any solutions. There are too many interests involved and no one wants to give an inch. 

However, with all the studies coming out showing the benefits of more sleep, I have a suggestion for Mr. Obama: Have a national sleep more month, where everyone in the country makes a commitment to sleep 30 to 60 minutes more every night for one month. There are studies showing that better sleep improves everything from energy levels, to weight loss, to improved memory and cognition,  and lower blood pressure and glucose levels. 

In the February issue of Glamour Magazine, I was quoted in an article where they had overweight women volunteer to change one thing for 10 weeks: sleep 7 1/2 hours every night. Women who stuck to the plan lost anywhere from 6 to 15 pounds automatically, without doing anything else differently. 

Imagine if they continued this regimen for one year. Imagine if everyone in the US followed this regimen. There would be much lower levels of high blood pressure,  depression, diabetes, and heart disease. Think of the billions of dollars in health care savings, just from sleeping a little longer every night.

For those of you that get stressed even thinking about this, think again. You may be thinking that you’ll lose valuable time by sleeping more. What you may not realize is that by sleeping longer, you’ll be much more clear-headed, more energetic, and much more productive.

It’s 10 PM now. I’m going to bed.

My Adventure with Swine Flu(?) and Soybean Sprout Soup

Traditional Korean culture states that you should eat soybean sprout soup to fight a cold. My wife had just bought some soybean sprouts for my two sons, Jonas and Devin, who had just come down with severe flu-like symptoms (along with half their classmates). Unexpectedly, my older son Jonas was feeling well enough to attend his 4th grade graduation recital on Saturday. That left me taking care of my other son Devin, who was still very sick, and our 4 month old, Brennan.

 

Although I had dabbled in Korean cooking in the past, I had never made soybean spout soup. It’s always been a comfort food that my mother and my wife would make for me whenever I was sick. So with my wife gone, I decided to try making it. I couldn’t find it in any of our Korean cookbooks, since it’s such a simple ordinary recipe. I ended up Googling it and found a great Youtube video by Maangchi. She’s a middle aged Korean woman with a thick accent, but thoroughly entertaining, and definitely educational. I made my first soybean sprout soup without any trouble, and my son ate it with some rice. The next day, he was feeling well enough to go fishing later in the day.

 

After watching another few dozen videos on Maangchi’s site, I now have a new desire to start learning to cook Korean. One man from Germany commented on her website that he lost 92 pounds in 18 months eating only Korean food!

 

Along these lines, one frequent question that I get from patients is how I manage to stay so thin in my middle years. Even when I’m not exercising, I don’t gain much weight at all. My honest opinion is that a long as I eat at least one Korean meal every day (preferably dinner and lunch, if possible), I don’t gain any weight. I have to admit that I do eat quite a bit of pasta and take out food, but as long as one or more meal per day is Korean, I’m fine. When I’m able to run at least 2-3 times per week, I feel great. 

 

Besides chicken soup, do you have any other traditional recipes handed down through your family that helps with colds?

 

Next time, I’ll tell you my take on the recent Swine Flu epidemic.

Get On The Fast Track To Weight Loss After Pregnancy

 

Once the excitement of seeing your newborn settles down, and the fog of post-partum breaks, one of the biggest concerns women have after delivering is: “How quickly can I get back to my pre-pregnancy weight”.

One of the worst things you can do at this time is to expect too much, too fast. Just as it took 9 months for your body to gear itself for birth, you must allow yourself time to go back to the way it was. To help you get on the right track, I invited our guest fitness expert, Tara Marie Segundo to guide you on how you can lose weight quickly and effectively, without spending a lot of time or money.
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Ok, ladies, reality check: you just delivered your bundle of joy and it finally hits you—your little one accounts for only about 7 lbs. of the 30 or so that you gained during pregnancy.  You leave the hospital looking like you are still pregnant, and you start to wonder if things are ever going to make it back to the their original spot…sound familiar?

The good news is that your body will one day return to some semblance of your pre-pregnancy state, and there are things that you can do to help hasten this process.

Whether you delivered via C-section or the good old-fashioned way, getting your doctor’s clearance before returning to exercise is a must.  Pregnancy and delivery present quite a trauma to the body, and a certain level of healing must occur before you place additional physical stress on yourself with exercise.

Once your doc gives clearance, you can consider these tips to help you drop your pregnancy weight:

1.  BREAST FEED IF YOU CAN.  Breastfeeding can help you shed your excess weight while eating your regular diet. Producing milk uses 200 to 500 calories a day, on average.  This may not sound like much, but that can add up to about a pound a week without making any other changes in your daily routine.

2.  DO SHORT BOUTS OF EXERCISE THROUGHOUT THE DAY.  As a mom caring for a newborn, you can’t expect to have long periods of time during which you can exercise.  Take advantage of 10 minutes here, 15 minutes there, to squeeze in some movement.  I had a client that had a treadmill in her home and everytime she got a short block of time, she would jump on the treadmill and kick out a brisk walk.  She clocked an hour a day by doing 10 minutes here and there.  This allowed her to care for her new baby and make use of the brief breaks that she had.
 
3.  MAKE EVERY CALORIE COUNT.  If you are breast feeding, it is recommended that you do not eat less than 1,800 calories a day so you can produce milk for your baby.  If you are not breast feeding, your doctor may allow you to diet.  Regardless, every calorie eaten needs to be nutritious.  Your body is in recovery and you need to provide yourself with foods that offer you what your body needs to thrive.  Make every calorie count toward the betterment of your health.  In general, if man made it, don’t eat it.  Stick to fresh whole foods that come from nature.

4.  BE REALISTIC.  You spent 40 weeks pregnant, so give yourself a break and don’t sweat it if it takes a full year to really feel like yourself again.  You may lose the excess weight quickly, but other shifts in your body may take more time to return to their pre-pregnancy state.  You will look and feel better if you don’t pressure yourself to do too much, too soon.  Do what you can, when you can, and enjoy your beautiful new baby in the meantime.  Most new moms report to me that it took them roughly a year to feel like themselves again.  Please don’t put undo pressure on yourself.

5.  PROCEED SLOWLY.  Right after you deliver is not the time to launch into a brand new, physically challenging exercise routine.  With your doctor’s OK, it is safe to slowly ease back into what you were doing before you were pregnant.  Walking (alone or while pushing a stroller) is a great form of exercise.  If you are a runner, there are some wonderful jogging strollers on the market.  If you can get to the gym, using a treadmill or an eliptical trainer is a gentle way of doing some cardiovascular training.

6.  DO SOME FORM OF RESISTANCE TRAINING.  Best case scenario, you have been doing resistance training all along and it helped you with your delivery.  If you have never embarked on a resistance training program before, work with a trainer at your gym that is knowledgable about working with women that have recently delivered a baby.  If lifting weights is not your cup of tea, there are other forms of resistance training that are very effective, including resistant bands and tubing and using your own body weight.  If you can’t afford to work with a personal trainer, most gyms offer a wide variety of conditioning classes.  Always mention to the instructor that you just had a baby so she can help you make any necessary modifications.  The name of the game in weight control is increasing your metabolic rate, and building muscle will permanently rev your metabolism.  Muscle requires calories to sustain itself and you will use more calories (even at rest) if you increase the muscle mass on your body.

7.  BE CREATIVE.  If you can’t afford to go to a gym and you can’t buy a decent piece of exercise equipment like a treadmill for your home, you must be creative.  The idea is to keep moving.  Turn on your favorite music and dance, buy a jump rope and use it throughout the day, walk up and down your stairs, etc.  You want to get moving and keep moving as soon as possible.  This will not only help you physically but will also help you stave off post partum depression.  There are a plethora of exercise DVDs on the market that specifically target different populations.  Do some research and find a few that are designed to help moms bounce back after baby.  Invite some of your new-mom girlfriends over and have an exercise class together!  This comraderie will be good for both body and spirit.  If you really want to be creative, use your baby as resistance!  Holding a 12 lb. baby while doing pliés is no different than holding a 12 lb. dumbbell.  Lying on your back and pressing your baby up and down works your triceps as much as holding a light barbell would.  There are “Mommy and Me” classes devoted to these sorts of creative exercises that involve your little one, so ask your friends or your doctor and find the one that works for you.

8.  DRINK PLENTY OF WATER.  Most of us go through life dehydrated.  As a new mom, the last person you think about is YOU.  Be sure to drink plenty of water (one gallon daily would be great, but at least 3 liters) and do not wait until you are thirsty.  Drinking water will not only help you with weight loss and metabolism, but it will also keep you feeling full and curb hunger.

9.  EAT 4-6 SMALL MEALS A DAY.  Your body will absorb and metabolize food more efficiently in smaller doses, and eating every 3 hours or so will keep your energy up.  Taking care of a newborn is hard work and you will feel better if you don’t wait too long between your own feedings. 

10.  EAT HIGH FIBER FOODS.  Eating a lot of fiber is always ideal, but when you are trying to shed body fat, it is the golden rule.  Eating high fiber foods (and drinking plenty of water) will make you feel full more quickly and leave you feeling full longer.  I personally live by this rule:  I eat a large volume of food every day, but it is not calorie-dense food.  I eat plenty of steamed and raw veggies that leave me feeling full without eating too many calories.  High fiber foods and drinking a lot of water will also keep you regular.  Recently giving birth and constipation don’t go together, and that’s all I am going to say about that.

All of this basically adds up to common sense, creativity and patience.  Take good care of your body and it will take good care of you.  Do the best you can, when you can, as often as you can and relax about this process.  Mother Nature knows what to do, and you WILL feel like yourself again soon!

Enjoy!

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Tara Marie Segundo, M.A. is a WNBF Natural Figure Pro, personal trainer, freelance writer and radio and TV personality based in New York City.  For more information or to book an appointment, call 877-692-6221 or visit www.taramariesegundo.com.

Does Oprah Have Sleep Apnea?

Oprah’s recent revelation in her magazine that she’s back above the 200 pound threshold made a lot of headlines recently. She was quoted as saying that rather than falling off the wagon, the wagon fell on her. Oprah attributes her weight problem to an ongoing thyroid condition. An excellent detailed description of her thyroid condition can be found on Mary Shomon’s site. 

 

Ninety percent of women with obstructive sleep apnea in this country are undiagnosed. Instead, they are treated for the signs and symptoms of obstructive sleep apnea, such as weight gain, depression, hypothyroidism, diabetes, high blood pressure and heart disease. It doesn’t matter if you’re a celebrity—many women are susceptible to sleep-breathing problems, especially if you’re peri or post-menopausal.

Here are the tell-tale signs that Oprah may be suffering from untreated sleep apnea, including:

 

     • yo-yo-like weight fluctuations

     • her highly publicized diets and weight loss programs

     • her well-known thyroid hormone imbalance

     • an admitted food addict and cravings for junk food   

     • her feelings of depression and anxiety  

     • her chronic fatigue

I can prove that Oprah has sleep apnea—all she has to do is to undergo a formal sleep study.

Copyright © 2008 Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring · Design by Fervent