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?

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:

What’s your experience with weight loss? Did your sleep apnea improve?

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.

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.

Discover the REAL reasons why most weight loss plans fail…

Dr. Park interviews Ms. Tara Marie Segundo who shares The Most Overlooked Solutions for Weight Loss.

Tara is an award winning Pro Natural Figure Competitor and a credentialed fitness authority who is a frequent contributor in several top health and fitness magazines, and is also the host of her own radio program, The Time Is Now on Hotradio125.com.

During this 2 part interview, Tara reveals:

• The #1 reason why most people can’t lose weight
  
• Her proprietary 5 Key Success Principles for losing weight and keeping it off
  
• How to strategically achieve your weight loss goals like the Pros do
  
• How to lose weight without counting calories and depriving yourself
  

Two 60 minute MP3 audio recordings for just $17
 

 

 

 

Start Breathing, Sleeping, and Living Better with Dr. Park’s Expert Interview Series!

 

 

 

Sleep apnea patients are often told to lose weight. As you may be aware, that’s easier said than done. Although you don’t have to be overweight to have sleep apnea, the vast majority are overweight or obese. One recent large scale population study showed that a 10% drop in body weight was associated with a 30% drop in the apnea hypopnea index (the AHI, which is what’s used to measure how severity of sleep apnea). 

A more recent study looked at this issue again and found some mixed, but promising results. Twelve patients, mostly obese women, with an average BMI of 36 and an average AHI of 24.6 were enrolled in a 16 week diet an exercise program. Everyone in the study lost a significant amount of weight (except one), with an average drop of 8.3 Kg (about 18 pounds), but the drop in AHI was somewhat disappointing. The average AHI drop was 6.6%, and it was not statistically significant. Of all the patients that underwent post-treatment sleep studies, 40% had an AHI that increased. Many of the patients did improve subjectively with regard to how they felt and how much they snored, as well as with many of their metabolic markers on blood tests.

What this shows is that weight loss alone (although important) should not be the only form of therapy for obstructive sleep apnea. However, since every patient is different, treatment options should be customized to patient needs and responses to conservative treatments.

If you have sleep apnea, has weight loss helped you feel better? Did it lower your AHI or improve your snoring?

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.