Did you know that sleep disorders such as sleep apnea can lead to increased risk of metabolic disorders such as metabolic syndrome, diabetes and obesity?
Did you also know that metabolic disorders such as metabolic syndrome, type 2 diabetes and obesity (dubbed as diabesity) in turn increases the risk of sleep apnea?
In other words, sleep disorders such as sleep apnea and obesity are bidirectionally related.
So, let us examine what sleep apnea is and how it might lead to weight gain!
What is sleep apnea?
Sleep apnea (AP-ne-ah) is a very common sleep disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.
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How long do the breathing pauses in sleep apnea last?
Breathing pauses can last from a few seconds to minutes but most typically, these pauses are about 15-30 seconds in duration. They may occur anywhere from 5 times an hour to over 30 times or more an hour.
What are different types of sleep apnea?
Sleep apnea can be obstructive meaning there is a component of obstruction usually in the upper airway leading to pauses in breathing or central where the brain may not be sending the signal to breath. In some situations, it can be a combination of these two in which case it is called mixed sleep apnea.
How does sleep apnea lead to excess day time sleepiness?
Sleep apnea disrupts your sleep multiple times throughout the duration of sleep that it causes frequent microarousals leading to shallow breathing, oxygen desaturations, increased sympathetic tone, elevated blood pressure, and increased risk of medical problems including high blood pressure, obesity, cardiovascular disease, stroke, depression and even increased risk of diabetes. Since you are waking up so many times with or without your knowledge, you do not feel as refreshed when you wake up leading excessive day time sleepiness.
How does sleep apnea affect deep sleep or REM(Rapid Eye Movement) sleep?
When your breathing pauses or becomes shallow, you’ll often move out of deep sleep or even REM sleep and into lighter sleep or even wakefulness thus causing loss restorative sleep and increased feeling of tiredness or sleepiness during the day.
How do micro-arousals cause excessive daytime sleepiness?
Since these disruptions in sleep due to microarousals cause non-restorative sleep, it is no wonder that sleep apnea is a leading cause of excessive daytime sleepiness.
How common is sleep apnea?
Sleep apnea often goes undiagnosed as some estimates say up to 85% of those with sleep apnea still remain undiagnosed. In fact, sleep apnea is as common as diabetes although sleep apnea is very under diagnosed despite significant health risks.
How do I know if I am at risk for sleep apnea?
Most people who have sleep apnea don’t know they have it because it only occurs during sleep and unless somebody else observes their sleep, they may not know or realize that they may be risk for sleep apnea. Often, the first sign is a history of loud snoring as noted by family members or bed partner. You may also feel a bit not refreshed in the morning or feel tired during the day.
Obstructive sleep apnea is caused when the upper airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses leading to reduced oxygen supply to the heart, brain and other organs in the body. This also puts a lot of stress on the body and stimulates the flight or fight hormones, catecholamines, stress hormones etc. thereby leading to increased sympathetic tone in the blood circulation and increased blood pressure at night time which can spill over during the day. In fact, treating sleep apnea is shown to be equivalent to one blood pressure medication as sleep apnea has a causal role in obstructive sleep. If you have high blood pressure and you snore, you should definitely get checked out to see if you have sleep apnea.
What is central sleep apnea?
Central sleep apnea is a less common type of sleep apnea and is caused by lack of the brain signals to the respiratory muscles or the diaphragm. It is commonly caused by conditions associated with central nervous system or in those taking centrally acting medications such as narcotics.
Central sleep apnea can occur with obstructive sleep apnea or alone and snoring typically doesn’t happen with central sleep apnea unlike obstructive sleep apnea where snoring is a prominent feature.
Not everyone who snores has sleep apnea but most people with obstructive sleep apnea do snore.
Symptoms of obstructive sleep apnea include:
- Loud snoring
- Excessive day time sleepiness
- History of unrefreshing sleep
- Nocturia, or need to go to the bathroom to urinate at night (This is the number one symptom of sleep apnea, snoring is number 2, as the heart is under stress when one has sleep apnea which then sends a peptide hormone called Atrial Natriuretic Peptide or ANP to the kidneys to reduce preload leading increased production of urine)
- Morning headaches
- Memory or learning problems and not being able to concentrate
- Feeling irritable, depressed, or having mood swings or personality changes
- Waking up frequently at night
- Dry mouth or sore throat when you wake up in the morning
How is sleep apnea different in children?
In children, sleep apnea can present with opposite symptoms – instead of hypersomnia or excess sleepiness, children can present with hyperactivity, poor school performance, and angry or hostile behavior. Children who have sleep apnea also may breathe through their mouths instead of their noses during the day(mouth breathing).
How Is Sleep Apnea Diagnosed?
Sleep apnea is diagnosed based on medical and family histories, a physical exam, and sleep study results.
List of the common sleep problems
Insomnia: Insomnia can be either difficulty falling asleep or staying asleep and can be acute or chronic.
Hypersomnia: This condition is usually the opposite of insomnia where a person is sleepy all the time, especially during the wake time or their day time.They not only sleep longer but remain sleepy despite getting enough sleep opportunity. It can be a sign of an underlying sleep problem such as sleep apnea, narcolepsy or idiopathic hypersomnia.
Noctural Enuresis or Children Bedwetting: It is a sleep disorder, belief it or not.
Bruxism: Clenching and grinding the teeth while sleeping. This condition is common in children but occurs in adults as well.
Obstructive Sleep Apnea: Airway obstruction while sleeping, which limits deep sleep; snoring usually accompanies it Types of Sleep Apnea
Delayed Sleep Phase Syndrome (DSPS): A person goes to sleep much later, and has trouble waking up in the morning, usually affects teenagers but can affect anybody.
Advanced Sleep Phase Syndrome (ASPS): A circadian rhythms disorder where person goes to sleep early and rises early
Non-24-Hour Sleep-Wake Syndrome: is a circadian rhythm disorder where the body does not function with the 24 hour biological clock
Narcolepsy: Caused by a deficiency of wakefulness promoting chemicals in the brain for unknown reasons, Narcolepsy is a condition where a person has excessive daytime sleepiness, sleep paralysis, hypnogogic and hypnopompic hallucinations, sometimes cataplexy(see below).
Nocturia: A reoccuring need to go to the bathroom and urinate at night
Cataplexy: Abrupt weakness with one’s motor muscles
Shift Work Sleep Disorder: a person does shift work and feels sleepy or tired during their wakeful time, and has difficulty falling asleep at times.
Night Terror: Not nightmares but rather a sudden awakening with gasping, moaning, or crying out that tends to happen in children but adults can also have it.
Restless Leg Syndrome (RLS): Associated with Periodic Limb Movement with an irressistable need to move the legs
Periodic Limb Movement Disorder (PLMD) / Nocturnal Mycolonus: The involuntary movement of legs and/or arms while sleeping
Rapid Eye Movement Behavior Disorder (RBD): Movements in REM sleep from twitches to acting out dreams
Other less common sleep problems include:
- Sleep Paralysis: A temporal paralysis of the body right before or after sleep. Often associated with auditory, visual, or tactile hallucinations and it can be sign of narcolypsey.
- Sleep walking, sleep talking, sudden infant death syndrome, night eating disorder etc.
At W8MD Medical Weight Loss and Sleep Disorders Centers, we realize the connection between sleep disorders and weight gain. We therefore, address not only weight loss but also any of the underlying sleep disorders in most of our locations including in our Brooklyn New York office, Philadelphia office and New Jersey office.
List of our sleep medicine services
Sleep Disorders Treated at W8MD medical weight loss and sleep centers
- Obstructive Sleep Apnea
- Restless Legs Syndrome
- Central Sleep Apnea
- Circadian Rhythm Disorders
- Sleep Walking
- REM Sleep Behavior Disorder
- Periodic Limb Movements of Sleep
- Pediatric Sleep Disorders
Assessments & Treatments of sleep disorders
- Polysomnography with Full EEG
- Home Sleep Testing
- Multiple Sleep Latency Testing
- Maintenance of Wakefulness Testing
- CPAP and BPAP
- Adaptive Servo-Ventilation
- Average Volume Assured Pressure Support
- Light Treatment
- Durable Medical Equipment (CPAP, Auto-PAP, BPAP)
Locations for getting tested for sleep apnea
While there are many sleep centers that can diagnose and treat sleep apnea, W8MD medical weight lsos and sleep centers are a bit different in that we not only diagnose and treat sleep disorders such as sleep apnea, but also help reverse some of the risk factors such as weight gain through our unique insurance physician weight loss program.
Our sleep doctors
Our founder, Dr. Prab R. Tumpati, has been a practicing board certified internal medicine, sleep and obesity medicine physician. As a practicing sleep medicine physician, Dr. Tumpati sees a lot of obese patients that are struggling to lose weight.
Obesity Medicine Fellowship Training
Since Obesity is a risk factor for many sleep disorders such as sleep apnea, and sleep apnea in turn can have an effect on Leptins and Ghrelins. These Leptins and Ghrelins play a central role in leptin resistance which is believed to be central in the weight gain seen in patients with sleep disorders.. Realizing this, Dr. Tumpati did a fellowship program in the field of Obesity Medicine and has passed a written board examination in Bariatric Medicine/Obesity Medicine.
If you are in the Greater New York City, New Jersey or Philadelphia area with either sleep problems such as sleep apnea, insomnia, Restless Leg Syndrome, excessive daytime sleepiness etc. or weight related issues, you may want to call the unique W8MD sleep and weight loss centers at 1-800-W8MD-007 to learn more.
Sleep Disorders and Obesity Since sleep disorders and weight gain go together, mostw8md Centers also address any underlying sleep problems including
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