Sleep Dynamic Therapy

Sleep Patterns Affect Obesity in Young Children

Dr. Krakow — Tue, 08 Apr 2008 04:02:35 +0000

This new study is intriguing, but more analysis is needed. First, we would suspect that sleep-disordered breathing is present in some of these kids, which could produce fragmented sleep, awakenings, and ultimately short sleep duration, a fairly common presentation for SDB in children. Second, the connection to TV viewing also suggests something about family dynamics. If parents let their kids watch too much television, it may say a lot about the parents’ own energy levels and the need to use “surrogates” to entertain the kids, while the parents try to recover their own energy or manage other tasks. In short, the more the parents let their kids watch TV, then the more the parents may suffer from their own sleep problems, which they pass on genetically to the kids. And these sleep disorders may be an obesity trigger or contributor.

In sum, I doubt it’s as simplistic as just the number of hours these children sleep. Rather, the number of hours they sleep is a marker of another process that also influences weight.

Obesity and Poverty: Is Anybody Sleeptalking?

Dr. Krakow — Sun, 27 Jan 2008 15:32:12 +0000

There’s an interesting topic by Megan McArdle about obesity and poverty at Atlantic.com. No surprise, there is no discussion about the sleep angle, so I added my comment there, which you can read below:

Sleep is an important link between obesity and poverty. Obesity radically drives up the risk of suffering from sleep-disordered breathing (SDB), a condition that destroys your sleep by two distinct processes: sleep fragmentation and oxygen fluctuations and desaturations. Both processes are very damaging to the brain, producing both temporary and irreversible changes in cognitive function most notable in the areas of attention, concentration and memory. As you would expect, these changes result in a lower IQ either permanently if the condition continues too long untreated or temporarily if the condition is reversed with proper treatment.

Some years ago we published information about two small studies on sleep disorders among individuals in welfare-to-work programs. The most striking finding was that more than 50% of these individuals, who were predominantly women, reported symptoms consistent with serious and complex sleep disorders likely to be compromising their intellectual function. These disorders included SDB, chronic insomnia, chronic nightmares, and sleep-related leg movement conditions. Many of the participants in our study were obese as well.

I have long advocated the use of sleep evaluations (and essential treatment) by various service programs that help individuals in lower socio-economic situations. The likely impact in terms of health benefits, quality of life,work performance, productivity, and cost-savings would no doubt be huge and certainly something for policymakers to “sleep on.”

You can find more discussion about sleep disorders and their impact on health, wealth, and quality of life at my blog: http://www.sleepdynamictherapy.com.

Bariatric Surgery and Death Rates

Dr. Krakow — Wed, 28 Nov 2007 05:55:39 +0000

A useful study has shown that death rates are a bit higher than anticipated following bariatric surgery, and in the short commentary that was written up in JAMA about the article, it merely states that the deaths in the first few months were largely due to coronary artery disease. Yet, no mention is made about the likely contribution of untreated sleep apnea in many of these cases. Even today, it is not clear whether all bariatric centers require pre-op sleep testing in obese patients to determine whether they suffer from sleep apnea.

Obesity and Cancer

Dr. Krakow — Wed, 31 Oct 2007 13:04:38 +0000

I’ve not read the report yet, but the media summary is quite interesting on the proposed relationship between obesity and cancer. No doubt many individuals who suffer obesity also suffer from SDB. And, SDB is a major cause of oxidative stress in which various biomolecules attack the inner lining of blood vessels. Oxidative stress is a major pathway through which we are at risk for hypertension and heart disease. I wonder if this pathway may be relevant in the discussion on obesity and cancer.

More On Obesity Epidemic in Children

Dr. Krakow — Fri, 07 Sep 2007 11:54:19 +0000

Again, another high profile commentary on obesity and no mention of sleep. No discussion on how obesity worsens sleep breathing problems, which in turn may adversely influence eating behaviors, and no mention of how underlying poor sleep quality may influence eating behaviors and lead to obesity.

Obesity Epidemic

Dr. Krakow — Tue, 28 Aug 2007 07:03:08 +0000

Once again, another major report on obesity and barely a word about the role of sleep and sleep disorders in this epidemic.

Obesity and Mortality: What About Sleep?

Dr. Krakow — Thu, 23 Aug 2007 04:45:31 +0000

In this Washington Post article covering recent research on longevity in patients undergoing weight loss surgery, the emphasis seems to favor bariatric procedures. That is, it appears that those who undergo weight loss surgery and lose weight increase their lifespan. I’ve not read the research articles yet, but the question raised would be why would these patients live longer. Obesity is a risk for many diseases, but the one least likely to get a mention would be obstructive sleep apnea. I’d bet the research articles mention SDB as one explanation for why patients might live longer, even though the Post didn’t make a comment on it. However, I doubt the research conducted pre and post weight loss sleep tests to find out what happened to the severity of SDB in these cases. That information might prove quite illuminating.

Obesity and Earning Power: Is Sleep a Factor?

Dr. Krakow — Sun, 15 Jul 2007 07:57:24 +0000

There’s an interesting debate going on at www.reason.com regarding why obese people might earn less money than non-obese. I’ve commented there on how the sleep breathing angle, a common condition among obese people, might lead to cognitive impairment and thus lower one’s earning potential.