As described in the Vicious Cycle page, if you are overweight and want to lose weight, you MUST get proper restorative sleep. Losing weight is hard. It’s nearly impossible if you are clinically obese and are not sleeping properly because you have undiagnosed sleep apnea. As an FYI, studies have shown that 100% of morbidly obese men suffer from sleep apnea and 60-70% of morbidly obese women.
Changes in levels of two hormones in particular, Ghrelin and Leptin, are thought to be associated with untreated sleep apnea, increasing appetite and calorie intake, exacerbating obesity. Ghrelin is the hormone that stimulates hunger. PAP therapy is thought to reduce the level of Ghrelin thus achieving satiation before it would otherwise occur (Harsch et al 2003) and help you achieve a lower BMI thus playing an important role in the management of obesity (Takahashi et al 2008).
Ghrelin is the counterpart of the hormone Leptin that is made in your stored fat. When your Leptin level is low it signals to your body that you need to eat and when the level is high it sends a signal to your brain that you are full. One of the most basic Leptin problems encountered if you are overweight is that your body becomes desensitized to the Leptin signal, in the same way you become insulin resistant when you develop diabetes. This means that you will have a subconscious drive to eat more food than you really need in order to feel satisfied. And there is a double impact as at the same time your body can think you are hungry and thus adjusts your metabolic rate downward, setting it into hibernation mode, not knowing that you are actually eating more than you need. Multiple studies have shown that PAP therapy may help you reduce weight by better regulating your Leptin levels (Patel et al 2004, Harsch et al 2003).
Bariatric surgery patients
If you are planning bariatric surgery to help you lose weight your doctor should schedule you for a sleep study before surgery. Undiagnosed and /or untreated sleep apnea can impact you both pre-operatively and post-operatively. This is because obesity itself predisposes to hypoxemia (a deficiency in the amount of oxygen reaching the body tissues) following surgery. Anesthesia and narcotic analgesics exacerbate pre-existing obstructive sleep apnea to further contribute to the hypoxemic burden. And studies have shown an increased persistence and serious post-operative complications following surgery are seen in patients with undiagnosed and untreated sleep apnea, compared to those with treated sleep apnea or without sleep apnea (Massie & Hart 2010).
If you really want to lose weight…
If you are obese (particularly if you are morbidly obese) and want to lose weight you should:
First see your doctor and asked to be screened for sleep apnea – if you are an insomniac, ask your doctor for a sleep test as screening may not show you as a candidate (to learn about home sleep testing visit the Home Sleep Testing page of this website).
Learn about and maintain good sleep habits (called sleep hygiene). Losing weight is hard. Losing weight when you are not achieving restorative sleep is really hard. And keeping it off, harder still. Getting restorative sleep is the key to achieving and maintaining weight loss.
Visit a weight loss clinic and seek dietary advice under the care of a doctor and/or nutritionist in your area or try a major commercial weight loss company (e.g. Weight Watchers, NutriSystem or Jenny Craig) to ensure a weight-loss regimen including a balanced diet and a support infrastructure.
Practice good Sleep Hygiene.