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Brandon Peters, M.D.

30 Days to Better Sleep: Focus on Weight Loss

By January 25, 2013

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Your ability to sleep well at night may be profoundly affected by being overweight or obese. The extra weight may contribute to various sleep disorders, including obstructive sleep apnea, obesity hypoventilation syndrome, and restless legs syndrome. There is a complex interplay between sleep and metabolism, and sleep deprivation may contribute to weight gain. What is the best way to lose weight? Focus on weight loss, including diet and exercise, and you may find that you are able to sleep better.

The greatest concern related to being overweight or obese is the effect that this can have on breathing during sleep.  The most commonly associated condition is obstructive sleep apnea. Sleep apnea is the collapse of the upper airway during sleep. This may occur scores or even hundreds of times during a night. It disrupts the flow of air into the lungs, leading to drops in the blood's oxygen levels. When the brain recognizes this, an awakening is triggered, disrupting sleep. Therefore, sleep becomes fragmented and is not fully refreshing. In the setting of obesity, increased levels of carbon dioxide during sleep may lead to the diagnosis of obesity hypoventilation syndrome.

How does excessive weight cause sleep apnea? There is increased fat (or adipose) tissue throughout the body. This may increase the size of a belly or bum, but it also lines the airway with padding. In combination with a large stomach that pushes upward when lying on the back, the pressure can more easily collapse the airway. This may manifest with snoring or pauses in breathing that characterize sleep apnea.

Interestingly, people who are overweight or obese also are at increased risk of restless legs syndrome. This is characterized by an uncomfortable feeling in the legs at night when lying down that is relieved by movement. It can be very aggravating and may lead to difficulty falling asleep, a symptom of insomnia.

If you don't sleep enough at night, you may have another reason to get sufficient rest: Sleep deprivation contributes to weight gain. This may be dependent on numerous factors. A lack of sleep may disrupt or change normal metabolism. Resulting excessive daytime sleepiness may affect food choices and lead to increased caloric intake, including caffeine-containing products. There may also be less motivation or energy to exercise.

If you are overweight or obese based on your body mass index (BMI), there are a handful of recommendations that can be helpful for weight loss. By incorporating these changes, you will be able to shed the extra pounds and maintain a healthy weight. In order to lose weight, consider these guidelines:

  1. Measure and record weight at the same time every day.
  2. Eliminate empty calories including junk food such as soda pop, candy, and fast food.
  3. Try to eat more fruits, vegetables, and whole grains.
  4. Cut portion sizes by putting food back after fixing a plate.
  5. Get 30-60 minutes of exercise daily, including low-impact activities such as walking or swimming.

By measuring and recording your weight each day, preferably in the morning in the nude before getting ready, you will have a daily reminder of how the weight loss process is going. You will need a scale at home to accomplish this. It can be helpful to record these daily weights in a log. You can then track your progress, comparing your weight to benchmarks weeks or months before. If you have a bad day, failing to exercise or making the wrong food choices, you will have immediate feedback on the consequences.

Calories can be hidden in foods. It is shocking when you really pay attention to food labels. Stop drinking juices and soda pop. Try drinking more water. Cut out manufactured foods that are high in sugar. Avoid fast food, much of which has high caloric, fat, and salt content. Incorporating healthier foods that are filling and more nutritious can make a huge difference.

Too often our eyes are bigger than our stomachs. If this persists, our stomachs will soon catch up, however. When we are at our most hungry, it is easy to serve large portions and fill our plates with tempting fare. Once we start eating, it takes time for the signal from a full stomach to reach our brain, letting us know that we are satisfied and should stop eating. In the meanwhile, we can clean our plates and consume more calories that we may not need. By fixing a plate and then putting part of the portions immediately back, we can avoid eating too much.

Finally, there is a critical role for staying active and engaging in exercise. No matter our personal physical limitations, it is possible to exercise. This may be as simple as stretching or walking. Another low-impact activity is swimming. In the setting of other health problems, you should discuss your exercise regimen with your physician before increasing your activity. The more active you can be, the better you will sleep at night as well.

Weight loss can be a battle, but it is a struggle that can be overcome. Simple steps such as those outlined above can make a big difference. Not only will you feel better during the day, but you will also sleep better at night.

Check out the entire series, "How to Sleep Better in 30 Days."

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