Weight loss surgery and severe headaches

A study claims that weight loss surgery can increase a person's likelihood of having severe headaches.

After weight-loss surgery, some patients may be at risk for developing severe headaches, a new study suggests.

In a small number of people, the surgery was associated with a condition known as spontaneous intracranial hypotension -- or low blood pressure in the brain. The condition can trigger headaches while standing that disappear when lying down. These headaches can be accompanied by nausea, vomiting, neck stiffness and difficulty concentrating, the researchers added.

But Dr. Mitchell Roslin, chief of bariatric surgery at Lenox Hill Hospital in New York City, said the study is too small to be able to draw any firm conclusions.

"You're talking about 11 people out of more than 300, and that's a low number," said Roslin, who had no part in the study. "The other thing that's strange is that these headaches showed up an average of 56.5 months after surgery, which is a long time.

"This would not be my concern if I was contemplating bariatric surgery," Roslin said.

The report was published online Oct. 22 in the journal Neurology.

Although it is not clear why this condition might develop after weight-loss surgery, the researchers speculated that significant weight loss alters pressure in the brain, which might uncover a pre-existing condition that causes fluid to leak from the spine and trigger severe headaches.

While the study showed an association between weight-loss surgery and an increased risk of severe headaches, it did not prove a cause-and-effect link.

For the study, a team led by Dr. Wouter Schievink, of Cedars-Sinai Medical Center in Los Angeles, studied 338 people with spontaneous intracranial hypotension. They compared these people with 245 people with unruptured intracranial aneurysms -- a weak spot in a blood vessel in the brain that can break and cause bleeding, another condition that can cause headaches.

The researchers found that 11 of those with spontaneous intracranial hypotension had weight-loss surgery, compared with two of those with intracranial aneurysms (3.3 percent versus 0.8 percent).

Among those who had weight-loss surgery, headaches started within three months to 20 years after the procedure.

Of the 11 people who had weight-loss surgery and spontaneous intracranial hypotension, treatment relieved the headaches in nine cases. Two patients continued to have headaches after treatment, the researchers found.

"It's important for people who have had bariatric surgery and their doctors to be aware of this possible link, which has not been reported before," Schievink said in a statement. "This could be the cause of sudden, severe headaches that can be treated effectively, but there can be serious consequences if misdiagnosed."

Dr. John Morton, chief of bariatric and minimally invasive surgery at Stanford University School of Medicine, noted that obesity increases pressure in the brain and is a more common cause of headaches.

"When you carry excess weight, you have increased pressure in the brain," Morton explained.

In some patients, that increased pressure leads to headaches and even blindness, which are actually relieved by weight-loss surgery, he noted.

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Sleep improved after weight loss

A study looks into mood and sleep after substantial weight loss and found that both improved in those studied.

Obese adults who lose at least 5 percent of their body weight report that they sleep better and longer after six months of weight loss, according to a new study. The results were presented Tuesday at the joint meeting of the International Society of Endocrinology and the Endocrine Society: ICE/ENDO 2014 in Chicago.

"This study confirms several studies reporting that weight loss is associated with increased sleep duration," said the study's lead investigator, Nasreen Alfaris, MD, MPH, a fellow in the Department of Medicine at the Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

In addition, the study found that weight loss at 6 months improved sleep quality, as well as mood, regardless of how the individuals lost the weight.

The 390 study subjects participated in the Practice-Based Opportunities for Weight Reduction at the University of Pennsylvania (POWER-UP) trial. This 2-year study, funded by the National Institutes of Health, compared three behavioral interventions for weight loss in obese adults treated in primary care practices.

Subjects (311 women and 79 men) were randomly assigned to one of three programs that provided varying amounts of support to achieve the same diet and exercise goals. The groups were: (1) usual care, in which subjects received printed educational materials during quarterly visits with their primary care provider; (2) brief lifestyle counseling, which included quarterly visits with their primary care provider, combined with brief meetings with lifestyle coaches; or (3) enhanced brief lifestyle counseling, with meal replacements or weight loss medications added to the second intervention.

The researchers evaluated changes in weight, sleep duration and quality, and mood after 6 and 24 months of treatment. They compared subjects who lost 5 percent or more of their original body weight with those who lost less than 5 percent, regardless of their group assignment. The analyses controlled for several subject variables, including sex and age.

At month 6, subjects in both lifestyle counseling groups lost more weight on average (brief counseling: 7.8 lb; enhanced counseling: 14.7 lb) than those in the usual care group (4.4 lb), Alfaris reported.

Examining all three groups together, subjects who lost at least 5 percent of their weight at month 6 reported that they gained an average of 21.6 minutes of sleep a night, compared with only 1.2 minutes for those who lost less than 5 percent. Likewise, subjects who lost >5% of initial weight reported greater improvements on measures of sleep quality and mood (i.e., symptoms of depression), compared with subjects who lost <5%.

Only improvements in mood remained statistically significant at 24 months, according to Alfaris.

"Further studies are needed to examine the potential effects of weight regain in diminishing the short-term improvements of weight loss on sleep duration and sleep quality," she said.

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Losing weight can help you lose sleep apnea

A study shows that losing weight can help a person lose sleep apnea.

Losing weight -- and keeping it off -- could help sleep apnea from getting worse and could even reverse it, a small new study suggests.

Researchers from Finland found that maintaining weight loss of as little as 5 percentis associated with improvement in obstructive sleep apnea, which is a sleep disorder characterized by pauses in breathing during sleep leading to disrupted sleep.

The findings confirm sleep apnea treatment guidelines issued last year by the American College of Physicians, which say that the very first treatment for sleep apnea among overweight people should be weight loss, and the second treatment option should be continuous positive airway pressure (CPAP).

For the new study, published in the journal Sleep Medicine, researchers followed 57 people who were obese and had mild obstructive sleep apnea. The participants were randomly assigned to one of two groups: One group underwent a year-long lifestyle intervention program, while the other group just received general diet and exercise information. The researchers specifically wanted to see how a 5 percent weight loss would potentially affect sleep apnea.

Researchers followed up with the participants four years later (after the year-long intervention program), and found that 20 were "successful" in achieving 5 percent weight loss, while 27 were "unsuccessful" in achieving 5 percent weight loss. The ones who did lose the weight had an improved apnea-hypopnea index (an indicator of sleep apnea severity, which is calculated by dividing the number of pauses of breathing by hours of sleep) compared with those who didn't lose the weight.

Plus, people who lost the weight were less likely to have their obstructive sleep apnea progress over the follow-up period than those who didn't lose the weight, researchers found. 

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Study: Almost half of the world suffers from a sleep disorder

A study claims that 45% of the world's population suffers from some type of sleep disorder.

Forty-five percent of the world's population suffers from some form of sleep disorder. Obstructive sleep apnea, the most common sleep disorder reported in Canada, affects three out of four adults above the age of 45.

According to new recommendations recently published by the American College of Physicians (ACP), individuals suffering from sleep apnea should not consider surgery, but rather two complimentary approaches: weight loss and treatment with continuous positive airway pressure (CPAP).

CPAP is a non-invasive therapy that works by providing a gentle flow of pressured air through the nose and or mouth using a mask. The positive air pressure prevents the airway from collapsing so the user can breathe freely during sleep.

The ACP recommendations state that CPAP more effectively raised the minimum oxygen saturation compared to other treatment options.

Sleep apnea affects approximately 860,000 Canadian adults, and is a known risk factor for a host of other conditions including heart attack, diabetes, high blood pressure and daytime drowsiness.

“There are three important steps to helping individuals with OSA: awareness, diagnosis and treatment. Each is integral to improving the sleep quality and overall health of individuals around the world,” said Dr. Lee-Chiong, chief medical liaison for Philips Home Healthcare Solutions.

Individuals affected by sleep apnea stop breathing repeatedly during sleep because of a blocked or collapsed airway, but are generally not aware of it. During these moments of paused breathing, which can last between 10 seconds to more than a minute, oxygen levels drop.

Obesity is known to raise the likelihood of having sleep apnea, but people of any weight can experience it.

If you think you or someone you know may suffer from as sleep disorder, take the online risk quiz http://worldsleepday.respironics.com/risk-test.html and talk to your doctor.

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Children who get more sleep weigh less

A study claims that children who sleep more weigh less than their sleepier counterparts. This shows how important getting enough sleep is to children and their health.

Getting a good night's rest is an essential part of our every-day health. It's as simple as that.

The American Psychological Association shows that as many as 40 million Americans suffer from over 70 different sleep disorders, and 60 percent of adults report having sleep problems a few nights a week or more. Not enough sleep can greatly interfere with daily activities, create moodiness and instability in an individual's life and can also be a contributor to weight gain, among other health problems.

A recent study shows that more than ever, sleep is particularly important for children-and this can play a major contribution to losing weight.

"Achieving a good night's sleep during childhood should be explored as an important strategy to enhance prevention and intervention approaches for obesity," said associate professor of public health at Temple University's Center for Obesity Research and Education in Philadelphia, Chantelle Hart. She is also the lead study author of the research.

While looking at a three-week study involving 37 children ages 8 to 11, findings suggest that increasing sleep could help decrease food intake over time and improve weight regulation in this age group.

The children who added sleep tended to eat less, with an average of 134 calories a day. They also shed about half a pound on average and had lower morning levels of the hormone leptin-a 16-kDa adipokin that plays a key role in weight regulation.

Researchers are hoping to determine if sleep over a longer period may help prevent weight loss, as well.

"The evidence is incredibly strong and consistent that a short list of lifestyle factors has a phenomenal influence on weight, health and even gene expression," Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Conn. said, via Health.

Combined with a good night's rest, physical activity, eating a healthy diet, not smoking and stress reduction, these all play an important role in helping lose or maintain a healthy weight.

While adults can scrap by with eight hours a night, the National Sleep Foundation suggests that children and teens may need more.

For instance, school-aged children should get 10 to 11 hours a night while teens need around 9.25 hours of sleep, according to the organization.

At the end of their research, study authors note that while there is not a solid link between more sleep and weight loss, it potentially opens the door for greater research regarding the topic.

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Botox helps rats lose weight

A study using rats showed that botox can be used as a weight loss aid.

Researchers from the Norwegian University of Science and Technology have had promising experimental results from using Botox as a weight loss tool in rats. The research group hopes to win approval for human testing in the near future.

You may know Botox from its use by the rich and famous to eliminate facial wrinkles. But now Helene Johannessen, a PhD candidate at the Norwegian University of Science and Technology (NTNU), is studying whether or not Botox could be used as an alternative to treating morbid obesity, replacing costly and dangerous operations.

Tests on rats have shown that treatments with Botox injected into the vagus nerve in the stomach can lead to weight loss. When Johannessen injected rats with Botox, the animals ate less and lost 20-30 per cent of their body weight over five weeks. The treatment effectively paralyzes the vagus nerve, which triggers the sense of hunger and controls the passing of food through the intestines.

Paralyzing the nerve paralyzes muscles in the stomach, which appears to slow the passage of food through the stomach. This effect might one day lead to treatments that cause people to feel fuller for longer.

EU project fights obesity
The hope is that the use of botox can be developed into an alternative to gastric bypass surgery. Johannessen and her research are part of the Experimental Surgery and Pharmacology research group, which is exploring alternatives to gastric surgery. The Botox treatment study is part of an EU project called Full4Health.

Botox is actually botulinum toxin, which when ingested in spoiled foods can lead to both paralysis and death. Nowadays Botox is used in the medical treatment of dystonias and spasms, as well for its more famous cosmetic use. If Johannessen and her colleagues succeed in their efforts, it might also become useful in giving people a healthier and less weighty life.

Clinical studies coming
Johannessen told the Norwegian Broadcasting Corporation (NRK) that her research team will start human clinical studies as soon as Norwegian medical ethics authorities give their approval.

"As a start, we will be inviting patients who are candidates for obesity operations but who, for one reason or another, cannot undergo one,"  Johannessen told NRK.

Obesity is a growing problem across the globe. Being overweight can lead to severe diseases and conditions including diabetes and heart problems. The World Health Organization estimates that obesity is responsible for 2-8 percent of health care costs and 10-13 percent of deaths in different parts of Europe.

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Study shows why resolutions about physical activity are difficult to keep

An interesting study shows a neurological basis of why New Years Resolutions regarding physical activity are difficult to keep.

Physical inactivity is a major public health problem that has both social and neurobiological causes. According to the results of an Ipsos survey published on December 31, the French have put "taking up a sport" at the top of their list of good resolutions for 2013. However, Francis Chaouloff, research director at Inserm's NeuroCentre Magendie (Inserm Joint Research Unit 862, Université Bordeaux Ségalen), Sarah Dubreucq, a PhD student and François Georges, a CNRS research leader at the Interdisciplinary Institute for Neuroscience (CNRS/Université Bordeaux Ségalen) have just discovered the key role played by a protein, the CB1 cannabinoid receptor, during physical exercise. In their mouse studies, the researchers demonstrated that the location of this receptor in a part of the brain associated with motivation and reward systems controls the time for which an individual will carry out voluntary physical exercise. These results were published in the journal Biological Psychiatry.

The collective appraisal conducted by Inserm in 2008 highlighted the many preventive health benefits of regular physical activity. Such activity is limited, however, by our lifestyle in today's industrial society. While varying degrees of physical inactivity may be partly explained by social causes, they are also rooted in biology.

"The inability to experience pleasure during physical activity, which is often quoted as one explanation why people partially or completely drop out of physical exercise programmes, is a clear sign that the biology of the nervous system is involved," explains Francis Chaouloff.

But how exactly? The neurobiological mechanisms underlying physical inactivity had yet to be identified.

Francis Chaouloff (Giovanni Marsicano's team at the NeuroCentre Magendie; Inserm joint research unit, Université Bordeaux Ségalen) and his team have now begun to decipher these mechanisms. Their work clearly identifies the endogenous cannabinoid (or endocannabinoid) system as playing a decisive role, in particular one of its brain receptors. This is by no means the first time that data has pointed to interactions between the endocannabinoid system, which is the target of delta9-tetrahydrocannabinol (the active ingredient of cannabis), and physical exercise. It was discovered ten years ago that physical exercise activated the endocannabinoid system in trained sportsmen, but its exact role remained a mystery for many years. Three years ago, the same research team in Bordeaux observed that when given the opportunity to use a running wheel, mutant mice lacking the CB1 cannabinoid receptor, which is the principal receptor of the endocannabinoid system in the brain, ran for a shorter time and over shorter distances than healthy mice. The research published in Biological Psychiatry this month seeks to understand how, where and why the lack of CB1 receptor reduces voluntary exercise performance (by 20 to 30%) in mice allowed access to a running wheel three hours per day.

The researchers used various lines of mutant mice for the CB1 receptor, together with pharmacological tools. They began by demonstrating that the CB1 receptor controlling running performance is located at the GABAergic nerve endings. They went on to show that the receptor is located in the ventral tegmental area of the brain (see diagram below), which is an area involved in motivational processes relating to reward, whether the reward is natural (food, sex) or associated with the consumption of psychoactive substances.

VTA: Ventral tegmental area/NAcc: nucleus accumbens/PFC: prefrontal cortex/DA: dopamine

Based on the results of this study and earlier work, the Bordeaux team suggests the following neurobiological explanation: at the beginning and for the duration of physical exercise, the CB1 receptor is constantly simulated by the endocannabinoids, lipid molecules that naturally activate this receptor in response to pleasant stimuli (rewards) and unpleasant stimuli (stress). Endocannabinoid stimulation of the CB1 receptor during physical exercise inhibits the release of GABA, an inhibitory neurotransmitter that controls the activity of the dopamine neurons associated with the motivation and reward processes. This stimulation of the CB1 receptor "inhibits inhibition," in other words, it activates the dopaminergic neurons in the ventral tegmental area. The CB1 receptor must therefore be stimulated before the exercise can go on for longer and the body must receive the necessary motivation.

Conversely, without these CB1 receptors, the "GABAergic brake" continues to act on the dopaminergic neurons in the ventral tegmental area, leading to the reduced performance levels observed above.

It is already known that CB1 receptors play a regulatory role in the motivation to consume rewards, whether natural or not. What is original about this research is that it shows that physical exercise can be added to the array of natural rewards regulated by the endocannabinoid system. "If confirmed, this motivational hypothesis would imply that the role played by the CB1 receptor has more to do with 'staying power' in the exercise than with actual physical performance levels" explain the researchers.

This work reveals that the endocannabinoid system plays a major role in physical exercise performance through its impact on motivational processes. It thus opens up new avenues of research into the mediators of pleasure -- and even addiction -- associated with regular physical exercise. "After endorphins, we now need to consider endocannabinoids as another potential mediator of the positive effects that physical exercise has on our mood," the researchers conclude.

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Losing weight when obese increases sleep quality

A study from Johns Hopkins shows that losing weight while obese improves sleep quality for those individuals.

Weight loss, whether it's from dietary changes alone or from diet combined with exercise, can help improve the quality of sleep among people who are overweight or obese, according to a new study by Johns Hopkins researchers.

"We found that improvement in sleep quality was significantly associated with overall weight loss, especially belly fat," says Kerry Stewart, Ed.D., professor of medicine at the Johns Hopkins University School of Medicine and director of clinical and research exercise physiology.

Stewart is the senior author of the study, which will be presented at the American Heart Association Scientific Sessions on November 6, 2012 by lead author Soohyun Nam, Ph.D., who is now at the Yale University School of Nursing. Her presentation is titled Predictors of Sleep Quality Improvement Among Overweight or Obese Individuals: A Randomized Controlled Trial.

For the six-month study, the researchers enrolled 77 people who had type 2 diabetes or pre-diabetes. The participants, all of whom also were overweight or obese, were randomly assigned to one of two groups. One group went on a weight-loss diet and had supervised exercise training, while the other group only had the diet intervention. A total of 55 participants completed all phases of the study.

The participants filled out the Hopkins Sleep Survey at the beginning and end of the study to identify sleep problems, including sleep apnea, daytime fatigue, insomnia, restless sleep, excessive sleep or sleepiness and use of sedatives to aid sleep. Their body mass index and amount of abdominal fat were also measured at the start and end of the study.

Both groups -- those assigned to a weight loss diet plus supervised exercise and those who only went on a diet -- lost about 15 pounds, on average. They also lost about the same amount of belly fat, about 15 percent, which was assessed by magnetic resonance imaging (MRI).

Although a variety of sleep problems were reported by the participants, none stood out as being the most common, so the researchers analyzed a composite score, which reflects overall sleep health. What they found was that both groups improved their overall sleep score by about 20 percent with no differences between the groups.

"The key ingredient for improved sleep quality from our study was a reduction in overall body fat, and, in particular belly fat, which was true no matter the age or gender of the participants or whether the weight loss came from diet alone or diet plus exercise," says Stewart.

Good sleep quality is important in general for good physical and mental health, as well as for a healthy cardiovascular system, notes Stewart. Depending on the cause, chronic sleep disruptions increase the risk of high blood pressure, heart attack, stroke and irregular heartbeats. Obesity increases the risk of sleep problems.

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Improving sleep can help with energy and weight loss

A new study discusses how improving your sleep can increase your energy and help promote weight loss.

Those with problems sleeping often are stuck in a vicious cycle that can sabotage their weight-loss efforts. Many who find themselves tired all the time actually are suffering from a sleep disorder, including the most common issue — obstructive sleep apnea.

Dr. James Cygan, medical director for the Aspirus Regional Sleep Disorders Center, reviews results of polysomnograms, sleep studies from patients at Aspirus facilities in Wausau, Medford and Rhinelander and from Riverview Hospital in Wisconsin Rapids.

“The biggest issue is people with apnea are chronically sleep deprived, and they might eat more to get that energy. Then, apnea is worse, and patients don’t feel like exercise, with no energy,” Cygan said.

Apnea causes the throat to collapse during sleep, blocking proper air flow. Patients might snore loudly and hold their breath for long pauses. The throat muscles are supposed to contract involuntarily. Genetics and poor diet might both play a part, Cygan said.

“I would recommend that anyone that’s been known to stop breathing during their sleep go in and see somebody,” said Joe Rohling, respiratory therapy services manager at Ministry Saint Clare’s. Since November 2011, all in-patients and pre-surgical patients are screened for sleep disorders at the Weston hospital.

Rohling said staff members have seen sleep disorders starting at younger ages, especially with heavier children.

He pointed to studies in the last decade that link more health concerns, including a higher incidence of strokes, congestive heart failure and diabetes, to sleep apnea.

“It might be driving their current health condition,” Rohling said.

And screenings are aimed at catching problems early. Nursing staff will ask patients whether they are fatigued during the day, whether they snore loudly enough that others could hear outside a closed room and whether they or a sleep partner know they stop breathing overnight.

“Research has shown that up to 40 percent of all patients admitted to the hospital could have undiagnosed sleep apnea,” Rohling said.

He said the majority of the newly screened Ministry patients who are advised to get medical advice are getting diagnosed with sleep disorders and seeking treatment.

The screening process identified 44 people attending a summer festival called Weston Fest as at risk for sleep apnea as well, he said.

In minor cases, just changing your position and sleeping on your side could alleviate sleep apnea symptoms. But, Cygan said, for mild to moderate sleep apnea, an oral appliance that helps a patient keep his mouth closed during sleep will give more space in the back of the throat.

Those with severe apnea typically are prescribed a Continuous Positive Airway Pressure machine, or CPAP. Cygan said 80 percent of his Sleep Disorders Center patients require the CPAP to limit sleep apnea and between 15 percent and 20 percent are helped with an oral appliance.

The next option — “pretty aggressive” surgery — breaks the jaw and physically reconstructs it, he said. However, it might not guarantee permanent relief from sleep apnea, Cygan said.

It might be human nature to avoid a fix for a problem that a patient simply is used to dealing with, but Cygan points out studies have demonstrated people who are sleep deprived have similar reaction times to people who are intoxicated.

Sleep deprivation contributes to lack of energy at the workplace and at home, poor judgment, slower reflexes, poor memory and daytime sleepiness — none of which do anything to spur motivation to exercise and eat healthfully.

Getting treatment for a sleep disorder just might be the start of a new energetic you.

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Longer Sleep Times May Counteract Genetic Weight Gain

 Editors note: hmmm.  lose weight by sleeping... it's easier than exercise. JR


Toss out another old wives' tale: Sleeping too much does not make you fat. Quite the opposite, according to a new study examining sleep and body mass index (BMI) in twins, which found that sleeping more than nine hours a night may actually suppress genetic influences on body weight.

The study looked at 1,088 pairs of twins and found that sleeping less than seven hours a night was associated with both increased BMI and greater genetic influences on BMI. Previous research has shown that genetic influences include things like glucose metabolism, energy use, fatty acid storage and satiety. In this study, the heritability of BMI was twice as high for the short sleepers than for twins who slept longer than nine hours a night.

"The results suggest that shorter sleep provides a more permissive environment for the expression of obesity related genes," said principal investigator Nathaniel Watson, MD, MSc, of the University of Washington. "Or it may be that extended sleep is protective by suppressing expression of obesity genes."

Watson and colleagues determined that for twins sleeping less than seven hours, genetic influences accounted for 70 percent of the differences in BMI, with common environment accounting for just 4 percent and unique environment 26 percent. For twins averaging more than nine hours of sleep, genetic factors were attributed to 32 percent of weight variations, with common environment accounting for 51 percent and unique environment 17 percent.

More research is needed, Watson said, but these preliminary results may suggest that behavioral weight loss measures would be most effective when genetic drivers of body weight are mitigated through sleep extension.

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Sleep-deprivation can lead to excess eating and weight gain

If you’re concerned about your weight and trying to shed a few pounds, you would be well advised to get a good night’s rest.

That’s the take-home message from a study by researchers at Mayo Clinic in Rochester, Minn. They found people eat more when they’re sleep-deprived.

The new report builds on earlier observational studies of the general population that suggest people who suffer from chronic sleep problems are prone to weight gain.

But in this case, the Mayo Clinic researchers studied 17 healthy young men and women in a carefully controlled laboratory setting, hoping to obtain a better understanding of the effects of sleep on food consumption.

For three days, the volunteers were closely monitored to determine how much they normally eat and sleep. Then they were randomly divided into two groups for eight more days of testing.

About half of them were allowed to maintain their regular sleep habits. But the other half had their sleep cut back to two-thirds of their normal shut-eye. During the study, all the volunteers were allowed to eat whatever they wanted.

The study revealed a reduction in sleep led to a significant increase in the amount of food eaten. The volunteers in the sleep-restricted group consumed an average of 549 additional calories on the days after their sleep was curbed, compared to when they got their normal night’s rest.

And despite being awake longer, they didn’t burn a lot more energy with extra activities. So the additional calories could potentially cause a person to put on pounds over time.

“If what we found over eight days occurs in somebody repeatedly and the effects last for many days, this could indeed be a powerful force driving somebody to gain weight,” said Andrew Calvin, a co-author of the study, which was presented this week in San Diego at a meeting of the American Heart Association.

Active males in their 20s typically need up to 3,000 calories per day, and females of similar age and activity level require about 2,350 calories. “The 549 extra calories could add up to a pound of fat in less than a week should no compensation occur [in terms of increased exercise],” said Dr. Calvin.

The researchers aren’t sure why a lack of sleep causes people to eat more. And they acknowledge the results need to be confirmed with a much larger study lasting a long period of time.

Even so, Dr. Calvin said the common problem of people not getting enough sleep could be contributing to rising obesity rates in many countries around the world.

“I think we are really in the middle of two epidemics. The first is the obesity epidemic. The second is the sleep-deprivation epidemic,” he said. And if Dr. Calvin’s hunch is correct, these two epidemics could be more closely linked than previously imagined.

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Vicious cycle of sleep apnea and obesity in kids

Vicious cycle of sleep apnea and obesity in kids

Great advice:  To summarize  "

If your child is overweight, please consult a doctor to find out if he or she has the symptoms of sleep apnea, such as snoring, rough breathing, daytime sleepiness, poor academic performance, behavior issues and depression." JR

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

The classic pediatric sleep apnea patient is a skinny 6-year-old with chronic congestion and dark circles under his eyes. We still see many kids in the sleep center who match this profile, but over the past 10 years, a new clinical picture has emerged. Coinciding with the dramatic rise in childhood obesity, there is a clear change in our younger patients. We now see many overweight children in the sleep clinic who have obstructive sleep apnea that resembles the adult version. The thin child with OSA does not usually act sleepy in the daytime. On the contrary, they often act hyperactive or inattentive. In fact, their symptoms can mimic attention deficit hyperactivity disorder. Large tonsils and adenoids are the primary cause of OSA in thin children because these and surrounding tissues can relax during sleep and block the airflow to the lungs. In fact, 80 to 90% of such cases of pediatric OSA are cured by surgically removing the tonsils and adenoids. Overweight or obese children are not such an easy fix. They usually present with loud snoring and significant daytime sleepiness. In obese children, the tonsils often become enlarged due to fatty tissues in the upper airway. Fat deposits in the neck and chest also add to the collapsibility of the upper airway during sleep. Unfortunately, a tonsillectomy/adenoidectomy is curative in only about 50% of overweight kids who have OSA. The others are encouraged to try continuous positive airway pressure (CPAP) which is the most common treatment for severe OSA. When adults have mild-to-moderate OSA, we offer them an alternative treatment called an oral appliance (also called a mandibular advancing device). However, we cannot use this treatment in children and teens whose mouth and jaw are still changing. The important thing for pediatricians and parents to keep in mind is that the connection between weight and sleep is a two-way street. It’s not just that excess weight increases the likelihood that kids have obstructive sleep apnea, but that having sleep apnea increases the risks of gaining weight. Sleep deprivation due to poor sleep or too little sleep can cause hormonal havoc that leads to weight gain. For example, when research subjects were allowed to sleep for only four hours per night, the hormones that control appetite got all out of whack. Leptin, which acts on the brain to make people feel full, was abnormally decreased and ghrelin, which makes people hungry, was unusually high. These hormonal changes caused the research participants to be very hungry and eat more during the day. Children and teens with sleep apnea might seem to be sleeping a lot, but their sleep is constantly disturbed by brief turbulence in their brain waves - what sleep experts call micro-arousals. In effect, these kids are as sleep deprived as people who only get four to five hours of sleep. Not only do obese kids with OSA have a similar clinical presentation as adults, they unfortunately can have the same adverse outcomes if the sleep apnea is not treated. We are seeing pre-teens who have what we use to think of as adult diseases such as high blood pressure, pulmonary hypertension, heart disease and congestive heart failure. If your child is overweight, please consult a doctor to find out if he or she has the symptoms of sleep apnea, such as snoring, rough breathing, daytime sleepiness, poor academic performance, behavior issues and depression. OSA is easy to diagnose with an overnight sleep test and as I outlined above, there is more than one treatment option. Treating sleep apnea, if present,

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