Link Between Weight Gain and Sleep Apnea

Hello cpap community,

I was curious about the link between weight gain and sleep apnea, and thought I'd chime in with my knowledge. I could only find articles stating that there is a link, but not stating the cause and effect. I am not overweight, however as I am currently cutting down to about 10% body fat from about 13-14%, I would like to chime in on my personal experience. I lost 80 pounds when I was 17 years old, and usually go through cycles of cutting and gaining small amounts of weight. Therefore, I know my body like a clock. Right now I am currently eating at a 500 calorie daily deficit as I usually do, but have noticed much slower fat loss than in the past. Usually at that rate, I lose about one pound of fat per week. Those numbers are producing about .5 pound weight loss a week, which I know is abnormal to me. Although it has been much of a damper, I am optimistic that my metabolism will return to normal once my CPAP arrives. Here is my humble opinion on why sleep apnea results in weight gain.

Since our body is constantly waking up from the inability to breathe at night, this throws many things off balance in addition to spiking adrenaline. This is a survival response, and I would much rather have a little more difficult losing weight than to not wake up at all. However, when this is happening an abnormal amounts of times per night (AHI>5), the constant adrenaline spikes subsequently raise cortisol levels, and I believe that this carries over into the daytime. Our body constantly remains in the "being attacked by a tiger at 3AM" state, and therefore we get all the negative side effects that come with that. In short, I believe sleep apnea has an impact on weight gain indirectly by throwing off cortisol patterns.

In addition, if that theory stands true, then we would also receive all the other negative effects of raised cortisol levels. This would include a diminished sex drive, slowed metabolism (By changing the conversion rate of thyroid hormones in the body. The body thinks we are in danger, and slows metabolism to help us retain energy and survive the threat), anxiety, digestive issues (due to digestion not being a priority when the body is in fight or flight), and many other symptoms. Although it may seem like the worst thing in the world, I think it is important to be grateful for this stress response that allows us to live another day, even though our body is unable to breathe multiple times per night. I am still learning about this condition, so if anyone else wants to chime in on why my information is incorrect or with other mechanisms that contribute to negative side effects of sleep apnea, please do.

It may be easier for me to say as I am still awaiting my CPAP and still have to go through initiation hell, but I know that non-compliance will not be an option for me. There is too much at stake for our bodies to let something like discomfort put a damper on our life.

That's a bit rough but there is some truth in what you are saying.

Leptin and ghrelin work in a kind of "checks and balances" system to control feelings of hunger and fullness, explains Michael Breus, PhD, a faculty member of the Atlanta School of Sleep Medicine and director of The Sleep Disorders Centers of Southeastern Lung Care in Atlanta. Ghrelin, which is produced in the gastrointestinal tract, stimulates appetite, while leptin, produced in fat cells, sends a signal to the brain when you are full.

So what's the connection to sleep? "When you don't get enough sleep, it drives leptin levels down, which means you don't feel as satisfied after you eat. Lack of sleep also causes ghrelin levels to rise, which means your appetite is stimulated, so you want more food," Breus tells WebMD.

The two combined, he says, can set the stage for overeating, which in turn may lead to weight gain.
Studies: Those Who Sleep Less Often Weigh More

How the hormones leptin and ghrelin set the stage for overeating was recently explored in two studies conducted at the University of Chicago in Illinois and at Stanford University in California.

In the Chicago study, doctors measured levels of leptin and ghrelin in 12 healthy men. They also noted their hunger and appetite levels. Soon after, the men were subjected to two days of sleep deprivation followed by two days of extended sleep. During this time doctors continued to monitor hormone levels, appetite, and activity.

The end result: When sleep was restricted, leptin levels went down and ghrelin levels went up. Not surprisingly, the men's appetite also increased proportionally. Their desire for high carbohydrate, calorie-dense foods increased by a whopping 45%.

It was in the Stanford study, however, that the more provocative meaning of the leptin-ghrelin effect came to light. In this research -- a joint project between Stanford and the University of Wisconsin -- about 1,000 volunteers reported the number of hours they slept each night. Doctors then measured their levels of ghrelin and leptin, as well as charted their weight.

The result: Those who slept less than eight hours a night not only had lower levels of leptin and higher levels of ghrelin, but they also had a higher level of body fat. What's more, that level of body fat seemed to correlate with their sleep patterns. Specifically, those who slept the fewest hours per night weighed the most.

http://www.webmd.com/diet/features/lose ... e-sleeping

Search for medical studies on gherlin and leptin.

Sorry, I can't write further at this time.

ChicagoGramps

ChicagoGranny wrote:That's a bit rough but there is some truth in what you are saying.

Leptin and ghrelin work in a kind of "checks and balances" system to control feelings of hunger and fullness, explains Michael Breus, PhD, a faculty member of the Atlanta School of Sleep Medicine and director of The Sleep Disorders Centers of Southeastern Lung Care in Atlanta. Ghrelin, which is produced in the gastrointestinal tract, stimulates appetite, while leptin, produced in fat cells, sends a signal to the brain when you are full.

So what's the connection to sleep? "When you don't get enough sleep, it drives leptin levels down, which means you don't feel as satisfied after you eat. Lack of sleep also causes ghrelin levels to rise, which means your appetite is stimulated, so you want more food," Breus tells WebMD.

The two combined, he says, can set the stage for overeating, which in turn may lead to weight gain.
Studies: Those Who Sleep Less Often Weigh More

How the hormones leptin and ghrelin set the stage for overeating was recently explored in two studies conducted at the University of Chicago in Illinois and at Stanford University in California.

In the Chicago study, doctors measured levels of leptin and ghrelin in 12 healthy men. They also noted their hunger and appetite levels. Soon after, the men were subjected to two days of sleep deprivation followed by two days of extended sleep. During this time doctors continued to monitor hormone levels, appetite, and activity.

The end result: When sleep was restricted, leptin levels went down and ghrelin levels went up. Not surprisingly, the men's appetite also increased proportionally. Their desire for high carbohydrate, calorie-dense foods increased by a whopping 45%.

It was in the Stanford study, however, that the more provocative meaning of the leptin-ghrelin effect came to light. In this research -- a joint project between Stanford and the University of Wisconsin -- about 1,000 volunteers reported the number of hours they slept each night. Doctors then measured their levels of ghrelin and leptin, as well as charted their weight.

The result: Those who slept less than eight hours a night not only had lower levels of leptin and higher levels of ghrelin, but they also had a higher level of body fat. What's more, that level of body fat seemed to correlate with their sleep patterns. Specifically, those who slept the fewest hours per night weighed the most.

http://www.webmd.com/diet/features/lose ... e-sleeping

Search for medical studies on gherlin and leptin.

Sorry, I can't write further at this time.

ChicagoGramps

I understand that ghrelin and leptin has to do something with it, but then the effect on weight gain would be a direct cause of calorie intake>calorie expenditure. Since being diagnosed, I think I am one of the rare cases where my appetite has completely gone down the gutter. Therefore I'm comparing net calorie intake to my current metabolic state with sleep apnea.

When you go on a radical diet, so does your metabolism, and your body just lies asleep, in wait for your diet to end and then it goes nuts, gaining even more than what you might have lost. You're much better off to eat more, but in smaller amounts throughout the day, being careful of course about what you eat, but not starving on 500 calories! And be careful about exercise as it can also jazz up your appetite afterward.

the effect on weight gain would be a direct cause of calorie intake>calorie expenditure.

This is a simplistic view that has no practical use.

By way of anecdote, every morning that I step on the scale at the gym I weigh 180 lbs. On average, three days per week I exercise ferociously for 45 minutes to two hours. I do not lose weight on those days despite the very high calorie expenditure.

Likewise on the days I do not exercise, I do not gain weight despite eating the same number of calories as on the days I exercise.

The general point is that body weight is relatively stable from day to day despite big swings in calorie expenditure and calorie intake. Why is this the case? The body has a physiological control system that overrides calorie in/calorie expenditure theory.

But this is not to mean that less intake and more expenditure should be abandoned when trying to lose weight. It only means that the system is more complicated than that.

Since being diagnosed, I think I am one of the rare cases where my appetite has completely gone down the gutter.

Causation or mere happenstance?

ChicagoGramps

the effect on weight gain would be a direct cause of calorie intake>calorie expenditure

Carbs and sugars digest and are processed differently - sugars go directly to the liver and are turned into fats.

http://www.nytimes.com/2011/04/17/magaz ... d=all&_r=1&

The phrase Lustig uses when he describes this concept is “isocaloric but not isometabolic.” This means we can eat 100 calories of glucose (from a potato or bread or other starch) or 100 calories of sugar (half glucose and half fructose), and they will be metabolized differently and have a different effect on the body. The calories are the same, but the metabolic consequences are quite different.

The fructose component of sugar and H.F.C.S. is metabolized primarily by the liver, while the glucose from sugar and starches is metabolized by every cell in the body. Consuming sugar (fructose and glucose) means more work for the liver than if you consumed the same number of calories of starch (glucose). And if you take that sugar in liquid form — soda or fruit juices — the fructose and glucose will hit the liver more quickly than if you consume them, say, in an apple (or several apples, to get what researchers would call the equivalent dose of sugar). The speed with which the liver has to do its work will also affect how it metabolizes the fructose and glucose.

In animals, or at least in laboratory rats and mice, it’s clear that if the fructose hits the liver in sufficient quantity and with sufficient speed, the liver will convert much of it to fat. This apparently induces a condition known as insulin resistance, which is now considered the fundamental problem in obesity, and the underlying defect in heart disease and in the type of diabetes, type 2, that is common to obese and overweight individuals. It might also be the underlying defect in many cancers.

That is a good article, but your statement is not precise.

xCarbs and sugars digest and are processed differently - sugars go directly to the liver and are turned into fats.x

Not Fade wrote:That is a good article, but your statement is not precise.

xCarbs and sugars digest and are processed differently - sugars go directly to the liver and are turned into fats.x

But close enough. Calories in does not equal calories out.

Also fat around the organs is a lot worse then fat on your thighs. Obese children have fatty livers.

So my cat is now diabetic. One of the signs is eating a lot and losing weight. Does everyone get this, eating a lot of calories but losing weight plus filling the cat box with lots of "calories out".