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Category: sleep

Sleep Apnea

January 27, 2016 8:11 am

Snoring is often viewed as an inconvenience but it can be a potentially serious issue. It may be the presenting sign of a condition known as Sleep Apnea. Unfortunately, a serious sleeping condition often gets overlooked, which can triple the risk of death for the affected! Certain signs such as consistent loud snoring, daytime fatigue, and weight gain may be indications of this serious illness.

Sleep Apnea is usually chronic issues that results in  one or more pauses in breathing during sleep. People with this disorder can repeatedly stop breathing while sleeping which usually results in a reduced oxygen supply to the brain and the tissues of the body.

Each pause in breathing is called an “apnea” and can last for several seconds to several minutes. When breathing is paused, carbon dioxide builds up in the bloodstream and chemoreceptors in the blood stream instantly respond to the high carbon dioxide levels. The brain is then signaled to wake the sleeping person and breathe in air in order to release the carbon dioxide built up. Breathing normally restores oxygen levels and the person falls asleep again.

Symptoms of Sleep Apnea:

  • Loud snoring, which is usually more prominent in obstructive sleep apnea
  • Episodes of breathing cessation during sleep witnessed by another person
  • Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea
  • Abrupt awakenings with a rapid pounding or racing heart rate
  • Awakening with a dry mouth or sore throat
  • Morning headache
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Attention problems
  • Irritability

Complications of sleep apnea can result in a variety of health problems, including:

  • High blood pressure
  • Stroke
  • Arrhythmias
  • Obesity
  • Heart Problems
  • Diabetes
  • Depression
  • Headache
  • Weight Gain

Obesity can cause  a specific type of Sleep Apnea called Obstructive Sleep Apnea. Obstructive Sleep Apnea (OSA) is a common chronic disorder that often requires lifelong care.  It is well documented that daytime fatigue can be prevalent in obese patients even though they may not demonstrate symptoms of sleep apnea. However, there is strong data demonstrating the fact that obese patients run a proportionately much higher risk of having sleep apnea.

Bariatric or Weight loss surgery has been shown to be  an effective treatment for OSA in patients who are obese and often also resolves the underlying co-morbidities of sleep apnea. While scientific reasoning for this requires further study it is theorized that the weight loss is associated with a decrease in upper airway collapsibility and obstruction mostly caused by tissues size, which is one of the major causes of Obstructive Sleep Apnea.

Effective weight loss through bariatric surgery has helped many patients achieve complete resolution and improvement of their co-morbidities such as diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea. Studies show sleep investigations performed approximately one year after the bariatric surgery revealed a significant decrease in the number of “apnea” episodes per hour of sleep and an improvement in all sleep quality related measurements as well. Bariatric surgery is perfectly suited for obese patients with OSA.

The correlation between Sleep Apnea and obesity has been well documented and supported through modern science. Clinical data, medical trials, and patient testimonials all underscore major improvements in the symptoms of Sleep Apnea after bariatric surgery.

Sunshine, Water, Rest, Air, Exercise and Diet

May 23, 2014 4:10 pm

Sunshine, Water, Rest, Air, Exercise and Diet

Of course this is over simplified, but we can’t forget the importance of the basics in our general well being. Weight loss surgery and especially Duodenal Switch have distinctive supplement requirements that need to be individualized based on your individual needs.

Sunshine is essential to life. It provides the light that wakes us and helps to regulate wake/sleep cycles and provides us with a feeling of well being. Sunlight is not only the basis of all living things but crucial in boosting the bodies Vitamin D supply. Most Vitamin D deficiencies in the general public are caused by lack of sun exposure. It is important to note that our bodies can not accomplish Vitamin D metabolism if we are wearing sunscreen. Without adequate Vitamin D stores bones will not form properly, muscle strength is impaired and osteoporosis.  Vitamin D 1,25(OH) accumulates in cell nuclei of the intestine, where it enhances calcium and phosphorus absorption, controlling the flow of calcium into and out of bones to regulate bone-calcium metabolism. However, after weight loss surgery this mechanism can be impaired.  Addition supplementation of Vitamin D is usually required based on laboratory studies following weight loss surgery.  Duodenal Switch patients should take a dry “water miscible” type of Vitamin D3 daily. 

Water comprises 50-60% of our adult bodies.  Water is essential in cell life.  It aids in transporting vitamins, nutrients and minerals to our cells. Chemical and Metabolic reactions rely on water to remove waste products including toxins that the organs’ cells reject and removes them through urine and feces. Our body temperature is regulated by sweating and the evaporation of water on the skin. Also, effectively Lubricating our joints and acting as a shock absorber for our brain, eyes, and spinal cord. Decreased stomach size, after weight loss surgery,  limits the amount of water a person can drink at one time.  It is imperative that patients ingest enough waters and fluids after surgery. We like to see our patients consume a minimum of 64 ounces of fluids a day, more on warmer days.

Rest is something we can all use more of.  Lack of sleep can cause a whole host of health issues ranging from altered levels of hormones involved in metabolism, appetite regulation, stress response to cardiovascular health, insulin resistance, immune function and most importantly post-operatively tissue repair, muscle growth and protein synthesis.  It’s easy to take rest for granted but  do not underestimate the power of sleep.

Air is an obvious essential of life.  It is important in about every function of our cells.  After surgery it is important to lung health and tissue repair. Be aware of the type of air you are breathing.  Pollution and contaminants in the air can impair lung function.  After surgery your breathing and breathing exercises will prevent complications such as pneumonia and atelectasis.  Long term air contaminants can cause asthma and long term lung health. In addition, post surgical patients will need to use their incentive spirometers to combat lung complications.

Exercise’s health benefits can not be denied. Exercise combat health conditions and disease such as stroke, metabolic syndrome, diabetes and cardiovascular disease. It also improves emotional outlook and mood. Physical activity stimulates the brain to release chemicals that involve increasing memory function.  Exercise helps maintain healthy weight, improves energy, promotes better sleep, lowers stress and anxiety.  Needless, to say after surgery exercise is extremely important for all the above reasons but also to ward off complications such as pulmonary embolism and deep vein thrombosis.

Diet is last but definitely not least. Balance along with moderation and eating whole unprocessed foods are best ways to ensure your health.  We derive most our building blocks for cell growth from the nutrients we consume. The quality of the food we put into our bodies is important in lowering health risks such as cardiovascular disease, cancer, and weight control. Protein is crucial in muscle growth, hemoglobin, cell structure and enzymes formation.  It is extremely important after weight loss surgery to remain diligent about protein intake throughout your lifetime.

It is interesting to see how all these elements are so intertwined in their synergy to maintain health.  Most are easily found or done in nature. When engaging in one of these elements,  many of the others are needed or benefited by the doing the first. Exercise requires that you stay hydrated, deep breath, possibly out in the sunlight and therefore you will rest better. Always follow your surgeon’s orders and recommendations based on your individual health status and laboratory studies.