Obesity In Children Linked to Lack of Sleep and Breathing Problems

March 7, 2015

A child’s difficulty to sleep and breathing problems can influence the risk of your child from getting obese. The recent research study published in The Journal of Pediatrics revealed that these two conditions may double the risk for obesity of a child as he reaches the age of 15. The lead researcher, Prof. Karen Bonuck, indicated that sleep and breathing problems are correctable conditions, but when not treated accordingly can increase the risk of the child to become obese.

Sleep disordered breathing

Sleep disordered breathing is considered to be a risk factor to child obesity. The condition includes sleep apnea and snoring. Parents of children in the study were asked to provide information involving their child’s sleep duration and sleep disordered breathing symptoms since birth until the child reaches the age of 6 years. Data on body mass index(BMI) were also obtained. The study showed that those with a higher BMI and with severe sleep disordered breathing symptoms are at the greatest risk of getting obese. Their chance to become obese as they reach the age of 7 to 15 years old is twice as much as those who are symptomatic with sleep disordered breathing condition. A study made in Hong Kong revealed that children with an excess weight tend to have a breathing problem because it causes the narrowing or congestion of the child’s airway while sleeping. Children with sleep disorders also tend to have enlarged tissues at the back of their throat, increasing their chance to getting obese later on.

Sleep duration symptoms

Children with a shorter sleep duration at the age of five or six have about 60 to 100 percent of getting obese upon reaching the age of 15. This finding, however, is interestingly not consistent among children of other age group. Short sleep duration in children refers to sleep that is less than 90% than the other children of their age. Parents are advised to help their children get enough sleep at an ideal duration, considering that about 25 to 50 percent of preschoolers suffer from lack of sufficient sleep.

In a research study published in Pediatrics that was conducted by the University of Chicago researchers, the sleeping patterns of about 308 children between the age of 4 and 10 were tracked down using a special wrist device. These children were categorized with normal, overweight and obese according to their respective body mass index. The study revealed that obese children in the group have variable sleep patterns and they tend to have short duration sleep as the other children. They were also identified to have the unhealthiest blood profile during blood extraction.

Additional findings of the researchers show that those children having the tendency to become obese are more protected when they get adequate sleep. Additional observation was added by Dr. Phyllis Zee, a sleep researcher, where he agreed there is a correlating link between sleep and obesity, but also signifies that the variability of sleep-wake timing in children can also be a contributing factor in regulating weight.

Other researches were also focusing on the resulting interrupted or disordered activity of the body’s metabolism and endocrine system caused by the lack of sleep. This is especially significant among children whose body are still growing. Another relation to sleep and obesity are the changes in the levels  of two hormones named leptin and gherlin, which are responsible for appetite and hunger regulation. The body often misinterprets sleep cravings as a hunger that causes an increase in the activities of these hormones that makes a child overeat.

Helping dog breathe easier can reduce snoring

Notes from Dr. Norman Blumenstock

Does your dog snore?

 5:00 a.m. Sunday, Jan. 11, 2015

Question: My dog snores louder than my husband. How can I make him stop?!

Answer: Many dogs snore and it can keep their owners up at night! Certain breeds of dog are genetically more likely to snore because of the shape of their head and nose. The brachiocephalic breeds ( dogs with a short nose and pushed in faces) tend to have very tiny nostrils, excess tissue in their throats, and elongated soft palates. This combination can cause breathing difficulties and snoring. Surgery can sometimes be done to help improve the breathing for these dogs. Examples of brachiocephalic breeds include bulldogs, pugs, and Boston terriers.

If your dog is not a short-nosed breed and he did not snore until recently, he may have something else going on. Common things that can cause snoring are: weight gain (obesity), allergies, old age, second hand cigarette smoke, dental disease, nasal or upper respiratory infections, foreign body inhalation (grass or stickers), laryngeal paralysis, polyps and tumors. You will need a trip to your veterinarian to help sort through these possibilities.

Most snoring is caused by the nose and throat tissues getting swollen and narrowing the area for air to pass. There are things that you can do to help soothe the airway and make breathing easier.

1. Keep your pets bedding clean and dry. Replace the top sheet daily. Wash bedding in hypoallergenic laundry soap.

2. Vacuum frequently to keep your floor sniffing dog from inhaling dust and dirt.

3. Decrease pollen in the home by using a HEPA filter and dusting with a microfiber cloth to trap the dust.

4. Keep the air clean! Do not smoke inside your home or near your pet. Don’t burn real candles or use air fresheners.

5. Get fit and healthy! Get your dog at a healthy weight and exercise him daily.

6. Brush your dog’s teeth daily! Dental disease is a main component in inflammation and infections. Schedule a complete dental cleaning at least once a year with your veterinarian.

7. Put your dog in a hot steamy bathroom twice a day to help hydrate and soothe the nasal passages. Try a vaporizer in the bedroom at night.

8. Avoid exercising your dog in the middle of the day when it is very hot and humid.

9. Clean and change the water dish at least twice a day. Add water to your dog’s food. Drinking more water can help keep sensitive nasal tissues moist and comfortable.

10. Give your dog a pillow for his head or use a cuddler dog bed that has raised padded sides where he can rest his head. Elevating the head can sometimes improve airflow and reduce snoring.

11. Video your dog snoring and show it to your veterinarian, it may help to determine a treatment plan for your dog.

Notes from Dr. Norman Blumenstock

Breathing problems or a chronic lack of sleep early in life may double the risk that a child will be obese by age 15, according to research published Thursday in The Journal of Pediatrics.

December 11, 201410:54 AM ET

ALISON BRUZEK

Sleep tight — and quietly, please.

ImageZoo/Corbis

A solid night's sleep does more than recharge a growing brain — it may also help keep a growing body lean.

Breathing problems or a chronic lack of sleep early in life may double the risk that a child will be obese by age 15, according to research published Thursday in The Journal of Pediatrics.

Childhood obesity has been linked before with the number of hours a kid sleeps each night. But other early problems with nighttime breathing — like snoring, or the more serious sleep apnea — also seem to be predictive of significant weight gain among children, according to the research.

It's the first study to look at both sleep duration and breathing problems as separate risk factors for obesity, says Karen Bonuck, professor of family and social medicine at the Albert Einstein College of Medicine of Yeshiva University and lead author.

"Sleep problems need to be thought of as a composite," she tells Shots. "It's not just sleep duration, sleep hygiene, sleep-disordered breathing. We need to think about healthy sleep overall, and we need to think about it early."

To examine sleep habits and how they might predict a child's body mass index, Bonuck and her colleagues used the Avon Longitudinal Study of Parents and Children, which tracked 1,900 children in England for 15 years.

The mothers surveyed were asked how long their children typically slept at ages 18 months, 2.5 years, about 5 years, 6 years and 7 years. They also reported any sleeping problems like snoring, apnea or mouth breathing between the ages of 6 months and about 7 years old. Finally, the survey collected the height and weight of the children at ages 7 years, 10 years and 15 years.

They found that children who had multiple sleeping problems were twice as likely to be obese by age 7, 10 or 15 years, compared with those who had no problems. At age 15, 9.7 percent of teens with no sleep problems were obese, compared with 18.3 percent of those with multiple sleep problems.

In addition, children who slept less than 10 hours per night at ages 5 and 6 years were more likely to be obese at age 15.

While the study could only confirm an association, not causality, it makes sense that children who don't get enough solid sleep are tired, and may eat more, sleep scientists say. "Some of this actually might be related to certain hormones that regulate appetite," says Dr. Rakesh Bhattacharjee, a pediatric sleep medicine specialist at the University of Chicago Medicine Comer Children's Hospital.

Another theory holds that poor sleep quality or short duration may cause stress on the body that leads to inflammation.

Though many questions about sleep's effects and mechanisms remain, all agree it's important, especially in growing children, Bonuck says. Newborns should get around 16 to 18 hours per day, according to the Centers for Disease Control and Prevention, and preschoolers 11 to 12 hours.

Parents should look for early signals, Bonuck says. Noisy or halted breathing at night could mean something serious is amiss. "Watch your child," she says. "Does she or he snore more than three times a week?"

The American Academy of Pediatrics recommends that all children who snore regularly be screened for sleep apnea — partly because it's easier to prevent childhood obesity than to treat it. "As Benjamin Franklin once said, 'An ounce of prevention is worth a pound of cure,' " Bonuck says. "Pun intended."

Evidence Mounts for Poor Sleep/Pediatric Obesity Connection

Sleep-related breathing problems and chronic lack of sleep may each double the risk of a child becoming obese by age 15, according to new research from Albert Einstein College of Medicine of Yeshiva University. The good news is that both sleep problems can be corrected. The study, which followed nearly 2,000 children for 15 years, published online in The Journal of Pediatrics.

“In recent years, lack of sleep has become a well-recognized risk for childhood obesity,” said Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women’s health at Einstein and lead author on the paper. “Sleep-disordered breathing, or SDB, which includes snoring and sleep apnea, is also a risk factor for obesity but receives less attention. These two risk factors had not been tracked together in children over time to determine their potential for independently influencing weight gain. Our study aimed to fill in that gap.”

Dr. Bonuck and her colleagues used data collected on 1,899 children by the Avon Longitudinal Study of Parents and Children (ALSPAC) based in Avon, England. ALSPAC collected parent questionnaire data on both child sleep duration and SDB symptoms from birth through 6.75 years and child BMI data from research ALSPAC clinics.

Sleep-disordered breathing

The researchers found that children with the most severe SDB had the greatest risk for obesity. Those children who fell into the “worst case” SDB category were twice as likely to become obese by 7, 10 and 15 years of age, compared to the asymptomatic group. Children considered “worst case” scored highest for SDB symptoms of snoring, sleep apnea or mouth-breathing.

Children whose SDB peaked later, around 5 to 6 years old, fared better but still had a 60 to 80 percent increased risk of becoming obese. Overall, one-fourth of children in this population-based cohort had an increased statistical risk of obesity that arose from SDB symptoms experienced earlier in life.  Obesity was defined as BMI greater than the 95^th percentile for age and gender, according to the International Obesity Task Force.

Sleep duration

With respect to sleep duration, children with the shortest sleep time at approximately 5 and 6 years of age had a 60 to 100 percent increased risk of being obese at 15 years. Children with short sleep duration at other ages saw no significant increase in risk. (In this study, children with short sleep duration were those who, in any given age group, slept less than 90 percent of their peers. For those aged 5 and 6 years old, this was 10.5 hours a night or less.)

Interestingly, SDB and lack of sleep were equally strong risk factors for obesity, but their effects were independent of each other. The researchers looked for associations between short-sleep-duration children and SDB children across all age groups included in the study but did not find clustering, i.e., there was little evidence that children with one risk factor were more likely to also be affected by the other.  The study did not analyze whether children affected by both of the sleep-related risk factors were at greater risk for obesity than were children who had just one risk factor.

BMI Calculator: How Healthy Is Your Weight?

Notes from Dr. Norman Blumenstock

Typically, people with higher BMIs have a greater likelihood of developing conditions such as heart disease, high blood pressure, sleep apnea, and type 2 diabetes. But many factors — including your family history, eating habits and activity level — also influence your overall health.

http://www.aarp.org/health/fitness/info-05-2010/bmi_calculator.html?cmp=NLC-MBA-090814&e2token=Ymx1bWVuc3RvY0B5YWhvby5jb20%3D

Calculate your BMI.

4 Days, 11 Pounds

Notes from Dr. Norman Blumenstock

If you are looking to lose weight you might find this of interest.  Loss of weight is usually a help in managing obstructive sleep apnea.

By GRETCHEN REYNOLDS 

 MAY 22, 2014 12:01 AM

This article appeared in the May 25, 2014 issue of The New York Times Magazine.

Losing weight is simple: Ingest fewer calories than your body burns. But how best to do that is unclear. Most experts advise small reductions in calories or increases in exercise to remove weight slowly and sensibly, but many people quit that type of program in the face of glacial progress. A new study, published in March in The Scandinavian Journal of Medicine & Science in Sports, suggests that minimal calories and maximal exercise can significantly reduce body fat in just four days — and the loss lasts for months. The catch, of course, is that those four days are pretty grueling.

Researchers in Spain and Sweden had 15 healthy but overweight Swedish men restrict their calories to about 360 a day, a reduction of approximately 1,800 calories. What calories they did ingest came in liquid form: Some men drank mostly sugary carbohydrates, others a high-protein drink. The men also exercised — a lot. Their days began with 45 minutes of cranking an arm-pedaling machine for an upper-body workout. Then, as a group, the men strolled for eight hours across the Swedish countryside, with only a 10-minute break every hour. They were allowed as much of a low-calorie, sports-type beverage as they wanted during their walks.

Most of the men “were surprised that it was easier than they thought it would be,” says José Calbet, a professor at the University of Las Palmas de Gran Canaria in Spain; he and his colleague Hans-Christer Holmberg, a professor at Mid Sweden University in Ostersund, led the study. Some of the subjects experienced “minor problems with pain in the joints” and blisters on their feet, according to Calbet, but none dropped out or complained of hunger.

After four days, the men had each lost almost 11 pounds, with nearly half of that coming from body fat; the rest of the loss came primarily from muscle mass. The researchers had anticipated that the high-protein drink would protect people against muscle-mass loss. In fact, the losses were the same, whether the men had been given sugar or protein.

More surprising, the men did not immediately put the weight back on after the study ended. “We thought they would overeat and regain the weight lost,” Dr. Calbet says. Instead, when the volunteers returned a month later, most had lost another two pounds of fat. And a year after the experiment, they were still down five pounds, mostly in lost body fat.

Dr. Calbet and his colleagues hope to study whether women respond similarly to men and whether repeated bouts of such a program might affect muscular health and appetite hormones.

But given the doleful statistics on weight loss — most people regain everything they lose dieting and more — these results are startling. They also, at the moment, are inexplicable. “The only explanation we can offer” for the sustained loss, Dr. Calbet says, is that the men were inspired by their hypercompressed success to change their lifestyles. The men moved more and ate less than before.

TWO SIGNIFICANT INDICATORS OF SLEEP APNEA- BMI and NECK CIRCUMFERENCE. Calculate them here:

Notes from Dr. Norman Blumenstock:
Calculate your Sleep Apnea risks factors here:

The Body Mass Index (BMI) appraisal is one of the most widely used tools to measure healthy body weight. This ratio of height to weight will help assess whether you are underweight, normal weight or overweight.

 The higher the BMI, the greater the risk of some diseases, including:

Sleep Apnea, Stroke, High blood pressure, Coronary artery disease, Osteoarthritis, Some cancers,  Diabetes type 2.

Sleep Apnea awareness is “contagious”. As more and more people learn about SA, doctors are driven to get training and certification to be able to discover and treat this disease. Less than 1 % of doctors are trained in Sleep Medicine to help the 40 million people afflicted with SA.

Here is a BMI calculator, from the Mayo Clinic, that you can use to determine your (or a child’s) BMI. http://www.mayoclinic.com/health/bmi-calculator/NU00597

Take the assessment, then rate yourself (below).

CATEGORY	BMI RANGE – KG/M2	BMI PRIME
Very severely underweight	less than 15	less than 0.60
Severely underweight	from 15.0 to 16.0	from 0.60 to 0.64
Underweight	from 16.0 to 18.5	from 0.64 to 0.74
Normal (healthy weight)	from 18.5 to 25	from 0.74 to 1.0
Overweight	from 25 to 30	from 1.0 to 1.2
Obese Class I (Moderately obese)	from 30 to 35	from 1.2 to 1.4
Obese Class II (Severely obese)	from 35 to 40	from 1.4 to 1.6
Obese Class III (Very severely obese)	over 40	over 1.6

Each unit increase in BMI is associated with a 14% increased risk of developing sleep apnea, and a 10% weight gain increases the odds of developing moderate or severe obstructive sleep apnea by six times. Compared to normal-weight adults, those who are obese have a sevenfold increased risk of developing obstructive sleep apnea.

NECK CIRCUMFERENCE

 

BMI isn’t the sole marker of obesity that’s important. Men with a neck circumference above 16.5 inches (43 centimeters) and women with a neck circumference above 15 inches (38 centimeters) also have a significantly increased risk of developing obstructive sleep apnea.  That is because a thick neck may narrow the airway.

MEN- What size shirt do you wear?

Dreaming of Sleep: Silencing snoring for restful nights.

Notes from Dr. Norman Blumenstock:
This a decent article about snoring. Unfortunately it doesn't mention it's connection to obstructive sleep apnea.

POSTED BY LOUISE PYPER / FEBRUARY 19, 2014 /

As children we all used to tease our parents and grandparents for snoring. It is not just the ‘old folk’ who snores, some of us can start snoring in our late teens and early twenties.

Snoring usually happens when something is partially obstructing your airways. The sound comes from you throat where air flows pass relaxed tissue and as you breathe the tissue starts for vibrate, causing the snoring sound. Snoring is not particularly dangerous, but can be depending on how your parter might ‘deal’ with the constant snoring.
There are different grades of snoring:

• Grade one – snoring is almost harmless, where snoring is infrequent and the sound is not very loud.
• Grade two – snoring is when a person snores on a regular basis (more than 3 times per week). They might also have mild breathing issues during sleep making them feel tired and sleepy the next day.
• Grade three – snoring is when a person snores very loudly each and every night. People suffering from Grade Three snoring may have obstructive sleep apnoea, which can lead to the airways being completely obstructed for up to 10 seconds. This can cause an individual to wake from a deep sleep during the night making them feel extremely tired the next day. This may effect your day-to-day life as you might experience poor memory, poor concentration, headaches, anxiety, depression, irritability and a short temper.

If you think you or your partner might be suffering from snoring you should try these methods:

1. Sleep on your side – lying on your back or stomach can be stressful on your neck.
2. Lose weight – excess body weight especially around the neck puts pressure on your airway.
3. Stay away from alcohol and sleeping pills – both of them can depress your central nervous system and relax the muscles in your throat.
4. Sort out your allergies – when your nose is partially blocked you will automatically start breathing through your mouth.
5. Get a mouthguard – to keep your teeth together when sleeping.
6. Stop smoking – as it damages your respiratory system.
7. Elevate your upper body – by raising the head of the bed or propping up your upper body to decrease the stress on your neck
8. Ozone therapy – might also improve your snoring and sleeping habits as Ozone Therapy increases oxygen levels in the blood, improves blood circulation, balances the body’s metabolism, relieves stress and anxiety and improves sleep. Ozone Therapy also combats allergy causing substances and will improve your overall health.

It is very important to keep a regular sleep schedule, by going to bed at a set time and waking up at a set time. This way you can insure you are getting your 7-8 hours of sleep. If you are pregnant and you start snoring all of a sudden it is best to go see your GP. It is no surprise that pregnant women start to snore as they have gained some extra body weight. When you snore your baby might get deprived of oxygen especially if you are a Grade Three snorer.

Snoring is not the end of the world. Try these steps and if none had worked visit your GP as something sinister might be going on.

Are you the culprit or the victim?