6 Things That Are Keeping You Fat.

K. Aleisha Fetters, U.S. News & World Report
MARCH 30, 2015  11:23 AM

You're filling up on healthy foods, exercising daily and still, the scale isn't budging. It's mind-numbingly frustrating. Luckily, it's also fixable. Here are six common things that could be standing between you and your weight-loss goals – plus easy ways to bust through each.


1. You Aren't Tracking What You Eat

"Most of the time, when someone comes into my office saying they aren't losing weight, the problem is that they are eating a lot more than they think they are," says Holly Herrington, a registered dietitian and clinical nutritionist with the Center for Lifestyle Medicine at Northwestern Medical Faculty Foundation. "Almost every single person underestimates how much they are eating." You can blame oversized restaurant portions, mindless munching and "health halos" for that, she says.

After all, French fries and ice cream aren't the only things that are calorie-packed. So are healthy foods, including olive oil, avocado and nuts. For instance, 1 cup of almonds contains about 750 calories. If you're snacking on them (a great idea), but without measuring and tracking those calories (a bad idea), you could easily end up gaining weight, Herrington says.

She recommends tracking everything you eat, at least for a couple months, with apps like My FitnessPal, which will help you learn proper portion sizes and how your favorite health foods measure up calorie-wise. In one American Journal of Preventive Medicine study, people who kept daily food records lost double the weight of those who didn't track their food intake.

2. You're Not Sleeping Enough

A bad night's sleep can wreck your weight-loss efforts through a two-pronged approach. For one, it makes you hungry and likely to overeat. "When you don't get enough sleep, your levels of cortisol and also ghrelin, a hormone that increases the sensation of hunger, rise," explains board-certified internist Dr. Patricia Salber.

For example, in one University of Chicago study, healthy young men who got just four hours of sleep two nights in a row (compared to their usual seven to nine hours) reported a 24 percent increase in appetite, along with cravings for candy, cookies, chips, bread and pasta. They also experienced an 18 percent decrease in leptin, which promotes fullness, and a 28 percent increase in the hunger-hormone ghrelin.

Second of all, not getting enough sleep could make your body store what you do eat as fat. For instance, a 2011 study in the American Journal of Clinical Nutrition found that just one night's bad sleep caused healthy men's resting energy expenditure – the number of calories they burned by simply being alive – to drop by 5 percent. The number of calories they burned after each meal also dropped by 20 percent.

"Sleep deprivation and sleep apnea may affect blood sugar levels and increase insulin resistance," says endocrinologist Dr. Michael Bergman, clinical professor of medicine at the NYU Langone Medical Center. "Sleep disorders, namely obstructive sleep apnea, [have] been associated with the development of Type 2 diabetes."

If clean-sleep habits – such as keeping your bedtimes consistent and not playing on electric devices in the hour before bed – don't help you get eight solid hours a night, talk to your doctor about how you can sleep better and longer, he says.

3. You're Eating the Same Number of Calories You Did on Day One of Your Diet

Oh, the weight-loss plateau: At the beginning of your diet, you were losing weight and feeling great. But now, you're doing the exact same thing, but with zero results. That might be the problem. "As you lose weight, your caloric needs will change," Herrington says. "The smaller you get, the fewer calories your body needs, so the fewer calories you'll need to eat to continue losing weight."

If your weight-loss results have plateaued for one to two months, she recommends gradually cutting back on calories. Start by eating 100 fewer calories a day and see how the scale shifts in a couple weeks' time. Don't cut back too much, though. Most women shouldn't eat any fewer than 1,200 calories a day and men shouldn't eat any fewer that 1,700 a day. Meanwhile, you should never feel famished or low on energy, she says.

4. You're Constantly Stressed

Acute stress – say from a looming work deadline or relationship drama – can cause your appetite to go MIA. But if the stress keeps up and becomes chronic, too-high levels of the stress hormone cortisol can increase your appetite, particularly for high-carbohydrate foods, according to Salber.

"When stressed, people seek to comfort themselves and relieve the tension," she says. "All too often, that means turning to sugar or starchy foods." High-carb foods can cause a quick spike in blood sugar and feel-good serotonin levels. But both crash quickly, and put you in a vicious cycle of stress and overeating.

Meanwhile, by stimulating the production of insulin, cortisol also increases your body's tendency to store calories as visceral fat. A type of fat that hangs out in the abdominal cavity and likes to hug your vital organs, visceral fat is associated with the development of insulin resistance and, in some cases, diabetes, Salber says.

If you can't remember the last time you weren't stressed, consider visiting your doctor or a therapist to help you manage your stress levels and get healthy. Mental health issues, including stress, are no different than physical health issues, she says. They deserve professional help.

5. You're Using Artificial Sweeteners

Artificial sweeteners, whether you stir them into your coffee, get them from diet sodas or spoon them from your yogurt container, are an easy way to cut calories and sugar in the short term, but they could harm your long-term weight-loss efforts. Case in point: Research from the University of Texas found that over the course of 9.5 years, the average two-a-day diet-soda drinker puts on five times more belly fat than do people who abstain.

That could be because your brain responds to artificial sweeteners by telling you to eat more sweet stuff, according to the Harvard School of Public Health. Meanwhile, they may also throw off the balance of healthy bacteria in the gut, Salber says.

A 2014 study from the Israel-based Weizmann Institute of Science's immunology department found a significant correlation between the consumption of artificial sweeteners, gut bacterial configuration and a tendency to develop glucose intolerance, which contributes to the development of obesity and Type 2 diabetes.

Eliminate any artificial sweeteners in your diet and replace them with sweeteners that also contain vitamins and minerals, such as honey and maple syrup. Just make sure to count their calories.

6. You Have a Medical Condition

While rare, underlying health conditions can make weight-loss difficult to achieve on your own. For instance, Cushing's disease, marked by excess cortisol levels, and polycystic ovary syndrome, a common endocrine disorder in women, can both contribute to glucose disorders, Bergman says.

Meanwhile, hypothyroidism, a condition in which the thyroid gland doesn't produce enough hormones, can also contribute to weight-management issues. About half of thyroid disorder cases in America are undiagnosed, according to the American Association of Clinical Endocrinologists.

If you aren't losing weight, but feel like you are following your body's caloric needs and are exercising between two and five hours a week, Herrington recommends talking to your doctor about your weight-loss concerns. He or she may be able to run some simple tests to make sure a health condition isn't behind your frustrations. If something is amiss, treating it will do more than help you lose weight.

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.

Snooze and lose: Getting more sleep may be the key to weight loss

Registered dietitian Caryn Alter talks to her "Lighten Up Weight Loss" class in Freehold. Alter is one of a growing number of health professionals who agree that sleep deprivation can hinder weight loss. (Noah K. Murray | For NJ Advance Media)

By Susan Bloom | For The Star-Ledger 
on March 05, 2015 at 3:57 PM

Frustrated about that extra weight you've put on or those few pounds you just can't seem to lose? Put down that iPad and plump up your pillow instead -- a growing body of research has shown a strong connection between sleep duration and weight in adults and children, and suggests that a little more sleep might be just what you need to kick your body into natural weight loss or weight management mode.

With the hustle and bustle of 21st century life leading the average American to get up to two hours less sleep per night while tipping the scales at over 20 pounds more than they did 50 years ago, a variety of studies have explored the powerful correlation between sleep and weight. Among their findings, a Mayo Clinic study recently found that women who slept less than six hours or more than nine hours per night were more likely to gain 11 pounds than women who slept seven hours per night, while researchers at the Harvard-affiliated General Hospital for Children determined that, of the 1,000 children they tracked from the age of six months to seven years old, those who were the most sleep-deprived were about 2 1/2 times as likely to be obese as the children who consistently got enough sleep.

The average American requires 7-9 hours of sleep each night to function optimally, according to the National Sleep Foundation in Arlington, Va.

"But an estimated one-third of Americans are sleep-deprived in some way, which is an issue because a lot of important things happen as we sleep, " said Dr. Priyanka Yadav pediatrics and sleep medicine specialist at Robert Wood Johnson University Hospital's Comprehensive Sleep Disorders Center in Hillsborough.

State of Check

In addition to providing the body with critical restorative time and supporting focus, retention, and memory consolidation of what we learned during the day, she said, the process of sleep keeps the body in an important state of check and balance and sleep deprivation can absolutely affect metabolism and appetite.

That's because sleep-deprived individuals have been found to possess both higher levels of ghrelin, a hormone which drives feelings of hunger, as well as lower levels of leptin, a hormone which triggers feelings of fullness and satisfaction after we eat - a dangerous double whammy for weight gain.

"Many patients I treat for sleep issues also have weight management issues - these seem to go hand in hand because sleep deprivation can cause glucose intolerance, hormonal imbalances, and other metabolic conditions, " Yadav said. "In addition, when you're sleep-deprived, the frontal cortex of the brain - which controls our ability to plan, problem-solve, and make decisions and naturally blunts the impulse to eat more fatty, carbohydrate-heavy, and caloric foods - is less active, " she said.

Caryn Alter, a registered dietitian at CentraState Medical Center's Health Awareness Center in Freehold, agrees that sleep-deprived individuals can gain weight because of poor dietary choices they make - consciously or unconsciously.

"Carbohydrates tend to raise the body's levels of the neurotransmitter serotonin, which makes people feel sleepier and calmer, " Alter explained. "So when they're tired or stressed out, people often eat with less self-control and reach for carb-laden foods like ice cream, cookies and potato chips. The hitch is that these 'comfort foods, ' in large portions, can cause weight gain."

Her message for the tens of millions of Americans struggling with weight issues? "It's not necessarily that you don't have willpower or mindfulness, but rather that there may be a chemical event in the brain causing you to feel hungrier because you're simply tired, " she said.

"If you seem to have more of an appetite or find yourself nibbling more, it could be stemming from a physiological cause - too little sleep - rather than a psychological one."

At the "Lighten Up"weight-loss classes that she conducts weekly at CentraState, Alter instructs attendees on nutrition, exercise, and body chemistry but is also quick to advise on the importance of sleep to an overall healthy lifestyle and recommends a few extra hours of sleep each week for those getting less than six hours per night.

When it comes to weight loss, "getting more sleep and/or regulating your sleep pattern, in addition to mindful eating and exercising, may just be the missing link, " said Alter, who noted that it can be difficult to motivate yourself to exercise if you're tired, another factor increasing the likelihood for sleep-deprived individuals to pack on pounds.

Don't go too far

Yadav agreed that for many people, getting more sleep can be an easy way to feel better and start losing weight - to a point.

"Too much sleep causes people to burn fewer calories and is associated with an increased risk of mortality, " she said.

Colts Neck resident and former nurse Kathie Nolte, 64, said she experienced some of the diminishing returns of too much sleep following her retirement two years ago.

"When I was working a 7 a.m.-3 p.m. shift, I was waking up at 5:30 a.m. and going to bed at 9:30 p.m. and I was able to maintain my weight, " she said.

"But after retiring, I found myself going to bed later, reaching for a lot of carbs late at night, and waking up late after sleeping for 10 hours. I didn't have the same energy level as I did when I was working and it made me get down on myself, " she said of the way her new sleep pattern threw off her eating schedule, made her less productive throughout the day, negatively impacted her mood, and ultimately contributed to a 30-pound weight gain.

Sleep and slimming down

Nolte said she is already several pounds down since changing her sleep schedule and joining Alter's "Lighten Up" class in January.

"I feel much better about myself now - more put together and organized," Nolte said. "And I learned that getting good-quality sleep and the right amount is as important to your health as eating a proper diet or exercising."

"Most people know that diet and exercise are important to health, but many forget that sleep is the missing, third component of a healthy life cycle, " agreed Natalie Dautovich, National Sleep Foundation Environmental Scholar.

"Not only is adequate sleep necessary for healthy cognitive functioning, but because sleep is rejuvenating, a good night's sleep can help you slim down and maintain an ideal body weight. This rejuvenation can lead to more enthusiastic and longer workouts, which in turn can also lead to increased weight loss and better quality sleep. Sufficient, high-quality sleep also leads to a greater ability to self-regulate and select healthy food choices, which in turn helps with maintaining a healthy weight, " she said.

"It's great to see more awareness of the importance of sleep to our overall health and to our weight in particular, " said Yadav, who advises people to tap into the body's natural rhythm and enjoy the benefits of even an hour more sleep a night if they've been getting short-changed.

"The body is intuitive and is designed to survive. So we should just let it do what it needs to do and stop getting in the way of ourselves."

Why the workday should be 10–6, not 9–5

Notes from Dr. Norman Blumenstock

A new study shows those with a later work schedule get more sleep, which has prompted experts to suggest a later workday, according to Vox.

Updated by Susannah Locke on December 17, 2014, 9:10 a.m. ET

If you've ever wished you didn't have to get to work until later in the morning, you're not alone. A new study shows that those who start work later also get more sleep. And that's led some health experts to suggest that pushing back the workday could be a good idea.

Roughly 40 percent of Americans are sleeping less than they should. And a new study, published in the journal SLEEP, found that the main thing people were doing instead of sleeping was working. "It was evident across all sociodemographic strata no matter how we approached the question," study co-author Mathias Basner, a sleep psychiatrist at the University of Pennsylvania, said in an email.

It's tough to get people to work less and sleep more. But the researchers did find suggestive evidence of at least one potential remedy. For every hour later in the day that people started working, they got 20 more minutes of sleep. The researchers found a similar pattern for what time students started classes:

A later start of work or classes was correlated with more sleep overall. (Basner, M. et al. SLEEP Vol. 37, No. 12, 2014)

The study used data from the American Time Use Survey that the US Bureau of Labor Statistics does each year. Overall, they examined the habits of 124,517 people.
We don't know yet if the timing of the workday actuallycauses more sleep

There are several key caveats for this study, many of which were pointed out by either the authors themselves or by Lauren Hale, a public-health expert at SUNY Stony Brook, in an accompanying editorial published in the same issue of the journal.

For one, this dataset can only show correlations. It cannot determine that any factor really causes more or less sleep, or vice versa. As Hale notes: "It could also be that those who are short sleepers intentionally select jobs with earlier schedules (or those who prioritize long sleep do not consider jobs with earlier, more rigid schedules)."

She also writes that it's unclear if having people cut back on, say, paid work or commuting time would actually translate to more sleep: "Perhaps an extra hour in one's day will lead to more time eating potato chips on the couch rather than sleeping more?"

The only way to figure that out, though, is to go ahead and do an experiment and get people — and/or their bosses — to try it out.

But Starting The Workday Later Could Still Decrease Social Jetlag

There's actually another benefit to starting the workday later. Helping people get more sleep is the obvious one. But the other is that it would keep sleep schedules more consistent throughout the week, decreasing what researchers call "social jetlag."

There's increasing evidence that when people are sleeping can be as important as how muchthey're sleeping. Even if you get your recommended eight hours a night, you can still feel terrible if you are going to sleep and waking up at different times over the course of the week. And that's what most people are doing — essentially putting their brains through jetlag. It's one reason why so many people end up feeling terrible on Monday mornings.

SOCIAL JETLAG HAS BEEN LINKED TO OBESITY

Over the past few years, some research has been indicating that even a modest variation in waking and sleeping times can create serious health issues. For example, in 2012, German research Till Roenneberg co-authored a study that found that even the normal social jetlag that occurs between weekdays and weekends was correlated with increased body-mass index for overweight people. A lag of just one hour increases the likelihood of obesity by about a third.

So what can be done about it? There are really only two ways to fix social jetlag: either get up early on the weekends (ick) or sleep in later on workdays (hooray, hooray).
Not everyone can just show up late for work every day. Here's how to get more sleep, anyway:

The new SLEEP study noted several correlations that might be a little easier to get a handle on. It linked shorter sleep to watching more TV at night and spending more time grooming in the morning. So maybe there's something you can cut down on there. Like high maintenance hair.

There are also things you can do that didn't happen to be covered in the study. These include limiting caffeine in the afternoon, seeking out bright light in the morning and avoiding it before bed (including from glowing screens), and keeping regular wake and bedtimes through the week — even on weekends.

Notes from Dr. Norman Blumenstock

A five year study is a wake-up call to a child snoring problem

Obese boys are more prone to habitual snoring than other children and they sleep less hours.

This would have been a better study if they all had sleep studies to see how many children had undiagnosed sleep apnea.

Elizabeth Cheung elizabeth.cheung@scmp.comPUBLISHED : Tuesday, 11 November, 2014, 4:49am        UPDATED : Tuesday, 11 November, 2014, 4:49am

Obese boys are more prone to habitual snoring than other children, a five-year study reveals. Photo: Reuters

Obese boys are more prone to habitual snoring than other children, a five-year study reveals.

The paediatric department of Kwong Wah Hospital in Yau Ma Tei conducted a phone survey with parents of 3,047 children in 2002 to understand the prevalence of sleep symptoms among local primary school pupils.

A similar follow-up survey was conducted five years later when the students had reached puberty. In 2007, researchers managed to interview 2,005 of the students involved in the first survey.

They found that 12.7 per cent of respondents, or 254 teenagers, were habitual snorers, meaning they snored on at least six nights a week.

About 40.6 per cent of pupils suffered from habitual snoring in both studies, while 7.1 per cent of children became habitual snorers when they moved to secondary school.

Dr Daniel Ng Kwok-keung, head of paediatrics at Kwong Wah Hospital, said male gender and a body mass index over 30 were factors leading to persistent and incidental habitual snoring.

Allergic rhinitis, inflammation of the nasal airways, is associated with persistent habitual snoring, while asthma is linked with incidental habitual snoring, meaning non-snorers started to snore in the second stage of study.

Habitual snoring affected the quality of teenagers' sleep. Pupils who showed excessive daytime tiredness slept for 7.1 hours on average every day, which is half an hour less than those who did not show any tiredness during the day, the study found.

The study pointed out that as many as 90 per cent of respondents did not reach the international recommended sleeping range of at least 91/2 hours a day. Hong Kong teenagers sleep for an average of 7.6 hours a day.

To prevent habitual snoring, Ng suggests that children exercise for one hour every day to prevent obesity, treat allergic rhinitis with nasal wash or topical steroid, and avoid sleep deprivation.

He also advised children to maintain proper sleep hygiene, such as avoiding exposure to a computer monitor two hours before bedtime and by exercising in the afternoon.

The result of the research was published in the Journal of Paediatrics and Child Health in June.

More Sleep, Less Medicine: Sleep Disorders Center Breaks Insomnia’s Grip

Joint program of Rutgers and RWJ University Hospital offers range of sleep studies and treatment options for patients of all ages

By Robin Warshaw Friday, September 12, 2014

Patients suffering from insomnia find relief through a joint program through Rutgers Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital.

For more than 30 years, Donna* believed her chronic insomnia was something she and medical science couldn’t change. Most nights, she had difficulty falling asleep and staying asleep. Her doctors prescribed various medicines that did little to help.

Donna pushed her way through an ever-present blanket of fatigue to succeed in her career and raise three children. Yet the insomnia took its toll. “I was exhausted, I was irritable,” she says. “I somehow managed to have energy for things I needed and wanted to do, but I was sleep deprived. It was part of my life.”

When an acquaintance mentioned that a sleep specialist might help, Donna wasn’t interested at first. “I thought I had already been on everything,” she says. Realizing she had never seen a sleep expert, she went to the Comprehensive Sleep Disorders Center, a joint program of Rutgers Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital. To her surprise, “they had a completely different approach,” including patient education, behavioral changes and sophisticated testing.

5 Ways to Put Insomnia to Rest Advice

 

Advice for defeating insomnia, from physicians at the Comprehensive Sleep Disorders Center, Robert Wood Johnson University Hospital, New Brunswick:

 

1. Take anything with a screen out of your bedroom – TVs, cellphones, tablets, laptops. Use your bedroom for sleep or sex only.

 

2. Go to bed only when sleepy. To relax, take a hot shower, meditate or do yoga.

 

3. Get up at the same time every day, Monday through Sunday, no matter how little you’ve slept.

 

4. If you wake during the night and  cannot go back to sleep after 15 minutes, get out of bed and do something restful and calming. Read or listen to music. Do not watch television or get on the computer. Do not go back to bed until very sleepy.

 

5. Do not nap, even on weekends

Chronic insomnia, such as Donna experienced, is common and may be increasing due to 24-hour connected lifestyles, says Anays M. Sotolongo, medical director of the sleep center.  Unlike acute insomnia, a short-term condition caused by a stressor such as giving a speech, chronic insomnia produces troubles that last a month or more.

Most with insomnia symptoms get too little sleep. Some sleep all night, but have undiagnosed disorders – acting out dreams, sleep talking, sleep apnea – that affect restfulness. “They sleep seven to nine hours, but they feel awful,” says Sotolongo, who is an assistant professor of medicine in the division of pulmonary/critical care at Rutgers Robert Wood Johnson Medical School.

Sometimes, insomnia patients come looking for a quick fix and are not always happy, notes Sotolongo, when told the solution will take time. “Part of the process is to develop a sleep debt, to make them sleepy. It’s like going on a diet – they have to learn to feel hungry again.”

Sleep center physicians take patients’ medical histories and conduct full physical examinations to determine the source of the problem. Donna also had an overnight sleep study in the center’s sleep laboratory. That’s unusual for insomnia patients, but is used to identify any physiological causes, such as sleep apnea or seizures, Sotolongo explains. The center conducts about 1,500 sleep studies annually.

In the lab, patients sleep in a private room as skin sensors measure body functions and a trained technician monitors the study. “I was mildly nervous about it,” says Donna, who admits feeling “awkward” about having someone watch her sleep. “I wasn’t resistant to doing it because of the possibility it could be helpful.”

The study showed no physical cause for Donna’s chronic insomnia. Her sleep center physician, Jagadeeshan Sunderram, educated her about sleep health, had her change her sleep habits and reduced her medicine. “Nothing else had ever worked,” she says, “so I did what he told me.”

Her sleep improved gradually during the first year, and continued to improve. Donna lost her anxiety about not sleeping and stopped “night eating,” a habit she had used to get back to sleep. “As I began to sleep better and wake less, it went away,” she says.

Now, several years later, Donna generally follows the behaviors she learned, but not as strictly. When she has significant sleep disruptions, “Dr. Sunderram reminds me to go back to the basics.”

*Patient requested anonymity; name has been changed

Can Sleep Apnea Predict a Heart Attack?

By Eric Cohen, MD Published Sep 8, 2014

Many of the patients I see who complain about sleep issues have some level of obstructive sleep apnea (OSA). In fact, as many one in five adults have at least a mild form of sleep apnea. People with obstructive sleep apnea are also more likely to have hypertension, high blood pressure, and cardiovascular disease.

Now, as a result of the latest research, when we test for sleep apnea we also examine and focus on the state of a person’s heart.

The link between sleep apnea and cardiovascular disease has been studied for several years. In 2013 it was announced that this link even includes the possibility of heart attacks related to obstructive sleep apnea. The head of a long-term study, Apoor Gami, MD, a cardiac electrophysiologist at Midwest Heart Specialists-Advocate Medical Group in Elmhurst, Ill., notes, “The presence and severity of sleep apnea are associated with a significantly increased risk of sudden cardiac death.”

There are a number of causes behind this association. Sleep apnea can cause you to stop breathing several times a night. When this happens, your blood oxygen levels go down, which can cause your heart rhythm to flutter. This is a heart complication that also occurs at the time of sudden cardiac death.

The problem is huge. In the United States alone, more than 450,000 deaths are caused each year by sudden cardiac death. 

These figures illustrate why anyone presenting with symptoms such as loud snoring, daytime fatigue, waking with a sore throat, hypertension, high blood pressure or cardiovascular disease should be tested for sleep apnea. One positive from the study on sleep apnea, and recognizing the link between sleep apnea and heart problems, is we have found that improving obstructive sleep apnea may dramatically improve the health of your heart. The longer your symptoms go untreated, however, the higher your chance for heart disease, stroke, or cardiac arrest.

The good news is there are ways to improve your sleep without surgery. Here are six recommendation I give to my patients who want to improve the quality of their sleep:

1. Avoid caffeine in the evenings.
2. Avoid excessive alcohol consumption: Too much alcohol can affect a person’s sleep.
3. Create a regimen of regular physical activity.
4. Arrange your bedroom into a calming, sleep-inducing environment.
5. Establish a pre-sleep routine (bath, herbal tea, reading a book, etc.).
6. Keep a consistent sleep cycle; this helps your internal clock stay regulated.

If you’re over 60, obese, and constantly tired or fatigued, make sure you are tested for sleep apnea. Older women especially should be tested for sleep apnea, and your doctor should also be evaluating you for signs of heart disease. Tests can show weak spots, and if caught early, this could save lives. Now, as we know more about the connection between sleep apnea and the heart, doctors can get more accurate results regarding any sleep troubles you may be experiencing.

12 Foods That Sabotage Sleep

Notes from Dr. Norman Blumenstock
Remember not to go to sleep on a "full stomach".

It's recommended that you have at least 3 hours after eating before you go to sleep in order to avoid any negative issues.

Sleep Better

The foods you eat for dinner or shortly before bed can prevent you from getting some much-needed zzz's. Here's what to shun for up to several hours before turning in if you want to sleep better and wake rested — from tomatoes and chocolate to cheddar cheese.

Celery

Steer clear of celery just before bed. Celery and other foods with a high water content (cucumbers, watermelon, radishes and such) are natural diuretics that may cause you to wake in the middle of the night with a full bladder.

Tomatoes

Tomatoes are rich in tyramine, an amino acid that triggers the brain to release norepinephrine, a stimulant that boosts brain activity and delays sleep. Other tyramine-rich foods include eggplant, soy sauce, red wine and aged cheeses, such as brie and Stilton.

Cheese Pizza

Foods high in fat and fried foods take longer to digest and can cause discomfort that interferes with sleep. They can also reduce the effectiveness of some medications taken at night, says Alon Avidan, a neurologist and director of UCLA's David Geffen School of Medicine Sleep Disorders Center.

Alcohol

Although a nightcap or a glass of wine before bed may help you doze off quicker, it disrupts sleep later in the night and robs you of rapid eye movement (REM) sleep. Lack of REM sleep harms concentration, memory and motor skills.

Black-bean chili

This dish could be a disaster if you eat it close to bedtime. The body has a hard time digesting beans, so stomach-rumbling gas pains will keep you from a good night's sleep, says Helen Rasmussen, a research nutritionist at Tufts University.

Dark chocolate

A small piece of dark chocolate each day helps keep your heart healthy — but don't nibble it right before you go to bed. Dark chocolate (though not white chocolate), hot cocoa and tea all contain caffeine, and if you're caffeine-sensitive, you may find yourself staring at the ceiling instead of sleeping.

Gumdrops

A handful of gumdrops (or any candy) may cause your blood sugar levels to spike and then fall rapidly as the body releases insulin to bring them under control. You may fall asleep easily, but these fluctuations make it difficult to stay asleep.

Tacos

A taco liberally sprinkled with hot sauce may set your taste buds tingling, but eating it within a few hours of lights-out can set you up for a bad case of heartburn and a restless night. Ditto for other spicy foods.

Steak

Save the leftover slice of steak for lunch tomorrow. Foods high in protein and marbled fats, such as steak and roast beef, are slow to digest. If your body is busy digesting food, there's more of a chance that you'll have a restless night.

Carbonated soft drinks

Caffeine, that sneak thief of sleep, can turn up in unexpected places, including root beer and lemon-lime soda. Added to a food or beverage, caffeine must be listed as an ingredient; if it occurs naturally (coffee, tea, chocolate), it doesn't. Check the label.

Dagwood sandwich

A heavy meal just before bed can rob you of the shut-eye you need. Allow at least three hours post-meal before you turn in so your body has a chance to digest the food and you don't feel too uncomfortable to sleep.

Broccoli

Broccoli is a nutrition powerhouse, but its slow-to-digest fiber will keep your body working hard into the night. Broccoli and its relatives cauliflower and brussels sprouts also contain an indigestible sugar that will produce large amounts of gas.

Notes from Dr. Norman Blumenstock
Dr Oz  understands the importance of of optimal sleep.

Please check out the video.

http://www.doctoroz.com/episode/dr-oz-nationwide-sleep-clinic-sleep-breakthroughs-uncovered

Notes from Dr. Norman Blumenstock

Excessive snoring might seem like a relatively harmless issue, but more evidence shows that sleep apnea can cause serious health issues to your brain.

Kathleen Lees k.lees@scienceworldreport.com

First Posted: Sep 10, 2014 06:16 PM EDT

More than 18 million Americans are estimated to have sleep apnea, a breathing disorder that disrupts air flow and can result in a poor night's rest. (Photo : Reuters)

Excessive snoring might seem like a relatively harmless issue, but more evidence shows that sleep apnea can cause serious health issues to your brain.

Recent findings published in the journal PLOS ONE show that blood flow in the brain can actually damage related tissues presented by this health issue.

"We know there is injury to the brain from sleep apnea, and we also know that the heart has problems pumping blood to the body, and potentially also to the brain," said lead study author Paul Macey, associate dean for Information Technology andInnovations at the UCLA School of Nursing, in a news release. "By using this method, we were able to show changes in the amount of oxygenated blood across the whole brain, which could be one cause of the damage we see in people with sleep apnea."

For the study, researchers measured blood flow in the brain by using a non-invasive MRI procedure: the global blood volume and oxygen dependent (BOLD) signal. This method is usually used to observe brain activity. Because previous research showed that poor regulation of blood in the brain might be a problem for people with sleep apnea, the researchers used the whole-brain BOLD signal to look at blood flow in individuals with and without obstructive sleep apnea (OSA).

In the study, researchers measured men and women both with and without the issue that had their BOLD signals measured during three physical tasks while they were awake, according to the release: 

• The Valsalva maneuver: participants forcefully breathe out through a very small tube, which raises the pressure in the chest.
• A hand-grip challenge: participants squeeze hard with their hand.
• A cold pressor challenge: A participants's right foot is put in icy water for a minute.

"When we looked at the results, we didn't see much difference between the participants with and without OSA in the Valsalva maneuver," said Macey. "But for the hand-grip and cold-pressor challenges, people with OSA saw a much weaker brain blood flow response."

"This study brings us closer to understanding what causes the problems in the brain of people with sleep apnea," concluded Macey.

With future studies, researchers hope to determine better treatments for certain types of obstructive sleep apnea and how to reverse related health issues.