Sleep More, Stress Less to Achieve Your Weight Loss Goals

Weight Watchers and Jenny Craig should get with the program. Neither of the weight loss leaders integrates sleep education and sleep diaries. And the companies are making a big mistake, new research suggests. Popular approaches used by groups like Weight Watchers use a diary to keep track of food and exercise. Adding an extra column in the diary for hours slept would be a minor change that could make a significant impact.

A new study in the International Journal of Obesity found that adequate sleep increases your chances of success during weight loss efforts. People trying to lose at least 10 pounds more often reached their goal if they had six to eight hours of sleep per night. Stress reduction also helps with weight loss, the study reports.

A group of 500 study participants were instructed to lose 10 pounds over a six month period. All participants attended weekly weigh-in and educational meetings. Instructors at the meetings encouraged the participants to consume 500 fewer calories per day, adopt a healthy low-fat, low-sugar diet and exercise for at least 180 minutes a week. Participants were required to keep record of how long they slept, stress levels and mood. The class instructors encouraged participants to keep a food diary as well.

Nearly three-quarters of the people who slept more than six hours and kept a low-stress lifestyle were successful in losing 10 pounds or more and were twice as likely to meet their goals compared to those who get six or fewer hours of sleep.

Sleep loss tends to lead to weight gain or undermine dietary weight loss because it changes the body’s hormone levels. Lower leptin and higher ghrelin can lead to a slower metabolism but a bigger appetite for junk food.

Whether you are trying to lose weight or stay trim for swimsuit season, prioritizing sleep is always a good idea. The American Academy of Sleep Medicine recommends adults get at least seven hours of sleep. Don’t underestimate the power of diet and exercise. Weight loss programs like Weight Watchers work for many people because they educate people to make the right choices and encourage them to hold themselves accountable for their health.

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Middle-aged Sleep Loss Linked to Weight Gain for Women

It’s a troubling scenario for women as they get older: lose sleep and gain weight. New findings suggest middle-aged women with insomnia will likely pack on pounds.

A Finnish study published in the International Journal of Obesity followed more than 7,300 middle-aged men and women for seven years. About a third of the women who reported having difficulty sleeping posted a double-digit weight gain.

Sleep problems, whether chronic or occasional, came before weight gain in many cases. Lead investigator Peppi Lyytikainen told Reuters Health the findings do not prove a causal relationship. He believes the findings may suggest improving sleep quality can help with losing weight. It’s still unknown if treating insomnia will cause weight loss.

Men may not have to worry. Results showed no link between insomnia and weight gain in males. However, previous research suggests otherwise. Men who sleep less may gain weight because they exercise less and eat fewer healthy foods. Short sleep may alter appetite-regulating hormones and cause you to crave high-calorie, high-carb foods.

Middle-aged women are susceptible to sleep distubances due to the hormonal and physical changes related to menopause. Its not unusual for post-menopausal women to report poor sleep quality or insomnia.

Image by Robert Hruzek

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Obese short-sleepers eat out often, prefer fatty food

A large Japanese study suggests eating habits are only part of the reason why short sleep duration is interconnected with obesity. Findings published in the May issue of SLEEP show short sleep and high Body Mass Index are linked to a tendency to eat out and a taste for fatty foods. The authors suggest other unknown biologic factors are also at play.

Researchers reached this conclusion using a statistical analysis based on the results of a questionnaire about lifestyle combined with data from annual health checkups. About 3,800 white collar male employees at a Japanese energy company, ages 40 to 59, participated in the study.

The survey contained mostly “yes or no” questions about sleep length, dietary patterns, health history, exercise and substance use.

People categorized as short sleepers (6 hours or less) tended to weigh more and exercise less. The same group was also more likely to prefer fatty food, frequently snack and eat out more. Those dietary habits were also associated with high BMI, a characteristic of obesity.

Based on previous research, the authors state other physiological functions may also drive the relationship between sleep duration and obesity. Other studies have linked sleep restriction to levels of the appetite-regulating hormones leptin and ghrelin.

The study does have some shortcomings as noted by the authors. Women did not participate due to privacy concerns. The findings may not apply to everyone because the study only included middle-aged Japanese men. The measure for sleep duration was self-reported by participants and may not be true in all cases.

Read more about sleep and obesity and sleep and weight gain.

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Obese kids more at risk for snoring, obstructive sleep apnea, says Italian study

Childhood obesity carries a lot of risks, especially later in life, and new research shows it can affect sleep early on.

A new study suggests kids who are significantly overweight are twice as likely to have obstructive sleep apnea. Those who don’t are even more prone to snore loudly. The results were published in the May issue of the journal Chest.

Italian researchers compared more than 800 elementary school- or preschool-aged children in Southern Italy. The study divided them into three groups based on their answers to a questionnaire about snoring.

Scientists classified 5.4 percent of the children as habitual snorers. 17 percent occasionally snored. A vast majority – 77.5 percent – did not snore at all.

The habitual snorers received screenings for obstructive sleep apnea. Only 14 children had the sleep disorder.

The researchers calculated each child’s body mass index (BMI) based on Italian growth charts. About 8 percent of the children were obese. 15 percent were overweight.

Through statistical analysis, it turned out 12.5 percent of obese children snored regularly. Only 4.6 percent of normal-weight children were considered habitual snorers.

3.1 percent of obese children included in the study had obstructive sleep apnea. That’s twice many as their peers.

These findings are counter to previous research published in the Journal of Clinical Sleep Medicine and reported in the Sleepeducation blog. An Australian study concluded obesity increased the risk for obstructive sleep apnea for teens but not younger children.

Obstructive sleep apnea is a serious disorder and the symptoms can be mistaken for common snoring. Children with OSA often appear to struggler to breath during sleep, with obvious pauses and gasps for breath.

Two percent of healthy young children have OSA, according to the American Academy of Sleep Medicine.

Learn more about obstructive sleep apnea in children or snoring. Get help at an AASM-accredited sleep center near you.

Image courtesy Angela Wylie, Melbourne Sunday Age

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Study links women’s waistlines with sleep habits

Swedish researchers have further proof that your sleep habits contribute to obesity. They found women who sleep less tended to have bigger bellies and waistlines.

Past studies have linked short sleep duration to higher body mass index (BMI) scores. In a study published in the May 1st issue of SLEEP, researchers wanted to learn the relationship between sleep length and quality and central obesity, a key risk factor associated with heart disease, diabetes and mortality.

Central obesity is measured by combining a person’s waist circumference with belly size.

The study took place in two phases. First more than 7,000 randomly selected women in Uppsala, Sweden answered questionnaires about their sleep disorders.

Researchers then randomly picked 400 of those women to take tests and answered another questionnaire about their lifestyle. More than half of those women were snorers.

Each subject underwent an extensive overnight sleep study in their own homes. They were free to choose when they would go to sleep and wake up. Researchers measured the women’s total sleep and length of time spent in REM and short wave sleep. They also assessed their sleep for episodes of sleep apnea.

The following morning, a nurse measured their waist circumference, sagittal abdominal diameter and BMI.

The researchers found centrally obese women were less active and had higher BMI scores. They slept less overall. The centrally obese women had less slow wave sleep and REM sleep.

The study noted the link between sleep and central obesity was stronger in younger people.

While these findings are further evidence there is a relationship between short sleep and obesity, the study has its limitations. It did not account for external factors like emotional stress.

Because researchers examined an existing population of centrally obese women, they could not pin down a causal relationship.

Read more about sleep and obesity on the Sleep Education blog.

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Blogging about obesity, apnea and your brain

America’s public health epidemic is getting more play in the New York Times. This time a blogger is making the case that obesity is bad for your brain.

The author references studies comparing brain scans of average and severely overweight people. Obese people, on average, tended to have smaller, more atrophied brains - a feature of dementia.

The blogger offers a list of suggested causes, included genetics and fat cell secretions that damages brain cells. Here at the Sleep Education blog we want to focus on an aspect the blogger only briefly mentioned: obesity, obstructive sleep apnea and brain function.

The disorder, most commonly affecting obese middle age men, has been linked to progressive brain damage. Men with untreated OSA have less brain gray matter, which may lead to cognition problems.

Stroke risk is also elevated. In a study published earlier this month, researchers found men with mild to severe forms of obstructive sleep apnea were nearly three times more at risk of having a stroke than their peers. For women, the risk for stroke only really increased during severe cases of sleep apnea.

Treatment options are available. The AASM recommends dietary weight loss combined with either CPAP or an oral appliance.

Find out if you have symptoms of sleep apnea and if you’re at risk.
Then go to sleepeducation.com to learn how CPAP therapy can save your life.

Get treatment at an AASM-accredited sleep center near you.

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Sleep Loss & Weight Gain: Genetic or Behavioral?

There is growing evidence linking chronic sleep loss with an increased risk of obesity. Short sleep durations are associated with higher body mass index (BMI) scores.

What is the nature of this relationship? Is it genetic? Environmental? Behavioral?

A new study provides some intriguing insight. The results were published last month in the Journal of Clinical Sleep Medicine.

The study surveyed 612 pairs of twins. Each pair was raised together in the same household.

They had an average age of about 37 years. They reported their height, weight and habitual sleep duration.

Results show that 25 percent of participants reported sleeping less than seven hours per night. These short sleepers had a higher average BMI (26.0) than those with a typical sleep duration of seven to 8.9 hours per night (24.8).

An adult with a BMI of 18.5 to 24.9 is considered to be at a “normal” weight. An adult who has a BMI of 25 to 29.9 is considered to be “overweight.”

The results were confirmed in an analysis of 423 monozygotic pairs. Each of these twin pairs shares 100 percent of their genetics. Short sleepers again had a higher BMI (25.7) than normal sleepers (24.7).

There also were 245 twin pairs that differed in their sleep durations. An analysis of these pairs also produced similar results. The shorter-sleeping twins had a higher BMI (25.8) than the twins who had a typical sleep duration (24.9).

How strong was the genetic influence on sleep duration? Further analysis produced a modest heritability estimate of 31 percent for sleep duration. In comparison, the heritability estimate for BMI was 76 percent.

There was little evidence of shared genetics between sleep duration and BMI. Common environmental factors also appeared to have little influence on the link between sleep and BMI.

The results support the idea that voluntary sleep restriction affects BMI. This effect appears to be independent of familial factors.

Do you know your BMI? Use the BMI Calculator on the left side of the blog to find out.

Read more about sleep and obesity and sleep and weight gain.

Image by Jodi Green

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Sleep, Weight & Abdominal Fat

A new study examined the relationship between sleep duration and abdominal fat in a group of Hispanic and African-American young adults. The results were published today in the journal Sleep.

The study involved 1,107 adults between 18 and 81 years of age. Data were collected from 332 African-Americans and 775 Hispanics. Sixty-two percent of participants were female.

Body mass index (BMI) and abdominal fat were measured at a five-year interval. Belly fat was measured using abdominal computed tomography (CT) scans.

Results show that the mean self-reported nightly sleep duration was 6.7 hours at baseline. Seventeen percent of the sample reported sleeping five hours or less per night.

There was no link between sleep duration and abdominal fat change in people older than 40 years of age. But short and long sleep durations were associated with increases in BMI and belly fat in people younger than 40 years of age. The association was strongest in people who reported sleeping five hours or less per night.

They had an average BMI increase over five years that was 1.8 kg/m2 higher than people who slept six to seven hours each night. They also gained more abdominal fat.

“Appropriate amounts of sleep are important for maintenance of healthy weight,” lead author Dr. Kristen Hairston told the AASM. “In a group of African-American and Hispanic participants, those who slept less than this had greater increases in belly fat over a five-year period.”

The CDC reports that blacks are 51 percent more likely to be obese than whites. Hispanics are 21 percent more likely to be obese than whites.

The authors proposed that short sleep may promote abdominal fat gain by increasing hunger and caloric intake. It also may increase fatigue and reduce energy expenditure. Both increased caloric intake and decreased vigorous activity were observed in the short sleep group.

The authors also suggested that doctors should educate young adults about the important role of sleep in a healthy lifestyle. This is most important when young adults transition to life stages that often involve sleep deprivation. These include entering college, getting married and having children.

Last year a study found that blacks had a 78 percent increased risk of obesity related to short sleep. The risk of obesity related to short sleep in whites was increased by 43 percent.

Read more about sleep and weight gain and sleep and race.

Image by Jen R

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Sleep, Weight Gain & Obesity

A large Japanese study examined the relationship between sleep duration, weight gain and obesity. The results were published this month in the journal Sleep.

The study involved 35,247 employees of an electric power company in Japan. They were evaluated at an annual health checkup in 2006 and 2007. Usual sleep duration was self-reported.

Typically obesity in adults is defined as having a body mass index (BMI) of 30 or higher. But in this study a BMI of 25 or higher was considered to be obese. This criterion has been proposed for Asia-Pacific populations.

Results show that about 36 percent of men and 12.5 percent of women were obese. About six percent of the non-obese men were obese at the one-year follow-up.

Short sleep duration was associated with both weight gain and the development of obesity in men. The men who reported sleeping less than five hours per night were 91 percent more likely to develop obesity than men who slept seven to less than eight hours. Men who slept five to less than six hours per night were 50 percent more likely to become obese.

“I believe the data are currently compelling enough to recommend good diet, adequate exercise, AND adequate sleep in people trying to lose weight,” wrote Dr. Najib Ayas in a commentary on the study.

Sleep and weight are interconnected in a variety of ways. A recent study suggested that short sleep may lead to weight gain by reducing exercise. And eating when you should be sleeping may lead to weight gain.

Adequate sleep may be associated with more healthful food choices. But short sleep may cause you to crave more high-calorie, high-carb foods. And it may affect the levels of the appetite-regulating hormones leptin and ghrelin.

Read more about sleep and weight gain and sleep and obesity.

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Let’s Sleep: Preventing Obesity in Children

Yesterday first lady Michelle Obama introduced the new “Let’s Move” campaign. She is taking on the issue of childhood obesity.

The campaign is backed by a presidential memorandum signed by President Obama. It establishes a task force on childhood obesity.



One key component of the Let’s Move campaign is to help parents make healthy choices. How can parents help their children maintain a healthy weight?

A new study suggests that one way it to make sure that children get enough sleep. This is one of three household routines that may help prevent obesity in children.

The study involved 8,550 children who were born in the U.S. in 2001. They were a part of the birth cohort of the Early Childhood Longitudinal Study. Data were collected in 2005 when the children were 4 years old.

Obesity was determined by their height and weight measurements. The study also examined their exposure to three household routines:

• Eating the evening meal as a family more than five nights per week
• Sleeping for at least 10.5 hours per night on weekdays
• Watching no more than two hours of TV or videos per day on weekdays

Results show that 18 percent of children were obese. About 58 percent of parents reported that their child slept at least 10.5 hours per night.

The rate of obesity was 36 percent to 37 percent lower in children exposed to any two or all three of the routines. Exposure to only one routine reduced the odds of obesity by 16 percent.

“The routines were protective even among groups that typically have a high risk for obesity,” lead author Sarah Anderson said in a news release. “This is important because it suggests that there’s a potential for these routines to be useful targets for obesity prevention in all children.”

So which of the three routines was most important? Anderson said that each of the three routines appeared to be helpful.

“What this suggests is that you can’t point to any one of these routines,” she said. “Each one appears to be associated with a lower risk of obesity, and having more of these routines appears to lower the risk further.”

In October the Sleep Education Blog reported on sleep duration and obesity in children. A recent study found that children who slept less than eight hours on weekdays were more than two times more likely to be overweight or obese.

Read more about sleep and obesity and sleep and children.

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Sleep Apnea & Obesity in Children and Teens

A new study shows that teens were more likely to have obstructive sleep apnea if they were overweight or obese. But obesity did not increase the risk for OSA in younger children.

The results were published today in the Journal of Clinical Sleep Medicine.

The Australian study involved 234 Caucasian children. They were between the ages of 2 and 18 years. Their height and weight were used to calculate their body mass index. About 62 percent of the children were boys.

The children were suspected to have possible OSA because of parental concerns about their snoring. Their sleep was evaluated during an overnight sleep study.

Results show that the risk for OSA increased 3.5 times for each increase in BMI score in children 12 years of age and older. But increases in BMI score did not raise the risk for OSA in children under the age of 12.

OSA was detected in 34 percent of the children who were between 12 and 18 years of age. About 53 percent of the children in this age group were obese.

The authors suggest that developmental changes during adolescence may explain the results. These changes include reductions in the muscle tone of the upper airway.

They emphasized that the results are specific to Caucasian children. Obesity and OSA may interact at other ages in other ethnic groups.

The authors also noted that tonsil size may interact with obesity to increase the risk of developing OSA. But snoring teens who are obese should be evaluated for OSA regardless of their tonsil size.

The AASM reports that about two percent of healthy young children have OSA. It occurs when soft tissue in the back of the throat collapses and blocks the airway during sleep.

Most children with OSA have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

In June the Sleep Education Blog reported that the causes of sleep apnea in children are complex. Sleep apnea often occurs when a child has large tonsils and adenoids. But weight and nasal problems also can play a role.

Learn more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

Image by Robert Hruzek

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Sleep Duration & Obesity in Children

A new study examined the relationship between sleep duration and obesity in children.

The study involved 5,159 children from 13 schools in Hong Kong; they had a mean age of 9 years. Sleep times and other data were collected using questionnaires.

Results show that children with shorter sleep durations had higher body mass index scores. Children slept for more than 10 hours at night on weekends and holidays; but they slept for only a little more than nine hours on school nights.

Children who slept less than eight hours during weekdays were more than two times more likely to be overweight or obese. The risk was highest in children who did not compensate for weekday sleep loss by sleeping longer on weekends and holidays.

The Sleep Education Blog has reported on a variety of factors that contribute to sleep loss in children. These include family status, prenatal influences, inactivity and watching TV.

Other studies also have linked sleep duration to the risk of obesity. So what is a parent to do?

Don’t wait for your child to “catch up” on sleep over the weekend; help him or her get more sleep during the week to avoid building up a sleep debt.

In July the Sleep Education Blog reported that children who go to bed after 9 p.m. take longer to fall asleep; they also have a shorter total sleep time.

So make sure your child has time to wind down and get in bed before 9 p.m. each night. One way to help is to turn off the TV and the computer earlier in the evening.

What helps your children get to bed early on school nights?

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