Not only does obesity contribute to sleep problems, but sleep problems can also contribute to obesity. Building up a sleep debt over a matter of days can impair metabolism and disrupt hormone levels. Other studies have also demonstrated that sleep-disordered breathing is associated with glucose intolerance and insulin resistance.
Sleep deprivation activates a small part of the hypothalamus, the region of the brain that is also involved in regulating food intake are ghrelin and leptin. These hormones influence eating in different ways. Ghrelin is an appetite-stimulating hormone release mostly by the stomach. When ghrelin levels are up, people feel hungry. On the other hand, leptin, considered a satiety or fullness hormone, is released by the fat cells and informs the brain about the current energy balance of the body. When leptin levels are high, that sends a message to the brain that the body has enough food and hence the person feels full. Low levels indicate starvation and increase one's appetite. Both hormones are markedly dependent on sleep duration. Poor sleep results in a lower leptin level and higher ghrelin levels. This in turn causes an increase in appetite.
Failure to treat OSA could lead to increased cardiovascular risk and ensuing weight gain in the long run. The first line of therapy is to use nasal CPAP. CPAP will be used pre-operatively and continued post-operatively.
Obesity and Sleep Disorders: Implications for Bariatric Patients
Mahmood I. Siddique, DO, FACP, FCCP, FAASM, Iftekhar Mahmud, MD and Reshmi M. Siddique, PhD
