Hormones and Sleep
By Dr.
Michael A Barnett
December
19th, 2013
Obesity has
reached epidemic proportions nationwide, and Kentucky’s ranking in the top 10
most obese states is a reason to be concerned about Obstructive Sleep Apnea and
the relationship to obesity. Several studies have shown that obesity can be a
dominant factor in as many as 50% of the people with Obstructive Sleep Apnea
(OSA). The circumference of a person’s neck is a predictive marker for obesity.
Men with neck circumferences over 17” and women greater that 16”are more likely
to be obese which in turn increases the risk of having OSA. With OSA, the sleep
cycle is interrupted several times throughout the night, which can have a
definite affect on the endocrine system.
Many hormones associated with obesity, appetite, and metabolism are
affected, which in turn can possibly link obesity and OSA.
Insulin is a hormone
produced by the pancreas, which is vital in regulating carbohydrate and fat
metabolism in the body. Insulin causes
cells in the muscle, liver and fat tissue to take up glucose from the blood
storing it as glycogen in the muscle and liver.
Quite simply, high insulin levels cause fat storage. Frequently patients with OSA have what is
called insulin resistance that can cause increased waist size, elevated blood
pressure and a host of other features. It has been suspected that OSA may be an
important factor in diabetes.
Growth Hormone stimulates
growth, cell reproduction and regeneration.
This hormone is secreted only when someone is in the deeper stages of
sleep. Patients with OSA have fragmented or multiple interruptions in the sleep
cycle and frequently do not get to the deeper stages of sleep required to have
the growth hormone secreted.
Melatonin is secreted by
the pineal gland in response to darkness and is a very potent antioxidant. Its main function is to induce sleep but it
also functions to enhance the affects of Leptin in the body, which suppresses
appetite and promotes weight loss.
Prolactin produced in the
pituitary gland is an important regulator of the immune system. It is secreted 3-4 hours after the release of
melatonin. Late nights which mean later
melatonin secretion results in later prolactin secretion, which in turn upsets
the entire cycle. This can lead to increased carbohydrate cravings and an
increase in the level of insulin. When you wake up with high insulin levels you
frequently have a tendency to skip the important meal of breakfast.
Cortisol (hydrocortisone)
is a steroid hormone that is released in response to stress and a low level of blood
sugar. The primary function of Cortisol
is to increase blood sugar. Patients with sleep deprivation frequently have
elevated cortisol levels and therefore can trigger a series of negative events
in the sleep cycle to happen.
Dentists practicing dental
sleep medicine are committed to proper screening with specialized equipment
such as a rhinometer and pharyngometer, diagnosis by a board certified sleep
specialist M.D, and a commitment to helping patients manage their OSA.
Encouraging patients to go
to bed by 10 p.m. in a room that is cool, dark and quiet could possibly be one
of the best suggestions to improve health of an individual. The understanding
of the roles of the hormones and sleep can help achieve a better level of
health. Weight loss may be recommended
as a treatment for OSA, but OSA treatment may well be a very important
component of weight loss as well.
Providing this level of service to our patients, we play a vital role in
both directions of the obesity epidemic.
The
Importance of Sleep Wellness
By Dr. Michael Barnett
November 15, 2013
The importance of
sleep in physical health has been a fundamental principal of common medical
knowledge for centuries. Sleep allows our bodies to relax, rejuvenate,
and dream, thus permitting the mind to work in a more efficient way.
While we sleep our bodies undergo a very important restoration of critical
systems of our body. As we sleep our bodies burn calories, create vital
hormones, as well as a vast array of chemical processes that keep our bodies
balanced. When there is a lack of this important process of SLEEP, we
frequently see a decline in one’s wellness.
The
compromise of not having a healthy sleep seems to frequently be the norm in
today’s busy society. This lack of health sleep is an extremely large
percentage of the population is causing widespread concern in the medical
community. Sleep frequently is the topic of conversations with our health care
professionals. We even read articles on sleep in popular magazines such
as Time, Newsweek, and US News and report. Recently was a special report
on sleep presented on CNN narrated by Dr. Sanjay Gupta. We realize as a
medical community the consequences of lack of sleep such as weight gain,
headaches, inability to concentrate, hormonal imbalances and even depression
are found to be frequently linked to a lack of sleep.
There
frequently is a serious physiological cause of lack of sleep that exists called
airway obstruction. An airway obstruction at night results in what health
care practitioners call Sleep Disordered Breathing. Everyone is at risk,
and snoring is an alert call which may signal a greater problem. A severe
airway condition called Obstructive Sleep Apnea (OSA), is a commonly
undiagnosed disorder, and in many cases may be fatal when not treated.
Around
the world dentists are quickly becoming the first line of defense in raising
awareness of Sleep Apnea. Dentists can frequently offer treatment
options, such as Oral Appliance Therapy (OAT) to treat snoring and sleep apnea,
which can actually save lives! Many dentists have become experts in these
areas and continue to strive to improve the quality of life for many
patients. Dental professionals are learning to identify everyday signs
and symptoms of Sleep Apnea. Using specialized equipment to assist in the
diagnostic process dentists are able to put the patient through proven evidence
based protocols to help the patient with their sleep issues.
If
you are one of the many Americans who desperately need better sleep wellness,
or even believe you may have Sleep Disordered Breathing issues, ask your
dentist if they screen and treat sleep apnea. It may be one of the most
important questions you ever ask your dentist!
Diabetes and Sleep Apnea – Are you
tired of being tired?
By Dr. Michael Barnett
October 21, 2013
Meet Henry
Age: 40
Health: Henry
suffers from diabetes, loud snoring and daytime fatigue.
Do you suffer the same symptoms as Henry? Henry, like 65% of patients with
diabetes, suffers from sleep apnea. In addition, 40% of the 65% of the diabetic
patients have been diagnosed with moderate to severe sleep apnea.* Here is a
wake-up call to the millions of American men and women with type 2 diabetes:
Snoring at night or nodding off during the day may be symptoms of obstructive
sleep apnea. Millions of adults are affected by sleep apnea, and when present
with other conditions could have serious negative effects.
Sleep
Apnea is a sleep disorder that is characterized by abnormal pauses in breathing
or abnormally low breathing during sleep. Each pause in breathing, called
an apnea, can last from at least 10 seconds to minutes, and may occur 5 to 30
times or more an hour. If you suffer from high blood pressure, diabetes,
heart trouble or are overweight, managing your sleep apnea can improve all of
these conditions and make you feel better!
Sleep
apnea occurs when the muscles in the back of your throat that support the soft
palate, tongue, tonsils, uvula, and the side walls of your throat relax.
The airway narrows when these muscles relax when you breathe in which makes it
difficult to get an adequate breath of air in. Frequently the oxygen level in your
blood can lower when you are unable to get an adequate breath. A series
of events may happen if your brain senses that you are unable to breathe.
When the brain senses that you need to breathe it rouses you from sleep so that
your airway is able to open. Frequently when this happens you are not
even aware of it. You may also experience choking, gasping, or a snorting
sound. This pattern may repeat itself all night from 5 to 30 or more
times per hour all night long. When you are not able to reach the deep restful,
reparative levels of sleep you may feel sleepy during your waking hours.
If
you have sleep apnea, it means you are having difficult time breathing during
sleep. The airway either becomes too narrow for sufficient air to reach
your lungs, or it closes completely. In either case, you are NOT getting
the oxygen you need during sleep. Sleep apnea puts a tremendous
burden on the heart, is conclusively linked to high blood pressure and in
addition to causing heart attacks, is suspected of causing heart failure and
makes it difficult to manage diabetes. Sleep apnea also causes
sleepiness, which can result in mood swings, difficulties at work or school,
and even motor vehicle accidents.
What happens if sleep apnea is left untreated?
· Increases
risk for high blood pressure, heart attacks, heart failure and strokes.
· Fatigue-related
work and motor vehicle accidents
· Decreased
quality of life
The Good News: Sleep Apnea can be managed! You can now have an
overnight sleep test that is taken at home in your OWN bed that is given to you
by a trained DENTIST, with a diagnosis made by a sleep physician. Often
recommended treatment is Oral Appliance Therapy as a result of the information
captured by the overnight sleep test. Frequently patients who are wearing
the oral appliances experience a tremendous increase in the quality of their
life! Many patients are thankful for treatment that provides greater control of
diabetes as well as improving a much better night’s sleep!
Oral
appliance therapy is the most widely accepted treatment for sleep apnea.
An oral device is designed to keep upper airways open to prevent apneas.
Oral appliance therapy treatment does NOT involve drugs or surgery, and helps
hundreds of thousands of people worldwide enjoy healthier sleep and a healthier
life. Many patients experience the benefits quickly- often after the
first night’s use. There is no cure for sleep apnea at this time, there are
only ways to manage it.
Do you have any of the following symptoms?
o
Excessive daytime sleepiness
o
Loud, disruptive snoring
o
Restless sleep
o
Men neck size greater than 17”
o
Women neck size greater than 16”
o
Difficulty concentrating
o
Depression or irritability
o
Morning headaches
o
Type 2 Diabetes
o
High blood pressure
o
Stop breathing during sleep
o
Weight change (in the last 5 years)
o
Nodding/ falling asleep driving a vehicle
o
Memory Loss
o
Sexual dysfunction
If
you have noticed two or more of these symptoms, you may suffer from Obstructive
Sleep Apnea (OSA).
If
you have questions about sleep apnea or would like to see if oral appliance
therapy is right for you please contact our office.
If
you have questions about sleep apnea or would like to see if oral appliance
therapy is right for you please contact our office.
*
Information from this article was obtained from the National Institutes of
Health, American Academy of Dental Sleep Medicine and the American Diabetes
Association. www.nih.gov, www.aadsm.org, www.diabetes.org.