Too Much Weight, Too Little Sleep

Being overweight is a risk factor for sleep apnea.
Too Little Sleep

We Americans, by and large, are tired. Most of us don’t get the recommended seven to eight hours of sleep a night. But too many Americans don’t realize their poor sleep may be caused by a medical condition like sleep apnea, a common disorder that causes your breathing to stop or get very shallow for a few seconds or minutes and may occur 30 times or more an hour. Kristin Fless, M.D., a pulmonary and sleep medicine specialist with The Center for Sleep Disorders at Saint Barnabas Medical Center, says that about 10 percent of the population has been diagnosed with sleep apnea. “But that could be grossly underestimated, because having a body mass index (BMI) over 25 is a risk factor, and an estimated 65 percent of Americans have a BMI over 30,” she says.

Indeed, body weight and sleep have a complicated relationship. Excess weight may impair sleep, and too little sleep in turn affects weight. “A few days of sleep deprivation can change the way the body responds to food,” Dr. Fless says. “We get a response that mimics how diabetics respond to glucose. We also know that patients who are treated for sleep apnea have a decrease in abdominal fat, which is the metabolically active fat. This is probably related to insulin resistance, which can be seen with that sleep deprivation.”

Kristin Fless, M.D.

Kristin Fless, M.D.

Sleep apnea and other sleep disorders may cause even more serious problems. “If not treated, people with sleep apnea have eight times the risk of mortality of those without the condition,” she says. “Sleep apnea increases the risk for stroke, heart disease and motor vehicle mortality. That’s the danger if people don’t recognize that their fatigue could be a sign of a treatable medical problem.”

Treatable is the operative word. The most common treatment for sleep apnea is called continuous positive airway pressure (CPAP ). A CPAP device pumps air under pressure through a face mask and into the airway of the lungs, keeping the windpipe open during sleep. Other treatments include using a customized mouthpiece to hold the lower jaw and tongue forward to keep the airway open. “Newer technologies include a pacemaker-like device that stimulates the upper airway muscles,” Dr. Fless says. In some rare instances, surgery may be needed to remove oversized tonsils or other soft tissues.

A sleep study is the best way to diagnose a sleep disorder, and patients have the option of conducting a study in their home rather than in a sleep lab. “We now have very good technology for home sleep studies with results comparable to lab studies,” she says. “We show people how to use the equipment, and they take it home and bring it back to the lab the next day.”

To find out more about the Center for Sleep Disorders at Saint Barnabas Medical Center, please call 973.322.9800 or visit

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