Medical Barriers: Sleep Disorders

Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.

This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.


Physical co-morbidities are common in people with obesity and need to be addressed as part of any weight-management plan. Co-morbidities associated with obesity will improve as weight is controlled, but often make it difficult for patients to undertake the effort required for lifestyle-based weight management. In some cases, these physical barriers to weight loss may be insurmountable and the focus of treatment should, from the outset, aim to prevent weight gain rather than achieve weight loss. Strategies for obesity treatment should always be adapted to the patient’s particular situation to make it easier for them to cope with required changes over the long-term.


Sleep disorders are very prevalent among obese people. Obstructive sleep apnea is the most common disorder, but disturbed sleep may also be due to primary insomnia, or insomnia secondary to medications, medical or psychiatric disorders.

Sleep deprivation is linked to obesity. The primary putative connection can be found in the neuroendocrine regulation of appetite and food intake. Neuroendocrine regulation appears to be influenced by sleep duration and sleep restriction, with sleep deprivation favouring obesity as it increases serum cortisol and decreases serum leptin levels. Another reason for the sleep disorder-obesity connection may be simply that the more time a person spends awake, the more time they have in which to eat.

Insufficient sleep causes important neurocognitive changes such as excessive daytime sleepiness, fatigue and altered mood. These may, in turn, have a significant impact on the patient’s ability to persist with healthy lifestyle changes such as increasing their level of physical activity or taking the time to cook a healthy meal.

© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.

The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.

Members of the Canadian Obesity Network can download Best Weight for free.

Best Weight is also available at Amazon and Barnes & Nobles (part of the proceeds from all sales go to support the Canadian Obesity Network)

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