Sleep Yourself To a Leaner You?

Regular readers will appreciate the rapidly accumulating body of evidence linking much of the current obesity epidemic to a rather marked reduction in sleep that has befallen us all (not least our kids). In a commentary published in the Canadian Medical Association Journal (CMAJ), Jean-Philippe Chaput and Angelo Tremblay discuss this increasing evidence pointing to a critical role of sleep (or lack thereof) in weight management. As the authors note: “Chronic sleep restriction is pervasive in modern societies, and there is robust evidence supporting the role of reduced sleep as contributing to the current obesity epidemic. New studies provide evidence that insufficient sleep enhances hedonic stimulus processing in the brain underlying the drive to consume food; thus, insufficient sleep results in increased food intake. In addition, lack of sleep has been reported to decrease plasma leptin levels, increase plasma ghrelin and cortisol levels, alter glucose homeostasis and activate the orexin system, all of which affect the control of appetite and might compromise the efficacy of dietary interventions.” Although interventions focusing on sleep are still scarce, they do discuss one randomised controlled trial in which decreased sleep (5.5 vs. 8.5 hours) together with a calorie-deficient diet resulted in amost 60% less weight loss than in the long sleepers. In another study, participants in a 6-week weight loss intervention who reported better sleep and/or sleeping at least 7 hours experienced almost 35% more weight loss than those who did not. As the authors point out: “The Canadian Obesity Network recently launched a set of practitioner tools — the 5As of Obesity Management (ask, assess, advise, agree and assist) — that highlight the importance of addressing sleep for weight management.” They recommend the use of the Pittsburg Sleep Quality Index for screening and diagnosing common sleep/wake disorders and remind clinicians that the association between inadequate sleep and obesity can also be confounded by factors such as stress, depression, psychosocial problems, chronic illness and the use of hypnotic agents. Reason enough to go well beyond ‘eat-less-move-more’ (ELMM) recommendations on obesity management. AMS Edmonton, Alberta photo credit: Michael Sissons via photo pin cc

Electronic Entertainment and Communication Devices Deprive Kids of Sleep and Make Them Fat?

Lack of sleep is emerging as one of the key drivers of the obesity epidemic (probably right behind lack of time). This is perhaps even more true for kids. A study by Chahal and colleagues from the University of Alberta School of Public Health, published in Pediatric Obesity, shows that both the availability and night-time use of electronic entertainment and communication devices (EECDs) are strongly associated with short sleep duration and obesity among Canadian children. The researchers examined data from a representative sample of 3398 grade 5 children in Alberta and used a random effect models to assess the associations of night-time access to and use of EECDs with sleep, diet quality, physical activity, and body weights. Two out of three kids had access to one or more EECDs in their bedroom, which in turn was associated with shortened sleep duration, excess body weight, poorer diet quality, and lower physical activity levels. In light of these findings, the authors discuss whether… “…limiting the availability of EECDs in children’s bedrooms and discouraging their night-time use may be considered as a strategy to promote sleep and reduce childhood obesity.” Such efforts would be in line with the existing recommendations pertaining to TV and Internet access by the American Academy of Pediatrics and suggest to have these be expanded to restricted availability of video games and smart phones in children’s bedrooms. If you thought taking away unhealthy foods from your kids was difficult – just try taking away their smart phones, TVs or computers. I wonder if any of my readers have managed to actually do this and if this has had any positive effect on their kids health. AMS Edmonton, Alberta photo credit: soopahgrover via photo pin cc Chahal H, Fung C, Kuhle S, & Veugelers PJ (2012). Availability and night-time use of electronic entertainment and communication devices are associated with short sleep duration and obesity among Canadian children. Pediatric obesity PMID: 22962067 .

People Who Sleep Less Drink More

Earlier this week I blogged about the possible deleterious impact that sleep deprivation, alcohol intake and TV watching can have on food intake. Now a paper by Jean-Phillipe Chaput and colleagues from the University of Ottawa, published in the APPETITE, suggests that sleep deprivation in turn may contribute to increased alcohol consumption. This cross-sectional study looked at the association between sleep duration and alcohol consumption in adults (301 men and 402 women aged 18 to 64 years) from the greater Quebec City area. Participants categorized as short- (⩽6 h), compared to average- (7-8 h) or long- (⩾9 h) duration sleepers, consumed significantly more alcohol and had greater odds of odds of exceeding the recommendations for sensible weekly alcohol intake of 14 drinks for men and 7 drinks for women, even after adjusting for relevant confounders. While this relationship was evident in both sexes, binge drinking (i.e. ⩾5 drinks on one occasion) was more common in men than women. Thus, men sleeping less than 6 hours per night with a disinhibited eating behavior were more likely to report binge drinking (41%). Based on these findings the authors suggest that the combination of short sleep duration with disinhibited eating behavior is associated with greater alcohol intake in adults, findings that can certainly further explain the strong relationship between not getting enough sleep and weight gain. Perhaps counselling patients on sleep hygiene may do more for them than asking them to simply eat less and move more. AMS Edmonton, Alberta Chaput JP, McNeil J, Després JP, Bouchard C, & Tremblay A (2012). Short sleep duration is associated with greater alcohol consumption in adults. Appetite PMID: 22841812 .

Edmonton company helping obese people sleep easier

“I think there’s a huge market for this because like it or not, we’re talking about hundreds of thousands of Albertans or Canadians who weigh more than 250 pounds,” Sharma said. “It’s a good example of how an organization like the Canadian Obesity Network and obesity experts can partner with local industry to create products that are meaningful. We’re quite proud of this.”

Unique Mattress Provides Deep Sleep For Heavy Sleepers

One of the things I love most about my job is the opportunity to be involved in a wide range of projects, all aimed at improving the lives of individuals living with severe obesity. After hearing persistent complaints from my patients about their inability to find suitable beds or mattresses that would easily bear their considerable weight, I began to pursue the idea of finding a mattress manufacturer, who may be able to design a mattress that would meet their needs. It turns out that I did not have to look very far. Right here in Edmonton, Araam Inc. manufactures a range of standard and custom made mattresses. Surprisingly enough, this company even holds a Royal Warrant from Her Majesty Queen Elizabeth II, making them the only bed manufacturer to actively supply the British Royal Family and the Royal Household with their Hypnos brand of mattresses (also found around the world in the finest palaces, estates and hotels). Our project started with focus groups in which several of my patients and ergonomy experts from the Canadian Obesity Network met with the mattress folks in their West-Edmonton showroom to first discuss the limitation of current mattresses and determine the specifics of an ideal ‘bariatric’ mattress for home use. Based on the input from this focus group Araam then produced five prototypes from a wide range of materials and specifications, which was followed by another in-house focus group session to test the prototypes. However, given the wide range of shapes and sizes of 250+ lb individuals with varying dimensions around the upper, mid and lower section of their bodies, it turned out that the prototype that felt great around the head and shoulders, was too firm around the butt. The prototype that felt great around the calves and feet was too soft in the mid section. It soon became clear that any single mattress would simply not be good enough. For this Araam came up with a novel solution: a mattress that consists of three separate sections, each of which can be chosen to suit the specific dimensions and needs of each body section. The final product is then fused together into a single mattress that exactly meets the individual needs of each client. With four materials to chose for each section (memory foam, memory foam plus, latex, gel), each providing a different level of support, aeration, and firmness, clients can literally… Read More »