Obesity and depression may contribute to daytime sleepiness

Obesity and depression, not just lack of sleep, contribute to daytime drowsiness, according to Penn State College of Medicine researchers. Daytime drowsiness or sleepiness affects up to 30 percent of the U.S. population. It can reduce work productivity and cause car accidents. According to the States of Obesity report, 33.2 percent of Kentucky adults are obese.

The Penn State study used physiologic sleep data to show a connection between obesity and depression or sleepiness. Study participants filled out a comprehensive sleep history and physical examination and were evaluated in a sleep laboratory. "Obesity and weight gain predicted who was going to have daytime sleepiness," said Julio Fernandez-Mendoza, assistant professor of psychiatry at the Sleep Research and Treatment Center. "Weight loss predicted who was going to stop experiencing daytime sleepiness, reinforcing the causal relationship."

Body mass index and sleepiness association was independent of sleep duration, so obese people might be sleepy during the day regardless of how much sleep they get. Obesity is also associated with sleep apnea. The chief reason heavy people are more tired is that fat cells create immune compounds called cytokines that make one sleepy.

According to the study, depressed people have daytime drowsiness because they have trouble falling asleep and often wake up during the night. "The mechanism that we believe is playing a role here is hyperarousal, which is simply going to bed and being to alert; in other words, people with depression feel fatigued but do not necessarily fall asleep during the day, Fernandez-Mendoza said.

The study showed that a one-size-fits-all method for treating daytime drowsiness will not be effective. Daytime sleepiness doesn't always mean a person doesn't get enough sleep, Fernandez-Mendoza said. "The main causes of a sleepy society are an obese society, a depressed society and, to some extent, people who have a physiological disorder. By looking at our patients more closely, we can start personalizing sleep medicine."

KET will look Monday night at why lack of sleep is bad for your health, and offer advice on improving sleep quality

We live in a country where a third of adults report that they get less than six hours of sleep a night, which doesn't seem like a big deal until you consider the health risks that are associated with insufficient sleep.

The next edition of KET's "Health Three60" will explore these risks and advise how to improve your sleep quality. The program, "Sleepless in Kentucky," will air Monday at 10 p.m. ET.

Host Renee Shaw and guests will explore links between sleep deprivation and weight gain, diabetes, heart disease, cancer, skin issues, anxiety, concentration skills and impaired motor abilities. They will also look into how screen time (TVs and computers) affects sleep.

The show will discuss sleep apnea, treatments and what to expect in a sleep study. These issues will be examined by Jay McGuire, manager of the University of Louisville Physicians Sleep Center, and Dr. Egambaram Senthilvel, pediatric sleep specialist with University of Louisville Physicians.

The program will also examine how to improve sleeping habits by changing our sleep culture, including discussion about what can be done in schools and the workplace.

Other guests will include Dr. Phillip W. Bale of Glasgow Primary Care; Dr. Barbara Phillips, professor and medical director of the University of Kentucky Sleep Laboratory; and Dr. Mohamed A. Saad, director of the University of Louisville Physicians Sleep Center.

The series is funded in part by the Foundation for a Healthy Kentucky. (Read more.)

Number of sleep-disorder facilities growing as Kentuckians admit they're tired

The number of sleep-disorder facilities in Kentucky doubled from 25 to 52 in the past 10 years, part of a nationwide trend to help the 70 million Americans who have trouble getting some shuteye.

"Demand growth is a result of more physicians being better educated to recognize sleep deprivation symptoms as well as the public having more and better access to information and advertising that focuses on it," reports Anne Charles Doolin in an in-depth piece for The Lane Report. "Changes in insurance reimbursement also is playing a major part in the accredited facility surge."

Estimates show Americans suffer from more than 80 kinds of sleep disorders, though 85 percent of people are undiagnosed. "When we look at the most common sleep disorder, sleep apnea, we have evidence that demonstrates 25 percent of men are at risk and 9 percent of women are at risk," said Kathryn Hansen, executive director of the Kentucky Sleep Society.

In general, people don't think sleep problems can be fixed. "A typical patient is a male, in his 50s, slightly overweight," said Dr. Pam Combs, a cardiologist who has been studying sleep issues since the 1990s. "They don't think about sleep problems as the problem. They just think they're getting old and tired."

But not getting a good night's rest "is associated with a myriad of health conditions, and mental health conditions, and it undoubtedly affects productivity," said Dr. Ryan Wetzler, a clinical psychologist at Louisville's Sleep Medicine Specialists. "When you get a patient who has taken two hours to go to sleep for years or even decades, getting maybe four hours of sleep a night, and then with treatment they fall asleep quickly and get seven hours a night, it's a huge difference."

"Addressing the problem means less illness, less missed work and more productivity," said neurologist James M. Thompson. It's also less costly. Sleep disorders, sleep deprivation and sleepiness add up to about $15.9 billion to the national health care bill, the National Center on Sleep Disorders Research has found. "Other costs to society for related health problems, lost worker productivity and accidents can't be calculated, but educated guesses begin at 10 times NCSDR's health care cost tally," Doolin reports.

The assessment of sleep disorders has become more widely accepted as a field of study, with a recognized board exam, formal training programs and journals, said Dr. Barbara Phillips, director of the Sleep Center at the University of Kentucky Good Samaritan Hospital. But not all changes have been positive, with some fly-by-night "apnea mills" popping up "where the focus is on lucrative testing, and actual patient care and follow-up get shortchanged," Phillips said. (Read more)