How Sleep Apnea Drives Weight Gain, Memory Loss, High Blood Pressure, ADHD, And More

Coming up on this episode of the Doctor's Pharmacy.

One of the important things that happens with sleep apnea is it impacts REM sleep the most. And in REM sleep is where you're consolidating memory. And if you're not getting REM sleep, it's going to make it harder for you to function the next day. Not only are you going to be fatigued, but that part of your brain responsible for memory isn't going to be working as well. You're going to forget your keys, you're going to forget your tasks. you're gonna read something and forget what you just read. And that's sleep apnea. And it's underdiagnosed.

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Much as I do. Now let's get back to this week's episode of the doctor's Pharmacy. Hi, I'm Kaya perowit, one of the producers of the doctor's Pharmacy. Getting quality sleep is such a critical component of our overall health and well-being so it only makes sense that people who are affected by sleep apnea are in of developing a dangerous array of issues spanning from weight gain to cardiovascular disease, mood disorders, poor immune function, and much more. This is a topic that has come up often in Dr. Hyman's conversations with his colleagues at the Ultra Wellness Center, including when he sat down with Dr.

George Papamichael to discuss high blood pressure and anxiety. We know some of the major causes of high blood pressure are never addressed.

Right.

And the two biggest ones that I see treating patients is insulin resistance.

Sleep apnea. And sleep apnea. Yeah, so sleep apnea, there are about 25 million Americans that have sleep apnea. It is underdiagnosed. It's not just a disease of people that are overweight. Most people think about obstructive sleep apnea being related just being overweight, but you also can have upper respiratory anatomy and muscular relaxation that even if you're thin, you can have obstructive sleep apnea.

Yeah, you have a narrow palate, a small airway, you have sinus issues. And when you have sleep apnea, that.

Means you're just not getting enough oxygen to your body, particularly your brain, also to your, you know, to all your blood vessels and your cortisol levels rise. And then you get into that whole cycle you talked about before, which is an inflammatory cycle, which is an oxidative stress cycle, which can lead the hardening of the arteries. And when you're not getting oxygen to those blood vessels, then they're actually actually can't perform the work they need to do and create the energy they need to have. And so they can't contract and expand the way they should, and that can result in high blood pressure.

Yeah, and then it also drives insulin resistance. So if you have sleep apnea, it.

Also causes you to be prediabetic. Yeah, it causes- Independent of what you're eating, weight gain.

Weight gain leads to insulin resistance, it leads to diabetes, which complicates everything. So if you're falling asleep at work, if you're falling asleep in front of the TV, if you feel tired during the day, if your wife says you're snoring, and now there's apps you can get that actually record your, you're on your phone that record your snoring. So you can see because people don't believe it.

I don't snore.

And then I love that. And then it's one called sleep cycle that I like. It's record your snoring. And, and, and it, it, it's something that is easy to treat. I mean, there's different methods, CPAP and, you know, but, but it is a treatable condition and the weight loss then will happen and you'll feel better.

So tell us about this patient. He's 32. So yeah, so he's a 32 year old and he came in with his partner, his wife, and they, his major complaint was, I have panic attacks, particularly at night. And when I'm having panic, I'm also feeling bloated and distended.

Oh, interesting. So in this case, the patient had more psychological issues, ADD and anxiety.

And the bloating, that was definitely the SIBO was driving. The SIBO was driving part of the anxiety. Then he also had the gluten sensitivity, which causes a leaky gut. And there was another piece to this is that he had sleep apnea. The sleep apnea piece is like another critical piece. I just have to say the one thing about sleep apnea is that, you know, what sleep apnea is, it's pauses in your breathing that happen intermittently and frequently when you're sleeping. And when that happens, you have a lack of oxygen to your brain and you have disrupted sleep so that your brain can't do important things. And one of the important things that happens with sleep apnea is it impacts REM sleep the most. And in REM sleep is where you're consolidating memory. And if you're not getting REM sleep, it's going to make it harder for you to function the next day. Not only are you going to be fatigued, but that part of your brain responsible for memory isn't going to be working as well. You're going to forget your keys, you're going to forget your tasks, you're going to read something and forget what you just read. And that's sleep apnea. And so, and it's under diagnosed. We think that it's only obstructive sleep apnea, which is one of two forms of sleep apnea, only occur in obese people, but it can occur in thin people because it's not just the weakness of muscles in the throat that cause.

It, but also the upper airway.

And your airway is narrow or something. Right, yeah. And so he had sleep apnea and he'd been snoring all his life.

Point being is sleep apnea- maybe it's ADD and anxiety was probably related to his sleep.

He always steal my thunder, Mark. No, it's good.

He's like, read your mind.

Yeah, you read my mind.

So.

It'S very possible that his snoring as a kid was driving his ADHD, right? And as you age, we have a lot of adults that are being diagnosed with ADHD. Some of them had it all their life, some of them are developing it because of their sleep apnea.

Dr. Hyman further explored the way sleep apnea can negatively affect our health with Dr. Elizabeth Boham and nutritionist Maggie Ward.

Well, you had this other patient you had that, that was, was a male who really struggled. He was overweight, about 40 pounds. So tell us about him.

Yeah. So, you know, he came in and he was, he was, he was 55 and he was really struggling with his energy. He was very low energy. He was really frustrated with his, his sexual function. He noticed he had a low libido. He was having some erectile issues. He had gained, he gained these 40 pounds around his belly, but he was really having a hard time with with losing them.

So he had all these other issues and you sort of figured out that he had insulin resistance too that we were talking about.

Yeah, I mean the first thing we did with him was put him on that 10-day reset that you've put together, which really I think is a great jumpstart for people because it can help them say, okay, I'm just gonna, I gotta try this, but I need the tools, I need the map to do it.

Yeah.

It's really motivating because many times, because people were eating inflammatory foods before or they were eating the wrong foods at the wrong time, right? And they do this and they notice a significant improvement in how they feel. And he felt really motivated. He was really happy. But you know, he actually had a lot of other things going on. So he had lost some weight, but then we also noted, we also, you know, through questions, we found out that, okay, he might have some issues with sleep. He was snoring, his blood pressure was a little high, he had all this weight gain. So I said, you know what? We really need to get a sleep study on you. And so when we did the sleep study, we found out that he had sleep apnea.

Which is so common and underdiagnosed.

Yes, and sleep apnea where people stop breathing in the middle of the night even though they don't realize it, right? They're snoring and then they have apnea. episodes of apnea where they don't get any oxygen into the body, that in and of itself triggers insulin resistance. So that causes high levels of insulin in the body, which then as we've been talking about, causes us to gain weight around the belly.

So wait a minute, so what you're saying is if you don't sleep, you get fat even if you don't change your diet? Absolutely. This is something people need to realize because people think it's again, it's about what you eat and exercise. and yes, it is, but there are other factors that have to be looked at that most doctors miss.

So often when somebody has sleep apnea or might have the signs of sleep apnea, they think, okay, I'm just gonna lose weight and then it will go away, right? But so often it's the sleep apnea that's causing the weight gain. And of course it becomes a vicious cycle, but that sleep apnea causes high levels of inflammation in the body and it causes high levels of insulin and it just causes us to put on weight.

And it also is one of the biggest causes of high blood pressure. That's not true. Absolutely. I remember this one guy I had, it was like a lawyer who was in his 50s and he's like, you know, Mark, I have to work at my desk, but I have a standing desk because, and this is before standing desks were popular, because if I sit down, I fall asleep. And I'm like, you fall asleep driving home? You fall asleep watching TV? You snore? He's like, yeah, yeah, yeah, yeah. I'm like, you need to have sleep apnea.

Let's get you tested. We got him a CPAP machine. He lost 50 pounds.

Just boom like that, putting on a sleep apnea machine every night.

Right, right, because you're actually getting oxygen into the body, so the body's not at stress anymore. And so the insulin levels come down, the inflammation comes down in the body, and then the weight comes off. I think when people have undiagnosed sleep apnea, when it's not being treated, we can do all these great things in terms of shifting their diet and putting them on an exercise regimen and looking for other issues, but if we don't deal with that, It's almost like I always say to them, it's like you're running against the wind. You're not gonna get to your goals. Yeah, absolutely. And so we've gotta deal with the sleep issues.

And like you said, it's so common. So this woman, she's a 64 year old woman who I've been working with for a while, dealing with some weight gain. That was one of her main concerns. I mean, mild, about 20 pounds overweight, kind of came on around menopause for her. But she also had a very long history of reflux, had been on different medications. Heartburn, right? Right, Harper. So, you know, what I did with this woman, you know, to start was, because she really wasn't aware of if certain foods really bothered her around the reflux. You know, she said alcohol for sure, more stress, she would notice it. So we started with an elimination diet. The other thing I wanted to point out, and this is more of a medical piece, but in the packet that we ask clients to fill out and patients fill out, there's many, many questions there that we ask, and she had said that she snores at night. So, I didn't get into that much in that first appointment, but I did when I sent her her plan. I said, you can talk to your doctor about maybe doing a sleep study because she also had high blood pressure. That weight was there. We know that sleep apnea and things can cause weight gain along with the blood pressure and her fatigue. She said she was sleeping a fair amount, but when you're tired, you start thinking, okay, how good is that sleep?

I want to stop you there for a second because I think what people should understand is that is that sleep apnea is very common. It's underdiagnosed. It causes high blood pressure. It causes prediabetes. And the treatment with CPAP or breathing machine that helps you stop the snoring and opens your airways and literally will help people lose weight, lower blood pressure and feel better without even changing their diet.

Right.

And that's the thing. I think food is always going to be part of the solution for people. But many times there's multiple variables and you have to kind of be a detective. And I think that's what we do in functional medicine is look at these other pieces. I mean, there might be things I can't really address from a nutritional standpoint, but I can guide people, talk to your physician, look at this, look at that. And again, we were talking about doing the sleep study to look at that possible sleep apnea. And also say, talk to your doctor about getting some of these other tests. And many doctors are willing to work with their patients if they request these things.

Sleep apnea is most common in men between ages 40 and 70, and in people who are overweight. Smoking, drinking alcohol before bed, being in menopause, and having nasal congestion can also raise your risk of sleep apnea. The good news, however, is that sleep apnea can be treated. The most common treatment is a device called a CPAP, which stands for continuous positive airway pressure. It keeps your airway from collapsing at night and stopping you from breathing. Treating sleep apnea is relatively simple, but the results can be life-saving. To learn more about anything you heard in today's episode, I'd encourage you to check out Dr. Hyman's full-length conversations with Dr. George Papapolydorou, Dr. Elizabeth Boham, and Maggie Ward.

Thanks for tuning in.

Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. this podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed.

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