Obesity, Depression Blamed for Daytime Sleepiness ‘Epidemic’

WEDNESDAY, June 13 (HealthDay News) — Obesity has been linked to
a host of health problems including heart disease, diabetes and certain
cancers, and now new research adds excessive daytime sleepiness to this
list.

Well-publicized risks associated with excessive daytime sleepiness
among adults include accidents caused by drowsy driving and workplace
injuries.

The new, related studies found that the main drivers of daytime
sleepiness are obesity and depression. The findings are scheduled to be
presented Wednesday at the Associated Professional Sleep Societies annual
meeting, in Boston.

“The ‘epidemic’ of sleepiness parallels an ‘epidemic’ of obesity and
psychosocial stress,” study author Dr. Alexandros Vgontzas, of Penn State
Hershey Sleep Research Treatment Center, said in a meeting news
release. “Weight loss, depression and sleep disorders should be our
priorities in terms of preventing the medical complications and public
safety hazards associated with this excessive sleepiness.”

Two studies included the same group of 1,741 adults. Of these, 1,173
did not have excessive daytime sleepiness when the study began and 222
did. Depression and obesity were the main risk factors for “new-onset”
excessive sleepiness after 7.5 years of follow-up. Weight gain was the top
predictor for persistent daytime sleepiness during the same time frame.
The rate of new-onset excessive sleepiness was 8 percent, and the rate of
persistent daytime sleepiness was 38 percent When sleepy individuals lost
weight, they were less tired during the day.

The findings in the first two studies were backed by a study of 103
healthy volunteers, which took place over four nights in a sleep
laboratory. It also pointed to obesity and depression as risks for
sleepiness, the researchers report.

Dr. Scott Kahan, director of the National Center for Weight and
Wellness in Washington, D.C., said that the link between obesity and sleep
is a complex one. “This study adds further weight to the fact that it is
likely bi-directional.” This means that obesity could be the chicken or
the egg. “Obesity and weight gain affect sleep, and poor sleep affects
weight from a physiological and behavioral perspective,” he said. For
example, “when you are exhausted, it’s hard to care about whether you eat
a carrot or a Ho Ho,” he said.

People who are overweight or obese are also at higher risk for sleep
apnea, a condition marked by pauses in breathing during sleep. This can
result in excessive daytime sleepiness. But there is more to the
connection between sleepiness and obesity than sleep apnea alone, said Dr.
Michael Breus, a sleep expert based in Norfolk, Va. “There are more sleepy
people in the world than cases of sleep apnea,” he noted.

“We have to slim down as a nation,” he said. “One of the effects will
be a relief of excessive daytime tiredness and a mild decrease in
depression.” Sleep problems and depression are also inextricably linked,
he said: “When we put people with depression and insomnia on an
antidepressant, the insomnia gets better as does their depression, and
then you are not as sleepy during the day.”

Dr. David Kuhlmann, medical director of sleep medicine at Bothwell
Regional Health Center in Sedalia, Mo., agreed. “Weight loss should
improve the level of daytime sleepiness and this study would support
that,” he said.

Because this research was presented at a medical meeting, the data and
conclusions should be viewed as preliminary until published in a
peer-reviewed journal.

More information

What is excessive daytime sleepiness? Find out at the National
Sleep Foundation.

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