The Dr. Hyman Show - How Sleep Apnea Drives Weight Gain, Memory Loss, High Blood Pressure, ADHD, And More

Episode Date: June 25, 2021

How Sleep Apnea Drives Weight Gain, Memory Loss, High Blood Pressure, ADHD, And More | This episode is brought to you by ButcherBox Sleep is a major cornerstone for an energetic, joyful, healthy life. Unfortunately, millions of people are affected by a condition called sleep apnea and an estimated 80% of cases go undiagnosed. Sleep apnea is an extreme form of sleep deprivation where you wake up several times throughout the night. You can’t sleep, you can’t breathe, and as a result, you lack oxygen. You don’t even realize you’re waking up throughout the night. This lack of sleep drives weight gain and blood sugar imbalances. It can also raise your risk of type 2 diabetes, high blood pressure, heart attack, heart failure, stroke, and more. In this minisode, Dr. Hyman speaks with his colleagues at The UltraWellness Center, Dr. George Papanicolaou, Dr. Elizabeth Boham, and Maggie Ward, about patients they have treated for sleep apnea. They share cases on issues ranging from anxiety to low libido to high blood pressure in which sleep apnea was a contributing factor. George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. He is also an Institute for Functional Medicine Practitioner. Upon graduation from his residency he joined the Indian Health Service. He worked on the Navajo reservation for 4 years at the Chinle Comprehensive Medical Facility where he served as the Outpatient Department Coordinator. In 2000, he founded Cornerstone Family Practice in Rowley, MA. He practiced with a philosophy centered on personal relationships and treating the whole person, not just not the disease. He called that philosophy “Whole Life Wellness”. Over time as the healthcare system made it harder for patients to receive this kind of personal care Dr. Papanicolaou decided a change was needed. He began training in Functional Medicine through the Institute of Functional Medicine. In 2015, he established Cornerstone Personal Health—a practice dedicated entirely to Functional Medicine. Dr. Papanicolaou joined The UltraWellness Center in 2017. Elizabeth Boham is a physician and nutritionist who practices Functional Medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. Dr. Boham has contributed to many articles and wrote the latest chapter on Obesity for the Rankel Textbook of Family Medicine. She is part of the faculty of the Institute for Functional Medicine and has been featured on the Dr. Oz show and in a variety of publications and media including Huffington Post, The Chalkboard Magazine, and Experience Life. Her DVD Breast Wellness: Tools to Prevent and Heal from Breast Cancer explores the Functional Medicine approach to keeping your breasts and whole body well. Maggie Ward, MS, RD, LDN is the Nutrition Director at The UltraWellness Center. Maggie holds a master’s degree in Nutrition from Bastyr University which focuses on using whole foods for holistic Nutrition Therapy. In addition, she completed her requirements to become a registered dietitian at Westchester Medical Center in NY. Prior to joining The UltraWellness Center team in 2008, Maggie worked at The Brooklyn Hospital Center in New York providing nutrition counseling to children and families dealing with HIV. She also taught at the Jewish Community Center in Manhattan and other sites throughout New York City, teaching nutritionally focused cooking classes for children and adults. Much of her focus is on food allergies, digestive disorders, inflammatory conditions, Pediatrics and Sports Nutrition. Maggie has been counseling individuals, families and business groups on therapeutic diets to address various health concerns for more than 15 years. Her ongoing clinical training through the Institute for Functional Medicine uses a systems biology approach when working with those who suffer from chronic and acute conditions to help them find their path to healing. She has a passion for cooking and reconnecting people with their potential to heal using whole, organic and local foods. This episode is brought to you by ButcherBox. When you sign up to ButcherBox today, you’ll get 2 lbs of wild-caught Alaskan salmon free in your first box plus $10 off. Just go to butcherbox.com/farmacy.  Find Dr. Hyman’s full-length conversation with Dr. George Papanicolaou, “Treating The Underlying Causes Of High Blood Pressure” here: https://DrMarkHyman.lnk.to/HighBloodPressure Find Dr. Hyman’s full-length conversation with Dr. George Papanicolaou, “Is Anxiety All In Your Head, Or Is It In Your Body?” here: https://DrMarkHyman.lnk.to/Anxiety Find Dr. Hyman’s full-length conversation with Dr. Elizabeth Boham, “Why Eating Less and Exercising More is a Recipe for Weight Gain” here: https://DrMarkHyman.lnk.to/WeightGain Find Dr. Hyman’s full-length conversation with Maggie Ward, “Is Gluten-Free A Fad Or Is Gluten A Real Threat To Our Health?” here: https://DrMarkHyman.lnk.to/Gluten Hosted on Acast. See acast.com/privacy for more information.

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 going to read something and forget what you just read. And that's sleep apnea. And it's underdiagnosed. Hey, everybody. It's Dr. Mark. Now, one of today's episode sponsors is ButcherBox. I love this company because they make

eating high-quality meat and seafood accessible, affordable, and most importantly, really delicious. When I talk about high quality animal protein, that means caring for the lives of the animals and the livelihoods of the farmers, reducing our impact on the environment and the climate, and feeding our bodies real food to promote optimal health. This is a huge caveat when it comes to eating meat and seafood. It has to be clean to be a good part of your diet. ButcherBox delivers 100% grass-fed, grass-finished beef and wild-caught salmon right to my door. They have different package and frequency options available so you can order the best combination for you and your family without any penalty if you decide to cancel.

And shipping is always free. The meat and seafood I get from ButcherBox is way better than what I find in the grocery store. For a quick weeknight meal this time of year, I love grilling up some of their wild-caught salmon and throwing it together with some arugula, red onion, lots of basil, balsamic vinegar, alongside some spaghetti squash. Yum.

When you sign up to ButcherBox today, you'll get two pounds of wild-caught Alaskan salmon free in your first box, plus $10 off by going to butcherbox.com slash pharmacy. That's two pounds of sustainably caught wild Alaskan salmon free, plus $10 off your first box by going to butcherbox.com forward slash pharmacy. That's F-A-R-M-A-C-Y. I hope you take advantage of this great offer. I know you're going to love ButcherBox as much as I do. Now let's get back to this week's episode of The Doctor's Pharmacy. Hi, I'm Kea 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 danger 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 Papanikolaou 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. And 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 to 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 uh 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 they're they 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 pre-diabetic. Yeah, it causes weight gain. Independent of what you're eating.

It causes weight gain. It leads to insulin resistance. It leads to diabetes, which complicates everything. So if you're falling asleep at work, if you fall asleep in front of the TV, if you feel tired during the day, if your wife says you're snoring, now there's apps you can get that actually record your, you're on your phone, they record your snoring. So you can see, because people don't believe it, oh, I don't snore. I love that app, by the way. And then there's one called Sleep Cycle that I like, it's recording your snoring.

And it's something that is easy to treat. I mean, there's different methods, just CPAP. 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 was 32. So, yeah. So he's a 32-year-old.

And he came in with his partner, his wife, and 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 caused 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, 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.

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 it's underdiagnosed. 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. 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 sleep. You always steal my thunder, Mark. No, it's good, it's like reading your mind. Yeah, you read my mind. So it's- I slept last night, so.

It's very possible that his snoring, 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. We had this other patient you had that 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 55 and he was really struggling with his energy. He was very low energy. He was really frustrated with his sexual function. He noticed he had a low libido. He was having some erectile issues. He had gained these 40 pounds around his belly, but he was really having a hard time 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 like 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 going to – I got to try this, but I need the tools. I need the map to do it. Yeah. And 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 but then we also we also noted we also you know I've through questions we found out that okay this he might have some issues with sleep yeah you know he was snoring his blood pressure was a little high he had all this weight gain yeah 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. Yeah, 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 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, 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 what you're saying is if you don't sleep, you get fat even if you don't change your diet. Absolutely. Yeah. 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 going to lose weight and then it will go away. But so often it's the sleep apnea that's causing the weight gain. And, you know, 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.

Absolutely. I remember this one guy I had who was like a lawyer 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 sleep apnea machine. He lost 50 pounds. Just boom, like that. Putting on a sleep apnea machine every night.

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 going to get to your goals. And so we've got to 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, heartburn. 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. She said alcohol for sure. If 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. You know, that weight was there. We know that, you know, sleep apnea and things can cause weight gain along with the blood pressure and her fatigue. You know,

she said she was sleeping a fair amount, but when you're tired, you start thinking, okay, how good is that sleep? So, you know, I think that's where... I want to stop you there for a sec, because I think what people should understand 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 at night 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, you know, 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, you know, 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, you know, talk to your doctor about getting some of these other tests. And many doctors are willing to work with their patients, you know, 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 Papanikolaou, 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 healthcare practitioner, and can help you make changes, especially when it comes to your health.