Sleep - Naturopathic Weight Loss

August 13, 2024 Sleep naturopathic supplements, weightlossmedication

Tirzepatide in treating obstructive sleep apnea and obesity

Table of Contents Table Of Content Sleep apnea in-depth Sleep study Methods in the study The Results Adverse events Limitation Conclusion This is going to be a different type of blog post. Today we will discuss and summarize a recent paper published on June 21, 2024, in The New England Journal of Medicine exploring Tirzepatide for treating sleep apnea and obesity. Here we go! Approximately 39 million US adults have obstructive sleep apnea, and 936 million adults worldwide are estimated to have mild to severe obstructive sleep apnea. What is sleep apnea? Obstructive sleep apnea is a common condition where the airway gets blocked during sleep, causing breathing to stop and start repeatedly. One of the main risk factors for this condition is obesity. People who are overweight are more likely to have obstructive sleep apnea because the extra weight can put pressure on the airway and make it more likely to collapse during sleep. Hence it was no surprise, that there is a press release about a study that looked at how Tirzepatide affects sleep apnea. Sleep apnea in-depth Before we get to the findings, let’s learn more about sleep apnea. There are two types of sleep apnea. The first type is obstructive sleep apnea, which happens when the upper airway gets blocked during sleep. This blockage interferes with breathing and can cause a person to stop breathing for short periods while asleep. The second type is central sleep apnea. This occurs when the brain doesn’t send the right signals to the muscles that control breathing. As a result, the muscles and nerves aren’t activated enough for breathing, leading to pauses in airflow during sleep. The reason we care about sleep apnea is because, if left untreated, it can lead to many serious health problems. These include insulin resistance, type 2 diabetes, high blood pressure, abnormal cholesterol levels, high blood sugar, stroke, kidney disease, sexual dysfunction, and coronary artery diseases like heart failure. Essentially, untreated sleep apnea can cause a wide range of medical issues. Additionally, several health conditions can increase the risk of developing sleep apnea, such as hypothyroidism, cleft lip or cleft palate, heart disease, kidney disease, large tonsils, obesity or higher body weight, and even menopause. These conditions can either cause sleep apnea or make it worse. Now, how do you know if you have sleep apnea? Some of the most common symptoms include excessive daytime sleepiness, where you go to sleep, wake up, and still feel unrested. You might also experience loud snoring. Another symptom is observed episodes where you stop breathing while sleeping. You might suddenly start breathing again with a gasp, or someone may need to nudge you awake to resume breathing. People with sleep apnea might also wake up gasping or coughing. Additionally, some wake up with a dry mouth or sore throat in the morning. Morning headaches are also a common symptom. Sometimes, difficulty controlling blood pressure can be an indicator of sleep apnea. If you have any of these symptoms, it might be worth consulting a healthcare professional to get evaluated for sleep apnea. Sleep study If you think you might have sleep apnea and want to get diagnosed, the first step is to undergo a sleep study. There are several types of sleep studies available. The most common one is done at a sleep clinic, where you stay overnight. During this study, called polysomnography, they place leads on your head to monitor brain activity, and sensors on your chest to check your heart and breathing. They also measure your oxygen levels while you sleep. Another option is a home sleep test, which you can do in your bed. This test doesn’t use as many sensors. Typically, you’ll wear a device like a watch, have a band around your chest, a sensor in your nose to monitor airflow, and a pulse oximeter on your finger to check oxygen levels. This home test is more convenient and often less expensive than the in-clinic study, depending on your insurance. Both types of tests provide valuable information to help diagnose sleep apnea. As we know, Tirzepatide is a once-weekly GIP and GLP-1 receptor agonist known to lead to a 20% reduction in body weight. If you are familiar with Semaglutide, you can think of Tirzepatide as its younger stronger brother. Methods in the study It is an industry-funded study, it was conducted in two phase 3, double-blind, randomized, controlled trials involving adults with moderate-to-severe obstructive sleep apnea and obesity. The participants were assigned to receive either the maximum tolerated dose of Tirzepatide (10 mg or 15 mg) or a placebo for 52 weeks. In terms of the most salient exclusion criteria, type 1 diabetes, type 2 diabetes, a prior or planned surgery, or if they had a self-reported weight loss of more than 5kg in the past 3 months. The intervention was Tirzepatide, which started at a dose of approximately 2 and a half mg once a week and up to 15 mg once a week and to a comparison of placebo. The outcome was change from the baseline in the Apnea-Hypopnea Index (AHI). In brief, the AHI index is essentially how many times a person stops breathing every hour, it’s assessed with a sleep study. So, all the participants in this study had a sleep study done at the beginning and a follow-up sleep study at the end of the trial. The Results Now, let’s dive into the actual results! They recruited 470 adults, and as noted they were randomized to Tirzepatide or placebo. The average age was 50. 30% were women and 73% were white, the average BMI was 39 and the base AHI index was 50 as a point of reference “AHI above 30 is severe” In other words, this was the real deal in terms of sleep apnea. So, what happened? Well, in the group of Tirzepatide, those patients experienced a 25%-point reduction in their AHI index which is remarkable compared to the placebo which was only a

July 30, 2024 Sleep Caffine, Key to Quality Sleep, Quality Sleep, Sleep

Exploring the Key to Quality Sleep

Table of Contents Table Of Content Sleep pressure Introducing adenosine How to artificially mute signal of adenosine Caffeine on sleep pressure Deeper into adenosine Conclusion It would be no surprise if you felt the need to nod off or catch a quick nap during the day, even feeling lethargic during productive tasks, however when it’s the time to sleep at night you can’t drift off? — It’s so frustrating, I know!! If you can relate, this blog post is for you. People who struggle with sleep have a really hard time being compassionate with themselves when they do experience difficulties sleeping. There are many different reasons somebody might be having difficulties sleeping. I am not sure what yours is. As the saying goes “You’re the expert on you.” However, this post aims to introduce you to important chemicals which make up the sleep cycle, to increase your knowledge on sleep. Now you may say, you already tried to establish a healthy sleep routine but felt like you need more? We will dive into this topic and break down how to achieve a quality sleep which can develop into healthy sleeping habits. Our discussion today will focus on: Sleep pressure Two questions to start with. Do you ever wonder why you will get tired this evening? And why tomorrow morning when you wake up will you be free from that tiredness? (Source: Heydar Hasanov, 2024) Well, it turns out that there are TWO independent but very complementary forces that explains why exactly this is the case! The first of those is called “sleep pressure” and the second is called your “circadian rhythm.” From the moment that you wake up, a chemical has been building up in your brain and the longer that you are awake the more of that chemical will continue to build up and the more of that chemical that builds up the sleepier you will feel. This is what we call “sleep pressure” and that chemical is called ADENOSINE Introducing adenosine You can think of this chemical almost like a chemical barometer that continually registers the amount of elapsed time since you woke up this morning. So it’s a chemical signal that helps tell your brain and your body how long you’ve been awake. And when those levels get high enough, it will tell your brain, it’s time to go to bed because you are sleepy. Now adenosine accomplishes this sleepiness using a very clever action effect. High levels of adenosine in the evening will simultaneously turn down the volume in the wake promoting region and it will crank up the dial on the sleep-inducing regions of the brain. At that point with the adenosine concentrations peaking there should be an irresistible urge of slumber that will take hold of you. This happens to most of us somewhere after TWELVE TO SIXTEEN hours of being awake. How to artificially mute signal of adenosine I know it feels like a cruel joke that sometimes we battle with exhaustion and sleepiness during the day when we have responsibilities to fulfill, only to be wide awake and staring at the ceiling when bedtime arrives. The good news: you can however artificially mute the sleep signal of adenosine by using another chemical that makes you feel more alert and more awake. You SURE know this chemical, “caffeine.” it’s no coincidence that two things sound quite similar, “caffeine” and “adenosine,” it’s down to the systems in the brain that they both act upon. Now don’t worry, in a separate post, we will talk all about the effects of caffeine on sleep but here we are going to explain caffeine effects on adenosine, in other words on sleep pressure! Caffeine on sleep pressure Caffeine works by successfully battling with adenosine for the delightful privilege of latching onto what we call the “adenosine welcome sites” in the brain or in other words “adenosine receptors” With its pretty sharp elbows, caffeine will nudge adenosine out of the way and will latch onto those adenosine receptors. But unlike adenosine, caffeine is not going to stimulate those receptors to produce more sleepiness, instead caffeine blocks and effectively inactivates those receptors and acts like a masking agent. It will be the equivalent to sticking your fingers in your ears to shut out that loud sound of that tiredness, of that adenosine sleepiness. By hijacking and occupying those receptors, caffeine effectively blocks the sleepiness signal that would normally be communicated to your brain by the adenosine, so that’s how caffeine works, it blocks the signal of sleepiness. WARNING! This does not mean or suggests you should start drinking 10 cups of caffeinated drinks to stay up during the day, more on the effect of caffeine must be discussed carefully. Deeper into adenosine Let’s come back to this chemical. The buildup of adenosine during the day is only one half of our story when it comes to sleep pressure. That explains why you feel tired towards the end of the day, what it does not explain however, is why you DON’T feel tired or at least you shouldn’t feel tired the next morning when you wake up — and this is where sleep enters our story as a new lead actor in the second half of the post. Now the question is: what happens to all of that accumulated adenosine once you fall asleep? Well, it’s during sleep that a mass evacuation of adenosine gets underway, this means; its during sleep that the brain has a chance to degrade and remove the day’s weight of adenosine and across a night, sleep will essentially lift the heavy weight of sleep pressure of your brain lighting the adenosine load. After approximately eight hours of healthy sleep in the average adult, the adenosine purge is complete, with that clearance of adenosine together with changes in your circadian rhythm, you should naturally wake up feeling refreshed as long as your sleep has been long enough and of good quality. You will feel restored by

Category: Sleep

Tirzepatide in treating obstructive sleep apnea and obesity

Exploring the Key to Quality Sleep