Written By: Shannon Guthrie, RD, LDN
We’ve been hearing a lot from Dr. Newman (Eastern Nephrology Associates) about obstructive sleep apnea (OSA) and its contribution to progressing kidney disease. Read his blogs here & here about it - if you haven't already . Coming from a dietitian's perspective, I've decided to piggy-back off of his brillant writing & research to tie together how un/under treated OSA really effects diet quality and quantity.
There is a growing body of literature and more research being performed on poor quality & deprivation of sleep and nutrition. People who report poor sleep also report poor diets with lowered intakes of vegetables & fish and higher increase in cofectionary, sugar sweetened beverages, carbohydrates and red/processed meats. This makes sense, our bodies are unconsciously craving a quick source of energy to combat fatigue. Those with fragmented sleep associated with OSA have higher intakes of fatty foods, carbs, calories (328 +/-140/day) and snacks as well as increased levels of hunger and lowered satiety hormones (ghrelin & leptin).
That’s between, on average, someone with un/under treated OSA will consume somewhere between 188 - 468 more calories per DAY (likely of poor quality nutrition), have more hunger urges & less cues to know when your full verses someone without OSA. Remember, its excess calories that cause weight gain which increases the risk of development or aggravates conditions such as diabetes and hypertension which contribute to the progression of kidney disease. Other studies also suggest that a unidirectional relationship exists with diet and OSA, that a poor quality diet contributes to severe OSA.
Why does this happen? Researchers have found an important link between OSA and unhealthy diets may be through a lack of what’s called “N3 sleep”. N3 sleep is a regenerative period where the body heals itself and has an important role in memory and cognition. It also helps with regulating hormones that contribute to glucose tolerance and insulin secretion. Those with OSA have a decreased time in N3 sleep by 25-28% than in those without OSA. In fact, just after 3 months of CPAP treatment shows that N3 sleep levels increased to normal levels - which means, unconsciously you will consume less calories and have better food choices.
"Sleep is the Golden Chain that ties Health & our Bodies Together" - Thomas Dekker
So, its the preverbal chicken or the egg. But in this case, treating OSA and making positive diet changes will go along way with kidney health. I have witnessed it myself. I’ll admit, addressing OSA has now become integral in my approach to prevention of progression of kidney disease along with diet counseling (Thanks to Dr. Newman). There are a lot of people are in denial or simply don't know that they have OSA. Perhaps, people don't want to face or don't want or like the idea of wearing a face mask each night but believe me, I know several companies who won't mind tethering you to machines to live. As for me, I would take the CPAP machine all day long, at least I know it is helping to improve my life.
I do have have a personal narrative and find it so interesting that I have found myself in this OSA realm, tying it all together. At least 5 or more years ago, I diagnosed my mother with OSA (yes, little ‘ole registered dietitian me) - her Pulmonologist said “Your daughter has saved your life”. I take great pride in that statement as she is my very best friend and I want to keep her living as healthy as possible for as long as she can.
I implore you to get evaluated for sleep apnea, you can take this simple questionnaire below to see if you have risk factors for it. And if you are treating your sleep apnea, consider being monitored to ensure you are getting the best, optimize treatment (improved blood oxygen levels) where you will be more likely to be compliant and stick with treatment. Read Dr. Newman’s blog here about it.
In Peace and Good Health.