How is your BMI affecting your sleep?

If you have a higher than average BMI it may be having a harmful effect on your sleep. Dr Hassan Al Hariri, Head of Sleep Clinic and Pulmonologist, Rashid Hospital, says that weight-related issues are one of the key reasons for sleep disorders such as sleep apnoea. “Weight is a significant factor in your quality of sleep.

“If your BMI exceeds 35, there is a high tendency for your tongue or your neck muscles to relax, especially in deep sleep. This relaxation causes an obstruction at the back of your throat, and when your brain recognises the lack of oxygen you will wake up frequently to stretch those muscles. For some patients, they take a big snore, which occurs when they transition from deep to light sleep.”

Dr Al Hariri’s Sleep Clinic was opened in 2010. At the time, the centre was only able to perform one polysomnography [sleep test] per night and waiting times for patients quickly reached more than four months. Now, the Sleep Clinic is able to perform five tests a night and the waiting list has been reduced to around a week.

The most common disorders that are found in the sleep tests are insomnia and sleep apnoea. “The patient stays in a private room overnight and we assess them for brain waves, whether they are in deep or light sleep, their breathing, whether they are dreaming and oxygen levels,” says Dr Hariri. 

For the duration of your night’s sleep, for 15-20 per cent of the time, you should be in deep sleep and for 15-20 per cent of the time you should be dreaming in the mild to moderate stages of sleep. Dreaming is characterised by rapid eye movement, where your eyes flicker as you sleep.

Dr Hariri believes that the prevalence of sleep disorders in the UAE is around the same as the international average, affecting between 6 and 8 per cent of the population. In the UAE obesity remains far higher than the international average and Dr Hariri believes that this may have an effect on people’s sleep.

“We have a higher than average prevalence of diabetes in the UAE, which is why we start looking closely at the relationship between weight-related issues, diabetes and sleep disorders,” he says.

“We looked at data to see if when we treat people for sleep apnoea, does this help control their blood sugar levels and diabetes? In our preliminary findings, we found that when people sleep better, it helps control their blood sugar and blood pressure levels.”

Obesity hyperventilation syndrome

Obesity hyperventilation syndrome (OHS) is condition that affects people with a BMI higher than 35. It’s similar to sleep apnoea but sufferers have high levels of carbon monoxide in their bloodstream. “When you breathe, you breathe in oxygen and exhale carbon monoxide. Your body needs to keep the carbon monoxide levels at around 40 in your blood,” says Dr Hariri. “If you’re obese and, due to your weight, you are not taking deep breaths, carbon monoxide will start accumulating in your blood. OHS occurs when you are not breathing adequately to remove the toxins from your body.”

Raising awareness

Since its inception, the team at DHA’s Sleep Clinic has been working hard to raise awareness of sleep disorders and their symptoms. Initially, the focus was on educating healthcare professionals but the emphasis is now on spreading awareness in communities and among the Dubai population. One of the key milestones in the team’s efforts was to convince insurance providers that sleep disorders were diseases that required cover for diagnosis and treatment. “We established new standards for treating sleep disorders in Dubai and insurers started to recognise the importance of the disease and started providing cover for their patients,” says Dr Hariri.

Once patients are diagnosed with a sleep disorder, DHA takes multidisciplinary approach to treatment, where people are referred to nutritionists and ENT departments for specialised care. 

If you do suffer from a weight-related sleep disorder though, Dr Hariri’s first recommendation is to lose weight. Put simply, “weight loss is very efficient for treatment.”