Obesity And Poor Health In New Zealanders

Monday 30 April 2007

Sleep Disorders, Obesity And Poor Health In New Zealanders

An expert in respiratory conditions is warning that far too little attention is being paid to links between sleep breathing disorders, sleeplessness and obesity, affecting the lives and work of thousands of adults and children in New Zealand.

Dr Alister Neill, University of Otago, Wellington, is concerned that obstructive sleep apnoea and obesity hypoventilation syndrome are increasingly impacting on the lives of thousands of people, but getting very limited treatment or recognition by the health system.

Obstructive sleep apnoea (OSA)** affects at least 160,000 adults or 4% of the population, and 2% of 4-5 year olds. However the majority go untreated and undiagnosed. OSA results in repeated obstruction of the upper airway, loud snoring and daytime tiredness and impaired performance.

Obesity hypoventilation, or obesity related respiratory failure, occurs when the lungs and breathing control centres can no longer cope with the work of breathing. This leads to low levels of oxygen asleep and if untreated premature death for heart and lung failure.

“There’s a correlation between the obesity epidemic in NZ, poor sleep patterns and daytime performance,” says Dr Neill. “Overweight people sleep very badly because of repeated obstruction of their airways. This affects sleep quality and energy levels and often causes them to eat more. Chronic sleep deprivation has a similar effect increasing the desire to eat which in turn promotes obesity. ”

“In many cases it‘s a vicious circle, largely unrecognised in terms of loss of productivity and a deteriorating lifestyle.”

The dramatic rise in people afflicted by obesity is driving a similar increase in sleep apnoea; particularly amongst Maori (three fold prevalence), Pacific Islanders and lower socio-economic groups.

“The same symptoms affect obese children, which then results in tiredness and poor performance at school. Consequently this is a life-defining condition which can start very early.”

Dr Neill says there is a long list of other health consequences from sleep apnoea such as impaired thinking, increased risk of car crashes, diabetes, depression, heart failure and respiratory failure amongst others.

The problem in NZ is that there are effective treatments, but access to public services is limited because of capped funding. “We have an extraordinary situation in a number of New Zealand centres with long waiting lists to be evaluated at sleep laboratories that are operating at less then half of their capacity.”

“People working in this area are feeling very frustrated as the health consequences of sleeplessness and sleep apnoea increase daily, wrecking the lives of many people. The maintenance of normal breathing during sleep is a fundamental human process for survival,” he says.

Dr Neill says solutions are obvious: “We clearly need increased funding for diagnosis and treatment, there needs to be improved training of health professionals into sleep disorders, effective planning by the Ministry of Health, the development of services for groups with high needs as well as targeted research to improve clinical practice in diagnosis and treatment. “

Dr Neill is the Clinical Director of the WellSleep Clinic in Wellington, and a Senior Lecturer in Medicine at the Wellington School of Medicine and Health Sciences. He is engaged on a number or research studies into the physiology of sleep, epidemiology of sleep apnoea and new methods of treatment.

He is a member of the National Health and Medical Research Council, funded Australasian Sleep Clinical trials Network. He recently presented a submission to the Parliamentary inquiry into obesity and Type 2 diabetes in NZ on behalf of the Thoracic Society of Australia and New Zealand.

ENDS

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