Sleep Management
➤ Adequate sleep is essential for effective weight management.
• Poor sleep duration and quality have been linked to increased
cardiometabolic risk factors as well as higher BMI.
➤ Adequate sleep regulates neuroendocrine function and glucose
metabolism. Lack of sleep leads to hormonal disruptions (increase
ghrelin, decreased leptin) and metabolic disruptions (reduced
glucose tolerance, decreased insulin sensitivity, elevated evening
cortisol levels).
➤ Encouraging optimal sleep habits and good sleep hygiene can
improve metabolic health.
➤ Sleep disturbances contribute to hunger.
➤ Significant sleep pathologies, including obstructive sleep apnea,
are strongly correlated with obesity.
➤ Identify and address conditions that disrupt sleep (e.g., menopause,
lipedema, and restless leg syndrome).
Neck Circumference
Purpose
➤ Assess risk of cardiometabolic disease and obstructive sleep apnea.
Procedure
➤ Measure at the laryngeal process perpendicular to the long axis of
the neck.
Health Risk Indicator
➤ Atrial fibrillation risk increased: ≥17 in/43 cm (men) and ≥14 in/36 cm
(women).
➤ Obstructive sleep apnea risk increased: ≥17 in/43 cm (men) and
≥16 in/41 cm (women).
➤ Cardiometabolic risk increases with a larger neck circumference,
although sex and ethnic reference ranges are less well-defined than
those for other obesity measurements.
➤ Risk varies by ethnicity; Asian populations have a lower threshold.
Management
Assessment
