M12 Acabe com a Fraqueza, cansaço, sonolência - Aula 10. Como melhorar seu sono

Name: M12 Acabe com a Fraqueza, cansaço, sonolência - Aula 10. Como melhorar seu sono
Uploaded: 2025-08-28T18:12:47.000Z
Duration: 2 h 40 min 6 s

How to Improve Sleep After Bariatric Surgery

Introduction to the Live Session

The speaker welcomes participants to a live class within their community, indicating that the session will be recorded for later viewing.

Emphasizes the opportunity for live interaction and Q&A during the session, catering to those who prefer real-time engagement.

Understanding Sleep Disturbances Post-Surgery

The focus of today's discussion is on improving sleep quality after bariatric surgery, addressing various sleep disorders such as insomnia and poor sleep quality.

Highlights common issues like difficulty falling asleep, staying asleep, or waking up frequently during the night.

Impact of Poor Sleep Quality

Poor sleep quality negatively affects cognitive function, memory retention, and increases susceptibility to depression.

Discusses how inadequate sleep can hinder weight loss efforts; emphasizes that effective weight management requires a triad of good sleep, nutrition, and physical activity.

Causes of Sleep Issues After Bariatric Surgery

Notes that many individuals experience worsened sleep patterns post-surgery compared to pre-surgery conditions.

Identifies potential reasons for these changes in sleep quality and stresses the importance of addressing them.

Upcoming Challenge Announcement

Introduces an upcoming 21-day challenge aimed at helping participants lose between 3 to 7 kg through simple goals.

Details about participation logistics including access to a secret Instagram group and WhatsApp support group for challenge activities.

Challenge Structure and Support

Describes the structure of the challenge involving live sessions with various experts covering topics relevant to post-bariatric care.

How to Improve Sleep After Bariatric Surgery

Introduction to the Program

Juan, a bariatric personal trainer, will conduct training sessions from Monday to Friday at 7:30 PM and on Fridays at 7:00 PM. Participants will have exclusive access to these sessions via a secret Instagram account.

If participants miss the live sessions scheduled for 8:15 PM, they can access recorded versions later. A WhatsApp group will be open three times daily for interaction during the 21-day program.

Importance of Sleep Post-Surgery

The session begins with an emphasis on improving sleep quality after bariatric surgery. The speaker encourages audience engagement through comments while sharing slides.

Sleep is framed as a necessity rather than a luxury; many mistakenly believe that sacrificing sleep is a sign of hard work or success.

Effects of Poor Sleep

Lack of adequate sleep can lead to various health issues, including poor memory retention and emotional difficulties. The body processes toxins more effectively during sleep.

During sleep, the liver detoxifies and brain functions such as information processing occur, which are crucial for learning and emotional regulation.

Consequences of Insufficient Sleep

Individuals who do not get enough sleep may struggle with decision-making due to unprocessed emotions and thoughts accumulated throughout the day.

Poor sleepers face challenges in understanding their emotions and may experience memory problems, which can hinder weight management efforts post-surgery.

Hormonal Imbalances Related to Sleep

Inadequate sleep disrupts hormonal balance—leading to increased hunger (higher grelina levels) and decreased satiety (lower leptin levels), making it harder for individuals post-bariatric surgery to maintain weight loss.

Those who experience poor-quality sleep tend to have slower metabolisms, resulting in fewer calories burned daily compared to those who rest adequately.

Emotional Eating Triggers

Insufficient rest increases cravings for unhealthy foods due to hormonal imbalances and emotional stressors. This behavior undermines the benefits gained from bariatric surgery.

The speaker highlights that neurotransmitter imbalances contribute significantly to these cravings; thus, addressing sleep issues is vital for successful weight management post-surgery.

Conclusion on Weight Regain Prevention

Understanding Sleep and Its Impact on Weight Loss

Importance of Sleep for Weight Management

The session aims to explore how improving sleep can aid in weight loss, discussing dietary strategies and supplements to combat insomnia.

A study reviewed during the session highlights the recommended hours of sleep based on age groups, emphasizing its significance for overall health.

Recommended Sleep Duration

Infants require a specific amount of sleep represented by dark blue bars in the study, while lighter blue bars indicate acceptable variations.

Adults (ages 26 to 64) should aim for 7 to 9 hours of sleep per night, with a permissible range from 6 to 10 hours.

Deviating from this ideal range can lead to cognitive and physical issues such as memory problems, depression, and increased diabetes risk.

Personal Insights on Sleep Patterns

The speaker encourages audience interaction regarding their ability to achieve the recommended sleep duration.

Adjusting sleep schedules is crucial; even with a busy routine, aiming for at least 7 hours is essential for productivity and cognitive function.

Effects of Bariatric Surgery on Sleep Quality

A study involving nearly 300 bariatric patients assessed their sleep quality pre-surgery and at various post-operative stages.

Initially post-surgery (up to 1.5 years), patients experience improved sleep quality due to weight loss and lifestyle changes but may see deterioration after this period.

Long-term Implications of Obesity on Sleep

Patients with obesity typically suffer from poor sleep quality; however, improvements are noted shortly after surgery due to weight loss benefits.

Impact of Weight Loss on Sleep Quality

Immediate Effects of Weight Loss

Weight loss reduces fat, which in turn decreases pro-inflammatory cytokines, leading to improved sleep quality.

Engagement with healthcare teams and adherence to nutritional guidelines enhance lifestyle changes that positively affect sleep.

Long-term Challenges Post-Surgery

In the later postoperative phase, some individuals may regain weight, increasing inflammation and negatively impacting sleep.

A decrease in engagement with health professionals can lead to nutritional deficiencies that further disrupt sleep-promoting substances like melatonin and serotonin.

Importance of Continued Engagement

Maintaining a proactive approach post-surgery is crucial for sustaining improvements in sleep quality; patients should continue taking vitamins and monitoring their health.

For those experiencing insomnia after significant time post-surgery, it’s essential to address these issues promptly to prevent deterioration in sleep quality.

Factors Affecting Sleep Onset and Maintenance

Difficulty Falling Asleep

Issues such as delayed sleep onset may stem from inadequate melatonin production due to various factors including caffeine intake or excessive light exposure before bedtime.

Stressful stimuli or engaging content before bed can hinder melatonin production, making it harder to fall asleep.

Nighttime Awakenings

Waking up during the night (e.g., at 3 AM) could be linked more closely to stress levels and cortisol fluctuations rather than solely melatonin issues.

Cortisol has a natural cycle; elevated levels inappropriately timed (like early morning instead of upon waking at 6 AM) can cause unwanted awakenings.

Managing Caffeine Intake

Cortisol and Caffeine: Morning Routines Impacting Health

The Role of Caffeine in Cortisol Levels

Caffeine can delay the morning peak of cortisol, pushing it to midday or early afternoon, which may lead to lethargy upon waking.

This delayed cortisol peak could contribute to cravings for sweets after lunch, indicating a potential link between caffeine consumption and dietary habits.

Recommended Morning Routine

It is suggested to wait at least one hour after waking before consuming coffee; alternatives like ginger tea or chamomile are recommended to stimulate natural cortisol production.

A calm morning routine is emphasized, avoiding immediate engagement with phones or social media that can spike stress levels.

Importance of Nature and Mindfulness

Engaging with nature by opening windows or stepping outside can help regulate cortisol levels and reduce anxiety throughout the day.

Studies support that a peaceful morning routine enhances mental well-being, leading to better sleep quality at night.

Morning Hygiene Practices

After enjoying nature, practices such as tongue scraping can aid in detoxification from overnight digestion processes.

Maintaining a screen-free period in the morning allows for better focus on self-care routines before engaging with technology.

Timing of Breakfast and Coffee Consumption

After completing the initial morning activities within an hour, it's advisable to have black coffee; waiting two hours is even more beneficial for regulating cortisol cycles.

Adjusting breakfast timing based on personal schedules is encouraged but should prioritize a calmer start over rushing into daily tasks.

Sleep Disorders Post-Bariatric Surgery

Common Sleep Issues Observed

Patients post-bariatric surgery often report insomnia (difficulty falling asleep), excessive daytime sleepiness despite adequate nighttime rest, and movement disorders during sleep.

Causes of Sleep Disorders

Understanding Daytime Sleepiness and Nutritional Deficiencies

Causes of Daytime Sleepiness

Discusses hypersomnia throughout the day, highlighting how individuals may feel constantly tired due to deficiencies in essential vitamins or minerals necessary for energy production.

Mentions reactive hypoglycemia, where blood sugar levels fluctuate, causing fatigue and sleepiness after improper meals.

Nutritional Deficiencies Impacting Energy Levels

Identifies key nutritional deficiencies in bariatric patients: iron and vitamin B12, which are crucial for maintaining energy levels.

Emphasizes the importance of evaluating iron through ferritin levels rather than just serum iron, noting that a ferritin level below 70 can indicate deficiency.

Vitamin B12's Role in Fatigue

Highlights that low vitamin B12 levels (below 500) can lead to increased fatigue, memory issues, and even insomnia. A specific case is mentioned where a patient had a B12 level of 300 but was unaware of its significance.

Consequences of High Ferritin Levels

Warns against excessively high ferritin levels (above 150), which could indicate inflammation rather than just iron overload. This necessitates further investigation into potential underlying health issues.

Sleep Disorders Related to Nutrition

Discusses sleep disorders such as restless leg syndrome linked to stress and nutritional deficiencies like tryptophan and magnesium, both vital for relaxation and quality sleep.

Describes the cycle of daytime sleepiness leading to nighttime insomnia among bariatric patients due to poor dietary choices and lack of protein intake.

The Vicious Cycle of Nutritional Deficiencies

Illustrates how deficiencies in iron, B12, reactive hypoglycemia, and inadequate nutrition contribute to anxiety and depression among bariatric patients.

Points out that many patients rely on caffeine while neglecting proper nutrition, exacerbating their symptoms instead of addressing root causes.

Breaking Free from Nutritional Constraints

Expresses frustration over seeing patients trapped by their nutritional issues without understanding how to break free from these cycles.

Stresses the need for education on daily practices beyond consultations; knowledge about habits is crucial for overcoming challenges related to obesity post-surgery.

Importance of Comprehensive Knowledge

Understanding Sleep Disturbances Post-Bariatric Surgery

Main Causes of Sleep Disturbances

The speaker emphasizes the importance of a calm approach to understanding sleep disturbances after bariatric surgery, highlighting the need for community support in overcoming these challenges.

Key causes of sleep issues such as insomnia, nighttime agitation, and sleepwalking are discussed, with a focus on nutritional deficiencies that can lead to these problems.

Nutritional Deficiencies Impacting Sleep

Specific nutrients linked to sleep disturbances include magnesium, vitamin B6, vitamin B12, tryptophan, vitamin C, and fiber. These nutrients play crucial roles in maintaining healthy sleep patterns.

Tryptophan is described as a vital protein component that converts into serotonin—a neurotransmitter associated with happiness—indicating its significance in mental health post-surgery.

Connection Between Tryptophan and Melatonin

A lack of tryptophan due to insufficient protein intake can lead to decreased serotonin levels and subsequently increase the risk of depression among bariatric patients.

Serotonin transforms into melatonin throughout the day; without adequate tryptophan intake from proteins and necessary vitamins/minerals, melatonin production—and thus quality sleep—can be compromised.

Importance of Fiber in Diet

The speaker discusses how inadequate fiber intake affects gut health and consequently impacts brain function related to relaxation and sleep.

Emphasizing the role of dietary fiber for intestinal bacteria health, which produces substances that reduce inflammation and promote relaxation through neurotransmitters like GABA.

Lifestyle Factors Affecting Sleep Quality

The discussion shifts towards lifestyle choices contributing to insomnia post-bariatric surgery. One major factor identified is excessive or poorly timed caffeine consumption.

Sleep Quality and Caffeine Consumption

The Impact of Caffeine on Sleep

It is advised to wait at least one hour after waking up before consuming coffee to avoid disrupting cortisol levels, which can negatively affect sleep quality.

Individuals with anxiety or insomnia should refrain from caffeine intake after 3 PM to prevent further sleep disturbances.

If cutting out caffeine is challenging, decaffeinated options are recommended; however, even if one falls asleep after drinking coffee, the quality of sleep will likely be poor.

Limiting coffee consumption to a maximum of four small cups per day is suggested; for those with severe insomnia, reducing it to two cups may be beneficial.

Lifestyle Factors Affecting Sleep

Chronic stressors in daily life can disrupt cortisol regulation and consequently impact sleep quality. Everyday activities can contribute to this chronic stress.

Starting the day with calmness by waking up earlier than others allows for a peaceful morning routine that can help set a positive tone for the day.

Evening Routines and Sleep Preparation

To promote better sleep, it’s crucial to disconnect from screens (phones/computers) at least 60 minutes before bedtime as blue light inhibits melatonin production necessary for sleep.

Engaging in relaxing activities such as reading or meditating instead of screen time helps signal the body that it's time to wind down.

Nutrition's Role in Sleep Quality

Eating heavy meals late at night can hinder digestion and subsequently affect sleep quality. This is particularly true for individuals who have undergone bariatric surgery due to altered digestive processes.

Dietary Habits and Sleep Quality

Importance of Meal Timing

Eating earlier in the evening (around 7:00 - 8:30 PM) with lighter foods like vegetables, fish, and soups can improve digestion and sleep quality.

Heavy meals late at night can lead to nightmares due to indigestion and increased production of pro-inflammatory cytokines that disrupt sleep.

Managing Evening Hunger

If reducing meal quantity at night is challenging, try eating the same amount earlier in the day to avoid excessive hunger later.

Stressful days often lead to poor eating habits, resulting in excessive hunger at night. This cycle can be detrimental to sleep.

Case Study: Thaí's Dietary Patterns

Thaí, a 35-year-old patient post-bariatric surgery, experiences weight regain and insomnia due to poor dietary choices throughout her day.

Her breakfast consists of coffee with sucralose which disrupts cortisol levels and contributes to intestinal dysbiosis.

Nutritional Deficiencies Impacting Sleep

Thaí’s lack of protein intake during the day leads her to overeat at night. She consumes minimal nutrients that promote satiety.

The drop in serotonin levels by late afternoon increases cravings for pleasurable foods, exacerbating her nighttime eating issues.

Consequences of Poor Eating Habits

Nutritional Deficiencies and Their Impact on Health

Overview of Thaís' Nutritional Status

Thaís exhibits significant nutritional deficiencies, leading to fatigue. Blood tests reveal low ferritin (15), low iron (33), and elevated C-reactive protein (PCR at 9), indicating inflammation.

Low vitamin D levels can contribute to insomnia; additionally, extremely low zinc levels are linked to hair loss. High fasting insulin suggests a diet high in carbohydrates, while thyroid function appears disrupted as indicated by TSH levels.

Lifestyle Factors Affecting Sleep

Thaís' daily habits include excessive caffeine consumption immediately upon waking and after lunch, along with the use of harmful sweeteners like sucralose that may disrupt gut health.

A sedentary lifestyle is noted; studies suggest regular exercise improves sleep quality. Nutritional deficiencies such as lack of iron, zinc, B12, and fiber further exacerbate her condition.

Stress and Daily Routine Challenges

Thaís leads a stressful life balancing work at a bank and family responsibilities. This hectic schedule limits her ability to eat properly throughout the day.

The combination of inadequate protein intake and late-night overeating contributes to poor sleep quality.

Strategies for Improving Sleep Quality

Four main strategies are proposed: enhance lifestyle choices, reduce stress, organize nutrition better, and address nutritional deficiencies through diet or supplementation.

Enhancing Lifestyle Choices

Upon waking, avoid immediate screen time; instead, spend five minutes outside in natural light. Reduce exposure to bright lights one hour before bedtime.

Engage in physical activity whenever possible; morning workouts are preferable for better sleep outcomes.

Managing Stress Effectively

Various methods exist for stress management including meditation, avoiding toxic relationships or news sources, spending quality time with loved ones, and pursuing hobbies beyond food-related pleasures.

Dietary Recommendations for Better Health

Limit coffee intake to four small cups per day; avoid caffeine after 3 PM. Wait an hour after waking before consuming coffee.

Be cautious with dark chocolate consumption at night due to its caffeine content; aim for a maximum of 20g per day if consumed post-lunch.

Improving Nutritional Intake

Focus on meeting protein goals through various resources available within the community challenge programs.

Increase fiber intake by incorporating vegetables into meals—preferably cooked at dinner—and limit heavy foods late at night.

Digestive Support Options

Sleep Improvement Strategies and Supplementation

Relaxation Techniques

Incorporate relaxing teas throughout the day, such as valerian, melsa, and mulungu. It's advised to consume mulungu only before bedtime due to its strong relaxing effects.

Importance of Lifestyle Changes

Emphasizes that supplementation is just the tip of the iceberg; foundational lifestyle changes (diet, exercise, stress management) are crucial for effective results.

Vitamin B12 Supplementation

A good vitamin B12 level should be maintained above 500. Bariatric patients need continuous maintenance supplementation to prevent deficiencies leading to fatigue and cognitive issues.

Brazilian multivitamins often do not meet the necessary B12 dosage (600 mcg), requiring additional B12 supplements even if initial levels appear adequate.

Multivitamin Regulations

Brazilian regulations limit B12 in multivitamins to 9.9 mcg; thus, those relying on these must take extra B12 supplements separately.

Citoneurin can provide a weekly dose sufficient for maintaining adequate levels of B12; consult with a nutritionist for personalized advice.

Treatment for Low Vitamin B12 Levels

If vitamin B12 levels drop significantly, treatment may involve higher doses or intramuscular injections under medical supervision until levels stabilize.

Vitamin D and Its Role in Sleep

Vitamin D Recommendations

Maintaining vitamin D levels between 40 and 60 is essential for sleep quality and overall health. Recommended daily maintenance dosage is around 3,000 UI.

For low vitamin D levels, higher dosages (4,000 - 10,000 UI daily) may be prescribed until improvement is noted; best taken with meals containing fat for better absorption.

Magnesium Types and Their Benefits

Choosing the Right Magnesium

Different types of magnesium serve various purposes: Citrate aids constipation while malate boosts energy production. For relaxation and sleep enhancement, bisglycinate or inositol forms are recommended at doses up to 350 mg per day.

Nutritional Insights for Sleep and Gut Health

The Role of Algae and Nutrients in Sleep

Algae is highlighted as a natural source of blue color, containing beneficial nutrients such as lemon, passion fruit, inositol, magnesium, and tryptophan. A half dose can provide a good amount of these components when diluted in water.

Caution with Tryptophan Supplementation

Individuals with significant intestinal issues (diarrhea, constipation, gas) should avoid tryptophan supplements as it may worsen intestinal dysbiosis. It's advised to first address gut health before considering supplementation.

Once gut health is improved, tryptophan can be supplemented; however, those suspecting dysbiosis should opt for sleep supplements without tryptophan.

Benefits of Magnesium and Vitamin C

Magnesium is noted for its relaxing properties and its role in serotonin production which converts to melatonin. It also enhances GABA production—a neurotransmitter that promotes relaxation.

Vitamin C's emerging significance in sleep regulation is discussed; it helps manage cortisol levels which are crucial for sleep quality.

Consuming vitamin C-rich foods like citrus fruits (lemons, oranges), acerola cherries, and papaya can support melatonin production while regulating cortisol cycles.

Supplementation Strategies

Liposomal vitamin C is recommended for better absorption; Pura Vida is mentioned as a brand providing this form. Studies suggest 500 mg taken in the afternoon can help regulate cortisol cycles affecting sleep.

The relationship between cortisol (stress hormone) and melatonin (sleep hormone) emphasizes the need to lower cortisol levels to enhance melatonin production for better sleep quality.

Melatonin Usage Guidelines

Melatonin has recently been approved by Anvisa for nutritionists to prescribe. Proper dosing is critical; excessive doses can lead to rebound effects or feelings akin to a hangover the next day.

Typical prescriptions range from 0.21 mg up to 1 mg; sublingual forms are preferred due to faster absorption compared to oral ingestion through the digestive system.

Importance of Sleep Environment

Sleep Improvement Strategies

Nutritional Considerations for Sleep

Emphasizes the importance of proper nutrition, including protein intake and sources of minerals and vitamins, to prevent nutritional deficiencies that can affect sleep quality.

Highlights melatonin supplementation as a key component at the top of the nutritional pyramid for enhancing sleep.

Herbal Teas for Better Sleep

Recommends four herbal teas: Mulungu, Mela (likely referring to Melissa), Chamomile, and Valerian. Suggests varying their consumption throughout the day.

Notes that Mulungu should be consumed only at night due to its heavier effects on relaxation and sleep hormone promotion.

Preparation and Usage of Herbal Remedies

Discusses how Mulungu can be prepared as tea or in other forms like dry extract but stresses the need for individualized nutritional guidance from a professional.

Mentions that recipes for these herbal teas will be available in community resources, encouraging participants to take photos of the recipes shared during the session.

Community Engagement and Challenges

Introduces a 21-day weight loss challenge starting on Monday, emphasizing community interaction through Instagram and WhatsApp groups.

Announces prizes for participants, including supplements and consultations with nutritionists, motivating engagement in the challenge.

Vitamin D Supplementation Insights

Discusses vitamin D dosage recommendations, cautioning against high doses (50,000 UI weekly), which may be more suitable for treatment rather than maintenance.