Obesity and Apnea and research

[dravidio]

Since being diagnosed with moderate OSA I have become interested in the research behind OSA and have done a little background reading - though I am no expert. It appears that obesity and apnea are certainly inter-related. There seem to be two schools of thought and research evidence for both points of view:- Obesity can cause or worsen sleep apnea and there is evidence that losing weight can help diminish sleep apnea. On the other hand there is the idea that having sleep apnea can predispose people to be obese by making them sleepy and lacking energy and thus more likely to become obese.

Intuitively I would favour the first idea. Having said that I am not overweight - with a BMI of 25 - and I take regular exercise, yet I have moderate sleep apnea. It may be a case of chicken and egg, but certainly it seems to me to be obvious that if you are obese it is threatening your health - and that you ought to take steps to lose weight. I am not being judgmental here - I do not under-estimate the difficulty some people may have in doing this - and that they may need help, yet I am also aware that for some people eating an unhealthy diet, taking no exercise and putting weight on appears to be a lifestyle choice.

So is CPAP a quick fix? Easier to do than dieting and exercise? Well yes of course it is - that's human nature. Many obese people are turning to gastric banding as a way of losing weight - and it may be appropriate in certain cases.

Add to this the economics of the pharmaceutical industry who certainly have a vested interest in the manufacture of expensive medical equipment - and know that people will pay a lot of money if they think something will quickly improve their health.

I believe we have a personal responsibility for our own health. I think in my case - it may be to do with drinking alcohol at night - and I intend to address that, and to try to lose a little more weight and go to the gym more often. I will continue to persevere with the CPAP equipment but if I manage to address the other issues it may be interesting for me to do another sleep study in a year's time to see if I still have moderate sleep apnea.

[GrumpyBiker]

There certainly seems to be a vicious circle with apnea and obesity. Lifestyle, genes or whatever makes you obese which can lead to apnea. This leads to lack of energy so losing weight becomes a bigger mountain to climb and so it goes.

Others may be genetically predisposed to apnea, toungue fixed a long-way back in the throat, narrow gap between soft-pallete and the back of the throat (this describes me ) causes apnea as we age and muscle tone decreases. Follwed by tiredness, depression etc and lack of excersize to obeisety and round and round it goes.

I am obese and working on losing weight. I have also given consideration to learning the Didgereedoo (sp?) as this has been shown to significantly improve apnea due to its strengthening of the throat muscles.

Andy

[dravidio]

Ah the didgeridoo however it might be spelled. No chance of Rolf Harris getting sleep apnea then!

Good luck on your battle with your weight Andy. It is obviously a complex issue.....

[Debs79]

Well im not overweight bmi of 24, i dont drink or smoke, i take regular exersice, and my diet is good.
so im not your typical fit for sleep apnea?
when i was a baby i used to stop breathing in my cot and turn blue!!!! so this is a very long lasting problem for me, i hope the cpap works and its not just a silly quick fix that doesnt last. i think more reasearch would be good though.

[James @ Intus]

I suggest you do some further reading into Metabolic Syndrom and how this relates to OSA and 'collecting weight' through increased cortisol levels through chronic inflammation. That's like the 3rd school of thought and IMO very plausible too.

There are indeed a few who fall outside all of these paramaters and have OSA because of their short lower jaw, or floppy airways. For those it tends to be the toughest because there's absolutely nothing they can do whereas for some in the overweight category it's possible to loose the weight and cure the OSA (as did Puffin, a very knowledgeable member here who did a gastric bad op and has since ditched his CPAP so doesn't hang around here as much, unfortunately for us but good for him).

[dravidio]

A quick look at "Metabolic Syndrome" doesn't convince me. Chicken and egg again. Surely Type 2 Diabetes and obesity is much more likely to be the result of diet and lack of activity than anything else? You can add to this all the other related health issues.

I think we may be a victim of our evolution. In times of scarcity primitive man would eat as much as possible to build up strength. Now we can eat as much as we want that same instinct to gorge ourselves is still there and we crave that feeling of satiety - the antithesis of hunger.....

[paulbooth6]

OSA and associated illnesses

I have also been doing some research and have found an interesting if not disturbing potential link to my sudden poor health/weight gain over the past 7 years.

In 2002 I was diagnosed with OSA but medicine as it was then only related weight to OSA and as I lost 3 stone nothing more was done (even though my partner complained verociously about my snoring, stopping breathing and the subsequent splurting coughing and spluttering).

I then put the weight back on fairly quickly and I was diagnosed with depression, (sat around, stayed in bed, avoided crowds etc). At this stage nothing was said about my OSA. I then started suffering with acid in my mouth, constant clearing of my throat etc and was given medication for it.

The Weight gain continued as did the depression (occasional relief but still a downward spiral) and reflux (weight not too bad upto 115kg at worst but still enough to be classed as Obese).

June this year comes along and I feel tired but not as bad as 2002 when I could have slept standing up. So I go to my GP, she sends me to a Respiratory Consultant, (work send me to a Medical Doctor and subsequently sack me), I have full medical and low and behold I have type 2 diabetes so all of the stuff about the links between all of these are correct and i am the living proof.

This