Weight GAIN after CPAP?

[ozze_dollar]

I have been told by two doctors that I can expect to lose weight now that I use a vpap machine. Its not easy is it.

[AndyCelt]

Kind of a disappointing thread... I'd kind of assumed weight loss came with the CPAP usage. However, I have felt more energy and started to wonder what to do about that. Exercise may be the answer!

[BlackSpinner]

Kind of a disappointing thread... I'd kind of assumed weight loss came with the CPAP usage. However, I have felt more energy and started to wonder what to do about that. Exercise may be the answer!

Most people do lose weight after starting xpap therapy. But some don't and the rest of us still struggle with getting all the eating issues under control. Weight gain /loss depends on many many factors including the psychological need to consume, addictions, food intolerances, racial ancestry, and other health issues.

[CathyH]

My sleep doc said that it is widely accepted that someone with untreated sleep apnea cannot expect to lose weight until the sleep apnea is treated.

Same here. But now that I'm reading that it is not making a difference for alot of people, I wonder if it actually has much to do with weight control. Especially if people are saying they weigh more after starting the CPAP.

[Passiflora]

Hello,

Thank you to all of those out there who have posted on this topic... I had hoped CPAP would just make the pounds slide right off but that has not been the case.

I've been reading up on this topic to understand why I might have gained 8 pounds in the last two weeks, having started auto CPAP about 4 weeks ago.

I have several theories... one pertains to diuresis and another pertains to insulin production/sensitivity.

This is a beautiful explanation of sleep disordered nocturnal diuresis from Sleep Specialist Dr. Krakow:
https://www.youtube.com/watch?v=JQmyP0e ... re=related

Another related commentary by Sleep Specialist and ENT Dr. Steven Park:
https://www.youtube.com/watch?v=xpfM1CQ ... re=related

Once you correct your sleep disordered breathing at night through CPAP/BIPAP/ASV, you theoretically will prevent excess diuresis from over production of atrial natriuretic peptide. I noticed during the first two weeks of CPAP therapy that my face was uncharacteristically puffy in the morning, likely because I was retaining more fluid at night and not urinating as much. Eventually, my face seemed to maintain a relatively consistent appearance from the time I went to bed to the time I got up in the morning.

So I thought okay, perhaps it is normal to gain a few pounds of water weight when you start CPAP... but I'm reading about other people gaining additional pounds months into therapy despite not changing their diet/exercise. Some people have even gained weight after cutting their calories from 4000/day to 2500/day (after years of a stable weight on a high calorie diet). These discussions reminded me of what I know about diabetes... some people hate to treat their diabetes with insulin because they go from being skinny to rapidly heavier... without portion control they can become obese.

We know that many people with obstructive sleep apnea (OSA) are at a higher risk for diabetes... perhaps the mechanism is similar to some non-OSA patients who produce a lot of insulin but their bodies are less sensitive to the insulin. Perhaps CPAP therapy somehow alleviates insulin insensitivity, or allows the pancreas to produce more insulin to better process the glucose coming in.

Here is an interesting article that presents some research on the metabolic effects of CPAP use:
Garcia, Sharafkhaneh, Hirshkowitz, Elkhatib, Sharafkhaneh. (2011). Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity. Respiratory Research 12(80). (http://respiratory-research.com/content/12/1/80)

I did Weight Watchers a number of years back and was shocked to realize how much food I was really eating every day.
Since we don't want to stop using CPAP therapy to manage our sleep disordered breathing but we also don't want to gain weight, maybe this is the perfect time to use our new found energy and passion for life to start exercising more and improving/balancing our overall nutrition - maybe we even start cooking/eating healthier meals at home. There are many excellent websites online (many are free) to help a person determine the appropriate number of calories for daily consumption and to look up the calorie/nutrient content of food. Some websites even provide calorie/nutrient tracking resources. Your insurance might even cover a visit to a nutritionist... some food for thought!

Best to all struggling with their weight!

[cpaptex]

I lost weight after I started using my xPAP. I took a few weeks as I began to catch up on my lost sleep. But I lost a total of 14 lbs so far, and I not trying to lose weight. I didn't gain weight in the beginning either.

[Passiflora]

Cpaptex,

Interesting. I just edited my post to include the following:

Here is an interesting article that presents some research on the metabolic effects of CPAP use:
Garcia, Sharafkhaneh, Hirshkowitz, Elkhatib, Sharafkhaneh. (2011). Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity. Respiratory Research 12(80). (http://respiratory-research.com/content/12/1/80)

Perhaps weight gain is more likely to occur in obese (i.e., BMI > 30) CPAP users. My BMI currently hovers around 30.

[cpaptex]

Cpaptex,

Interesting. I just edited my post to include the following:

Here is an interesting article that presents some research on the metabolic effects of CPAP use:
Garcia, Sharafkhaneh, Hirshkowitz, Elkhatib, Sharafkhaneh. (2011). Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity. Respiratory Research 12(80). (http://respiratory-research.com/content/12/1/80)

Perhaps weight gain is more likely to occur in obese (i.e., BMI > 30) CPAP users. My BMI currently hovers around 30.

My BMI is 35.3, but I used to be on Prednisone for 3 1/2 years. So I know that off of it that it was likely that I would lose weight. My Lungs are messed up so I don't follow the "norm" of much anything either. At High doses of Prednisone I LOSE weight. I gained the weight when I was weaning off of it. I've been mostly off of it since June 2011.

[Kairosgrammy]

I am hoping not to step on a toe but I figure if anyone can leap in here, it would be me seeing as I have well over 100 lbs to lose. Being on cpap is not what will make you lose weight. It is always controlling your eating. Sleeping better gives you more energy to do what needs to be done with exercise and also it helps with intentionally eating better. Cpap isn't a magic panacea for weight loss. Weight loss requires intention, a decision to eat less and the decision to be more active. What lack of sleep does is decrease certain chemicals in your brain that make you crave food that isn't necessarily healthy. Feeling better, has for some, helped them lose weight, but it is still, you gotta eat less and eat healthier choices to lose weight.

One good site to help you track what you are eating and how much you are eating is http://www.sparkpeople.com. It is free and deals with eating right and exercise.

Hope I haven't been too harsh. I think a lot of us thought Cpap, I feel better so now I'll stop eating so much. I gained a lot of weight although I will say, that the majority of the weight I've gained has probably been the time my apnea was getting worse despite compliant use of my cpap.

I have gained 8 very unwanted pounds in the month I have been on CPAP. In general I am feeling better, more energy, no three hour naps Saturday and Sunday. Life is good, but with no change in eating habits I am gaining weight. Exercise levels are the same, also. I am baffled. Help, anyone?

[Passiflora]

My Upper Airway Resistance Syndrome was likely inducing reflux which was aggravating my asthma. Before starting CPAP I required high doses of Asmanex (inhaled corticosteroid) but now just one month later I'm down to the lowest dose! Steroids have so many complex effects. I had expected to lose weight when my dose decreased but instead I'm gaining. I'm going to watch the diet a bit more and see if it helps. Despite the weight gain, I feel GREAT. I feel younger, more energetic, there is a spring in my step when I go on walks, I rarely have chest pain or feel short of breathe, it's amazing. I wouldn't have guessed I gained weight except that the scale tells me so! I do think I have increased my muscle mass a bit too since starting CPAP.

[archangle]

When I had my CPAP machine set wrong, I was feeling sufficiently bad, including nausea and heartburn that I was eating less and losing weight.

If you're feeling better and going out more often or spending time fixing more big meals, you'll gain weight.

[Passiflora]

Since my last post, I lost about nine pounds through diet (lots of water, listening to hunger cues, lots of healthy fruits/vegetables/grains) and exercise. It was surprisingly easy. I just don't have the kinds of cravings I used to pre-CPAP.

[Kairosgrammy]

That's great!!! And exactly the right approach. Keep up the good work.

Since my last post, I lost about nine pounds through diet (lots of water, listening to hunger cues, lots of healthy fruits/vegetables/grains) and exercise. It was surprisingly easy. I just don't have the kinds of cravings I used to pre-CPAP.

[JDS74]

Interesting topic!
In the 14 months I've been using my machine, I gained a total of 20 pounds. I still don't get a good nights sleep because of waking up every 90 minutes or so from an undiagnosed medical condition ( it's not diagnosed not for want of trying with the most recent doc agreeing that he doesn't have a clue! Looked at and been cleared for lung cancer, pancreatic cancer, cardiovascular disease conjestive heart failure and, pheochromocytoma.) For most of the year my AHI has run about 5 with the OSI running between 0.5 and 1.0 The rest are centrals.

That said, in the last 40 days or so I've gotten down to 248 from 266 by a combination of diet and exercise.
I walk 4+ miles each day at a 3.5 t0 4.0 mph and keep my total calorie intake below 1500.

As a nice surprise from the exercise and reduced calories, my AHI is now averaging about 3 with an occasional night below 2.

The rule of weight loss is calories in <= calories burned. Nothing else matters in terms of actual weight loss.
Some side conditions will affect the rate such as water retention because of excess salt or kidney disease. But over the long haul, the weight will come down.

[Passiflora]

JDS74,

Congratulations on the weight loss and decreased AHI! I'm wondering if an AutoSV machine would also help you? At an AHI around 5, maybe your sleep breathing disorder was still affecting your body with respect to your mystery illness.

My doctor suggested that bipap can induce more centrals than an AutoSV. I used to fight with my settings on my PRS1 Auto CPAP to try to eliminate the obstructive and clear airway apneas and I just couldn't ever get rid of both in the same night. My AHIs were around 3 - 7 on good nights. So, based on my doctor's recommendation I switched to an AutoSV (never tried a straight bipap machine although I'm planning to try the PRS1 Auto Bipap soon for travel purposes) and now on good nights I have an AHI of 1 - 2. For me, it makes a big difference in how I feel. I still have clear airway apneas but they are much fewer.

Incidentally, while I was titrating my AutoSV, I had the pressures a bit too low initially and I felt more sleepy and had more of an appetite. I finally got the pressures where they need to be and over the last several days my appetite is starting to normalize (decrease) again. I'm having fewer and fewer cravings.

AND! I have been off all inhaled steroids for the past three days!!!!!!!!!! I was finally able to wean myself off them after almost 8 months of needing them for severe persistent allergic/reflux-related asthma. I'm still using a small dose of an intranasal steroid to help keep my nose patent for breathing/sleep. Hopefully, once my allergy immunotherapy starts working in about a year I can stop using that too.