I agree that some cases of sleep apnea are due to the structural abnormalities. I have some excess tissue in the back of my throat and also a deviated nasal septum from a broken nose. That being said, of the 60% (or more?) of the OSA sufferers who are overweight, many of them are significantly overweight. When dieted/exercised down from 225 to 204 lbs, my OSA improved and my pressures dropped some. If I could drop from 204 to say, 185 I would really be skeptical if my pressures did not drop a lot.robysue wrote:Mikey,ResmedUser wrote:I am skeptical that any of these really work all that well. The gold standard treatments for OSA in evidence based medicine are 1) CPAP and 2) weight loss, if weight loss is needed...which it usually is.
Mikey
According to my sleep doctor's PA some 40% of sleep apnea patients are NORMAL weight or UNDERWEIGHT. I'm one of them.
And of the 60% of apnea patients who are overweight, the vast majority of them will NOT be able cure their apnea even if they did lose ALL their excess weight. Why? Most OSA is caused by structural problems in the throat. In many (not all, but many) of the overweight apnea patients the connection between the apnea and the weight is far more subtle than your statement implies: For many overweight patients with OSA, the OSA lead to metabolic changes which lead to weight gain in the first place or which made it all but impossible to lose the weight until and unless the OSA is properly treated by CPAP (or an oral device---if the apnea is mild). The additional weight clearly stresses an already compromised upper airway system and may increase the severity of the apnea. But it seldom actually is the sole cause of OSA.
A lucky few overweight OSA patients are able to lose weight while NOT treating their apnea by CPAP and eliminate the apnea by weight loss alone. But they are very few and very far between.
A few more lucky overweight OSA patients are able to lose weight while ON CPAP and subsequently manage to demonstrate through a PSG that they no longer need CPAP therapy. But these people are also few and far between.
The vast majority of overweight OSA patients who manage to lose all their excess weight do NOT manage to free themselves of apnea. And they continue to need CPAP to properly treat their apnea. In many cases, the pressure needed to keep the airway does go down with weight loss, but even here it is an individual thing: Some folks find they need a pressure INCREASE after losing weight in order to keep the apnea under control.
SO: Please do NOT promulgate the myth that weight loss is a gold standard treatment for OSA. It most certainly is not. The ONLY gold standard treatment at present is xPAP therapy.
And please do NOT promulgate the myth that MOST OSA patients could cure ---or even substantially improve--- their sleep apnea by losing weight. First of all that completely ignores the 40% of us who do NOT need to lose weight. And second of all, it sends a message that the other 60% are somehow responsible for creating their problem by being overweight. And nothing could be farther from the truth.
I have noticed when I lose weight and my neck circumference goes under 17" I particularly begin feeling better.
Mikey