Having OSA and not obese

I am only a few pounds too heavy. I don't go by BMI, it's unreliable. I'm a former competitive weight lifter and developed above average muscle mass for my height. That messes up the BMI calculation. Anyway, I use percentage of bodyfat. Right now I'm about 23% body fat measured with underwater weighing. The recommended percentage for males is 20% or lower. So this only makes me a few lbs. too heavy. Most of what I read about OSA says that it's mostly in obese people. Am I a fluke or is it possible I was misdiagnosed? I also only snore mildly. Are there any others out there that aren't extremely overweight that have OSA?

If you are obese, please, please, please do not take offense to my post. I am not trying to insult anyone's body or say that I have a perfect body (like I said, I could lose a few pounds). I simply want to learn as much as possible.

Uncle Matt, studies are now showing that there are likely large number of slim folks who have apnea. It's obvious that central obesity compromises airways and compresses lungs BUT that's not the only reason that airways narrow or collapse. Apnea's just noticed-detected in the obese first.

I only snore in certain positions and even then only occasionally.

If a sleep study identifies apnea, it's certain you've got it, especially if done in an accredited sleep lab.

Unclematt, there is another post that was a poll as well about something like what you're asking about: viewtopic.php?f=1&t=43077&st=0&sk=t&sd=a

This is a C&P of what I said on that post : From what I've been able to gather from my mother, I was cutting down rain forests back when I was 15 and 115 pounds. I'm now 38 and 149 pounds and those forests are still falling. I don't think that weight is a factor as far as being a cause. I haven't started my treatment yet, but from what I've read here so far, many have lost weight, or have had a better time of losing it after they have started their treatment. Myself, I'm not sure if I can afford to lose weight and go back down to 120-130.

Anyone can have it. even bean poles like me.

I have thin friends too that are on the cpap. athletes are on it too.

I'm so glad this forum exists. It's great to be able to talk to other people with the same affliction.

BTW..my diagnosis was made in an accredited lab at a local hospital. The doctor making the diagnosis is William R. Beam, Diplomate, American Board of Sleep Medicine so I would hope that Dr. Beam got the correct diagnosis.

I have been "skinny" since High School. I am 6' tall and weighed 147 lbs as a HS senior, achieved my highest weight of 168 as a junior in college, and have been at 155 lbs + or - 5 lbs for the past 40 years (BMI of 20 - 21). I was diagnosed with Sleep Apnea in late 2005, much to the surprise of my doctors (PCP and cardiologist) at the time. They thought, as many people did in 2005 and still do today, that only "fat" people suffered from Sleep Apnea. My wife's cousin, not quite as thin as me, is also a CPAP user, having been diagnosed in 2001.

I have been physically active all my life (running, skiing, hiking, fast walking, ...) so I, luckily, don't have the physical complications that often come with being overweight. Still, I have Sleep Apnea and, in looking back, think that I had it, in a mild form, ten years or more before I was diagnosed.

I have adapted well to CPAP by learning from and following the recommendations of the experienced, caring, and helpful folks on this forum, along with acquiring (online) a data capable (AHI, Leak, ...) CPAP machine and supporting software (EncorePro). I received no follow-up assistance (other than a RX) from my doctor and DME in 2005 - 2006, and no assistance from my new doctor and DME (same one as 2005-2006) earlier this year when I "restarted" my CPAP usage.

With an attitude of "I can make this work for me", I believe most people, especially with the guidance available from others on this forum, can be successful. Good luck in reaching your sleep goals.

There are a large number of people with sleep apnea who are not obese. Many with sleep apnea are even very thin.

People who are not overweight but have sleep apnea tend to be undiagnosed, since many doctors have the same misconception that you had. Doctors don't usually suspect sleep apnea in people who are not overweight.

It's like anything else. People (including doctors) say you can't have something because you are too thin, or too young or too whatever!

If the signs and symptoms are there for any condition, a person should be checked,even if they don't meet the so-called standards.

When I was originally diagnosed with OSA I was about 173 pounds at 6' in pretty good shape. Of course I had a lack of energy and injuries over time compounded by lack of injury encouraged me to not workout like I should. I finally quit smoking last year and didn't see much improvement, infact I saw my energy level go down. Early this year I was diagnosed with low thyroid levels. Well. I was up to 240 and my energy level was low enough that I could fall asleep looking at a comfortable chair. I was still on BiPap at 21 over 17 and still having problems with my mask leaking or nearly lifting off my face at those pressures.

I was sent a sleep apnea specialist who also specializes in thyroid problems. I was put on thyroid meds began trying hard to watch what I was eating and try to do some physical activity. I also recently had a UPPP tonsils and the rest in the throat taken care of. My surgery has been less than two weeks and I am still recovering. I am still on the bipap but at auto and the pressure hasn't gone over 15 which allows me to wear the mask with barely a leak. I have lost weight not much only down to about 215 but I am working on it.

I was always one of those people everyone would say was thin. I didn't consider myself thin at 170 some pounds but I did look thin because I am 6' tall. There are many people who are not grossly obese who also have OSA.

That extra bulk you have from lifting weight could be part of the problem. Your neck is probably muscular and thick. When you go into deep sleep muscles relax causing the airway to collapse. I would bet a lot of people who lifted weights like you and bulked up and have thick necks from that also have OSA.

Gerry

Thinking that SA is for the obese is what keeps people like me (185 lb, 6ft 0) from even for a moment considering it as a cause of their symptoms. We need to help change that, now that we know better you and I. But I think that my condition was exacerbated when I put on a few pounds some months ago, a bit of it in the neck. Like so many other diseases, I believe that some people are predisposed (genetically) to get it - e.g. airway structure a bit narrow - and that environmental/behavior factors play a significant role (e.g. diet, exercise).

unclematt, yours is an important question. I don't think anyone will feel insulted, as the topic comes up from time-to-time (as it should).

I'm of normal weight, good physical condition (just ran a 5K yesterday), and by my reckoning, I've had the OSA for about 50 years.

Both of my brothers appear to have it (and they are of normal weight).

There are other causes besides obesity. Among them is a large uvula and also some abnormalities in airway architecture. A malformed hyoid process (a small bone) can do this.

There is wide agreement that OSA is significantly underdiagnosed. I suspect most strongly that OSA diagnoses among those of normal weight are missed more frequently because the epidemiological establishment has some catching up to do re OSA among non-obese. This happened to my brother, in fact. He presented with OSA symptoms, and the doc relied on his training, and told him that he does not have the condition. Eventually, sleep apnea will be much more widely suspected and diagnosed (and treated.)

Again, good question.



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I'm 6'2" and 200 lbs, but was about 180 lbs a year ago, and 165 lbs 3 years ago. I concur with some other posters some weight gain in my neck is what pushed my OSA over the edge into needing CPAP. I used to be a 15 1/2" neck when I was in my 20's and now I'm probably a 17" or 17 1/2" neck and I can't button any of my shirts if I need to wear a necktie. And since starting CPAP I've gained 10 lbs because I'm getting more restful sleep and not burning calories in restless sleep as I was prior to CPAP.

I was 6'3" 185lbs when I started, now I'm 200lbs. Though I don't feel any bigger, in fact I think my pants fit better....

The Dreamer.

The leading risk indicators of OSA, in order are (1) a history of heroic snoring, (2) being male, (3) over 40 years old and (4) being seriously overweight. I had the first three when I developed sleep apnea in 1990. My wife sounds terrible at night, being seriously overweight and now almost 59 years old, but she sleeps quite well despite her snoring and disturbed breathing pattern. My condition is herreditary and based on jaw shape, as proven by a hundred years of family photos in a family history published by my grandfather's brother. One of my brothers has OSA, and my own sons had upper airway resistance syndrome at reed-thin 12 years of age with a diagnosis of severe OSA as adults. Surgery cured my sons.

unclematt wrote:I am only a few pounds too heavy. I don't go by BMI, it's unreliable. I'm a former competitive weight lifter and developed above average muscle mass for my height. That messes up the BMI calculation. Anyway, I use percentage of bodyfat. Right now I'm about 23% body fat measured with underwater weighing. The recommended percentage for males is 20% or lower. So this only makes me a few lbs. too heavy. Most of what I read about OSA says that it's mostly in obese people. Am I a fluke or is it possible I was misdiagnosed? I also only snore mildly. Are there any others out there that aren't extremely overweight that have OSA?

If you are obese, please, please, please do not take offense to my post. I am not trying to insult anyone's body or say that I have a perfect body (like I said, I could lose a few pounds). I simply want to learn as much as possible.

I'm also very fit, very muscular, and far from obese. Snored heavily for years before any doctor recommended a sleep study. Turns out that my tongue is simply too large for my mouth size. CPAP user for almost two years now.

Raj, don't let them con you into moving the base of your tongue forward & screwing it down in a new position. That didn't help me. What did was extending the length of my jaw, which I don't recommend either. See:

viewtopic.php?f=1&t=43162&st=0&sk=t&sd= ... 15#p382433

The surgical solution I recommend is the one my sons had (described in the linked post), which is a variant on an orthodontic procedure for children whose jaws are too small for all their teeth. You will look pretty funny for a while, though, with an enormous initial gap between your front teeth on both jaws when the expander is taken out. But it does work.

Raj wrote:I'm also very fit, very muscular, and far from obese. Snored heavily for years before any doctor recommended a sleep study. Turns out that my tongue is simply too large for my mouth size. CPAP user for almost two years now.