Lost 87 lbs, sleep apnea remains, pressures about the same

[MrGrumpy]

Well, this post is for all the folks on here and elsewhere with sleep apnea who wrestle with the "if I lose a ton of weight, will my sleep apnea go away?"

I did just that and guess what? I did feel better and my blood pressure did go way, way, way down after losing 87 lbs and going off caffeine. Also felt very very relaxed. But my apnea did not go away. I was enrolled in a medical supervised, bariatric weight loss clinic in May 2014 with the original intent of doing gastric bypass surgery. I was accepted and had to complete a "medical" side attempt at weight loss first, per insurance requirements.

First six months in the program, I dropped from 258 to 206.

And this past summer and Fall, I lost most of the remainder, getting down to 171, with my ideal weight being 165. So I got down to just six or seven pounds of my high school Senior level weight. Im talking...skinny boy.

Did my apnea go away? No. 95th percentile at 171 lbs was still around 10.6. Although, as I mentioned above, I did feel better but probably for other reasons like, I looked better, purely psychological reasons, less stress on my joints and things like that. But no improvement in sleep quality and maybe dropped a point or two of pressure, but thats all!

Hard to believe, it must really be true that sleep apnea has as much to do with your airway shape and nasal structure, jaw structure as how fat you are.

[chunkyfrog]

Sadly, ASSumptions made in the nineteenth century are being desperately repeated,
even in the face of overwhelming evidence to the contrary.
And doctors wonder why some of us no longer trust their every gibbering word.

[LSAT]

There is no relationship between pressure and severity of sleep apnea. A person diagnosed with severe SA may only need a pressure of 8 while a person diagnosed with mild SA may need a pressure of 15.

[chunkyfrog]

Noted, and number of events per hour is of limited value
without considering the DURATION of said events,
and what stage of sleep in which they occur.

[MrGrumpy]

Well, ok then, however you wish to put it. Lets just say I still have mild sleep apnea then, but need a 10.6 pressure to keep the mild apnea under control AFTER losing 87 lbs!!

There is no relationship between pressure and severity of sleep apnea. A person diagnosed with severe SA may only need a pressure of 8 while a person diagnosed with mild SA may need a pressure of 15.

[Julie]

Yup, you made your own point about anatomy.

[Cathyann]

I want to congratulate you on your weight loss. Pretty awesome.

My OSA didn't go away after I lost weight either. I hoped it would, but nope.

[kurth83]

Same thing happened to me, I lost 35 lbs, got down to within 7 lbs of my high-school weight, and sleep apnea remained.

[Arlene1963]

What's really interesting is that although OSA seems to cause weight gain in many folks, XPAP treatment doesn't necessarily guarantee weight loss, despite resolution of O2 desaturations and dramatic improvements in AHI and sleep quality.

Oddly, studies point to a small but significant weight gain in many patients who use XPAP (esp. women)
I wonder why?

This does seem at odds with what one would expect logically. Counter-intuitively, weight doesn't decrease without dietary intervention when on XPAP

You've certainly worked hard to lose weight, well done!

[Mudrock63]

I think losing 87 lbs. is an awesome feat. Congrats! It will go a long way towards helping with any other medical conditions you might have. But I believe the overriding factor for sleep apnea is the fundamental structure of your nose and throat. Having an underbite also doesn't help. I think being overweight adds pressure on those structures and does contribute to worsening the condition somewhat. But you can lose 200 lbs. and it isn't going to change the basic architecture of your head and your throat.

I would be interested to hear of anyone "curing" their SA by losing weight. I could see possibly eliminating a very mild case, but moderate to severe? I doubt it.

[MrGrumpy]

Maybe if I lost that last ten pounds, got down to 160 it would suddenly "disappear?"

Doctors are obsessed with this relationship between obesity and sleep apnea. I think they get that obsession from the health insurance industry, which preaches that EVERYTHING! I mean EVERYTHING is ultimately rooted in obesity and being overweight, other than age.

Like, what about genetics? What about occupational injuries that screwed up your respiratory system decades ago?

I oftentimes believe that for us sleep apnea patients, the "sleep specialists" who we have to rely upon are sometimes are own worst enemies. Because of their lack of understanding of our illness.

I do admit after losing 87 lbs, I feel better. But not THAT better. I can remember when I was young, in my twenties when I first began putting on weight. I would lose twenty or thirty pounds sometimes and feel way better. Not so much now, however.

I do look better though, no doubt. No longer look like a fat POS. I can see my old jaw outline...have not seen that in almost two decades...kinda cool. And I can see my feet again...whoa. And I had to go down in pants size to waist size 34 from a 42. Women look at me again now, sometimes attractive women and I'm 46. <grin>

Another cool thing about it, I can see the blood vessels on the back of my hands and in my arms for the first time in probably fifteen years. Amazing. I knew they were in there, somewhere but now I can actually see them again.

And I admit it does make exercising much easier.

[WindCpap]

Congratulations. I am really happy for you. I am hoping to pull of the same thing. I have failed in the past, but with my apnea treated, maybe this time, it will be success.

[MrGrumpy]

Just some tips:

1) the high protein, lower carb/super low simple sugar diet thing is really bona fide. It is the kind of diet the bariatric specialists want me on longterm and I dont have diabetes, I was morbidly obese, however. Starches and simple sugars turn right into insulin and creates insulin resistance over time and that contributes to obesity over the long haul

The diet you want is high lean protein, high good fat, cut down bigtime on starchy veggies and bread products including cut down on pasta, almost cut out simple sugars. Eat a few pieces of fruit daily (an orange, an apple) and all the low starchy veggies you can eat...spinach, cauliflour, stuff thats not starchy. I go out to eat once a week and have a big medium rare steak at a good restaurant...the rest of the week I eat 1500 to 1600 calories a day

2) yeah, using your CPAP helps tremendously. Both with energy levels to exercise and also with...just the CPAP process itself creates deeper sleep and Ive learned I burn fat much easier when my sleep "feels deeper."

3) take a lot of vitamin D...it helps me lose weight. Weeks I'd take 100,000 IU vitamin D, I noticed I'd lose weight easier than when I did not take vitamin D, if you are really obese, personally I dont think you can OD on vitamin D just my personal opinion.

4) exercise as much as you can. Cardio to lose weight and use strength training to build muscle to speed up your resting metabolism, which makes you burn more calories all day long even when you are asleep. Plus the muscles make you look better

5) if you are truly obese, like morbidly obese, look into medically supervised high protein/high fat/low carb diets combined with regular exercise. They call it "ketogenic dieting." I was not in that program, but the clinic Im in has one and I dont think I was quite fat enough to qualify for it. But it works and its around if you look for it. You just have to do it medically supervised to be safe.

6) high protein makes you feel fuller, much longer, three meals a day of 40 grams of lean protein is what they have me on. Lean protein...chicken without the skin on it, fish, black beans, one or two cuts of red meat a week are allowed, lots of egg whites and a few whole eggs, milk protein is good. The proteins they want me to stay away from are the ones high in saturated fats...too much red meat basically, fried meats of any type

Once youve been on a high protein/lower carb for a while (six months or more) and lost a lot of weight, and you try going back to your old eating habits (pizza for dinner, processed food with a lot of carbs and sugars in them, starchy foods like maccaroni and cheese, potatos, etc)...the old foods dont even make you feel like you actually ate a real meal anymore. I swear its true. Only a meal that has a large amount of protein, say 30-40 grams of lean protein and some fat in it feels like a real meal anymore.

7) Youve been conned by the food industry and the restaurant indusry and the California, "fruits and nuts and whole grain bread products are good for you" crowd...but you probably dont realize it yet. I grew up thinking "fruits and nuts, whole grains, vegetables." Yeah right. <sarcasm>

fruit juice (orange juice) has more simple sugars in it than sugared sodas have in them!!! I did not believe it but its true. Instead of drinking OJ at breakfeast, EAT AN ACTUAL ORANGE INSTEAD!!!

Congratulations. I am really happy for you. I am hoping to pull of the same thing. I have failed in the past, but with my apnea treated, maybe this time, it will be success.

[Michelle-OH]

I know I had apnea, untreated but used to wake up gasping for air, 15 years ago when I was a good 40lbs lighter. And my neck still isn't as big around as to indicate apnea. I don't get why the dr's and sleep centers even make a big deal out of either of those measurements. Congrats on the weight loss!

[Drowsy Dancer]

My sleep doc told me years ago that the relationship between OSA and obesity is poorly understood, and that it is just as likely that prior OSA causes weight gain as it is that weight gain causes OSA. My own experience with losing a significant amount of weight without any change in pressure needs would appear to bear that out.