Losing weight really is the best long term solution

[Muse-Inc]

My sleep doc has always pushed weight loss...

Several of mine do and say that my apnea & its side effects will likely disappear when I get all my excess wt off. Another thinks these conditions are permanent...maybe, maybe not. Not all cases of apnea can be tracked back to excess wt, to assume it is is both simplistic and condensing at best. I track the beginning of my apnea to the yr I gained 50#s for no apparent reason.

I've noticed a 40% drop in my AHI with no other changes.

Good for you! I'm sure many are envious of the good result from a 10# wt loss.

Everyone here seems solely focused on their CPAP

Yeah, so? It's a potentially fatal condition...that makes it higher on my list of what I ABSOLUTELY MUST DO EVERY SINGLE DAY than the other conditions. Working on the root cause if one has been definitively identified is good but regardless of the cause, my continued survival depends on using CPAP every time I go to sleep.

What are each of you doing?

I, for one, am losing weight, exercising 45-75 mins/day, fighting my inner demons to stay positive, seeking to improve my CPAP therapy, sharing what's worked for me with others -- face to face and here as well as other places. I will not presume to state the same of others, but my short time here says eveyone is pro-active in their CPAP therapy -- that's the primary key to continued survival.

[rosiefrosie]

I also think you are making a blanket statement that most people with OSA are overweight. I gained weight after I started treatment for apnea and have lost 40 pounds in over the past year, ( I would pat myself on my back if I could reach it.) and now at a normal weight. This weight loss has done nothing to resolve my apnea. I think I will have to try the tongue crunches, presses and curls to see if that will help.

[BlackSpinner]

I was skinny for years until the sleep apnea really kicked in. Yes I could lose some weight now and I will start working out as soon as I recover a bit more but is was never a factor in me getting sleep apnea.

[dsm]

My sleep doc has always pushed weight loss as what I really need to do to treat my condition. I've always worked out, but still kept some weight on. I've been concentrating on losing it more lately and I've lost 10+ lbs. I've noticed an immediate change in my sleep and my memory card reader and software have backed it up. I've noticed a 40% drop in my AHI with no other changes.

Everyone here seems solely focused on their CPAP. What are each of you doing to lose weight to help the problem. It takes a lot more work than putting on a mask at night, but it really is the responsible thing to do. I know there are some slim people with apnea, but they are by far in the minority. What are each of you doing?

There are many among us who have lost weight & IT CAN & DOES reduce AHI scores.
I was 97 KG in Oct 2008 & today am 80-82KG - waist went from 113cm to 92cm (as checked this morning).
My AHI score was typically around 2.0 but is now mostly 0.2 or there abouts. But I am also much fitter as I
cycle 27kms each day (13.5 to & 13.5 from work).

I can go for a few nights without using a machine (I make sure I use Nasonex nasal spray) BUT I don't stay
off the machine for very long (max 4 days recently). What I find is that when things are going good I can stay
off but then I have a night where breathing goes off the rails & I wake feeling awful.

So weight has reduced the effects of OSA quite markedly but not to the point I am cured.

DSM

[SleepGuy]

Weight is definitely a factor for me.

I recently was able to lose 40 pounds on the hgc diet and after a month have been able to maintain the new weight, no problem (injection only--the oral hcg is a fraud from what I can see).

I will go back on the program to lose another 30-40 pounds and by that point will be close to my lowest adult weight from my early 20s.

Words almost cannot express how happy I am with this diet. Now I have never been one to diet or exercise but this program has been simple, effective, and has worked exactly as advertised. You just have to be literal about the program (and use the injection method).

All of that said there was a time before my diagnosis (about 7 years ago) when I lost a lot of weight on the Atkins diet - like 60 pounds. While I was not diagnosed back then I can say that my apnea was clearly a problem even at that lower weight, so I'm not planning on being able to shelf my cpap next month.

[kteague]

Hmmmm, Guest, we must not be reading the same board. Seems weight and/or exercise is discussed on here, and there are frequent reports of the increased activity various ones are now able to achieve once their apnea is treated. Here's where I see a disconnect... it seems you are assuming that discussing the value of cpap = dismissing the value of healthy eating and activity. The value of a healthy lifestyle is a given. Even if weight loss is the key to obliterating OSA in some, that does not make successful cpap therapy any less valuable in the interim, which is likely to be a significant time period.

I personally have posted in recent weeks about knowing some people who lost weight and no longer needed cpap (verified by testing). I also have posted that I'm sure I had apnea even when fit, so I don't expect my OSA to go away with weight loss. I am hopeful it will reduce the pressure I need, and even if not, the other health benefits are my motivator. By the way, I've lost over 50 pounds and my AHI has not shown any improvement yet. I may not know which came first, the chicken or the egg, but I am convinced that OSA set the stage for (notice I did not say caused) my weight gain rather than the other way around.

Overall, I agree that OSA can be caused or exacerbated by excess weight (for those that applys to). I just don't agree that being gung-ho cpap translates into settling for poor health in other areas. On the contrary, being willing to go thru what it takes to successfully use cpap seems to me represents a mindset of being health conscious. Just my 2 cents.

Kathy

[TSSleepy]

Don't mind me, I guess I'm just bitter.

Nine years ago I was 175 lbs, but my energy levels started declining and my ability to exercise started to wane. I ended up putting on 140 extra pounds. I fought it. I tried to diet and exercise. It was a long losing battle.

And doctor after doctor said "you need to diet and exercise". My blood pressure kept getting higher and higher. My blood glucose levels kept getting worse. I kept gaining weight. And the doctors kept chanting "you need to diet and exercise".

They wouldn't listen when I told them that something was wrong. Yes, that's correct. I'm neither lazy nor stupid. I was unable to keep the weight off because there was something wrong with me. It was sooo frustrating (and frightening) not knowing what that "something" was.

Finally, last winter I hit about 320 lbs and my body simply crashed. I could barely move and I could barely stay awake. And a coworker said, "maybe you have sleep apnea".

"No," I replied, "I sleep several hours per night, and am getting plenty of sleep". But then I read about sleep apnea and realized that it completely explained everything that had been dragging me down for the last several years. I've been on CPAP for about 4 months and feel better than I have in years. I'm finally able to start exercising some and am down to around 310 lbs, with a long way to go.

But I know for a fact that I will not be off CPAP, if I get back down to 175 lbs. In retrospect, it's obvious that I wasn't getting good sleep even back then, which is why I'm in this mess now.

So yes, I'm bitter. And it irritates me when people say that losing weight is the solution. I want the last several years of my life back. I want the doctors to have thought of this years ago, instead of just nagging at me to lose weight over and over and writing my health off as "my fault", because I was unwilling to exercise. Horse puckey!

I'm bitter because I have a friend who obviously has severe sleep apnea, and he refuses to get it checked out because he doesn't want to deal with CPAP and is trying to "cure" it by losing more weight (he's a whopping 20 lbs overweight).

I'm bitter because Robert Fogel of Harvard Medical School doctored his data to show a link between obesity and sleep apnea in his 2003 paper in the journal "Sleep", and that paper has been cited numerous times.

As for the original poster's question of what am I doing to lose weight? Now that I am on CPAP and able to sleep without severe oxygen deprivation and systemic stress...I am walking and using the elliptical and slowly losing weight as my fitness levels get better.

Do I want to lose weight? Absolutely. Will I be healthier when I go from 320 down to 175? Absolutely. Is it a "solution" for my sleep apnea? No...sleep apnea is what got me into this mess in the first place. Even when I am awake, if I lie on my back and relax my jaw and tongue...my throat closes. And that has nothing to do with how big my belly is.

Anyway, I can't help it. I'm carrying a lot of annoyance towards the medical establishment that failed to diagnose me for years and just told me to "go lose weight". I'd like to go back to those doctors, ask them to sleep only 4 hours/night for a few weeks, and tell me how much exercise they are able to do...

[roster]

As we all know, statistics can be very tricky.

The statistics say that overweight people (BMI 25 and up) are more likely to have apnea than normal weight people (BMI 18 to 25).

When overweight people complain to a doctor about fatigue, stress, depression, etc., there is a some probability, say 'X', that the doctor will suspect and screen them for sleep-disordered breathing (SBD).

When normal weight people complain to a doctor about fatigue, stress, depression, etc., there is a some probability, say 'Y', that the doctor will suspect and screen them for sleep-disordered breathing (SBD).

There is no doubt that in recent decades, probability X has been a large multiple of probability Y. In fact, probability Y has been near zero. There are bits of research starting to come out now that the incidence of SDB in normal weight people is much higher than anyone ever expected. Time and effort will eventually tell the truth.

So if increasing BMIs of our population is not the primary cause of the high prevalence of SDB, what is? I don't know, but one renowned SDB doctor believes the jaw began to narrow in our population about 200 years ago for some unknown reason.

Just for the record, I was very fit and my BMI was 21 at age 22. In my midtwenties I began to develop severe OSA. By age 40 my BMI was 25 but I still was very active. Recently I started CPAP, was able to increase my activity level to strenuous, and drive my BMI down to a very fit 21 at age 60. My OSA is still severe and the CPAP pressure requirements have not been reduced.

It is not the size of the neck on the outside; it is the size of the airway in the neck.

Rooster

[BeanMeScot]

I know of at least 3 people where I work that have sleep apnea. One of them is 100lbs soaking wet, one is a guy who might have an extra 20 on him and one is a girl who probably has an extra 30 on her. None of them would qualify as obese yet they all have apnea. In fact, most of the people I know who have it are at or near their ideal weight.

I think it is quite possible that people who are not obese simply aren't diagnosed with OSA very often although they probably have it at a similar rate to obese people. Their doctor's buy into the false belief that only obese people have it so they wind up suffering for it.

[Juliebove]

Not all people with sleep apnea are overweight.

Then there are some of us who can't seem to lose weight. Oh I *can* lose it. In fact I did, some years ago. Never quite got to my goal weight but lost enough that I looked slim. The problem was, I was eating so little that I would feel weak and unwell. And constantly hungry. I was also exercising for at least 2 hours a day. This was enough to give me injuries.

I used to go to bed earlier than I would have liked to just so I could try to sleep and ignore my hunger pains. And did I have apnea back then? I think so. I used to wake up and realize that I wasn't breathing.

I did manage to keep the weight off for 2 years. I monitored every bite I ate. I only allowed myself unlimited food once a week and that was from a salad bar. Vegetables only. Nothing like pasta or potato salad. No dressing of any kind. It was a very low fat diet I put myself on. Leaning towards vegan although I did allow myself some egg whites and occasionally low fat cheese.

And then I met the man who is now my husband. He is Italian and loves his food. But he was also a bachelor and rarely had any food in the house. He made a pot roast with potatoes and carrots once a week and called out for pizza the rest of the time. I began bringing healthy food to his apartment because I really didn't like pizza and being a vegetarian, didn't really want the pot roast. Somehow (I don't remember how it got there) a package of cheddar cheese appeared in his fridge. There was a loaf of bread that I may have brought over. He made me a cheese sandwich. He cut off what appeared to me to be a slab of cheese. If I ever did eat full fat cheese, I cut a paper thin slice of it and then cut it into matchstick size pieces and ate it slowly. My mom seemed to think that cheese and bread were the root of all fat people and therefore didn't let us have much of them. Anyway... I bit into that giant sandwich and it was all over for me. I was like... Ooooh! So THIS is how food is supposed to taste!

The weight didn't come right back on, but eventually it did. I began dining out more often and eating things I never allowed myself to eat. Like crepes Suzette.

Then I got fat again and struggled to take it back off. I tried different kinds of exercise, not wanting to give myself more injuries. I got married. Got a job at a golf course. Hit a bucket of balls every day after work and sometimes on days when I didn't work. Kept very active and watched every bite I ate again. Once again, fooled myself into thinking low fat eating was the way to go. Ate a lot of beans, rice, plain pasta, air popped popcorn and raw veggies.

Lost some of the weight, but also got thick in the middle. Imagine my surprise when I found out I was pregnant! Was told that I had gestational diabetes early on into the pregnancy. I am thinking now it was type 2. Why? Because a year after I had the baby, I was told I had type 2. And because the diagnosis during pregnancy came on so early.

Was told to lose weight and eventually did lose some. But the combination of meds I was on (some encourage weight gain) and a wacky thyroid made it very difficult and I couldn't seem to lose any more.

Diabetes eventually got out of control despite my careful diet and was put on insulin and then another kind of insulin as well. Consulted with medical people who insisted I must eat three meals a day. I had eventually found out that the only way I could lose weight was to stop eating lunch. And it worked out well for me that year. Daughter had an hour after school and then had to go to dance class. So I made an early dinner for us and those two meals were enough to keep us going.

This year was different and she either had to go to dance immediately after school or several hours later. We were eating really late dinners. So when they told me I had to eat lunch, I didn't protest. I ate it and immediately packed the pounds back on.

Then my Dr. got angry with me. Very angry. Threatened lap band surgery if I didn't lose the weight. When I told him about the lunch, he told me to stop eating it. So I did, but the hunger got the best of me. I just couldn't go 12 or more hours without eating. So I had a snack in the afternoon. I immediately lost 6 pounds but no more. And now I'm stalled.

So I would LOVE to lose weight, but don't see how to do it. I am on a very limited diet. I now know that I have food allergies. Almonds, dairy and eggs. I have gastroparesis. That means I don't digest my food properly so can only eat those things that are easily digested. If I eat too much salad it comes back up. The dietician was no help in that regard.

And even though I would love to lose weight, I don't think that losing it will make my apnea go away. As a child, I was very underweight. And back then I used to wake up and realize that I wasn't breathing. So... I think I've had this all my life. Or pretty much so.

[ldaiga]

Sleep apnea takes many forms and has many variances. Just as we are all individuals, our personal forms of apnea also exist.
This forum talks about many problems, trials and errors, and solutions. Some better, some worse. Nothing is a cookie cut solution.
I did not take the comments of the guest as looking down upon those that are a little pleasantly plump. I don't think that was the issue here. I think the guest was just trying to express his opinion about one facet that may influence sleep apnea. It was not meant as a blanket statement for all. Those people who have tried to lose weight and no change was evident, or those people who are slim don't fall in this situation. However, if a person has not tried to lose weight, it may be a point to consider. It may work, it may not. In the long run, if the person is successful in losing weight, he will have other positive results regarding health issues.
Yes, we are totally involved in trying to survive by handling our specific problems with sleep apnea. Maybe we don't have time and effort to do the diet thing. So be it. But, if the guest's comments have caused some small percent of those participating in this forum to think about it in a positive light, maybe the guest will have done good. Helping just one person is a step in the right direction.

[Cassandra]

Don't mind me, I guess I'm just bitter.

Nine years ago I was 175 lbs, but my energy levels started declining and my ability to exercise started to wane. I ended up putting on 140 extra pounds. I fought it. I tried to diet and exercise. It was a long losing battle.

And doctor after doctor said "you need to diet and exercise". My blood pressure kept getting higher and higher. My blood glucose levels kept getting worse. I kept gaining weight. And the doctors kept chanting "you need to diet and exercise".

They wouldn't listen when I told them that something was wrong. Yes, that's correct. I'm neither lazy nor stupid. I was unable to keep the weight off because there was something wrong with me. It was sooo frustrating (and frightening) not knowing what that "something" was.

Finally, last winter I hit about 320 lbs and my body simply crashed. I could barely move and I could barely stay awake. And a coworker said, "maybe you have sleep apnea".

"No," I replied, "I sleep several hours per night, and am getting plenty of sleep". But then I read about sleep apnea and realized that it completely explained everything that had been dragging me down for the last several years. I've been on CPAP for about 4 months and feel better than I have in years. I'm finally able to start exercising some and am down to around 310 lbs, with a long way to go.

But I know for a fact that I will not be off CPAP, if I get back down to 175 lbs. In retrospect, it's obvious that I wasn't getting good sleep even back then, which is why I'm in this mess now.

So yes, I'm bitter. And it irritates me when people say that losing weight is the solution. I want the last several years of my life back. I want the doctors to have thought of this years ago, instead of just nagging at me to lose weight over and over and writing my health off as "my fault", because I was unwilling to exercise. Horse puckey!

I'm bitter because I have a friend who obviously has severe sleep apnea, and he refuses to get it checked out because he doesn't want to deal with CPAP and is trying to "cure" it by losing more weight (he's a whopping 20 lbs overweight).

I'm bitter because Robert Fogel of Harvard Medical School doctored his data to show a link between obesity and sleep apnea in his 2003 paper in the journal "Sleep", and that paper has been cited numerous times.

As for the original poster's question of what am I doing to lose weight? Now that I am on CPAP and able to sleep without severe oxygen deprivation and systemic stress...I am walking and using the elliptical and slowly losing weight as my fitness levels get better.

Do I want to lose weight? Absolutely. Will I be healthier when I go from 320 down to 175? Absolutely. Is it a "solution" for my sleep apnea? No...sleep apnea is what got me into this mess in the first place. Even when I am awake, if I lie on my back and relax my jaw and tongue...my throat closes. And that has nothing to do with how big my belly is.

Anyway, I can't help it. I'm carrying a lot of annoyance towards the medical establishment that failed to diagnose me for years and just told me to "go lose weight". I'd like to go back to those doctors, ask them to sleep only 4 hours/night for a few weeks, and tell me how much exercise they are able to do...

Gosh, TSS. I hate to quote all of a long post, but I had almost exactly the same experience as you did. and it SO disheartening. Twenty years ago I was in great shape, thin and healthy. I started gaining weight and I was begging doctors to help me figure out what the problem was. I was on diet after diet and a couple of times became severely illl for my efforts to lose weight. Nothing worked. And even as I gained 110 pounds in just 4 years, I kept getting the same old garbage about how I needed to exercise and lose weight and I would feel so much better. (all the while working myself to death trying to lose weight.) I read a statistic just a couple of days ago that said HALF of OSA sufferers are over weight. That means HALF of them are NOT.

I still am very angry at all of those doctors who made assumptions and charged me a lot of money to give me no help at all. Finally, I diagnosed the problem and demanded the solution like I usually do. "I have sleep apnea! It's making me sick! Give me a machine!" And one of them finally relented and here I am a week later, finally feeling like I'm doing some good.

And by the way--I have lost 50 pounds since the end of March. It didn't cure anything. The machine has made almost instant noticeable difference, even though I don't have it down perfect yet.

And also, I read and post at diet and fitness boards when I want to talk about diet and fitness. When I want to learn about my CPAP machine, I come here.

Cassandra

[roster]

I think the medical profession is going to slowly find more and more cases like Cassandra's and TSS's. Eventually "Guest's" statement,

......... I know there are some slim people with apnea, but they are by far in the minority. ........

will be known to be totally wrong - these people were normal weight with sleep apnea and the doctors failed to diagnose it and without diagnosis and treatment, the apnea drove them to be overweight.

[LisaEileen]

Cassandra and TSS, I've had the same experiences. In my 20's, (I'm 40 now) i used to be one of those people who never sat down. I worked out twice a day and all day long I was doing something to keep active such as walking, crunches, etc. I am 5'4" and weighed 128 back then. I was a very muscular 128. My dh and I stayed at my MIL's cabin one weekend. She pulled me aside one morning and told me that if I would "lose that last 10 pounds, I'd stop snoring." After getting over the shock of her rudeness, it dawned on me what she just told me. I never knew I snored. DH never even told me that. Within a few years of that, my life started going down hill with aches, pains, weight gain, etc. For the past 11 years I've been on a quest to get my health under control. I got a diagnosis of ADD and fibromyalgia. In May, I was diagnosed with an obstructive airway sleep problem. It all makes sense now. My aches, pains, ADD, etc. are BECAUSE of my sleep problem. I know that the extra weight I put on is not helping my situation, but I know my weight is not the cause of my problem. I have had sinus problems my whole life. I almost got sinus surgery, but after doing the research and realizing I could end up with worse problems, I never did do it. Both of my doctors are pretty convinced that I will probably lose weight once I get my sleep problem under control. I know 3 other people who started cpap and lost about 30 pounds the first year without really trying. They started feeling better and became more active without really thinking about it.

[roster]

....one is a guy who might have an extra 20 on him and one is a girl who probably has an extra 30 on her. .......

What are their BMIs? 20 or 30 extra pounds can easily put one in the obese category (BMI 30 or greater).

I have been in an organized group recently doing an exercise where a doctor pointed out several and declared them "obese". The group protested and described the people as "a little overweight, but definitely not obese." The doc then measured their height, put them on the scales, and had the group calculate BMIs. The BMIs ranged from 32 to 36 - all were confirmed obese.

The point of the doc's exercise was that we live in a society of overweight and obese people and have mentally redefined what normal weight means. But our new definitions are not medically correct!

Of course the doc had been careful to not pick out the most obese people - and there was a large percentage who appeared to have BMIs considerably higher than 36.

I have become sensitized to this partly because of participating in the doc's exercise and partly because of my own weight loss efforts. In our morning newspaper recently there was a photo of all the top graduating high school scholars in the county. Many of the girls were in sleeveless or short sleeve dresses. I remarked to my wife that 12 out of 15 of the girls had fat arms, knees and lower legs. I pulled out my high school annual and it was remarkable that 90% of the girls were what would be described as skinny today. But they were not thought of as skinny back in 1967 when that annual was produced!

Don't run off blaming fast food. Sit-down restaurants serve more calories per customer than McDonald's and we aren't eating worth a damn at home either - just look at what is in the grocery cart in the line in front of you.