Controlling OSA with weight loss??

[BernieRay]

Since being diagnosed in 1997, my weight has fluctuated by about 150 lbs. First down, then up, now down again. Through all of that, my pressure has only changed between 10 to 12. I suspect that the ability for weight loss to impact OSA is dependent on at least the baseline size of the airway and the ability to lose fat along the airway. In my case, I have a narrower than normal airway, so weight change has very little impact.

[goldfinch]

There is research that shows substantial weight loss in obese or morbidly obese people can improve sleep apnea, sometimes to the point of a cure. For example, if the apnea was mild it may disappear. If severe, it may become moderate. But as some have said the apnea may be due to structural issues that weight loss does not help. There are plenty of non-obese people with sleep apnea.

I lost 20% of my weight. I have mild/moderate apnea so I still need CPAP. The apnea may have been worse before the weight loss, I don't know.

[NightMonkey]

There is research that shows substantial weight loss in obese or morbidly obese people can improve sleep apnea, sometimes to the point of a cure.

Have you looked at any long term studies where PSGs were used for confirmation? I haven't found such studies and I believe the track record in curing sleep apnea with weight loss is very poor.

[Judy in CA]

Congrats on the weight loss
I'd lost 40 #'s and then stopped smoking all the while getting used to new machines and masks after relocating to CA with different standards and alot of testing.
Now I've been to every dr and every test done and gained the 40 back since stopping smoking and finally getting the CPAP controled but know that while the 2 months I wasn't having success on the CPAP it's what was helping to add the weight as i wasn't eating differently just wasn't as active as i was SO TIRED all the time.
Judy

[Bluecat]

I have lost 36 lbs since beginning of May (started CPAP mid February). My pressure needs don't seem to have changed (90% pressure approx 11,5). There is still a long way to go (I started morbidly obese, am now severly obese, hope to be moderately obese by october... Overweight will be a 2012 goal ). I will probably try lowering the minimum pressure on my APAP later in the year to see if the 90% pressure goes down as well.
Even if I achieve my ultimate goal of being a normal weight, I don't think I will ever be cured of my OSA (narrow nose, high palate, big tonsils...).
Nevertheless, even if weight loss can't cure OSA, it is still very good for your health

Bluecat, BMI 37.7

[ozij]

I will probably try lowering the minimum pressure on my APAP later in the year to see if the 90% pressure goes down as wel

Bluecat, your 90% pressure means that your machine needs to go above that pressure only 10% of the night. Lowering your minimum pressure makes sense only if you find your 90% close to the minimum. I your 90% (that's actually your 90th percentile) pressure doesn't drop naturally, there's no sensed in lowering your minimum.

[Bluecat]

My minimum is 10. My average 90% is 11,5/11,7 but I have had a few "bad" nights (AHI between 1 and 2 instead of between 0,5 and 1, which I know is still very good!!) where I have had a few times where pressure went up and caused the 90% to go up. I am more and more getting nights were the pressure stays at 10 with little sawtooth changes (haven't got a graph available, as I'm at work just now). That's why I was wondering about bringing the minimum down a bit (9.5 or 9), to see if that pressure would be enough. I started in February with a wide open range of 6-18, and saw that a pressure of 10 was needed (my doctor decided to autotitrate at home with the APAP, because the wait for a sleep lab titration was over 6 months). Maybe with a good weight loss, 9 would now be enough... I will wait for a further weight loss though before changing!

[JohnBFisher]

I am still in the early stages of being diagnosed and trying to learn everything I can. I could and should realistically drop say 10 pounds and would have a mid ranged body mass index reading of 22.9 from current 24.5 but wondering if this would have any affect on my OSA symptoms. I am guessing it would not since I've probably had mild symptoms all my life even when a good 20lbs lighter but curious if anyone here has used weight loss as another tool in addition or even ultimately in place of a CPAP. Thanks!

Ugh! Here we go again.

Let me provide my experience, which flies in the face of the myth that weight causes apnea. In fact, in my case, I am more than willing to argue that apnea causes weight gain, which only makes the apnea worse.

When I was about 13 (and going through puberty), I started to snore. But not just any snoring. As my sister said, "You snore just like Grand Dad!". And trust me, if you heard him, you would be convinced he had obstructive sleep apnea. Loud snoring. Periodic pauses - and no breathing - and loud snorts. Yup. Pretty classic signs of obstructive sleep apnea.

And he died fairly young (62) of heart related problems. He died in his sleep.

Now, when my sister started to complain about my snoring, I was UNDER weight. I went another 20 years before being officially diagnosed with severe obstructive sleep apnea. I was a little overweight (about 40 pounds) at the time. But not all that bad.

But the point is that my apnea started before. And the struggle of dealing with feeling horrible each and every day led me to have problems with weight. I would eat to stay awake. I would eat to go to sleep (because sleep was so stressful). And as you can imagine this set me up for diabetes about 20 years after I was diagnosed with obstructive sleep apnea.

And there are LOTS of studies that show that poor sleep contribute to weight gain. It's a vicious cycle.

So, does weight gain = obstructive apnea. Nope. It can make it worse. But at least in my family there are clear signs that the apena comes first, followed by the weight gain.

However, that being said... Some people with mild sleep apnea do get to a point where they do not need the machine if they drop some of their weight. But appears to be the exception, not the rule.

Hope that helps.

[goldfinch]

There is research that shows substantial weight loss in obese or morbidly obese people can improve sleep apnea, sometimes to the point of a cure.

Have you looked at any long term studies where PSGs were used for confirmation? I haven't found such studies and I believe the track record in curing sleep apnea with weight loss is very poor.

The studies I read were all short term. The track record for curing apnea long term via weight loss may be poor partly because the track record for maintaining weight loss is poor. Either way, long term study is needed.

I am puzzling through this whole thing because I have mild sleep apnea, at 6.5 AHI in my sleep study. My apnea was "highly correlated" with the supine postion. I also had to take a xanax in the middle of the night to go back to sleep (they woke me up to tell me to sleep on my back). There were more events after the xanax. I weighed about 140 at my study. I now weigh 123. I still am a bit overweight but not by much. I can't help but wonder if I still meet the apnea guidelines. The PA at the doctor's office seems to think that the odds are I still have sleep apnea that should be treated via PAP and likely for life. She is just guessing though. The PA noted that my BP was down, but I said we don't know if that is apnea treatment or weight loss or both. I can't seem to figure out when and if follow up sleep studies are done if a person is borderline.

I am adapted to the PAP but of course it would be nice not to have to use it. I have decided to do an experiment. I have 30 days of Provent. I ordered an oximeter. Once my shoulder is better so I am not stuck on my back all night I am going to try the Provent with the oximeter and see how the desaturations go.

I wonder about another experiment. Can you effectively do your own sleep study by setting your cpap pressure to 4, run the PAP and an oximeter and then read the data for the night? Or am I full of it?

[Judy in CA]

well haven't posted on here for awhile but the weight issues continue
Internist, pulmonologist, and neuro said OSA will cause weight gain and b/c of health issues I can't exercise like I'd like to.
I'm going to PT for balance and now starting some pool therapy
My eating didn't change just my mobility and praying as new BiPAP starts working it will help. Should mention I'd lost 40 # before i stopped smoking and now gain it back. so
would love for some others to chime in
Judy

[Mary Z]

goldfinch, how are you doing with the Provent? Yet another person is asking about this "NewTherapy" and as far as I know you're the only one who has been willing to try the therapy.

[ThomasMcKean]

goldfinch, how are you doing with the Provent? Yet another person is asking about this "NewTherapy" and as far as I know you're the only one who has been willing to try the therapy.

*I* am willing to try it. But I only just heard about it from that other user. If I get around to it, I will post here and let yew know!

[Woody]

My sleep apnia is a lot beter when I weigh less. But a friend of mine who lost 80 lbs had to have her
pressure changed from 10 to 12. By the way I saw one study that said MRI studies of sleep apnia
patients ofton showed less grey matter in the part of the brain that controles breathing. These scientist
believe that the sleep apnia resulted because of less of this gray mater.

[Roger2]

I have now heard the same explanation from three physicians; my primary care physician whose specialty is internal medicine, my pulmonologist at National Jewish and my new sleep doctor also at National Jewish. All three said that OSA can and is frequently caused by obesity. All three also stated that it can and frequently is a genetically caused ailment but that if you are obese as I am the OSA severity can be greatly reduced by weight loss.

Looks like any way you cut it, weight loss can only benefit us. I am going to see the nutritionist next week to try to work out a diet.

Roger