Weight Loss and Breathing

[jda10000]

Hi -

I've been diagnosed with OSA / apnea, but believe it's come within the last four years, concurrent with gaining about 25 pounds, which put me at about 65 pounds of excess weight, with a BMI of about 36, and lots of incipient health problems.....

My studying on the topic of sleep apneas indicates it results from soft tissues in the through collapsing while sleeping, which of course the CPAP treats with air pressure. Some throats, of course, are simply formed in a way allowing apnea, even in lean fit folks.

What I cannot find is any reporting on those who address the weight issue - meaning, those who LOSE weight - and whether they can proceed through life without the expletive deleted CPAP machine.

I'm grateful, of course, for the treatment and the insurance to cover most of the costs, but I'm also committed to dropping the weight (18 down, 47 to go!), and am curious what the future holds for my CPAP machine after I get down to a svelte 165 pounds.

[Kiralynx]

Being claustrophobic, the idea of sleeping with a mask for the rest of my life thrilled me not at all.

Regrettably, although sleep apnea is to often characterized as a disease of fat folk, it isn't... although being overweight can worsen it.

Fact is -- my symptoms manifested right around the time I lost 75 pounds. I've since lost another 105, and have another 100 to go.

So, with a weight loss of 180 pounds, my apnea not only didn't go away, it just got bad enough to be diagnosed by a doctor who didn't say "Quit stuffing your face and lose some weight, and it'll all clear up." Instead, she said, "Poor sleep causes chronic pain, so I'm sending you for a sleep test."

Yup, it was positive. And my titration revealed I have complex sleep apnea. So I sleep with a Bipap Auto SV to address that. Mind, I wouldn't object if losing the last 100 pounds would eliminate the sleep apnea, and let me do without the mask again. But I can also tell you that I had the symptoms of apnea even when I weighed 135 pounds (I'm 5'6") -- those symptoms being hip pain with no apparent physical cause.

To sleep as I have been sleeping for the last two months, without pain, after years of hurt, I'd put up with many odder things than sleeping with a mask attached to a glorified hair dryer.

Just as an FYI, it can be monumentally hard to lose weight with untreated apnea.

[ca_hosehead]

Some people believe that overweight causes apnea. There are certainly a lot of people who have lost weight and seen their symptoms disappear or greatly improve. Fat accumulates in the tissues of the throat and makes it much easier for it to close.

There are also people of normal weight with apnea.

It is known that the chronic sleep deprivation that apena causes makes people gain weight and makes it very difficult to lose.

So if fat people have apnea, does that mean that you get apnea and then get fat, or do you get fat and then get apnea? Or do you just get apnea?

Obviously the answer is different for different people. There are a lot of variables here, weight is one. For you it could be the most important one and handling it could lead to relief.

However when you look at the overall picture, losing weight makes sense from so many angles. Even if it isn't a cure for apnea it will make everything easier.

And odds are not too bad that you *will* be able to live without the #$%^& machine.

[Julie]

There are not "a lot" of people who have lost weight and seen symptoms disappear, and even fewer who've been retested at that time and found to no longer have any signs of apnea. It's really too bad, but with medical science going at the rate it is today, who knows what'll happen tomorrow!

[Chris61]

There is a connection between weight and sleep apnea. I was tested in June of 07 and found out that I had OSA. At the time I was working on loosing weight and over the year I had lost over 75 lbs. I had another sleep study done in Sept. of 08 and my numbers had gone way down. The doctor felt if I lost some more it would down further. However he said that I still have OSA but it is below the action level. He felt that I would do good with the herbest retainer that I had. I was using the machine but was having problems with bloating and with keeping the mask on. So with the data from the machine he suggested a dentist for me to see and I got the herbest retainer. Here is a copy of the results.

Original study (pre weight loss)
Breathing event per hour: 68
Total breathing cessation per hour: 49
Lowest recorded oxygen level: 70%

New Study: post weight loss

No treatment:
Breathing events per hour: 19.4
Total breathing cessation per hour: 19.4
Lowest recorded oxygen level: 91%

With the Herbst device:
Breathing events per hour: 4.6 (counting little bitty ones 6.2)
Total breathing cessation per hour: 4
Lowest oxygen level: 92%

It turns out that with the Herbst, you are worst when you lie on your left side. Then you have 8.3 events per hour. In dream sleep, you have 10.2 events per hour

Your weight loss had the biggest effect!

Congratulations!

B. Gail Demko, DMD

I hope that this will help to answer your questions.

Chris

[beth1954]

Ok.....I'm a little challenged..............what is a Herbst?

[lvwildcat]

In Nov. 2005 I started on CPAP pressure of 15. Dec 2007 I had gastric bypass surgery. I have lost 153 lbs; 37 to go!!! My CPAP is down to 9 but that was from a study 80 lbs ago. My MD just wrote a script and submitted to DME for a APAP due to my ongoing fluctuation in weight.
My 20 yo son weighs about 150 lbs and is all muscle(BUFF!) the kid has sleep apnea and refuses(I can't even drag him) to go for a study. Even seeing how much the equipment has helped me...he'll have no part of it. I'm hoping as he gets older and understands more...he'll realize the importance of getting his sleep apnea treated.

[Chris61]

I also had weight loss surgery. I have the lapband and its one of the best things I have done for myself. The herbest retainer is a device that is used by orthodontics and oral surgerons to move either lower in or out. Now they are using it for sleep apnea. It looks like a regular retainer expect it has bars on each side that adjust. You only have to adjust it when you first get it. Once you are at a certian point it stays there. You also use rubber bands to help keep your mouth closed. What you are doing is pushing out the lower jaw a few mm so that you keep your airway open while you sleep. This device is one of the most prescribe devices. There are a lot of others and each has to see what works for them. If you go to sleepapenadentist.com you can see it there. I can also forward you some pictures of what mine looks like. As you can see from the sleep study it really does work. Also insurnace should cover it because it is condsider a durable medical device, just like the CPAP machine is. However it might take them a while to approve it. It took me a year and three appeals to get it paid for at 100%. I hope that this helps youout. Any questions just ask.

Chris

[gasparama]

My sleep doc, who has been in the business for a long time, said that he believes that OSA causes weight gain in some people and not the other way around. I've lost some weight since getting hosed, but I don't expect to ever be free of the OSA. Perhaps someday, my pressure can be lowered, but my tongue is located far back and will always get in the way. There is a person on a weight loss discussion board who lost over 200 pounds and says that he is now free of OSA and has sold his machine. But I don't think he had a Sleep Study for confirmation and I really wonder what's going on with him.

[kteague]

Just echoing what's been said about every case is different - and pointing out that any majority on this board is likely not proportionately representative of those in the general population with OSA. In the case of weight loss, those whose OSA was caused by weight and resolved by weight loss are not as likely to be posting here. I'd be interested in hearing from those who work in the field who have privy to post weight loss PSG's on patients and what trends they see.