The underlying causes of sleep apnea

My father already was snoring, when he was young and thin as a rake. He developed sleep apnea after he become older and put on weight.

It's absolutely true that sleep apnea has complex etiologies. Yet here you ASSUME that (despite his history of snoring) your father's weight gain caused the sleep apnea--not recognizing that the underlying cause may not have been his weight gain at all. Unless he had a sleep study ruling out sleep apnea when he was "young and thin as a rake", you don't know that he didn't already have sleep apnea. The weight gain may have been coincidental, or the apnea may have even caused the weight gain.

Yes, excess tissue from obesity can cause apnea in a subset of people. But I see too much assuming that because excess weight CAN cause apnea in obese people, therefore all obese people with apnea have apnea because they are overweight.

This belief is also a barrier to thin people getting proper diagnosis. How many thin people here were told that they couldn't possibly have OSA because they were thin--some had to really push their doctors for testing.

Janknitz wrote:

My father already was snoring, when he was young and thin as a rake. He developed sleep apnea after he become older and put on weight.

It's absolutely true that sleep apnea has complex etiologies. Yet here you ASSUME that (despite his history of snoring) your father's weight gain caused the sleep apnea--not recognizing that the underlying cause may not have been his weight gain at all. Unless he had a sleep study ruling out sleep apnea when he was "young and thin as a rake", you don't know that he didn't already have sleep apnea. The weight gain may have been coincidental, or the apnea may have even caused the weight gain.

Again I trust his experience gauging his own life quality during his years as a youth, more than some emotionally charged rebuttal full of conditional reasoning.

Janknitz wrote: Yes, excess tissue from obesity can cause apnea in a subset of people. But I see too much assuming that because excess weight CAN cause apnea in obese people, therefore all obese people with apnea have apnea because they are overweight.

Again that stems from a problem with lack of depth of knowledge and experience within the medical community, not with the fact that there is an observable relationship between sleep apnea and obesity. I don't understand why anyone could be so hung up on this. It's an undeniable fact. Just because there are different sets of circumstances doesn't mean a fact doesn't apply at all.

Janknitz wrote: This belief is also a barrier to thin people getting proper diagnosis. How many thin people here were told that they couldn't possibly have OSA because they were thin--some had to really push their doctors for testing.

Doesn't contradict the fact. Your main gripe seems to be with doctor's individual experience and competence level, not with obesity's relationship to sleep apnea.

Janknitz wrote:This belief is also a barrier to thin people getting proper diagnosis.

This was my week to see doctors. This morning was the annual sleep doc visit.

Monday I had my teeth cleaned and x-rayed. The hygienist knows I use CPAP and was telling me about her husband. He had used CPAP but then he lost a lot of weight and about two years ago quit using CPAP because "with the weight loss he no longer had sleep apnea." His doctor had told him if he loses weight he won't have sleep apnea.

That part I knew because she had told me the last time I had was in. But now she added something. In February he had a major heart attack.

So did the weight loss really cure him of sleep apnea? I have my doubts.

Boyce wrote:

Janknitz wrote:This belief is also a barrier to thin people getting proper diagnosis.

This was my week to see doctors. This morning was the annual sleep doc visit.

Monday I had my teeth cleaned and x-rayed. The hygienist knows I use CPAP and was telling me about her husband. He had used CPAP but then he lost a lot of weight and about two years ago quit using CPAP because "with the weight loss he no longer had sleep apnea." His doctor had told him if he loses weight he won't have sleep apnea.

That part I knew because she had told me the last time I had was in. But now she added something. In February he had a major heart attack.

So did the weight loss really cure him of sleep apnea? I have my doubts.

You're not following the reasoning here at all. One set of circumstances doesn't neccesarily contradict or negate another. If "A" is a cause and "B" is an aggravating circumstance, which leads to "C" it doesn't mean that "B" can never lead to "C".

Boyce wrote:Maybe you did not understand that I was responding to Janknitz's post?

As it turns out the study found nerve damage and muscular abnormalities in the 2 latter groups.

Maybe you want to expound on this statement.

Well as I wrote earlier. The research's findings pointed to degenerated muscle fiber morphology in the throat muscles. How it's accrued or whether it's hereditary isn't known. But the muscle defect is there, observable in biopsys of snorers and sleep apnea patients. Which shows a clear disorganization in morphology and atrophy in the muscle fibers of the throat compared to controls in a cross analysis. It's as evidence based as possible. You can argue that the findings can be nullified by some other possible explanation and findings which contradict the proposition and evidence or expound on the previous findings and attribute it to some other structural cause. But so far that's the closest thing to an explanation I've found on the subject.

tiredandscared wrote: A control group without problems and two respective groups of chronic snorers and sleep apnea sufferers.

How many subjects in each group?

What I'd like to see is results of a study comparing adults with SA who have their tonsils vs adults with SA whose tonsils came out when they were children (routinely, as was done decades ago). Not talking about the odd(?) adult with recent tonsillectomy, whether for SA reasons or not.

Julie wrote:What I'd like to see is results of a study comparing adults with SA who have their tonsils vs adults with SA whose tonsils came out when they were children (routinely, as was done decades ago). Not talking about the odd(?) adult with recent tonsillectomy, whether for SA reasons or not.

Please start a different thread. This is not part of the current discussion.

Boyce wrote:Maybe you did not understand that I was responding to Janknitz's post?

As it turns out the study found nerve damage and muscular abnormalities in the 2 latter groups.

Maybe you want to expound on this statement.

It might help to read some of Eva Svanborg's work (English language). You can get a better feel for what she is talking about in some of these sources - https://www.google.com/search?q=apnea+E ... 8&oe=utf-8

Here is one of her papers for those interested:
http://www.atsjournals.org/doi/full/10. ... Z2vassVjhA

The histories of many patients with obstructive sleep apnea syndrome (OSAS) reveal a gradual onset starting with habitual snoring, often rather early in life. OSAS is also an unusual diagnosis before middle age. The progressive nature of the disease has been confirmed in some studies of untreated mild– moderate cases (1, 2). The etiology of OSAS is only partly known. The most obvious pathogenic factor is a narrow upper airway due to enlarged tonsillar tissue, skeletal anomalies, or fat deposits. Weight increase often provokes impairment of obstructive respiration but does not always explain progression. Marked worsening of obstructive breathing has been found in some patients experiencing weight reduction (1), and in another study (2), there was no association between changes in weight and apnea index. After adolescence, the tonsils gradually become smaller, and the facial skeleton is usually not altered in adulthood. Another factor that changes over time must be responsible for disease progression.

He (my Dad) got sleep apnea when he started working night shifts and gained weight as a result.

Your Dad came home in the morning and went to sleep. But his snoring shook the whole apartment. According to the research study that you're providing, your Dad, even if he lost the weight, he still suffers now from sleep apnea. What about getting a CPAP for him too?

tiredandscared wrote: I personally had no issues with sleep, until january this year. And I have mild positional sleep apnea. In my case I got as a result of screwing with my sleep.

Do you honestly believe that you have a physical problem in your throat due to what time of night you sleep? Seriously?

I have had a narrow airway since I was a small child. I have had allergies since I was a small child. Allergies cause congestion, which narrows the throat more. I have the classic small chin, small jaw, crowded teeth, etc. Because my airway is smaller, it doesn't take as much to block the throat and cause breathing problems.

I was diagnosed in 2012, but I had known for at least 10 years that I had sleep apnea. And looking back, I had symptoms back in high school and college. But if you had asked me just before my sleep study, I would have told you that I snore, and don't spend enough time in bed, but my sleep is pretty decent. It wasn;t until I did the sleep study and felt the difference that I realized how bad my sleep really was. Who knows when the sleep apnea really started. It is not something that you suddenly catch, or something that you can cause by changing your sleep pattern.

There are also plenty of skinny people with sleep apnea and fat people without sleep apnea. Yes, there is a correlation, but it has been determined that lack of quality sleep leads to weight gain due to hormones and lack of energy (craving sugar and caffiene). So, the sleep apnea is often causing the weight gain. It is just that we don't notice the sleep apnea symptoms until years of suffering, and by that time, weight may have crept up.

zoocrewphoto wrote: Do you honestly believe that you have a physical problem in your throat due to what time of night you sleep? Seriously?

Not what I said. I said that I got it as a result of weight gain. In my case atleast. I had no breathing and no issues with my sleep until the last week of 2015 january. I woke up one day and it feelt like I had lost 20 iq points. At first I thought it was a hormonal issue or temporary insomnia. But then as it was consistent no matter what I did. Sleep hygiene, sleeping pills, none of them worked. Then I put two and two together and I noticed that I started getting this problem after I had gained weight. It's also in present in my immediate family (father has had it for years untreated).

Fortunely I'm vigilant enough to have caught it only after q. I haven't developed any related health complications. It's relatively mild as I dont get any serious desats and I only have problems if i sleep supine , awkwardly or eat a fatty meal before sleep. I was in good health in the bmi range of 29-31. Once I start push in over that range I get problems like this.

tiredandscared wrote:

zoocrewphoto wrote: Do you honestly believe that you have a physical problem in your throat due to what time of night you sleep? Seriously?

Not what I said. I said that I got it as a result of weight gain. In my case atleast. I had no breathing and no issues with my sleep until the last week of 2015 january. I woke up one day and it feelt like I had lost 20 iq points. At first I thought it was a hormonal issue or temporary insomnia. But then as it was consistent no matter what I did. Sleep hygiene, sleeping pills, none of them worked. Then I put two and two together and I noticed that I started getting this problem after I had gained weight. It's also in present in my immediate family (father has had it for years untreated).

Fortunely I'm vigilant enough to have caught it only after q. I haven't developed any related health complications. It's relatively mild as I dont get any serious desats and I only have problems if i sleep supine , awkwardly or eat a fatty meal before sleep. I was in good health in the bmi range of 29-31. Once I start push in over that range I get problems like this.

It is far more likely that it crept up on you over the years, and it is the cause of your weight gain. People want to blame it on weight gain as they hope that losing weight will make it go away. And that is their excuse for not using cpap. But instead, they usually never lose the weight, and they only get worse. Those who do lose the weight often find that they still have sleep apnea. Losing weight is a great goal as it will help other issues. But this false hope that it will remove sleep apnea is actually very dangerous since it people convince themselves that they don't need to use the cpap. Or, or they assume they cured themselves while the sleep apnea keeps getting worse over the years.

I have severe sleep apnea with an ahi of 79+. I wasn't severe when it first started. I didn't snore 10 years ago either. But I did have sleep apnea.

zoocrewphoto wrote:

tiredandscared wrote:

zoocrewphoto wrote: Do you honestly believe that you have a physical problem in your throat due to what time of night you sleep? Seriously?

Not what I said. I said that I got it as a result of weight gain. In my case atleast. I had no breathing and no issues with my sleep until the last week of 2015 january. I woke up one day and it feelt like I had lost 20 iq points. At first I thought it was a hormonal issue or temporary insomnia. But then as it was consistent no matter what I did. Sleep hygiene, sleeping pills, none of them worked. Then I put two and two together and I noticed that I started getting this problem after I had gained weight. It's also in present in my immediate family (father has had it for years untreated).

Fortunely I'm vigilant enough to have caught it only after q. I haven't developed any related health complications. It's relatively mild as I dont get any serious desats and I only have problems if i sleep supine , awkwardly or eat a fatty meal before sleep. I was in good health in the bmi range of 29-31. Once I start push in over that range I get problems like this.

It is far more likely that it crept up on you over the years, and it is the cause of your weight gain. People want to blame it on weight gain as they hope that losing weight will make it go away. And that is their excuse for not using cpap. But instead, they usually never lose the weight, and they only get worse. Those who do lose the weight often find that they still have sleep apnea. Losing weight is a great goal as it will help other issues. But this false hope that it will remove sleep apnea is actually very dangerous since it people convince themselves that they don't need to use the cpap. Or, or they assume they cured themselves while the sleep apnea keeps getting worse over the years.

I have severe sleep apnea with an ahi of 79+. I wasn't severe when it first started. I didn't snore 10 years ago either. But I did have sleep apnea.

Unlikely. If ive had it for years. It wouldn't be mild. As its a progressive disease. And like ive said. I never had a problem with sleeping until january this year. Like I said a million times over. Not everyone has the same circumstances. I didnt have any of those problems until recently. If i did i would have noticed. People seem fixated with the notion that somehow all cases of SDB happen on an assembly line. Its not blindness were talking about or leg amputation. People who're short sighted are not all going to have the same refractive error. And if i have it still within a year we will see. Im planning on buying one. Can people actually go by case to case basis.