Obesity and Apnea

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
thx1138
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Obesity and Apnea

Post by thx1138 » Fri Aug 05, 2022 6:37 pm

My understanding is there is a strong correlation between obesity and sleep apnea. I talked with a surgeon once, and he felt my apnea was related to my obesity, and until I handled that, any surgery would not do much good. I saw a sleep specialist and he said half his patients hate him and half love him, due to the CPAP machine. There was a Scandinavian study that said sleep apnea was related to 2.5x chance of driving accidents. But I digress…

I wanted to mention here these new drugs for weight loss, which you may have been reading about in the news e.g. https://www.mayoclinic.org/diseases-con ... q-20057955 The most effective one so far is Tirzepatide, sold by Lilly as Mounjaro. See https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

Its quite expensive, and insurers don’t want to pay for it. They’d rather wait and pay for diabetes treatment… But what I’m trying to say is, many can get Mounjaro for $25 a month with a new coupon program https://www.mounjaro.com/savings-resources There’s some fine print, but basically you can get it for a year at a massive discount. I’ll see where I stand after having lost 40 pounds a year from now.

If that doesn’t work out for you, it may be possible to send a prescription to e.g. Compounding Pharmacy of America, and get a sterile vial from them for the once-weekly subcutaneous self-injection.

TLDR: if you’re overweight, talk to your doctor about the new GLP-1 agonist drugs.

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Wulfman...
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Re: Obesity and Apnea

Post by Wulfman... » Fri Aug 05, 2022 11:57 pm

thx1138 wrote:
Fri Aug 05, 2022 6:37 pm
My understanding is there is a strong correlation between obesity and sleep apnea. I talked with a surgeon once, and he felt my apnea was related to my obesity, and until I handled that, any surgery would not do much good. I saw a sleep specialist and he said half his patients hate him and half love him, due to the CPAP machine. There was a Scandinavian study that said sleep apnea was related to 2.5x chance of driving accidents. But I digress…

I wanted to mention here these new drugs for weight loss, which you may have been reading about in the news e.g. https://www.mayoclinic.org/diseases-con ... q-20057955 The most effective one so far is Tirzepatide, sold by Lilly as Mounjaro. See https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

Its quite expensive, and insurers don’t want to pay for it. They’d rather wait and pay for diabetes treatment… But what I’m trying to say is, many can get Mounjaro for $25 a month with a new coupon program https://www.mounjaro.com/savings-resources There’s some fine print, but basically you can get it for a year at a massive discount. I’ll see where I stand after having lost 40 pounds a year from now.

If that doesn’t work out for you, it may be possible to send a prescription to e.g. Compounding Pharmacy of America, and get a sterile vial from them for the once-weekly subcutaneous self-injection.

TLDR: if you’re overweight, talk to your doctor about the new GLP-1 agonist drugs.

As has been discussed many times on the forum.....sleep apnea often causes weight gain but losing weight doesn't necessarily get rid of the sleep apnea.. Many normal-size to skinny people can also have sleep apnea.

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thx1138
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Re: Obesity and Apnea

Post by thx1138 » Sat Aug 06, 2022 8:50 am

It is my belief that obesity correlates with (non-central) sleep apnea. Not a 1.00 correlation, but a significant one. So yes, any non-100% correlation, you can say "doesn't necessarily". But more to the point, you can say "often". You can even put a percentage on it. Rather than using anecdotal data like, "well I know one guy who lost weight but his sleep apnea didn't go away".

Correlations do not always make clear the direction of any causality, that is, whether apnea causes obesity, or obesity causes apnea, or both.

That said, when your body gets fat, your throat gets fat, and puts the obstructive in obstructive sleep apnea. So for me its a reasonable hypothesis that losing weight may (often) reduce or eliminate sleep apnea. (not to mention that losing weight is desirable in its own right).

Because of the correlation, I posit that this forum of sleep apnea sufferers, has more than its share of overweight people. That's why I wanted to bring up this new drug, Tirzepatide. Potentially (often) revolutionary. Just trying to help.

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Pugsy
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Re: Obesity and Apnea

Post by Pugsy » Sat Aug 06, 2022 9:19 am

thx1138 wrote:
Sat Aug 06, 2022 8:50 am
I posit that this forum of sleep apnea sufferers, has more than its share of overweight people. That's why I wanted to bring up this new drug, Tirzepatide. Potentially (often) revolutionary. Just trying to help.
If going by numbers alone in the general population of people, both with and without OSA, who are packing around more pounds than they might need....I would posit that there's a sizeable chunk of people out there who might want to look at it.

Most of us likely could stand to lose a few pounds regardless.
Would it mean we could maybe lose the cpap machine as well??? A maybe and not a very solid maybe for a lot of people.
I lost 25 pounds a while back...didn't lose my OSA I am quite sure but I did lower the pressures needed to deal with my OSA.
Could I stand to lose a few more pounds...sure but I weighed all of 110 lbs when I was diagnosed and even if I should see 110 again (man do I wish) I know it won't fix my OSA. I am pretty sure that my OSA is tied to Mother Nature and again in general with good old menopause. With menopause everything starts to sag...boobs, butt, belly and airway tissues.
I never had one single symptom of OSA until menopause hit and then everything went to hell.

I did gain weight after my OSA diagnosis though...but it wasn't that OSA caused the weight gain.
The weight gain was again related to Mother Nature along with just getting old and the aches and pains that cause us to limit activity, etc. I quit doing a lot of stuff because I simply couldn't do it anymore but I could still bend the elbow and feed myself. :lol:
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babydinosnoreless
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Re: Obesity and Apnea

Post by babydinosnoreless » Sat Aug 06, 2022 9:32 am

Lost 65 lbs in first year of pap therapy. Still have sleep apnea. Its a cruel fallacy to give people hope of getting rid of their sleep apnea just by losing weight. And another sign of the medical and other discrimination against fat people.

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earlvillestu
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Re: Obesity and Apnea

Post by earlvillestu » Sat Aug 06, 2022 9:37 am

"There is a linear correlation between obesity and OSA. In obese people, fat deposits in the upper respiratory tract narrow the airway; there is a decrease in muscle activity in this region, leading to hypoxic and apneic episodes, ultimately resulting in sleep apnea. ... A four-year longitudinal study of overweight and obese American adults demonstrates that change in weight is directly proportionate to sleep disordered breathing (SDB). Those with the greatest weight gain had a more severe apnea-hypopnea index (AHI). The risk of OSA increases with age and body mass index (BMI)"

From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836788

That said, I am now the lightest I have been since I quit smoking 45 years ago, with a BMI of just under 21. When I was diagnosed with OSA in December, I was at about 23. Losing the weight had a lo of benefits, but it did not cause the sleep apnea to disappear.
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Pugsy
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Re: Obesity and Apnea

Post by Pugsy » Sat Aug 06, 2022 9:42 am

babydinosnoreless wrote:
Sat Aug 06, 2022 9:32 am
another sign of the medical and other discrimination against fat people.
Don't get me start on discrimination...lots of them against women especially.
Like the "doctor" who diagnosed my complaints of fatigue and morning killer headaches as "anxiety/depression" and gave me valium. Never asked me about my sleep quality or anything. Told me it was hormone related to menopause and essentially "all in my head". Dumbass.
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ozij
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Re: Obesity and Apnea

Post by ozij » Sat Aug 06, 2022 10:01 am

Pugsy wrote:
Sat Aug 06, 2022 9:42 am
babydinosnoreless wrote:
Sat Aug 06, 2022 9:32 am
another sign of the medical and other discrimination against fat people.
Don't get me start on discrimination...lots of them against women especially.
Like the "doctor" who diagnosed my complaints of fatigue and morning killer headaches as "anxiety/depression" and gave me valium. Never asked me about my sleep quality or anything. Told me it was hormone related to menopause and essentially "all in my head". Dumbass.
And was it a male "doctor"? Or a female?
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lynninnj
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Re: Obesity and Apnea

Post by lynninnj » Sat Aug 06, 2022 10:03 am

Pugsy wrote:
Sat Aug 06, 2022 9:42 am
babydinosnoreless wrote:
Sat Aug 06, 2022 9:32 am
another sign of the medical and other discrimination against fat people.
Don't get me start on discrimination...lots of them against women especially.
Like the "doctor" who diagnosed my complaints of fatigue and morning killer headaches as "anxiety/depression" and gave me valium. Never asked me about my sleep quality or anything. Told me it was hormone related to menopause and essentially "all in my head". Dumbass.
Curious.....male or female doctor?

It really chaps my butt when female doctors do and say stuff like this moreso than when someone lacking a uterus does it.

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Pugsy
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Re: Obesity and Apnea

Post by Pugsy » Sat Aug 06, 2022 10:23 am

ozij wrote:
Sat Aug 06, 2022 10:01 am
Pugsy wrote:
Sat Aug 06, 2022 9:42 am
babydinosnoreless wrote:
Sat Aug 06, 2022 9:32 am
another sign of the medical and other discrimination against fat people.
Don't get me start on discrimination...lots of them against women especially.
Like the "doctor" who diagnosed my complaints of fatigue and morning killer headaches as "anxiety/depression" and gave me valium. Never asked me about my sleep quality or anything. Told me it was hormone related to menopause and essentially "all in my head". Dumbass.
And was it a male "doctor"? Or a female?

Male of course. :lol: and an old male doctor at that.

But to be fair when I moved, and had to find another doctor, it was a male doctor who did ask the sleep questions and snore questions and here I am.
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thx1138
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Re: Obesity and Apnea

Post by thx1138 » Sat Aug 06, 2022 10:43 am

Having just pointed out the problem with anecdotal data, let me ask a question. Think of all the people you know that are 70… 80… 90… years old. How many, what percentage, of them are overweight? None.

Its unfair to use the criteria “complete 100% cure of apnea”. Using less air pressure is a sign of some improvement, even without complete remission.

If you didn’t get a complete cure, how bad is it to have lost weight? My apologies, but I bet you can gain it back if you want.

And yes, my male doctor was an idiot. What part of “I wake up gasping for air” did he fail to understand? I had to diagnose myself with sleep apnea. Got meself an CPAP, worked backwards from there. Since then I sleep the sleep of the just.

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Re: Obesity and Apnea

Post by lynninnj » Sat Aug 06, 2022 11:07 am

thx1138 wrote:
Sat Aug 06, 2022 10:43 am
Having just pointed out the problem with anecdotal data, let me ask a question. Think of all the people you know that are 70… 80… 90… years old. How many, what percentage, of them are overweight? None.

Its unfair to use the criteria “complete 100% cure of apnea”. Using less air pressure is a sign of some improvement, even without complete remission.

If you didn’t get a complete cure, how bad is it to have lost weight? My apologies, but I bet you can gain it back if you want.

And yes, my male doctor was an idiot. What part of “I wake up gasping for air” did he fail to understand? I had to diagnose myself with sleep apnea. Got meself an CPAP, worked backwards from there. Since then I sleep the sleep of the just.
LOL Good job!

And jftr, I don't want to sound like I am disparaging all the male docs out there. I have some pretty good ones right now.

But I learned a long time ago I will never go to a male gynecologist because they lack the appropriate anatomy to be compassionate with a speculum in hand.

Alas, I digress. Lucky for the guys I don't do hernia checks. :lol:

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babydinosnoreless
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Re: Obesity and Apnea

Post by babydinosnoreless » Sat Aug 06, 2022 11:34 am

Pugsy wrote:
Sat Aug 06, 2022 9:42 am
babydinosnoreless wrote:
Sat Aug 06, 2022 9:32 am
another sign of the medical and other discrimination against fat people.
Don't get me start on discrimination...lots of them against women especially.
Like the "doctor" who diagnosed my complaints of fatigue and morning killer headaches as "anxiety/depression" and gave me valium. Never asked me about my sleep quality or anything. Told me it was hormone related to menopause and essentially "all in my head". Dumbass.
Oh I'm right there with you. It took an er visit and my husband telling an er doctor that I stopped breathing at night to get the doctor to order a sleep test rather than telling me my racing heart and elevated blood pressure was anything more than a reaction to my thyroid meds. :x I HATE doctors. I have two letters one from a endocrinologist telling me I have hashimotos with toxicosis the other saying I graves. I should bring my husband with me to get some real answers. Did I mention I HATE doctors ?

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Re: Obesity and Apnea

Post by lynninnj » Sat Aug 06, 2022 12:22 pm

babydinosnoreless wrote:
Sat Aug 06, 2022 11:34 am
Pugsy wrote:
Sat Aug 06, 2022 9:42 am
babydinosnoreless wrote:
Sat Aug 06, 2022 9:32 am
another sign of the medical and other discrimination against fat people.
Don't get me start on discrimination...lots of them against women especially.
Like the "doctor" who diagnosed my complaints of fatigue and morning killer headaches as "anxiety/depression" and gave me valium. Never asked me about my sleep quality or anything. Told me it was hormone related to menopause and essentially "all in my head". Dumbass.
Oh I'm right there with you. It took an er visit and my husband telling an er doctor that I stopped breathing at night to get the doctor to order a sleep test rather than telling me my racing heart and elevated blood pressure was anything more than a reaction to my thyroid meds. :x I HATE doctors. I have two letters one from a endocrinologist telling me I have hashimotos with toxicosis the other saying I graves. I should bring my husband with me to get some real answers. Did I mention I HATE doctors ?
So you are hypo and hyper? -smh-
Seems like a straightforward blood test to me but some of these doctors go into it with a bias.

Good luck with that one.

Glad you have a health advocate and your husband. Good luck!

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Re: Obesity and Apnea

Post by latskogkatt » Sat Aug 06, 2022 12:51 pm

Correlation does not equal causation. There is also good evidence out there that having apnea causes the weight gain in the first place, as the body is bombarded with cortisol in reaction to the adrenaline released during apnea/hypopnea events. Based on my history of sleep issues, I likely had apnea when I was in high school, at 5'4" and 125 lbs. Had I known about it back then and treated it at the time, there's a damned good chance I'd have never gained significant weight... but I'd still have OSA.

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