You can't die from Sleep Apnea

split_city,

I would like to understand why you are focusing in on overweight people for the point of this discussion.

jen said:

Maybe if you got an md and were here to actually HELP people you wouldn't find yourself arguing so much.

you noticed that trend too, huh?[/quote]

So discussing studies which have been conducted and those which are being conducted in regards to the pathophysiology behind OSA isn't helpful?

Aren't OSA patients interested why they develop OSA?

Aren't OSA patients interested to know why the disorder is more common in males?

Aren't OSA patients interested to know why OSA is more common in overweight people? Again, I said common but not confined to overweight people

Alternatively, aren't OSA patients interested to know why there are healthy-weight individuals out there with OSA?

Aren't OSA patients interested to know why upper airway surgery doesn't always work?

Aren't OSA patients interested to know why lung volume affects upper airway size and collapsibility?

Aren't OSA patients interested to know why OSA is predominantly more severe in REM than any other sleep state and why airway collapsibility decreases is slow wave sleep?

Aren't OSA patients interested to know why arousal may actually perpetuate sleep apnea cycles?

This is some of the reseach I'm interested in and am happy to assist OSA patients when I can.

Windfall wrote:split_city,

I would like to understand why you are focusing in on overweight people for the point of this discussion.

Because this is my main area of work. I'm looking at mechanisms to perhaps explain why OSA is more common in overweight/obese males.

I'm looking at the effect of obesity on lung volume, diaphragm position, compliance of the respiratory system, the effect of obesity on pressure inside the abdomen.

How might all these factors contribute to OSA.

ok.....please tell me what obesity has to do with Nancy Graces comment. ??????? Did I miss something?

Who brough obesity into this in the first place?

"Posted: Tue Jul 10, 2007 8:19 pm Post subject:

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Well, sorry to be technical, but OSA is kinda snoring. It really is severe snoring. Snoring occurs when the airway narrows and vibrates. Eventually, the airway narrows so much and the snoring gets so bad, that you begin to have hypopneas and desaturate. An obstructive apnea is the end point of airway narrowing.





So are you sure you NEVER said apnea was snoring? Are you sure you mentioned O2 sats? Are you sure? Please read the part that says "It really is severe snoring."

Then you went on to say that apnea without snoring is called central. This is also stupid and completely untrue. I hardly snored at all at my sleep study.....and had almost NO central apneas. My AHI was at 42. So I guess all of the equipment, the sleep tech, the nurse practitioner, the sleep doc and my GP are all wrong and you are right. You must be the smartest man alive.....forget medical school....we should crown you the almighty SA king. Wanna do a UPPP on me? Maybe write me a new script for an auto or nifty bipap machine?

Sorry.....think I will stick with all the doctors and documented research. And of course the advice of some of the incredible and smart people on this forum.....like Jen who you made so mad she had to leave the post to keep from telling you what she really thought of you. Rest assured.....I have NO problem in that area.

split_city wrote:....You're right, I'm not a clinician, nor am I a tech. I'm only studying for a PhD in the field of sleep apnea. I have been working in the area of sleep apnea for about 5 years. ......

And please let us know if you ever take up a practice and start treating people with OSA.....
Personally, I REALLY want to AVOID going to you for treatment.

Others may find your novel approach refreshing and desirable though.

jennmary wrote:ok.....please tell me what obesity has to do with Nancy Graces comment. ??????? Did I miss something?

Who brough obesity into this in the first place?

I brought it up because of this comment:

tomjax wrote:The sequalea of apnea- htn, diabetes, stroke, chf, will be the eventual proximate cause of death although it was brought on by apnea.

I simply stated a possible alternative explaination. Aren't I allowed to do this?

jennmary wrote: "Posted: Tue Jul 10, 2007 8:19 pm Post subject:

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Well, sorry to be technical, but OSA is kinda snoring. It really is severe snoring. Snoring occurs when the airway narrows and vibrates. Eventually, the airway narrows so much and the snoring gets so bad, that you begin to have hypopneas and desaturate. An obstructive apnea is the end point of airway narrowing.


So are you sure you NEVER said apnea was snoring?

I said kinda snoring. Perhaps I should have said commonly accompanied by snoring.

jennmary wrote: Are you sure you mentioned O2 sats? Are you sure?

Yes I am sure...."that you begin to have hypopneas and desaturate." I.e. O2 levels go down.

jennmary wrote: Please read the part that says "It really is severe snoring."

Well, in simplistic terms, it could be classified as that. You even said that obstructive apneas are accompanied by loud snoring. The airway narrowing commonly results in snoring --> eventually, the patient doesn't get enough oxygen which increases respiratory drive i.e. trying to breathe harder against the narrow airway. Unfortunately, flow becomes independent on downstream pressure i.e. extra pressure generated by the diaphragm does not increase flow. The airway becomes narrower and snoring levels commonly increase. Eventually, the airway collapses (obstructive apnea) or an arousal occurs.

I was wrong to say that snoring = apnea, as other outcomes are required for it to be scored an apnea. Nevertheless, the factors which contribute to snoring also contribute to the apnea event.

How many marriages have nearly broken down due to excessive snoring from a member of the couple? How many of these snoring individuals get tested and show evidence of OSA?

jennmary wrote: Then you went on to say that apnea without snoring is called central.

I do apologise. I had a after I said that. It was not meant to be a serious answer

jennmary wrote: This is also stupid and completely untrue. I hardly snored at all at my sleep study.....and had almost NO central apneas.

Fine, I apologise for making that comment. But just to repeat, the factors which contribute to snoring also contribute to the apnea event. Obviously it didn't in your circumstance. Who's to say it doesn't in others?

jennmary wrote: My AHI was at 42. So I guess all of the equipment, the sleep tech, the nurse practitioner, the sleep doc and my GP are all wrong and you are right. You must be the smartest man alive.....forget medical school....we should crown you the almighty SA king. Wanna do a UPPP on me? Maybe write me a new script for an auto or nifty bipap machine?

That's just being silly now. I have never ever said I am 100% correct in what I say. I purely was discussing my obervations.

jennmary wrote:Sorry.....think I will stick with all the doctors and documented research. And of course the advice of some of the incredible and smart people on this forum.....like Jen who you made so mad she had to leave the post to keep from telling you what she really thought of you. Rest assured.....I have NO problem in that area.

And I asked her to say how I made her mad. She accused me of all this stuff without backing her comments up. I asked her to do so.

snork1 wrote:

split_city wrote:....You're right, I'm not a clinician, nor am I a tech. I'm only studying for a PhD in the field of sleep apnea. I have been working in the area of sleep apnea for about 5 years. ......

And please let us know if you ever take up a practice and start treating people with OSA.....
Personally, I REALLY want to AVOID going to you for treatment.

Where have I have I ever said I was treating people? I said that I have an interest in the factors which contribute to OSA.

If I was a clinician, what have I said that would make people avoid coming to me for treatment?

I make one mistake where someone has interpreted me saying that snoring = apnea, and I get my head blown off. I apologised for that.

Somehow it seems a few people think that I said that all OSA patients are overweight. I never said that

Somehow it seems that a few people think I said that hypertension, heart disease, diabetes is only in overweight people. Once again, I never said that.

Yet people are allowed to acuse me of stuff without providing evidence to back it up?

snork1 wrote:Others may find your novel approach refreshing and desirable though.

What novel approach?





[/quote]

curious.. I too email her at the CNN address but I really kinda doubt they even care. After all she is already involved in one lawsuit for her mouth.. and that caused the death of one person.. so this is not something new to Ms grace.

Anyway, I missed her show tonight did anyone catch it? Did she say anything about the remark last night?

It would be nice but I really think CNN has other agendas to take care of..

Jen likely didnt come back to your little fight because you truely do not deserve her insight.....and because nothing she says is going to sink into your head. In one ear out the other.....or in one ear twist a little then back out of the mouth.

In case you are not aware of this (and stupid people rarely are) weight is a very sensitive topic for a lot of people. People beat themselves up enough about their weight without someone basically saying that maybe it isnt the apnea.....maybe their blood pressure is high because they are fat. Are you so incredibly insensitive that you do not see how this could be something that would offend people?

Just so you know.....I am overweight. Got that way after 8 months of bedrest during my pregnancy with my daughter 3 years ago. I was on so many meds to keep from losing her that I am sure that helped with the weight gain. Then I broke my pelvis during delivery and spend another 3 months in bed and 6 without any impact or weight bearing activity. My daughter is 2 now and no I have not take off the weight. My blood pressure, cholesterol, and EKG were all what my doctor called "beautiful" as was my fasting and non fasting glucose tolerance test. Thyroid cascade came back normal and so did everything else we ran 3 months ago.

But if you are going to say that heart disease, stroke and high BP can be caused by obesity......isnt it also true that obesity in itself can be caused by apnea and if that is the case then arent all of those things, obesity included really comortalities or sleep apnea? In some if not many cases?

You did say you were working on your PHD.....this implies to some if not most people that you someday intend to see patients. And you can add me to the list of people who want to know if that happens.....I would gladly move to the other side of the country to avoid your practice.

All,

Please forgive me, I'm sleep deprived and cranky. It took months for me to stop lurking and start interacting. Thank you all for the education, sense of community, understanding and support you've provided.

split_city,

I appreciate the clarification that the main area of your work is looking at mechanisms to perhaps explain why OSA is more common in overweight/obese males. Yes, I want answers to many of the WHY questions you posed earlier, particularly if it could help me understand WHY this is happening to me.

But since it's not always about me, I need to consider how my remarks impact other people (intent versus impact) and approach people non-defensively. People will usually reflect back to me what I first give to them.

In short, IMHO, you need to work on your bedside manner.

split_city wrote: You say these co-morbidities were brought upon by apnea. How do you know they weren't simply brought on by obesity? There are many obese individuals who don't suffer OSA but have these co-morbidities.

split_city wrote: But I'm just focussing on overweight people for the point of this discussion..

split_city wrote: That's just being silly.

split_city wrote: That's just being silly now.

Please stop dismissing the opinions and feelings of others.

I'm hopeful that your research will eventually help me and others who are blessed to experience the whacked world of sleep disorders. But, in the meantime, it would help us (ok, make that me since it's really all about me) understand your point of view if you would be more gracious in accepting our (my) point of view.

Thank you.

I'm exhausted from reading this debate. I would like to say that to "imply" that OSA is a weight issue is simply not true and is an unkind thing to say to people who live qith this day in and day out. You may be in the field of sleep diseases but, we live it, experience it and are here on this site to lend support. Negativity has no place in here. This disease is dibilitating to so many already. I am lucky mine is mild with no other medical issues but my heart goes out to all of you who are struggling to get it under control. Lets lift each other up in a positive way and give no credence to someone who is pointing fingers and trying to place blame and doesn't even have SLEEP APNEA for gosh sakes!!!

jennmary wrote: Jen likely didnt come back to your little fight because you truely do not deserve her insight.....and because nothing she says is going to sink into your head. In one ear out the other.....or in one ear twist a little then back out of the mouth.

First of all, two other people said pretty much what I said in regards to "death caused by OSA." There were:

tomjax wrote: I do not think it is possible for a persons aiirway to collapse and then die because it would not open. Something else must happen.

and

Julie wrote:They don't die because the airway closes up and stays shut

This is what I said. The actual collapsed event doesn't cause death, but more the secondary effects.

Why was I targerted for this comment and not those above?

If people think I'm wrong, why can't they provide some evidence instead of accusing me of stuff I never said?

Second of all, I read everything Jen said. I took it on board. I provided an opinion about the topic. I even agreed saying that OSA may also cause all those co-morbidities. Again, how did it end in an arguement after that?

Then Jen went on and said this:

"That is just as crazy as you trying to say that being fat causes all ills. I gained weight because I was too tired to move. I was thin when it started. I wish you would give up the apnea patients are fat line, it is getting sooooooo old

I never said these things. I asked her to show me where I said these things. Isn't it wrong for someone to accuse you for something you didn't say?

jennmary wrote: In case you are not aware of this (and stupid people rarely are) weight is a very sensitive topic for a lot of people. People beat themselves up enough about their weight without someone basically saying that maybe it isnt the apnea.....maybe their blood pressure is high because they are fat. Are you so incredibly insensitive that you do not see how this could be something that would offend people?

Where have I ever said any of this? I understand that "weight" is a sensitive issue, but please show me where I have said anything that would indicate that I have been insensitive about the issue. If I did say something in that respect, I apologise wholeheartedly

jennmary wrote: Just so you know.....I am overweight. Got that way after 8 months of bedrest during my pregnancy with my daughter 3 years ago. I was on so many meds to keep from losing her that I am sure that helped with the weight gain. Then I broke my pelvis during delivery and spend another 3 months in bed and 6 without any impact or weight bearing activity. My daughter is 2 now and no I have not take off the weight. My blood pressure, cholesterol, and EKG were all what my doctor called "beautiful" as was my fasting and non fasting glucose tolerance test. Thyroid cascade came back normal and so did everything else we ran 3 months ago.

I thankyou four explaining that to me. I would never pretend to understand what you went through. I'm happy to hear that your blood pressure, cholestrol, EKG etc are all normal.

However, you must agree that being overweight is a risk factor for devloping those co-morbidities? It's common knowledge. It's been explained in a number of studies. It's talked about on the TV, in newspapers, on the radio. I never said that if you are overweight, you will have these other problems.

Therefore, I'm going to repeat myself again. It was stated by one of the posters on here that apneas cause these problems. While this might be the case, you cannot say this conclusively in an overweight person given that being overweight is a risk factor for high blood pressure, heart disease, diabetes etc. I was just describing an alternative. That's not to say that it's true and it's not to say that everyone, be it a healthy-weight or overweight individual will suffer from these co-morbidities or even OSA. I didn't tend to be insensitive about weight at all.

jennmary wrote:But if you are going to say that heart disease, stroke and high BP can be caused by obesity

Obesity is a risk factor for the development of these conditions. Do you disagree?

jennmary wrote: ......isnt it also true that obesity in itself can be caused by apnea and if that is the case then arent all of those things, obesity included really comortalities or sleep apnea? In some if not many cases?

I totally agree. I was discussing this with a patient the other day. There are OSA patients who developed OSA when they were healthy-weight. They became tired--> less physical activity --> started to put on weight --> more tired, depressed --> became sedentary --> put on more weight --> OSA got worse etc etc.

Furthermore, some then begin to develop hypertension, diabetes, heart disease. Now, you could say that the apnea caused these co-morbidities. However, obesity is a confounding factor so you cannot conclusively state that the apnea causes these conditions.

On the otherhand, take a healthy-weight indididual without diabetes, heart disease, hypertension BEFORE they developed OSA. You could argue that OSA may have caused these conditions if they became apparent once the individual developed OSA. Again, there are confounding factors age, lifestyle, exercise, eating habits etc.

I'm just discussing the variables

jennmary wrote:You did say you were working on your PHD.....this implies to some if not most people that you someday intend to see patients. And you can add me to the list of people who want to know if that happens.....I would gladly move to the other side of the country to avoid your practice.

I already do see patients. They are my research subjects. I very much appreciate the time and effort they put in to helping us out. I have had nothing but positive feedback from all the patients I have spoken to in regards to helping them understand their condition.


I did see that Jen started another thread talking about me. She said that someone called her "dumb" tonight. I would be very upset if she was referring to me because I DID NOT say that at all.

Are we SURE that Mr. Mango hasn't picked up a new name de plume?

atruvirgo wrote: I'm exhausted from reading this debate. I would like to say that to "imply" that OSA is a weight issue is simply not true and is an unkind thing to say to people who live qith this day in and day out.

Can you please let me know where I "implied" this? I have said a number of times (even in this tread and in others) that OSA is not confined to individuals who are overweight. I really don't know how many times I have to say this. The only suggestion of this is that I have said that obesity is a predictor for OSA. The facts are in black and white. There is a greater chance of devloping OSA (or hyptension, diabetes, high cholestrol, heart disease) if you are overweight compared to if you are healthy-weight. I fail to see how this is being insensitive.

I said predictor for OSA. I never said all overweight people will develop OSA. It's the same with smoking and lung cancer. If you smoke, your chances of developing lung cancer increase. That doesn't mean that all smokers are going to develop lung cancer.

atruvirgo wrote: You may be in the field of sleep diseases but, we live it, experience it and are here on this site to lend support. Negativity has no place in here.

I understand. I don't have OSA. I don't live with people who have OSA. I will never be able undestand the heartache that patients go through unless I suffer from the disorder. Would I be wrong to say that some of this heartache is there because patients simply want answers? That is why I am here. I have provided some answers to help OSA patients to perhaps understand why they suffer from OSA. Unfortunately, I cannot provide every single answer.

I have never said to anyone on here that "they have to lose weight to cure their OSA." I get the vibe that this is what a few people on here think I suggested

atruvirgo wrote:This disease is dibilitating to so many already. I am lucky mine is mild with no other medical issues but my heart goes out to all of you who are struggling to get it under control. Lets lift each other up in a positive way and give no credence to someone who is pointing fingers and trying to place blame and doesn't even have SLEEP APNEA for gosh sakes!!!

I agree with you. However, I'm seeing accusations been thrown all around. A person saying I have "outrageous hypotheses" and have "no practical experience" and "his view of the journals that he reads is illuminated only by the reflections off the ivory tower and not the true light that shines upon the real world."

First of all, why are my ideas outrageous?

Explain why increased pressure in the abdomen is not a likely force to push the diaphragm and airways up towards the end, perhaps reducing tension in the upper airway, making it more collapsible. There is evidence to support that the airway becomes more collapsible if you reduce the amount of stretch on it and vice-versa. Diaphragm ascent may reduce tension on the airway. Is this really that outrageous??

In terms of no practical experience? Where did that come from? I work in a sleep lab with OSA patients. I have run studies. I am in the process of getting a study published. I'm also currently undertaking another study. Do you still say I don't have "practical experience?"

In terms of the journals stuff. You do realise most of the advice/precautions that we are told everyday are the result of studies? Theses studies are published in journals. This is the real world

Another poster talks about:

For some reason, people feel freer to vent their anger/aggression/frustration on the internet because it is like annonymous"

I see others venting their anger, not me

I glad to have brought this to everyone's attention.... even if it has stirred such a debate.

As I said early, the debate of OSA killing someone is really a pointless one... even rather OSA kills the patient, short or long term, the OSA is the REAL cause of thier demise.

It is sort like saying, one doesn't die by falling from a building. Sure... true... the impact is what kills you.

My Dad fell from a ladder several years ago. Yes the impact is what caused his death... but I always say his fall from the ladder is what killed him.

I think I can say that it would be best to simply say that Nancy Grace had no business making such an inaccurate, off base, flip remark in regards to a very potentially very serious health problem.

I'm sure no one who suffers from OSA appreticates thoe comments.

On the other hand, at least the people(members) that read to forum know they have OSA and hopefully are on CPAP or some other modality of treatment.

The ones I feel sorry for are the ones that may have heard the comments and either makes them where they may be less knowledgeable than they would otherwise... in other words... someone tells someone they have sleep apnea and now due to Nancy's comments fail to understand what sleep apnea is. How many people fail to realize that it is a breathing disorder???

The others I feel sorry for might be for someone that learns they have OSA and might not take it seriously as a result of her comments.