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Hi John, where have you been hiding? Good to see you again.

JohnBFisher wrote: the fact is there is more of a correlation in hereditary factors than in weight.

And I've read more than one study that shows the obstructive sleep apnea leads to weight gain, not the other way around.

If you come across any of these studies again, I'd be interested in seeing them. I've seen several people post this, and I have yet to see a single study that shows that OSA causes weight gain more often than weight gain causes OSA. I'm not saying it isn't so, only that I have not seen this data (and it would be a tough study to do).

I've cited this powerpoint presentation about obesity and OSA before:

http://www.stanford.edu/~davesv/Weight%20&%20OSA.ppt

Some highlights:

Obesity is the most powerful risk factor for obstructive sleep apnea (OSA)

Potentially modifiable risk factors for OSA also include alcohol, smoking, nasal congestion, and estrogen depletion in menopause.
Data suggest that obstructive sleep apnea is associated with all these factors, but at present the only intervention strategy supported with adequate evidence is weight loss. ( Young et al. 2002)

The presentation goes on to ask whether OSA can cause weight gain (it can), and has an interesting, albeit inconclusive, discussion about whether weight loss helps OSA.

Two things that I see crop up in discussions like this one here: (1) Thin people can have OSA so being overweight doesn't cause OSA, and (2) losing weight doesn't improve OSA, so it wasn't caused by the weight gain in the first place. Regarding #1... That thin people can have OSA does not mean that OSA isn't most often caused by being overweight (independently or in conjunction with other risk factors). I'm actually not sure if #2 has ever been stated explicitly as I can't think off the top of my head of even one person who has posted, "I lost all my excess weight and my OSA is the same as it was" (the fact that no one has posted that is an interesting topic in its own right). But even if it is true that losing weight doesn't cure OSA, it doesn't mean the excess weight didn't cause OSA in the first place, alone or in conjunction with other risk factors (e.g., any woman whose ever suffered stretch marks caused by pregnancy can attest to the fact that delivering the baby doesn't always "cure" the stretch marks, yet no one would argue that the pregnancy caused them in the first place.)

Now back to the OP... I agree with those who posted comments suggesting that it's really none of your boss' business. How does he know you have apnea? Is there evidence of your sleep disorder at work? If not and you've shared this personal information with him, why did you? Are you friendly with your boss? If so, your willingness to be open about your condition may have led him to believe that you're open to talking about it. So he's talking about it, and sharing his misinformation, biases, and unsolicited advice. If you don't like that, you need to change the terms of the relationship where he doesn't feel comfortable doing this. If he's a friend, you can talk to him privately and tell him how you feel. You probably do have legal rights, what with the "hostile workplace" business, but I can't advise you on that.

Bearcat42 wrote:I am by no means a skinny or slim person. In fact I am overweight and I am the first to admit it but I really don't find it fair for others to judge someone diagnosed with sleep apnea and say that you wouldn't have that problem if you would lose weight.
Well, that is what my boss has told me, on several different occasions. He has that mentality that if I lose weight then all of my problems are solved. He doesn't understand that people with different body types and weights have sleep apnea. Losing weight is important for overall health if a person is seriously overweight but that is a personal decision and should not be brought up, especially in a group setting. If it is an issue that impairs a persons ability to do their job then a boss has the right to pull that employee to the side and talk to them, but never, ever in front of their peers.
My weight does not keep me from doing my job and I feel that his comments are just plain malicious and judgemental, not to mention uninformed. Have any of you ran into this in the workplace and if so how did you handle it?

Ummmm... Your boss is ignorant and misinformed. Did I mention his comments are borderline harassment? Sure many sleep apnea patients are over weight; however, that certainly is not always the case. You may need an attorney. It's none of his or her business regarding your medical treatment.

Let me guess.... He'll say Jews are the cause of the economic collapse and they should be placed in secret camps to ensure fiscal prosperity? Your boss is an ignoramus buffoon.

well, about the weight thing...

this is what my pulmanary doctor relayed to me....

the suffocation in severe apnea cases causes the release of cortisol

and that is a contributing factor to weight gain, (from what I understand)

Your health issues should always be kept confidential from your boss and co-workers. Period. No boss wants an employee that may be giving less than 100% plus.

Asides from that, since he already knows you use CPAP therapy for OSA, you should agree with him. Yes, weight is definitely a factor in OSA. No question. But I can give you a long list of friends and relatives that are as skinny as toothpicks that suffer from severe OSA. In fact, one of them lost his drivers license a couple of years ago as a result and only received it back after beginning CPAP therapy and having a second sleep study done. He was falling asleep at the wheel and is lucky he did not kill himself. And I shudder to think of the perils of an electrician with OSA.

In any event, you are unlikely to convince your boss of ANYTHING as he knows it all already so I would try to slip below the radar at this point I think. Arguing with the boss generally leads to less than optimal outcomes.

If you work for a large company that is sensitive to this issue you may complain and keep your job.

If you bring a lawsuit and you win and you have pissed off your supervisor and this boss can he make your life difficult or could he find another reason to let you go? If so plan on changing jobs and file suit to get some money or to push back. Be sure the litigation will not cost you more than you can afford.

Consider the cost of litigation in terms of the time it takes and effect on getting other jobs. It can be hard to put the old job behind you if the litigation is ongoing.

There is a saying that goes "may you be cursed with a law suit where you are in the right"

It is not just but sometimes the best thing that you can do is to stick it out or find another job elseqhere.

torontoCPAPguy wrote:Your health issues should always be kept confidential from your boss and co-workers. Period. No boss wants an employee that may be giving less than 100% plus.

Hi,

I believe just the opposite. I am going to tell everyone that I know, and even tell strangers that I meet for the first time. If someone is going to have a problem with me, I want to know as soon as possible so I can avoid them. If a company has an issue, I want to know so I can go somewhere else.

As it turns out, I have yet to meet anyone who reacted negatively. People are either curious or say nothing. My current employer is fantastic. They hired me when I was still having issues and were supportive of time off needs when I was having studies and getting started with CPAP. I was up front and honest, and they were too. I have since learned that there are a number of folks at work who use CPAP, including one 20 year employee who is as thin as a rail.

Everyone either has issues that they are dealing with, or will at some point in their career. Any boss who isn't able to deal with that is going to find it hard to attract and retain the type of talent that is needed to be successful over the long haul.

-john-

Bearcat42 wrote:I am by no means a skinny or slim person. In fact I am overweight and I am the first to admit it but I really don't find it fair for others to judge someone diagnosed with sleep apnea and say that you wouldn't have that problem if you would lose weight.
Well, that is what my boss has told me, on several different occasions. He has that mentality that if I lose weight then all of my problems are solved. He doesn't understand that people with different body types and weights have sleep apnea. Losing weight is important for overall health if a person is seriously overweight but that is a personal decision and should not be brought up, especially in a group setting. If it is an issue that impairs a persons ability to do their job then a boss has the right to pull that employee to the side and talk to them, but never, ever in front of their peers.
My weight does not keep me from doing my job and I feel that his comments are just plain malicious and judgemental, not to mention uninformed. Have any of you ran into this in the workplace and if so how did you handle it?

A bit sensitive are we??. You, your family and your boss have a vested interest in your health, and if he gives you a little kick in the ass to keep you motivated to lose weight, he'd doing you a big favor. Just remember back to when your coaches dragged you off the field , chewed you out, and sat you on the bench when you werent performing at your best. A little motivation never hurt anyone (IMHO)

silver123 wrote:Talk to him about it clearly or with support from HR if needed.

You must be kidding?? Whining to HR?, and no doubt the lawyer is next?? and then whining to mommy??
This world is falling off a cliff

Whether the concept of weight loss is right (or not), I feel it's not the place of a boss to be telling an employee they should lose weight (unless of course, it is a job requiring a high level of fitness to perform and your performance is suffering - still that is more a fitness statement rather than body size). It just strikes me as inappropriate. He's just given him self away, showing his character is one of ignorance, and prejudement.

I am very fortunate. I work in a larger organization but very small office. My boss and I have a very good, friendly and open rapport. I sat on this whole sleep apnea thing quietly for like 8 months (while waiting for testing, diagnosis, etc.) then finally had the need to have a candid discussion when I was clearly acting scattered and fatigued. I don't know how much she picked up on that - the scatteredness etc., but I wanted to acknowledge that this was bothering me, and provide insight that I expect things to improve greatly once therapy would be started.

How'd she react? Very understanding, and most interested, because after discussing it she believes she too, could very well have sleep apnea. All the symptoms are surely there.

I can't add much to what was said regarding the OP's situation. So... I'll just address the original question: "How does your boss treat you concerning CPAP?" The answer is, I don't feel the need to share that with my boss or anyone at work. If it comes up, I'd easily admit that I use CPAP and gladly answer any questions, but otherwise no. I also don't share any of my other medical history, current medications and so forth. As long as I'm doing the job they hired me for, that's all that counts. Good luck with your current situation. I'd tend to err on the side of downplaying it rather than going the lawsuit route. My own preference.

SleepingUgly wrote: I have yet to see a single study that shows that OSA causes weight gain more often than weight gain causes OSA. I'm not saying it isn't so, only that I have not seen this data (and it would be a tough study to do).

If you expect any study to ever prove one thing causes something else, you will be sorely disappointed either way.

No study proves weight causes OSA. No study proves OSA causes weight. Investigative medical studies are primarily about statistical associations, not causes, whether the study authors themselves understand that or not. People (especially study authors and journalists) assume causes based on statistical associations, but that doesn't prove them, especially broad correlations about general health. It is all about the spin when it comes to the beliefs that grow out of the studies.

People with health issues tend to have weight issues. So weight will always show up with a statistical relationship to most any health issue studied. So will age. But no one argues about fighting "the age problem," so it amuses me so many argue about fighting "the obesity problem." A healthy person will tend to have a healthy weight. An unhealthy person will tend to have an unhealthy weight (too high or two low). Telling an obese person to lose weight in order to be in a measured category that is considered healthy makes about as much sense as it would have been to tell dying HIV patients 20 years ago that everything would be fine if they would just gain weight, since people who weigh more than them tend not to die.

Similarly, it can be proved statistically that there is an association between seeing a doctor and being sick. Some idiot could conclude that this proves that it is seeing doctors that causes people to be sick. Why hasn't anyone done that study? Because people are mostly at least smart enough to know that sick people are more likely to go see a doctor. Why can't that same logic be applied to statistical association of health issues and weight issues? It is because too many people aren't smart enough to understand that health issues very often lead to, or show up as, weight issues. That's why.

It is criminal, in my view, that people are put under greater stress to do something unhealthy when they go to a doctor. Yelling at patients simply to lose weight to solve all their health problems will one day be viewed as silly as bloodletting is now viewed. (Medical misapplication of the weight-related data is, in my view, more dangerous overall than bloodletting.) Bloodletting seemed to make sense at the time. Doctors are no brighter today than they were then. There is more "science" at their fingertips, yes. But much of that "science" is misapplied by journalists and doctors and most egregiously by study authors who seem to think that just because they ask the question about something or measure something, that something must be the CAUSE.

People aren't really all that bright. Any of them. Especially not bosses who think they are fitness/medical experts.

OT - love your avatar, who.

Sandra wrote:OT - love your avatar, who.

Thanks! I stole it myself.

who wrote: People with health issues tend to have weight issues. So weight will always show up with a statistical relationship to most any health issue studied. So will age. But no one argues about fighting "the age problem," so it amuses me so many argue about fighting "the obesity problem." A healthy person will tend to have a healthy weight. An unhealthy person will tend to have an unhealthy weight (too high or two low). Telling an obese person to lose weight in order to be in a measured category that is considered healthy makes about as much sense as it would have been to tell dying HIV patients 20 years ago that everything would be fine if they would just gain weight, since people who weigh more than them tend not to die.

Unfortunately a lot of overweight/obese people will deny there is anything wrong, will insist that they are healthy and anyone thinner then them must be having problems. Many do this because they over eat due to emotional and/or lifestyle issues and it is easier to blame it all on some external issue.

The is an obesity problem. Last week really illustrated that. I have a "Habitat for humanity" house being built beside me here in Montreal. Last week a busload of students from a university in Pittsburgh came up to work on it. Nearly every single one of the kids was over weight - like little dough boys and girls, budging out over their jeans in classic muffin tops, and straining their Habitat t-shirts . Right now there is a local group of about 12 young people working on it, 1 is a bit pudgy, 1 is obese and one guy has the beginnings of a classic beer belly - the rest are slim and ordinary (for here).

BlackSpinner wrote:

who wrote: People with health issues tend to have weight issues. So weight will always show up with a statistical relationship to most any health issue studied. So will age. But no one argues about fighting "the age problem," so it amuses me so many argue about fighting "the obesity problem." A healthy person will tend to have a healthy weight. An unhealthy person will tend to have an unhealthy weight (too high or two low). Telling an obese person to lose weight in order to be in a measured category that is considered healthy makes about as much sense as it would have been to tell dying HIV patients 20 years ago that everything would be fine if they would just gain weight, since people who weigh more than them tend not to die.

Unfortunately a lot of overweight/obese people will deny there is anything wrong, will insist that they are healthy and anyone thinner then them must be having problems. Many do this because they over eat due to emotional and/or lifestyle issues and it is easier to blame it all on some external issue.

The is an obesity problem. Last week really illustrated that. I have a "Habitat for humanity" house being built beside me here in Montreal. Last week a busload of students from a university in Pittsburgh came up to work on it. Nearly every single one of the kids was over weight - like little dough boys and girls, budging out over their jeans in classic muffin tops, and straining their Habitat t-shirts . Right now there is a local group of about 12 young people working on it, 1 is a bit pudgy, 1 is obese and one guy has the beginnings of a classic beer belly - the rest are slim and ordinary (for here).

I think there is a health problem. I think there are unhealthy eating habits. I think there is unhealthy lack of exercise. I think everyone needs to eat well and exercise. That should promote good health.

For some, the lack of health will show up in how much they weigh. For others, it will not. Some with unhealthy habits will be too thin. Some with unhealthy eating habits will show up in a healthy weight range which will hide their lack of health. ALL of them need to be reminded of the importance of good eating habits and good exercise.

There is no reason to assume that those of a particular weight, within reason, need those reminders more than others. If genetics causes health problems to manifest a particular way in a particular person, that information is useful for assessing overall health. But taking our eye off the ball of better health for all is, in my opinion, counter-productive. Oversimplifying the issue into one of obesity is, in my opinion, counter-productive.

A healthy person should crave the right amount of calories in the right variety and be able to be of a functional weight with sufficient activity. When that is not the case, something is wrong. And it is wrong beyond simple will-power questions. Punishing people for their genetic makeup is not rational. Attempting to help ALL people eat well and exercise, is, in my opinion.

So yes, fuss at fat people. Fuss at skinny people. But also fuss at normal-weight people just as much. Because even if it doesn't show up in being too thin or too thick, due to their genetic makeup, the fact is that so-called "normal"-size, or "healthy"-weight, people need to eat healthy and to be sufficiently active for the sake of their health too.