What is sleep apnea?
Sleep apnea is one of the most common chronic sleep disorders, characterized by episodes of shallow breathing or breathing cessation during sleep. The interruption can happen multiple times throughout the night, and it can last for a few seconds or minutes.
People with sleep apnea snore loudly, and they may feel exhausted during the day. Sleep apnea can be caused by various factors, including excess body weight, having enlarged tonsils, smoking, or may run in families.
What are sleep apnea symptoms?
Sleep apnea is a sleep disorder, and symptoms can vary from person to person, but they typically include loud snoring, gasping for breath, and pauses in breathing during sleep.
In some cases, sleep apnea can also cause morning headaches, daytime sleepiness, fatigue, and difficulty concentrating during the day. With proper sleep apnea treatment, the symptoms can be managed and controlled.
Can obstructive sleep apnea cause weight gain?
In general, sleep apnea does not directly but indirectly cause weight gain.
Sleep apnea can lead to weight gain in several ways.
1. First, the disruptions to sleep can cause fatigue and make it difficult to exercise or be active during the next day.
2. Sleep apnea can cause changes in hormones (it increases ghrelin and decreases leptin) that regulate hunger and fullness, increasing cravings for sugary and fatty foods.
3. It can be a vicious cycle where sleep apnea leads to weight, and excess weight leads to severe sleep apnea.
4. Lastly, when you don’t get enough sleep, your body doesn’t have time to repair itself.
What are the different forms of sleep apnea?
There are three primary forms of sleep apnea (Strohl, 2020):
1. Obstructive sleep apnea
2. Central sleep apnea
3. Mixed sleep apnea
Obstructive sleep apnea (OSA):
The more common type occurs when the airway becomes blocked, and sometimes the patient stops breathing during sleep. Some of the contributory factors are fat deposition in the neck muscles, increased tongue fat, recent weight gain, and obstruction to the upper airway anatomy and the nose. The most significant risk factor is excessive weight. Essentially, the more fat the person has, the greater the chance of developing sleep apnea.
Central sleep apnea:
In this condition, the brain fails to send signals to the respiratory muscles that control breathing due to neurological or underlying neuromuscular diseases.
Mixed sleep apnea:
In this condition, the patient suffers from both central and obstructive sleep apnea.
What are the risk factors associated with sleep apnea?
There is a direct relationship between severe obstructive sleep apnea and diseases such as metabolic syndrome, increased insulin resistance, cardiovascular disease, high blood pressure, and increased weight gain. Obesity and overweight patients are at risk of sleep deprivation and disordered breathing due to severe OSA. However, the reverse is not valid. Not every overweight or obese patients develop obstructive sleep apnea.
Can weight loss cure sleep apnea?
According to some experts, even a small amount of weight loss can help to reduce sleep apnea symptoms. Losing just 10%-15% of body weight has improved sleep apnea in 50% of patients who were moderately obese (Pacheco, 2022). Of course, losing weight is not easy, but it may be worth it for those who suffer from this condition. A randomized study found that obese patients improved their symptoms after weight loss surgery. (Karason et al., 2000). In addition to improving sleep quality, weight loss treatment can also help to reduce the risk of conditions such as diabetes and heart diseases. As a result, it may be worth speaking to a doctor about weight loss in treating sleep apnea.
What is AHI (apnea hypopnea index)?
Apnea is the complete absence of breathing, while hypopnea is a partial loss of breathing for 10 seconds or longer. The apnea hypopnea index is a ratio that indicates the severity of sleep apnea (OSA risk). A score of less than 5/hr is normal, and a score of more than 30/hr indicates severe sleep apnea.
What is the treatment of sleep apnea?
The treatment options for sleep apnea depend on the OSA severity.
1. First-line treatment to improve quality sleep for mild cases includes maintaining a healthy weight and healthy lifestyle.
2. Lifestyle changes, including losing excess weight, quitting smoking, and avoiding alcohol, maybe enough to improve symptoms.
3. More severe cases of sleep apnea sufferers may require sleep medicine or oral appliances such as continuous positive airway pressure (CPAP therapy) machine, which helps keep the airway open during sleep.
4. When patients do not respond to conventional therapy, surgery may be necessary to remove excess tissue or implant a device supporting the airway.
5. Bariatric surgery to help with significant weight loss and simultaneously treat acid reflux may be an option for a few.
Regardless of the treatment approach, including starting a weight loss program, it is essential to seek medical help if you suspect that you or a loved one has sleep apnea.
How does treatment with CPAP machines and therapy help with sleep apnea and weight loss?
CPAP may affect your weight and health conditions indirectly.
1. Decreases drowsiness during the day
2. Decreases the ghrelin (the hunger hormone)
3. Reduces high blood pressure and heart disease
4. Decreases abdominal/visceral fat
5. Increases insulin sensitivity and lowers the risk of diabetes mellitus
6. Increases quality of life.
CPAP reduces weight along with a good diet and regular exercise.
Conclusion:
Sleep apnea and weight loss are interconnected, and evaluating this complex condition requires a thorough examination by an experienced physician. Many factors may be responsible for this condition, including upper airway obstruction and weight gain. This condition can be frustrating and can interfere with your quality of life.
By embracing a healthy lifestyle plan (including a nutritious diet and regular physical activity), you can lose weight and combat your sleep disordered breathing. The key to accomplishing this is a partner who has the expertise and is invested in your health, weight management, and breathing disorder.
Seeking a primary care physician specializing in lifestyle changes and weight loss may be the solution to getting your condition under control. At Bassi Clinic, we can help you develop a tailored treatment plan that keeps your lifestyle in mind. Let Bassi Clinic help you take the next strides on your journey to better sleep and health.
References:
How weight affects sleep apnea. Sleep Foundation. (2022, April 11). Retrieved May 18, 2022, from https://www.sleepfoundation.org/sleep-apnea/weight-loss-and-sleep-apnea
Karason, K., Lindroos, A. K., Stenlöf, K., &Sjöström, L. (2000). Relief of cardiorespiratory symptoms and increased physical activity after surgically induced weight loss: results from the Swedish Obese Subjects study. Archives of internal medicine, 160(12), 1797–1802.
Strohl, K. P. (2022, April 18). Sleep apnea – lung and airway disorders. Merck Manuals Consumer Version. Retrieved May 18, 2022, from https://www.merckmanuals.com/home/lung-and-airway-disorders/sleep-apnea/sleep-apnea
