Photo by Siora Photography via Unsplash

 

 

Weight Management - Facts and Strategies for Sleep Apnea Patients

 

By Admin

 

 

Not everyone who has sleep apnea has a weight problem, but over half of those with obstructive sleep apnea (OSA) are either overweight or obese, defined specifically as having a body mass index (BMI) of 25-29.9 or 30.0 or above, respectively. Weight issues are the number-one cause of OSA in adults, and it is common for sleep apnea to develop in individuals who have gained weight, the obstruction developing from the added weight in the area of the upper airway. For this reason, weight loss is one of the first recommendations made by doctors who diagnose and treat sleep apnea syndromes. In addition to PAP therapy, lifestyle changes such as dietary restrictions and exercise regimens are prescribed as a comprehensive strategy for reducing sleep apnea events, especially in the long term. While many patients find these recommendations to be challenging and disruptive to their daily routines, it is often insufficient simply to use PAP therapy on its own. Weight control is as crucial to sleep apnea prevention as CPAP, affecting nearly every organ system in the body and improving overall health in ways that can very likely save your life. 

The LInk Between Weight Gain and Sleep Apnea

The link between weight gain and sleep apnea is well established. A larger neck circumference is often a sign of potential blockage in the back of their throat, leading to sleep apnea events in the night. While we all know that losing weight is not the easiest thing to do, it should never be disregarded as a supplementary treatment. Those extra pounds can add up to real damage over time, contributing to a great number of potential health conditions you can prevent with rather subtle changes in your day-to-day life. According to the American Medical Association, even modest weight loss can be effective in managing and preventing sleep apnea syndromes. In two controlled studies, investigators have demonstrated that a 10-to-15 percent reduction in body weight leads to an approximately 50-percent reduction in sleep apnea severity (as measured by AHI), making visceral fat accumulation the number-one risk factor for the development of OSA in adults. Obstructive sleep apnea (OSA) is the form of sleep apnea most affected by weight issues, and a large number of adverse health conditions are associated with the disorder, including high blood pressure, insulin resistance and diabetes, problems of the heart such as atrial fibrillation and bradycardia (slow heart rate), and other forms of cardiovascular disease. People with severe OSA are reportedly four times more likely to have atrial fibrillation than people without sleep apnea. On the brighter side of this complex relationship is the effect that weight loss can have on multiple bodily systems at the same time. Doctors continually see improvements following weight loss that extend well beyond the symptoms of disordered breathing. Mood, mental acuity, libido, energy, sleep, stress, and attitude are all affected by weight management, and the more excess pounds you are able to shed, the more likely you are to see improvements. In some cases, OSA may even be preventable or even cured, especially if treated early in life with weight management as a major focus of health-conscious lifestyle.  

How to Keep Your Exercise Routine

Often the biggest problem with exercise as a weight loss strategy is the fact that weight gain reduces energy and often causes fatigue, making it difficult to perform the exercises on a regular basis. For those with sleep apnea, this problem is two-fold. Weight loss is both a cause and a symptom of sleep apnea, and vice versa. This cycle of unhealthy conditions can work against you in extreme ways, to the point that a single exercise seems like an unbearable task. But if PAP therapy does its work, this should become less of an issue over time. Often the use of CPAP takes the edge off exercise pains and difficulties with increases in energy and better sleep. But if exercise remains a problem, there are strategic approaches that may help to solidify the routine. To begin, always set goals in increments and establish a game plan. It is daunting to say that you are going to lose a large amount of weight, and it takes time to reach those landmark moments of major and obvious success. It is just as important to establish daily goals, or weekly goals, in order to make your journey a single step at a time. This is extremely important, and will help you to keep the routine because it will make regular demands of your behavior. Another strategy is keeping the workout sessions short and in bursts so that you can compel yourself to jump straight into it and be proud of what you achieve in so little time. Every breath of exercise makes a difference, and all it takes to get started is the motivation to move, to carry yourself into the moment. By the end, you will almost always feel better, and there’s a reason for that. These moments of exertion are doing remarkable things for your body and mind, and you should focus on those positive results.  

Weight Management and Diet

Research published in the Lancet Diabetes and Endocrinology journal reports that a daily reduction of 300 calories is enough to have positive effects and increase life expectancy. This amounts to roughly one snack a day cut out of your diet. A single muffin with butter tends to measure about 400 calories, so a 300-calorie reduction should not be difficult. If those reduced calories are fat laden or full of carbs, then you are doing yourself two favors at once, day after day. Over time it is recommended to make further reductions in these areas, concentrating on healthy alternatives to high-fat or high-carb foods, but just like exercise, diet demands discipline and consistency. Just remember that nothing is accomplished immediately. Take pleasure in each small step you make on the way to a healthier life.  

Obesity and General Health

According to the National Center for Health Statistics, nearly 40 percent of Americans are affected by excess weight or obesity, which can increase the risk of many health problems, especially diabetes, high blood pressure, heart disease, stroke, and some cancers such as prostate cancer, liver cancer, and kidney cancer. More severe obesity is also associated with an increased death rate at early ages. Results from the National Health and Nutrition Examination Survey (NHANES) showed that weight is on the rise in America. In 2011–2014, nearly 70 percent of American adults age 20 years or older were overweight or obese, and more than a third (36.5 percent) were obese. In the past, for example, in the 1988–1994 survey, the number of overweight of obese adults aged 20 years or older was at 56 percent, amounting to one-percent increases every passing year. This tells health researchers that social influences are contributing to unhealthy behaviors. Public health campaigns and increased dietary standards for schools and other institutions are doing what they can to reverse this trend, but it is a difficult task, and each person who decides to make a change is both a public and private success, as the habit of good eating and healthy living can influence those around you and spread to others, impacting family, friends, and the larger community in which you live.  

The Health Numbers

Listed in the National Institutes of Health website and database, the numbers below represent the target numbers for each measurement. Variations between men and women are included. For BMI, 25 to 29.9 is considered overweight, while 30 and above is considered obese.  

 

 

Target BMI    18.5-24.9
Waist Size    Men: less than 40 in. Women: less  than 35 in.
Blood Pressure    120/80 mm Hg or less
LDL (bad cholesterol)    Less than 100 mg/dl
HDL (good cholesterol)    Men: more than 40 mg/dl Women:  more than 50 mg/dl
Triglycerides    Less than 150 mg/dl

 

Obesity and Sleep Apnea in Children

The reasons for maintaining healthy weight in children are numerous and important for a number of reasons, but among them is the prevention of sleep apnea before it develops. For children and adolescents (younger than 20 years of age), weight standards are based on the CDC’s BMI-for-Age Growth Charts, which are based on a number of parameters such as length-for-age, weight-for-age, head circumference-for-age, stature-for-age, and BMI-for-age. Free training courses are provided on the CDC Growth Chart Training Website to explain how the system works for each age group. Along with the adult population in the U.S., the percentage of children and adolescents who are overweight has also increased over time, especially in the last two decades. As a result, early-onset diabetes and other illnesses related to weight, including obstructive sleep apnea, are also on the rise. With what we know about the relationship between weight and health, it should be clear to any parent that diet and exercise are equally important (if not more important) for the young. Whether or not a child has sleep apnea, increased weight should always be addressed proactively, and a healthy lifestyle should be a top priority for both the parent and the child. When modeled after the values of parents or guardians, positive attitudes about proper diet and exercise can last a lifetime, and so can their effects.  

 

Sources

American Thoracic Society - Patient Information - https://www.thoracic.org/patients/patient-resources/resources/obstructive-sleep-apnea-and-heart.pdf

Cancer.gov - https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet

CDC.gov - National Health and Nutrition Examination Survey - https://www.cdc.gov/nchs/nhanes/index.htm

European Respiratory Journal - https://www.ncbi.nlm.nih.gov/pubmed/2376247

Harvard Health Publishing - https://www.health.harvard.edu/blogb/weight-loss-breathing-devices-still-best-for-treating-obstructive-sleep-apnea-201310026713

Journal of the American Medical Association - https://www.ncbi.nlm.nih.gov/pubmed/11122588

Journal of Internal Medicine - https://www.ncbi.nlm.nih.gov/pubmed/9042088

National Center for Health Statistics Data Brief (288) - https://www.cdc.gov/nchs/data/databriefs/db288.pdf

National Institutes of Health - https://www.nih.gov/news-events/news-releases/rates-new-diagnosed-cases-type-1-type-2-diabetes-rise-among-children-teens

National Institutes of Health - National Institute of Diabetes and Digestive and Kidney Diseases - https://www.niddk.nih.gov/health-information/weight-management/health-risks-overweight

Proceedings of the American Thoracic Society - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645252/

Seminars in Pediatric Neurology - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2490595/

The Lancet Diabetes and Endocrinology - https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30151-2/fulltext

U.S. Department of Health and Human Services - National Center for Health Statistics - https://www.cdc.gov/nchs/data/hus/hus15.pdf

WebMD - https://www.webmd.com/sleep-disorders/sleep-apnea/obstructive-sleep-apnea-causes#1