Stephanie Watson

Weight loss, breathing devices still best for treating obstructive sleep apnea

New guidelines from the American College of Physicians (ACP) emphasize lifestyle modifications—especially weight loss—for treating obstructive sleep apnea. Though the guidelines don’t offer any radical treatment updates, they do reinforce the effectiveness of tried and true therapies.

Obstructive sleep apnea is a disorder in which the airway becomes blocked during sleep, interrupting breathing—sometimes dozens of times during a single night. Having obstructive sleep apnea puts you at risk for a number of other conditions, including high blood pressure and stroke.

After researchers from the ACP Clinical Guidelines Committee reviewed studies on the effects of various sleep apnea treatments, “their conclusion was that current therapies are effective and there wasn’t a lot of new evidence to suggest doing anything different,” says Dr. Lawrence Epstein, assistant medical director of clinical sleep medicine at Harvard-affiliated Brigham and Women’s Hospital.

The importance of weight loss

The ACP’s first recommendation centers on weight loss for people who are overweight and obese. The link between excess weight and sleep apnea is well established. People who are overweight have extra tissue in the back of their throat, which can fall down over the airway and block the flow of air into the lungs while they sleep.

Though losing weight is easier said than done, it can yield real results. “If we can get people to lose weight, it would make both sleep apnea and other health problems [such as heart disease] go away,” says Dr. Epstein. Losing just 10% of body weight can have a big effect on sleep apnea symptoms. In some cases, losing a significant amount of weight can even cure the condition.

Other options

The ACP also strongly recommends continuous positive airway pressure, or CPAP. This is typically the first-line treatment for people with sleep apnea, because weight loss can be so hard to achieve. CPAP is a mask or device that fits over the nose and mouth. It blows air into the airways to keep them open at night.

CPAP works well—but not everyone who needs it is willing to commit to wearing the clunky apparatus. Half or more of people who try CPAP don’t stick with the treatment, research has found. “It takes some getting used to,” Dr. Epstein acknowledges. The good news is, changes to the technology are making CPAP much easier to tolerate. “When CPAP therapy was introduced, it was one-size-fits-all. As we’re looking for more ways to improve patients’ ability to use it, there are a whole variety of mask styles being developed.”

CPAP_machine_image

A continuous positive airway pressure (CPAP) machine prevents sleep apnea by blowing air into a mask that covers the nose and mouth. The stream of air keeps the airways open.

Another alternative to CPAP is an oral appliance. These plastic inserts fit into the mouth and prevent the tongue and tissues in the back of the throat from collapsing over the airway during sleep.

CPAP and oral appliances work well, but they’re not cures for sleep apnea. The only sure way to rid yourself of the condition for good is to either lose weight or have surgery to remove excess tissue from the palate or throat. Surgery can have side effects, which is why it’s usually viewed as a last resort. But if you can’t tolerate CPAP or oral appliances and you’re struggling to lose weight, it is an option.

Treatment is personal

Before you can decide on a treatment, you first need to identify that you even have sleep apnea. Because the breathing pauses happen during sleep, most people with apnea have no idea they’ve got it.

Important clues are nighttime snoring and daytime sleepiness. Your doctor can do a sleep study, checking your breathing while you sleep in a laboratory or are attached to a monitoring device at home. “It’s important to get an objective measure like a sleep study, because the treatment you select will depend on how severe the sleep apnea is,” says Dr. Epstein.

Sleep apnea isn’t like pneumonia. You can’t try one treatment and expect your symptoms to disappear. Instead, treatment requires individualization. “When patients ask me which CPAP device is best, I tell them, ‘The one you’re going to use.’” says Dr. Epstein.

He recommends choosing a doctor who is experienced in treating sleep apnea—someone who can help you find the treatment you’re most likely to stick with, and teach you how to use it correctly.

Comments:

  1. Marc Khachatur

    Has anyone heard or tried using the APAP (Automated Positive Airway Pressure) device for sleep apnea treatment?

  2. James EasyWeightLossAddict Forest

    Great post! One can never get too much information on how to maintain a healthy body. Sleep is so important to every part of our waking life that losing weight to ensure a good night’s sleep is a no brainer to me.

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  3. Kim

    My son is 31 and was just diagnosed with sleep apnea by an eye doctor. I did smoke when I was pregnant. My son is blaming is whole life’s problems on sleep apnea. Which he said the reason he has it is because of my smoking. He is overweight. Is this all my fault?

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  6. Joseph

    A friend of mine had sleep apnea and even went to a sleep clinic to see how bad of a problem it was. Several options were given to him, including risky surgery. Ultimately, he went on a weight loss plan, to mainly get healthier with a new baby joining the family. Not only did he lose weight/fat and his health improved drastically, but his wife reported she has slept a lot better since! Sometimes the easiest solution is right in front of you and the benefits are two-fold. Try it for yourself at fatloss123.net

  7. Sally Marino

    My weight caused two problems preventing me from sleeping. The fat caused sleep apnea as well as sever aside reflux

    I lost 60 pounds and have kept it off for 5 years. You can do this too.
    I did two things:
    1. Added strength training with lighter weights/higher reps to my cardio. Strength training really gets your metabolism up and you lose weight more quickly.
    2. I researched and learned how to eat. Less calories will make you lose weight.
    Nutrition is an important component of weight loss.

    Good luck in your weight loss!

    • Ivy

      Sally,

      Where is a good place to start to learn about nutrition?

    • Charity

      Thank-you for sharing your story! It struck a personal note with me, because in the last 3 years I have a gained a considerable amount of weight. About 2 years ago I noticed the development of 2 new health conditions: 1) the development of painful gastric reflux and 2) waking up feeling less rested. I thought both were simply the result of age. However, after hearing more stories and reading up on the negative effects of weight gain, I am convinced that these new conditions are a result of gaining weight. I keep planning to start a diet, but sometimes it feels too overwhelming, and I question whether I’ll be able to keep it off. Reading your comment was very encouraging. Thank-you again for sharing!

  8. Apria

    Sleep Apnea is a dangerous condition that has been shown to cause loss of sleep, discontent for your partner, and even hypoxia that promotes angiogenesis which increase vascular and tumor growth, which in turn results in a 4.8 times higher incidence of cancer mortality.

  9. Medical Weight Loss Diet

    I think the best option for sleep apnea is weight loss program. I was overweight and i have problem with sleed anea. My BMI is more than 40. My Height is 170cm.
    I started weight loss program from 120kg and now i have 72kg. my Problem with Sleep anea was gone. I was being recommended with my doctor to loose my weight and i can see the result and many benefits that i can get in my ideal weight now.

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  13. Nikole

    Hi my name is Nikole and I am a young mother of 2 lovely children and have had thyroid problems my whole life (due to over production losing weight is not a simple process for me and my metabolism is very slow… Ii also had SEVERE breathing problems back then and that is how I found your site, I took Garcinia Cambogia extract a supplement to help losing weight in the form of pills for almost 7 months now with good and long lasting results, what I do know from studies is that it can damage the liver and there are also studies about it affecting the production of sperm, nevertheless not many studies. After reading your article I can relate to it because indeed when I lost weight some of the conditions went away, I dont know if its related but so it seems. Thank yu for your rich article and I wish you all nice day :) Nikole

  14. Eve rider

    I m using plastic appliances for several years. My question, is the plastic save, it comes from Sweden.
    2. My appliance removers itself from my mouth . I do not know , how many ours I sleep with it.
    3. It is not so bad that I need another appliance per sleep study clinic.
    I would appreciate to know more about the plastic and my health.

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  16. Marc

    Weight loss cured my sleep apnea!

  17. boxing exercises

    Well, overweight always lead to bad healthy even for our sleeping time.
    So, go to routine activity and best diet for our health. important, indeed.
    Thanks