A Cure for O.S.A.

[Dreamcatcher]

The experts say that the number 1 cause of OSA is weight gain. I find this hard to believe. So If I light back up and start smoking again and lose the extra pounds I gained when I quit, I'd be cured? I dont think its that simple, there must be other factors as well otherwise most of the population would be suffering and also what about the thin people.
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.."Being overweight or obese is perhaps the major predisposing factor for sleep apnea. Being overweight likely contributes in two ways. First, when you are overweight extra fat tissue will build up throughout your body, including along your airway. This may lead to some narrowing -- especially in the throat -- that could make it more prone to obstruction while you sleep.

In addition, the extra pounds may serve as an external pressure that accomplishes the same thing. Imagine a 30-pound bag of sand sitting on your chest or stomach. It’s no wonder that this extra weight can disrupt your breathing. Individuals with large necks are especially at risk for apnea because the pressure is more direct.

Taken from About.com.

Large Necks? How large and above what size....
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..."As your collar size grows, so does your risk of heart disease.

It's true for both men and women: Neck fat adds to your risk of heart disease, over and above the known heart risk from belly fat.

The finding comes from data collected from 3,320 people in two studies of heart disease risk factors.

Belly fat -- specifically, fatty deposits around the organs of the central body -- is known to increase the risk of heart disease. Sarah Rosner Preis, ScD, MPH, and colleagues theorized that upper-body fat, as measured by neck circumference, also raises heart risk.

Sure enough, they found that the bigger a person's neck size, the greater that person's risk of high levels of LDL "bad" cholesterol and blood fat, insulin resistance, and high blood sugar. This held true even after controlling for belly fat.

Taken from Webmd.com

Hold on a minute, so does this mean a large neck will not only give you sleep apnea but another chance of heart trouble? So thats double chance of a heart attack.

My neck is 17 inches is this big or small?

Well according to the chart Im a X-Large so maybe there is something in neck sizes but what else....
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Causes

Common causes

Most cases of OSA are believed to be caused by:
old age (natural or premature),
brain injury (temporary or permanent),
decreased muscle tone,
increased soft tissue around the airway (sometimes due to obesity), and
structural features that give rise to a narrowed airway.

Decreased muscle tone can be caused by drugs or alcohol, or it can be caused by neurological problems or other disorders. Some people have more than one of these issues. There is also a theory that long-term snoring might induce local nerve lesions in the pharynx in the same way as long-term exposure to vibration might cause nerve lesions in other parts of the body. Snoring is a vibration of the soft tissues of the upper airways, and studies have shown electrophysiological findings in the nerves and muscles of the pharynx indicating local nerve lesions.

Craniofacial syndromes

There are patterns of unusual facial features that occur in recognizable syndromes. Some of these craniofacial syndromes are genetic, others are from unknown causes. In many craniofacial syndromes, the features that are unusual involve the nose, mouth and jaw, or resting muscle tone, and put the individual at risk for OSA syndrome.

Down syndrome is one such syndrome. In this chromosomal abnormality, several features combine to make the presence of obstructive sleep apnea more likely. The specific features in Down syndrome that predispose to obstructive sleep apnea include: relatively low muscle tone, narrow nasopharynx, and large tongue. Obesity and enlarged tonsils and adenoids, conditions that occur commonly in the western population, are much more likely to be obstructive in a person with these features than without them. Obstructive sleep apnea does occur even more frequently in people with Down syndrome than in the general population. A little over 50% of all people with Down syndrome suffer from obstructive sleep apnea (de Miguel-Díez, et al. 2003), and some physicians advocate routine testing of this group (Shott, et al. 2006).

In other craniofacial syndromes, the abnormal feature may actually improve the airway, but its correction may put the person at risk for obstructive sleep apnea after surgery, when it is modified. Cleft palate syndromes are such an example. During the newborn period, all humans are obligate nasal breathers. The palate is both the roof of the mouth and the floor of the nose. Having an open palate may make feeding difficult, but generally does not interfere with breathing, in fact,if the nose is very obstructed, then an open palate may relieve breathing. There are a number of clefting syndromes in which the open palate is not the only abnormal feature; additionally there is a narrow nasal passage - which may not be obvious. In such individuals, closure of the cleft palate- whether by surgery or by a temporary oral appliance, can cause the onset of obstruction.

Skeletal advancement in an effort to physically increase the pharyngeal airspace is often an option for craniofacial patients with upper airway obstruction and small lower jaws (mandibles). These syndromes include Treacher Collins syndrome and Pierre Robin sequence. Mandibular advancement surgery is often just one of the modifications needed to improve the airway, others may include reduction of the tongue, tonsillectomy or modified uvulopalatoplasty.

Post-operative complication

OSA is a also serious post-operative complication that seems to be most frequently associated with pharyngeal flap surgery, compared to other procedures for treatment of velopharyngeal inadequacy (VPI).[7] In OSA, recurrent interruptions of respiration during sleep are associated with temporary airway obstruction. Following pharyngeal flap surgery, depending on size and position, the flap itself may have an "obturator" or obstructive effect within the pharynx during sleep, blocking ports of airflow and hindering effective respiration.[8][9] There have been documented instances of severe airway obstruction, and reports of post-operative OSA continue to increase as healthcare professionals (i.e. physicians, speech language pathologists) become more educated about this possible dangerous condition.[10] Subsequently, in clinical practice, concerns of OSA have matched or exceeded interest in speech outcomes following pharyngeal flap surgery.

The surgical treatment for velopalatal insufficiency may cause obstructive sleep apnea syndrome. When velopalatal insufficiency is present, air leaks into the nasopharynx even when the soft palate should close off the nose. A simple test for this condition can be made by placing a tiny mirror at the nose, and asking the subject to say "P". This p sound, a plosive, is normally produced with the nasal airway closed off - all air comes out of the pursed lips, none from the nose. If it is impossible to say the sound without fogging a nasal mirror, there is an air leak - reasonable evidence of poor palatal closure. Speech is often unclear due to inability to pronounce certain sounds. One of the surgical treatments for velopalatal insufficiency involves tailoring the tissue from the back of the throat and using it to purposefully cause partial obstruction of the opening of the nasopharynx. This may actually cause OSA syndrome in susceptible individuals, particularly in the days following surgery, when swelling occurs (see below: Special Situation: Anesthesia and Surgery).

Taken from Wiki...

So thats several ways of getting this illness now. I guess for me it must be weight gain that caused it as the other possible causes did not feature and the only other posible cause was of me gaining weight. Does this mean that if I lose weight Im cured? Maybe I should start smoking again for the sake of my health as it will have a dramatic effect on my weight but I dont think its as simple as that, it may have been the cause of it but I beleive that losing weight wont cure me but would just ease the symptoms.

I thinking smoking again would be a serious error on my part. I believe that the only option is for me to shed the pounds and see what happens, at least I can try.

..but what about you? Do you have a large neck or have gained pounds, do you know how you caught OSA?

[TheDreamer]

Don't forget that OSA also causes weight gain....or rather poor sleep causes it.

I recently found that long before I was diagnosed with OSA, I've had a Mallampati score of 3...with a comment suggesting that I might have sleep apnea. Wasn't until I expectedly gained a lot of wait and my BP went from its normally a little high to a lot higher, that doc suggested a sleep study. I had been complaining of EDS and sleep attacks for decades before.... (the car accident had been 11 years prior)

Otherwise, I used to be a skinny 6'3" guy (underweight)...now I'm just at the top end of 'normal'.

I also always had a large neck...made it annoying buying shirts when I was younger, parents would not understand that they needed to buy me shirts to fit my neck...not my thin build.

[greatunclebill]

to me, weight is a denial mechanism that some people use to justify in their mind that osa is temporary for them. i do not believe this to be a disease or illness that you can catch or cure. osa is a physical condition that has always existed in the person that has it.

you may understand it better thinking about glasses. some people need glasses and bifocals at an early age. most people need bifocals or reading glasses around age 39. this is because your eyes adjust themselves so you internally squint without making a conscious effort. around age 39 in most people your eye muscles tend to get tired and are unable to automatically focus like they used to. this result in headaches. most people get bifocal or reading glasses at this age because of they told the doctor they are having headaches.

apnea is no different. some people get diagnosed with osa at an early age. but for most people around that same age 39 + or - some years, the throat muscles get tired and are unable to keep the windpipe open like they used to resulting in the pipe closing during episodes and you going to the doc saying you are exhasted.

around age 39 + or - in normal people, when you tell the doc you have headaches or are exhausted he knows you need bifocals or reading glasses or need a cpap. you will be referred to the optometrist or sleep doc. some people go into denial and fight it longer so age age could be many years later.

to start smoking to "cure" apnea is the sign of an idiot. i'm sure you're not an idiot so i imagine after thinking about it you will not start.

weight loss is something we all probably need. while it may improve your condition, and in some rare borderline people get them off the mask they probably didn't really need to begin with, for most people it will have no or little effect on the osa.

[zimlich]

When I was diagnosed I had been seriously depressed and was very underweight. Never heard of the Mallampati scale. Thanks for that, The Dreamer.

[CHanlon]

I've always been "overweight" - even when I was a kid and even during the most active times of my life, such as 2 years in the military. For me, it's a normal state, I'm not a big eater - I have 3 younger brothers that are all skinny as heck, and all of them eat more on average then I ever have. I've also always snored - loudly. Being diagnosed with SA wasn't a big surprise to me, in fact, I would have been more surprised if I *didn't* have it. When I went in to see about doing something about it, though, my doctor - who also has SA - sent me for a few tests... one of which showed that I'm also hypothyroid. (Which, actually, didn't surprise me either.) Both conditions cause weight gain... and both get worse with weight gain... Since I've been on thyroid hormone supplements, and on APAP, I've lost 35 pounds, and over the last couple of months I've noticed that the 95th percentile pressure has been dropping. So I think it's pretty definite that there is a correlation between weight and OSA, in my case at the very least.

[PaulaO2]

I know of a lot of people who, after losing weight, need their CPAP pressure lowered. But I know of no one who has been able to get rid of the machine altogether.

I also know a lot of people who are skinny and have OSA.

I know someone who just had major mouth and throat surgery (it sounds like he had UPPP surgery) because his throat was too narrow and he was choking on his food a lot. There were other symptoms but that was the one that sent him to the doc. BUT, he had a sleep test and did not have OSA. Despite the narrowing of his throat, the small mouth inside, etc, he did not have sleep apnea. So why not?

I've had surgeries and tests in the past where I was knocked out for them. That means tube down the throat. But it was not until I had my colonoscopy that I actually heard the anesthesiologist mention I needed a smaller tube than they had planned. They were having problems finding a vein (hard enough to find on a good day; add in dehydration? ha, good luck) so it was taking longer and everyone was hanging around while they looked for a place. The anesthesiologist was there of course and at one point, another one came in. The conversation went something like:

"This is the patient I was saying we needed a smaller tube for."
(2nd guy looked at me and spouted medical-ese for 'she's fat, that's why')
But the 1st one, who was holding my hand as they poked the other arm, squeezed it and corrected him. He asked me to open my mouth. He then gave a short medical-ese lecture on my mouth and throat structure, essentially saying it was overly small.

No one, in all the times I've been knocked out, mentioned this. No one, in all those times, mentioned sleep apnea.

But, going back to the co-worker, I don't choke on my food.

So what's the difference?

That's the thing with sleep apnea. Why does one obese person have it and not another? Why do skinny people have it?

Obesity is a catch-all for medical crap they can't figure out. Like they just said autism can happen if the mother is obese. And it can happen if she is skinny but saying obesity causes it gets more attention.

[Dreamcatcher]

So 2+2 really does equal.....




Who's calling me an Idiot As if I would start smoking to cure my OSA (In a heartbeat) if it was true. Mention sleep apnea and the next sentence will usually have a weight question or comment to follow it, UTTER NONESENCE! Weight will effect my OSA just like it would effect my effort on climbing Everest or getting out of my chair, its a real pain when they relate the two.

So can someone tell the pro's that losing weight will not cure sleep apnea and never will......

[SuperSleeper]

That caulk board reminds me of calculus classes... not a good memory at all...

Math...

[Dreamcatcher]

That caulk board reminds me of calculus classes... not a good memory at all...

Math...

I take it someone has been playing with code? either that or Paula got fed up of my "Big Pictures"

[greatunclebill]

So 2+2 really does equal.....




Who's calling me an Idiot As if I would start smoking to cure my OSA (In a heartbeat) if it was true. Mention sleep apnea and the next sentence will usually have a weight question or comment to follow it, UTTER NONESENCE! Weight will effect my OSA just like it would effect my effort on climbing Everest or getting out of my chair, its a real pain when they relate the two.

So can someone tell the pro's that losing weight will not cure sleep apnea and never will......

of course it's best to never say never as anything can happen. start your diet which is always good anyways. start smoking too if you think it will help you. however, apnea is not a disease or sickness that you can cure. until you understand that it's a phyical condition it won't make sense. your questions are best asked of your doctor who knows your medical history and condition. your doctor will know if you are borderline enough that weight loss will help. i suspect if that was really the case he would have suggested it before cpap. if weight loss were a viable option, do you think for one minute that insurance companies wouldn't require doctors to require weight loss attempts prior to paying for cpap's?