Cure OSA Weith Weight Loss?

[GingerMan512]

Howdy hose noses!

I never had OSA until I started putting on weight about four years ago. I've lost 40lbs this year, another 60 to go. At what point may I want to go in for another sleep study to have my treatment reevaluated? After I lose enough weight and cure my OSA would I notice my AHI drop to zero or is a certain number of events considered normal?

[Possum]

Certainly excess weight can cause or exacerbate OSA as the extra weight around the neck area can cause the airway to collapse easier; however, it is not the only culprit. I have a friend who is in excellent physical condition but still has OSA and requires treatment.

I would say if your machine regularly stays at or near the minimum pressure setting and your AHI's are always consistently low, you might consider reassessing with an updated sleep study. You can also purchase a recording oximeter to monitor your SPO2 levels with and without treatment. If treatment does not significantly impact your SPO2 levels during the night, then perhaps you don't need it. But, as always, you should avoid self diagnosis - if you think you don't need it, get data to support that hypothesis before taking drastic action, such as discontinuing treatment on your own.

For what it's worth, I've lost 35 lbs since Xmas, and I've noticed that my 95% Pressure is typically about 33% less than it was at that time, but I still have sleep apnea and will continue treatment as long as I do because I'm well aware of the benefits to my overall health.

[nydiver]

A friend was quite obese, lost over 250lbs, and at 5'10" 190lbs I'd say he's in a good place. He now exercises almost daily with a 15-20 minute cardio to start the workout. He lost the weight over a year ago and has been maintaining for about 6 months now. He just went in for a new sleep study and was still at 27/hr. Just losing weight is no real indicator that you'll be able to get off CPAP, clearly it can help, and it will improve your lifestyle and longevity, but you shouldn't see it as a "miracle cure" for your sleep apnea.

Lose your weight, exercise as much as you're able, and do your own home test with a recording pulseox and no machine. If your dipping into the 80's at points then your going to want to continue therapy. Perhaps a dental appliance might be more to your liking, it could be that will work for you after weight loss.

Best of luck to you

[eseedhouse]

After I lose enough weight and cure my OSA would I notice my AHI drop to zero or is a certain number of events considered normal?

Anything below 5 is "normal". But it may not be normal for *you*.

I don't think losing weight will really "cure" OSA. Rather let's say it may well put it in remission and you may not need the mask for awhile. But there *are* thin people with OSA.

Unfortunately the vast majority of people who get in great shape and lose lots of weight cannot keep it up forever. I did it three times, but every time I found I could not keep it up and the weight came back on. There is some evidence, if I recall rightly, that such "yo-yo" situations may do you more harm than just staying "weighty".

Good luck in your endeavour - you may be an exception and I hope you are.

[trish6hundred]

Hi GingerMan512,
CONGRATULATIONS on your weight loss.

[PaulaO2]

Another member's wife lost a lot of weight and was able to go off the CPAP for about a year or so. But eventually had to go back on it at a much lower pressure. Even though she maintained the weight loss, her OSA just was not "cured" enough.

My bet is you have had OSA for a while but the weight gain made it bad enough it disrupted your sleep enough that you finally took notice.

[FormerFed]

Howdy hose noses!

I never had OSA until I started putting on weight about four years ago. I've lost 40lbs this year, another 60 to go. At what point may I want to go in for another sleep study to have my treatment reevaluated? After I lose enough weight and cure my OSA would I notice my AHI drop to zero or is a certain number of events considered normal?

“Every picture tells a story, don’t it?” Not that I’m a HUGE fan of Rod Stewart - and don’t care much for that song, itself, actually - but that line did jump to my mind when I read through this thread. Please don’t be discouraged if others haven't had great successes with weight loss vs. apnea. 40 pounds is great - 60 more is outstanding! There are studies showing weight loss has had positive effects on apnea. I found them in searching for real medical facts about what could be done to lessen or stop atrial fibrillation for me. 14 months ago I started random palpitations. They were identified as a-fib 11 months ago, that i.d. was followed by battery of tests to seek a cause, including a sleep study. No cause was apparent, and I had an AHI of only 6, but it was the only test that didn't come back "no problems here," so I was started on CPAP 8 months ago. While both the apnea and the a-fib are both quite mild, the a-fib still creates a stroke risk, so we're covering all the bases - rate control, clotting and cholesterol meds, and lifestyle changes, and CPAP, as cardiology has definitely tied the occurrence of apnea with the occurrence of a-fib. Seems, to this layperson, that it is still sort of a chicken/egg kind of situation as to which comes first, but, I gather from the literature, that there is a lot yet to be learned on the subject but the two are definitely somehow linked.

A “take-away” I’d like to share with you from my adventures in a-fib research thus far is that there just doesn’t seem to be a lot of science yet on weight loss/a-fib/apnea, but the science that I have found definitely shows that weight loss can be quite effective for a-fib - AND - in the studies that also report evaluation of the additional medical problems that the a-fib study participants happened to have going into the studies, there were quantifiable improvements in these conditions also. This information comes from studies announced and published on sites of the American Heart Assoc., American College of Cardiology, NIH, Journal of Amer. Medical Assoc. The studies divided folks into groups of those who were given diet/exercise programs to follow and folks who were not in the diet/weight loss groups. The most detail on the other-than-a-fib medical conditions reported to be improved were on hypertension and diabetes, but sleep apnea improvements were also noted. Do some searches, yourself – studies that come to mind were REVERSE-AF, LEGACY, CARDIO-FIT. Also just performing searches on the terms “weight loss and sleep apnea” will turn up some positive information. I printed some and re-read it to re-encourage myself. Good luck to you – to all of us!

[PsychoMike]

Hey Gingerman,

For some folks, losing weight does help...but realistically, it's not so much about the physical weight as the structures within that lead to OSA. Sure, having more mass on the neck and chest won't help, but OSA is typically associated with airway collapse and less about the weight.

Losing the weight (though very good for you) doesn't mean you'll be cured of OSA. In many cases, the excess weight and sleepiness help in the diagnosis...many GPs don't associated sleep apnea with anyone with a healthy BMI...even though it may have been present long before when the person was at a healthier weight. A thin sleepy person is more likely to get a different diagnosis (thyroid issues and depression are the ones I heard from a thin hosehead friend of mine) from their doctor unless they have their partner swearing on a stack of Bibles repeatedly that they are snoring or stopping breathing during the night.

Lose the weight and hopefully it'll help, but don't assume it means you'll be off CPAP.

[E.W.]

I lost about 45lbs and it made almost no difference well my average pressure changed from 14" to 13" . But lately I noticed something, if I go to bed after a
big meal my AHI tends to be much lower than if I hadn't eaten. I think I noticed someone else making a comment about this.

[under pressure]

I am now 60 years old and managed to go from 323 pounds down to 215 pounds within the space of a year, and am keeping the weight off successfully. I rode my bicycle over 2,000 miles during the last year so my cardio is good now too.

I have been on CPAP for 12 years now and also suffered from a debilitating case of severe a-fib. Got the a-fib under control with an ablation procedure in 2010 which has allowed me to increase my excercise level considerably without pushing myself back into an a-fib state, which was a big problem before because every time I tried to excercise vigorously I would go into a bad a-fib situation for days at a time.

As a result of the weight loss and increased exercise I have been able to substantially reduce my APAP pressure range, and I can see from my Sleepyhead data that my 95% pressure figure has gone down from around 14cm to 8cm. But I still have obstructive apnea; my doctor and I both agree that I will still suffer from the apnea even with my now almost normal BMI range (I am 6'2" height wise). I will continue with the weight loss, hoping for around 190 eventually, but I am sure I will still need to continue with my APAP therapy.

Someone above mentioned the old "what came first, the chicken or the egg" scenario, in my case I think I had obstructive sleep apnea for years before I put on the weight and then I gradually gained weight and had the associated heart issues long after my first signs of apnea. Looking back I think I had sleep apnea even as a teenager based on my levels of extreme fatigue even at those younger ages, and reports from people that I snored heavily. I was pure Spring Steel and Tiger Meat when I was young (6'2" and 175 lbs) so I guess my point is that some individuals may have sleep apnea because of their basic airway physiology rather than due to obesity. And this apnea can contribute significantly to becoming overweight in later years if left undiagnosed and untreated.

Bottom line it all depends on the individual and their own unique circumstances. Continue with the exercise and associated weight loss, it can only help in the long run. Get a follow-up sleep study to see how the apnea is being affected, maybe you'll be lucky and be able to get off the hose, but be aware that you may need to continue your CPAP therapy even after getting to a normal weight, sometimes it's just your basic airway structure.