Insane! 5lbs makes HUGE OSA difference???

[Don in Austin]

Stats and facts:

67 years old, 5' 8", waist 33", weigh somewhere in mid 170s. BMI says I am "overweight" but does not take into account a long trunk and relatively short legs. Perhaps I am overweight, but not by much. I have been exercising fanatically for the last five years -- gym 2x/week, 100 miles/week on a bicycle seeking out hills, and used to weigh 210 +. No statins, no blood pressure meds and good cardio-vascular bloodwork. Untreated OSA is high moderate/low severe. I do not use a CPAP and would appreciate this thread NOT turning into "What's wrong with you, why DON'T you use CPAP?" I will keep an open mind and if I become that desperate may try CPAP again.

I am under the care of a sleep specialist dentist, a conventional sleep specialist who normally turns to CPAP for her patients, and have seen an ENT. Several months ago, all three of these medical professionals and I were in agreement that the regimen I was on was working reasonably well if not perfect. This regimen is a custom-made TAP oral device in combination with a "bumper belt" to keep me off my back -- (more or less.) I have my own recording pulse/oximeter and bring a week's worth of readings into my doctor appointments. Last of all, the whole thing is complicated by PLMD syndrome, but I don't think that is my primary problem.

Coincidental with acquiring a little extra weight over the Christmas/New Year's holiday the oximeter readings went to crap and the poor readings were corroborated by the all too familiar waking up at 12:30. 2:00, 3:00 4:30, 6:00 and difficulty getting back to sleep. Everybody on this forum knows what I am talking about! Discouraging to say the least! Damn near like I was before any treatment at all. With the help of fasting 40 hours for a colonoscopy last week, a little vigilance re' gratuitous calories and better weather allowing more cycling miles, I have lost a few pounds. How much did I lose? Hard to say because the scale fluctuates + or - almost 4 pounds with hydration level, meals, exercise etc, but it isn't much more than 5 lbs. Yet there has been a huge encouraging improvement. This morning's pulse/oximeter graph was back to the ballpark of what we all agreed was liveable and I slept 7 hours straight through.

It seems a real stretch that something like a 3% weight loss could have such a dramatic effect, but if so, I will take it. Not only will I take it, but I will do what needs to be done to lose maybe 10 or so pounds more. I hadn't been motivated previously because, as I said earlier, my weight is not really that excessive -- confirmed by two different personal trainers -- and because of fanatic exercise I have had the luxury of eating as much as I want, (with strict avoidance of junk carbs and junk food in general,) and maintaining.

I will be consulting my sleep dentist next week and think I may also move up my checkup appointment with my general sleep specialist nurse practitioner -- excellent lady who listens and informs very patiently however long it takes. When I made the appointment with the sleep dentist, his nurse did say that they had one lady who put on just a few pounds over holidays and had a major setback.

Has anyone else here found a seemingly trivial weight change to have a major effect on their OSA?

Awaiting and very appreciate of reports from anyone else who may have experienced such a correlation. If its something else altogether than weight-related I have no clue what!

Don in Austin

[me50]

I sometimes gain weight (holidays like you mentioned and sometimes for other reasons like I get stressed and eat comfort food) and I don't have more events (there are a lot of factors that would cause more events, etc.) but I sometimes, depending on how much I have gained, see my pressure needs increase but there again, a lot of factors can go into an increase in pressure.

Losing weight definitely won't hurt anything even though most often it won't make OSA go away. As far as treatment, that is an individual choice and only the person with OSA and their docs can make that decision. The best I can say about that is just get treatment so you don't have the repercussions of untreated OSA.

[Don in Austin]

I sometimes gain weight (holidays like you mentioned and sometimes for other reasons like I get stressed and eat comfort food) and I don't have more events (there are a lot of factors that would cause more events, etc.) but I sometimes, depending on how much I have gained, see my pressure needs increase but there again, a lot of factors can go into an increase in pressure.

Losing weight definitely won't hurt anything even though most often it won't make OSA go away. As far as treatment, that is an individual choice and only the person with OSA and their docs can make that decision. The best I can say about that is just get treatment so you don't have the repercussions of untreated OSA.

Even though I rejected CPAP, I am still very committed to working on this. The way I was doing was pretty good, and if weight really is a huge factor for me I will lose more. My cycling friends spend hundreds if not thousands of dollars on high-tech bike frames and components for the sake of reducing bike weight by a few trivial pounds, so it could be pretty cool to have 10 pounds less body fat to pedal up a 20% grade and be better rested, better recovered from the last ride to boot!

Don in Austin

[zonk]

Even though I rejected CPAP, I am still very committed to working on this.

As far as I,m concerned CPAP saved my life and knowing dying is a certainty but would not be from untreated OSA
At least that one been ruled out .... YMMV

[PaulaO2]

It depends on where the weight was gained or lost, in my opinion. Instead of measuring your waist, it would be interesting to instead measure your neck. If the weight was spread out, including a slight increase in the neck area, then yes, I can see how even 5 lbs could make a difference.

And we also have to keep in mind that 5 lbs of fat is not like a 5 lb bag of sugar. 5lbs of fat is huge.

If you gained weight at your middle, you might not notice the bumper belt as much and slept on your back more.

[Don in Austin]

It depends on where the weight was gained or lost, in my opinion. Instead of measuring your waist, it would be interesting to instead measure your neck. If the weight was spread out, including a slight increase in the neck area, then yes, I can see how even 5 lbs could make a difference.

And we also have to keep in mind that 5 lbs of fat is not like a 5 lb bag of sugar. 5lbs of fat is huge.

If you gained weight at your middle, you might not notice the bumper belt as much and slept on your back more.

Thank you so much for some interesting thoughts!

I am incredibly resourceful at finding ways to defeat the bumper belt -- all in my sleep no less. One way is to pile a bunch of pillows to lift my head and take pressure of the blocks. This is maybe not so bad as there is supposed to be something to be said for an elevated head -- almost sitting up.

At my very first sleep study it was stated that my apnea is quite position dependent and it was even suggested that position therapy alone might suffice. They did not put me on CPAP during the study. That said, this was a really wretched sleep clinic with a really wretched doctor and staff. The sleep clinic I switched to did put me on CPAP halfway through my sleep study there.

I have never measured my neck, but maybe I should. "Further research is needed." I will have my wife measure my neck and keep trying to lose weight. Because of my exercise level and super high HDL, low triglycerides etc., I had been feeling free to eat 24 oz porterhouse steaks, drink lots of (good, grass-pastured, organic) whole milk and etc. Told my wife to make roasted vegetables for dinner several nights a week. Onions, zuchinni, chili peppers, eggplant, tomatoes, carrots, etc. lightly drizzled with olive oil and put in the broiler. Filling, wholesome and relatively few calories.

CPAP or no, I intend to stay on the case!

Don in Austin

[Don in Austin]

I sometimes gain weight (holidays like you mentioned and sometimes for other reasons like I get stressed and eat comfort food) and I don't have more events (there are a lot of factors that would cause more events, etc.) but I sometimes, depending on how much I have gained, see my pressure needs increase but there again, a lot of factors can go into an increase in pressure.

Losing weight definitely won't hurt anything even though most often it won't make OSA go away. As far as treatment, that is an individual choice and only the person with OSA and their docs can make that decision. The best I can say about that is just get treatment so you don't have the repercussions of untreated OSA.

Well, I don't expect OSA to go away but I have to make it more manageable than it was a couple of week ago. I WAS having more events. Obviously, with my program I can't just crank up a setting on a machine to avert that. I like the dental device for comfort and ease of use and able to comply 100%, but it needs help.

Don in Austin

[me50]

Well, Don in Austin, your positive attitude and getting treatment that works for you will go a long way.

[PaulaO2]

Neck thickness used to be one of the main diagnostic criteria for sleep apnea in men. Not sure how much they rely on it now, though.

Also, the muscles in the throat are voluntary, meaning we control them. There are exercises you can do to strengthen those muscles. Like learn to play the digerdoo or however that is spelled. And I think there was some discussion about singing, as well. Strengthening the muscles doesn't mean they won't relax in your sleep but it would make them leaner. I think that is the idea.

[cellikbhoy]

Well, personally I have never seen fat people riding bikes like you do, so sounds like you are not overweight. I have recently lost 30lbs, and plan on another 30, guess i should go back to my Doctor for more tests to see if the readings are any different. Good luck...