Sleep Care

kkkk Weight Loss Series: Lose Weight, Sleep Better

After years of being told by his family that he snored heavily and would stop breathing during his sleep, James met with a sleep specialist and underwent a sleep study.  When the results came back positive for severe sleep apnea, he returned to the sleep lab for a Continuous Positive Airway Pressure (CPAP) titration.  While he found he could tolerate the mask and air pressure, he was interested in exploring other treatment options.  Noting that he was about seventy-five pounds over an ideal weight for his height, the sleep specialist recommended that he lose some weight and see if that improved his sleep apnea symptoms.

A Universal Problem

Current estimates claim that more than 55% of American adults are either overweight or obese.  The prevalence of obesity is roughly the same between genders: in 2007-2008, it was 32.2% among men and 35.5% among women.  Race can also play a factor: according to statistics on obesity from the American Heart Association’s website, higher percentages of Hispanics and African-Americans of both genders are overweight or obese than Caucasian Americans.

For many, the cause of obesity is simple:  too many calories are taken in (through food) and not enough energy is expended (through exercise or other physical activity).  However, there are a variety of other factors that can play a role as well, such as genes and metabolism.  Behaviors and environments shaped by cultural, social, and economic forces can also have an impact as well.




Obesity and Sleep Apnea: A Significant Relationship

It is fairly common for an obese individual to also have sleep apnea.  Studies indicate that an obese male, for example, is anywhere from 5-18 times more likely to have sleep apnea than a normal weight male.  About 50% of obese males are estimated to have sleep apnea.

There are several ways a person’s obesity can affect their likelihood for sleep apnea, and they usually center around where their weight is distributed on the body.  Excess weight around the neck, for example, makes the airway more likely to collapse once an individual is asleep and the airway muscles start to relax.  High concentrations of adipose (fat) tissue in the throat make the airway smaller in diameter, which makes it easier to completely close during sleep.  If the extra weight is concentrated around the stomach and waist, it can be more difficult to inhale deeply because of the increased effort needed to take a complete breath.

Strategies for Losing Weight

Men and women generally tend to store excess weight in different areas on their bodies.  Despite this, studies have found that the effects of weight loss on reducing sleep apnea, snoring, and daytime sleepiness is similar for both genders.

Time-tested methods for weight-loss, such as eating a balanced diet, increasing the amount of physical activity and exercise during the week, still work effectively for most people.  Group weight-loss and exercise programs can be effective because of the support members can provide to each other.  A recent study of obese adults with diabetes found that the group which participated in a weight-loss and diet program was three times more likely to see resolution of their sleep apnea symptoms than a control group that only participated in a diabetes management program.

In addition to choosing healthier foods, portion control is another component of dieting that is important to consider.  While this can be a challenge in today’s fast-paced, fast food-oriented society, there are some practical steps to take.  For example, when dining out, ask for a take-home box or container and put half of the meal in it for later before starting to eat.  Try to eat slowly to give the body time to realize how full it is getting—otherwise, it is easy to overeat.  Drinking some extra water before eating can also help reduce hunger and curtail the tendency to eat too much too quickly.

Increasing exercise or physical activity is also an important aspect of weight-loss.  According to the American College of Sports Medicine, adding a minimum of 2.5 hours per week of moderate intensity exercise (such as brisk walking or jogging) produces significant results.  For long-term maintenance of weight loss, however, the recommendation is 3.3 to 5 hours per week.  This can be easily broken down to just 30-40 minutes each day of activity.

Although weight-loss supplements and drugs are popular, the American College of Sports Medicine suggests they are most effective when used in combination with dieting and exercise, as opposed to being used without any other changes.

For some individuals, bariatric surgery can be an option when repeated attempts at diet and exercise have failed to produce any weight loss.  Common baratric procedures include the Roux-en-Y gastic bypass and a gastric lap band procedure.  While there are usually several steps to go through before the surgery can be done, bariatic surgery can produce significant weight loss results when effective.

Regardless of the approach taken, a physician consultation is always recommended to make sure the individual is healthy enough for whatever changes are planned.

James joined a gym and signed-up for some of their exercise programs, in addition to making changes to his diet.  After six months, he’d lost about fifty pounds and found he was sleeping much better.  A repeat sleep study showed a significant reduction in his sleep apnea, although he still had a tendency to snore.  “I have some pounds left to lose,” he admits, “but it’s encouraging to know that my efforts have really improved my sleep apnea.”