Sleep Apnea and Obesity – Breaking the Vicious Cycle
By Dr. Mitch Roslin
Sleep Apnea and Obesity – Breaking the Vicious Cycle
About 90 million Americans get nudged, elbowed or awakened each night because they’re snoring. Though loud snoring is something of a joke in our culture, when coupled with obesity, it can signal obstructive sleep apnea, a serious sleep disorder in which a person’s breathing is interrupted repeatedly throughout the night as they sleep, sometimes hundreds of times. Here I’ll explain the dangers associated with sleep apnea, the underlying problem of obesity, and how weight loss surgery can be the solution to both. By Mitchell S. Roslin, MD, FACS, Director of Northern Westchester Hospital’s Bariatric Surgery Program and Professor of Surgery at Hofstra Northwell School of Medicine.
There’s a profound link between sleep and obesity.
It’s a vicious cycle. Abnormal sleep cycles promote obesity. Think about people who work overnight shifts. After their shift is over, they may feel fatigued. That makes routine exercise and activity a challenge. Aside from exhaustion, not getting enough sleep often results in poor food choices – snacks of cookies, chips and candy, especially – that promote weight gain and obesity. Because obesity is the leading cause of obstructive sleep apnea and the vast majority of people with severe obesity have some degree of this dangerous sleep disorder, you’re now dealing with both the dangers of being obese and not being able to breathe properly.
The Vicious Cycle and it’s Dangers to You…Explained.
When you’re awake, the muscles in your throat help keep your airway open so you can breathe. During sleep, those muscles relax, narrowing the throat. If you’re at a healthy weight, this narrowing usually doesn’t block your airway. However, when you’re overweight or obese, excess fat tissue — particularly inside the neck or windpipe area — tends to narrow your airway even further, causing limited air flow and snoring.
People with obstructive sleep apnea snore, don’t get enough air, and keep waking up in order to oxygenate. Because they can’t get a good night’s sleep, their brain and body never fully re-energize. That can lead to chronic hypoxia or lack of oxygen, which can impair memory and cognition. This group may not be as productive at work, and has a higher degree of absenteeism on the job.
Obstructive sleep apnea combined with obesity can also cause more serious complications. Low oxygen and sluggish blood flow through the arteries may make breathing difficult. Blocked airways may lead to high blood pressure in the heart-to-lung system, a condition called pulmonary hypertension. Now, your heart must work harder to pump blood back to the lungs. That can strain the heart and can be life-¬ threatening.
Your sleep apnea can endanger others.
Obstructive sleep apnea can also endanger others around you. Daytime sleepiness is a common symptom of the condition, causing risky situations for those behind the wheel of a car or on the road. Sleep apnea is a common cause of fatal transportation accidents because of people falling asleep at the wheel. In fact, it’s the third leading cause of transportation fatalities, after drugs and alcohol. If you are obese and believe you have obstructive sleep apnea, it’s important to identify your symptoms and take action to improve your sleep and the quality of your life, and equally important, to reduce your chances of having a car accident.
How to find relief, peace of mind and a peaceful sleep.
If worn regularly, sleep apnea devices can help patients breathe more easily during sleep. These devices, which typically include an airway pressure hose and an attached mask, gently blow air through your mouth or nose at a constant pressure. The pressure keeps the throat and airway open while you sleep. However, while the devices may help you sleep better, they don’t address the underlying problem of obesity. To truly cure a person’s sleep apnea, you need to treat their obesity.
Weight loss is the ideal treatment for most obstructive sleep apnea patients. Surgical weight loss for those with moderate-to-severe sleep apnea who also have a body mass index (BMI) greater than 35 is the preferred method. Very soon after surgery, patients typically notice a difference in their sleep patterns. When you lose 20 to 30 pounds in one month, the change is profound. Within six months, a patient can expect to lose up to 60 pounds and decrease their BMI by 10 units. At this point, most symptoms disappear and patients no longer need their sleep apnea devices.
If you are considering surgical weight loss to treat obesity and obstructive sleep apnea, you’ll meet with a surgeon to discuss the best surgical option. At Northern Westchester Hospital, we offer a number of procedures, including the Vertical Sleeve Gastrectomy, the Modified Duodenal Switch/SIPS Procedure, and the Laparoscopic Gastric Bypass. Dietitians, fitness experts, psychologists, and a patient educator will guide you through your weight-loss journey, providing support before, during, and after surgery.
Post-surgery, patients must be committed to leading an entirely different lifestyle, one in which they eat healthily and exercise at least five days a week. You must be dedicated to maintaining a healthy lifestyle. Otherwise, you risk both the weight and your sleep apnea returning.
To learn more about surgical weight loss at NWH, visit nwhsurgicalweightloss.org
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