Sleep Apnea and the Vicious Cycle

Sleep apnea is a disorder in which one’s airway becomes obstructed while asleep, causing loud snoring in its most benign form and complete cessation of breathing, cardiac arrhythmias, and low blood oxygen levels at its worst. Sleep apnea is a dangerous and growing problem in the U.S. It is also inextricably related to the epidemic of obesity.

The repeated episodes of apnea (lack of breathing) cause frequent nighttime awakening (though the patient is often unaware) and broken, choppy, non-restorative sleep. The problem is often first noticed by the patient’s spouse or partner, who is disturbed by the patient’s loud snoring and/or apneic episodes. Individuals with the disorder often complain of morning headaches, constant fatigue, listlessness, and moodiness. These are people who easily fall asleep watching television, a movie, or just sitting at a red light.

Sife Effects From Sleep Apnea
Sife Effects From Sleep Apnea

Obstructive sleep apnea is much more common in obese individuals. It is believed that the airway of the obese individual becomes obstructed by large tonsils, enlarged tongue, and increased fat in the neck, all pressing on the airway when the throat muscles are relaxed with sleep. A person’s neck circumference is a good predictor of sleep apnea. Obese men with a neck circumference of 17 inches or greater, and women with a neck circumference of 16 inches or greater are more likely to have sleep apnea.

The worst part of this is that not only does obesity have an association with sleep apnea, but sleep apnea as well as poor sleep, tends to cause people to eat more. There seems to be a relationship between hunger and satiety hormones and sleep deprivation, though the exact nature of this relationship is unclear. Also, individuals with sleep apnea often have elevated blood pressure, high fasting glucose, and high cholesterol, all of which can be made worse with sleep deprivation.

It’s a vicious cycle. Obesity, especially morbid obesity (BMI > 40), can lead to sleep apnea, which, itself, then causes changes in the hormones that control eating habits, leading to more weight gain, worsened blood pressure, glucose intolerance, worsened apnea, and the cycle goes on and on.

If you are concerned that you may have sleep apnea, talk to your doctor. Treatment usually involves wearing a CPAP (Constant Positive Airway Pressure) mask apparatus at night, which, as the name suggests, props the airway open with positive air pressure generated from an attached machine.

If you are considering weight-loss surgery, schedule an appointment with Dr. Shawn Tsuda. Getting to a healthy weight is one way to improve or even cure symptoms of sleep apnea.

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