The Link Between Sleep Apnea and Weight

Obstructive sleep apnea, or OSA, is a sleep related breathing disorder that causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway.  As you fall asleep, the muscles in the throat normally relax, but with increasing weight, or anatomical abnormalities, some individuals have a blockage that impairs air entry into the lungs.

It is thought that approximately 25 percent of adults are at risk for sleep apnea. Men are more commonly affected than women; other risk factors include middle and older age, being overweight or obese, high blood pressure, and type 2 diabetes mellitus.

There is a strong relationship between weight and OSA. Your neck gets thicker as you gain weight. This increases the level of fat in the back of the throat, narrowing the airway. With more fat in the throat, your airway is more likely to be blocked.

People with OSA are often obese and have a neck size of more than 17 inches. Many people with OSA also have high blood pressure.

Some clues that one may have sleep apnea

• Unintentionally falling asleep during the day
• General daytime sleepiness
• Unrefreshing sleep
• Fatigue
• Insomnia
• wake from sleep with a choking sound or gasping for breath
• Has your bed partner noticed that you snore loudly or stop breathing while you sleep?

Almost all people with OSA snore loudly, and about half of the people who snore loudly have OSA. Snoring is a sign that your airway is being partially blocked. While you may not think you snore, ask the person who sleeps next to you. He or she can tell how often you snore and whether or not you stop breathing.

Many people with OSA are sleepy during the day. They find that they are still tired even after a nap. When you stop breathing, your body wakes up. It happens so quickly, you aren’t even aware of it. This disrupts your sleep process. You can stop breathing hundreds of times in one night. This will make you feel very tired the next day.

Almost all people with OSA snore loudly, and about half of the people who snore loudly have OSA. Snoring is a sign that your airway is being partially blocked. While you may not think you snore, ask the person who sleeps next to you. He or she can tell how often you snore and whether or not you stop breathing. However, if the person does not have a bed partner, he or she may not be aware of the snoring. Sleepiness can also develop gradually over time to the point that the person accepts it as normal.

Other symptoms may include one or more of the following:

• Restless sleep
• Awakening with choking, gasping, or smothering
• Awakening with chest pain or discomfort
• Morning dry mouth or sore throat
• Morning confusion
• Morning headaches
• Personality change
• Memory impairment, difficulty concentrating
• Impotence
• Frequent awakenings to urinate
• Blood oxygen level
• Heart rate and electrocardiogram (ECG)
• Breathing effort and airflow
• Duration of the various stages of sleep
• Body position
• Limb movement

Risks for Obstructive Sleep Apnea
 Risks of sleep apnea include daytime sleepiness and difficulty concentrating, both of which increase the risk of accidents and errors in normal daily activities. Studies have shown that people with severe OSA are more than twice as likely to be involved in a motor vehicle accident as people without these conditions.
In addition, there is evidence that people with untreated OSAH have an increased risk of cardiovascular problems such as high blood pressure, heart attack, abnormal heart rhythms, or stroke. This risk may be due to the wide fluctuations in heart rate and blood pressure that occur in people with sleep apnea.

Treatment for Obstructive Sleep Apnea
Patients with OSA are usually referred to a sleep laboratory for a full sleep study, which is called a polysomnogram.