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How Weight Loss Improves Sleep Apnoea

What Is Sleep Aponea?

Sleep apnoea is a common and serious disorder in which people experience disrupted breathing while they are sleeping (DerSarkissian, 2021).

They can experience onwards of thirty breathing disruptions per night with breathing repeatedly stopping for 10 seconds or more during sleep. (Pacheco, 2021). The disorder results in less oxygen in the blood and can briefly awaken sleepers throughout the night.

The two main types of sleep apnoea are obstructive sleep aponea (OSA) and central sleep apnoea.

As weight gain contributes to OSA, this article by LifeShape Clinic discusses this type of apnoea.

Obstructive Sleep Aponea (OSA)

OSA is the most common type of sleep apnoea, often occurring as a result of gaining weight and can lead to one of the most common medical disorders in the general population (Hamilton & Joosten, 2017) being linked to many health problems that affect millions of Australians.

OSA develops when there is a problem with the mechanics of breathing due to the soft tissue of the mouth blocking the airway when the throat and tongue are more relaxed in sleep. Excess weight creates fat deposits in a person’s neck called pharyngeal fat which can block a person’s airways during sleep when the airways are already relaxed. Therefore, snoring is one of the most common symptoms where the air is squeezed through a restricted airway, causing a loud noise.

How Excess Weight Can Cause OSA

The most common cause of OSA is carrying excess weight. As the medical community learns more about sleep apnoea, there are important associated health risks with excess body weight emerging. Not only can excess weight cause sleep apnoea, but it can worsen the symptoms leading to detrimental health effects. Additionally insufficient sleep as a result, may also lead to weight gain, making it a vicious cycle.

There are other causes or risk factors of OSA including a narrow throat, hypothyroidism, allergies, medical conditions, smoking and enlarged tonsils or dental conditions.

The size of your neck plays another role in OSA. Men with a neck circumference above 43 centimetres and women with a neck circumference above 38 centimetres have a much higher risk for OSA.

Additionally, an increased abdominal girth from excess fat can compress a person’s chest wall, decreasing lung volume. This reduced lung capacity reduces air flow, making the upper airway more likely to collapse during sleep (Pacheco, 2021).

More than half of people with OSA are either overweight or obese. A 10% weight gain raises your risk of OSA by six times (DerSarkissian, 2021).

Additionally, OSA also elevates carbon dioxide and glucose levels in the blood, disrupts the part of the nervous system that controls heartbeat and blood flow, increases insulin resistance, and alters the flow of oxygen and carbon dioxide. As a result, sleep apnoea is associated with the following heart, lung, and metabolic problems, among others:

  • Hypertension (high blood pressure)
  • Heart failure
  • Gastroesophageal reflux disease
  • Hypothyroidism
  • Daytime sleepiness (leading to motor vehicle accidents and depression)
  • Strokes or mini strokes (TIA’s)
  • Coronary artery disease
  • Type 2 Diabetes
  • Metabolic syndrome (obesity, hypertension, diabetes, and elevated fats such as dyslipidemia)
  • Obesity Hypoventilation Syndrome (excess weight puts pressure on a person’s chest wall, compressing lungs and interferes in ability to take deep, well-paced breaths – OHS rises to 50% in those with BMI’s greater than 50).
  • These above complications increase the release of the stress hormone cortisol which can trigger frequent decreases in blood oxygen levels and reduced sleep quality. This may lead to increased heart rate and to the development of worsening heart failure.

Treatment For Sleep Apnoea

Treating OSA, starts with lifestyle and behavioural changes. Encouragingly, there are studies showing that weight loss improves sleep apnoea (Pacheco, 2021). Medical intervention (CPAP machine or oral appliances or surgery) may also play a role in controlling sleep apnoea (Hamilton and Joosten, 2017).

Weight loss has been found to reduce the fatty deposits in the neck and tongue (Wang et al. 2020) which subsequently improves airflow. This also reduces abdominal fat, which in turn increases lung volume and improves airway traction, making the airway less likely to collapse during sleep.

In summary, addressing obesity with a dedicated weight loss involvement is crucial to improving health risk factors, improve sleeping patterns and reducing the incidence of sleep apnoea.

References

  • DerSarkissian, C. Web MD. 2021
  • Hamilton, G. S. & Joosten, S. A. “Obstructive Sleep Aponea and Obesity”. RACGP. 2017; 46(7): 460-463.
  • Pacheco, D. “How Weight Affects Sleep Aponea”. Sleep Foundation. 2021.
  • Wang, S. H., Keenan, B. T., Wiemken, A., Zang, Y., Staley, B., Sarwer, D. B., Torigian, D. A., Williams, N., Pack, A. I., & Schwab, R. J. (2020). Effect of Weight Loss on Upper Airway Anatomy and the Apnoea-Hypopnea Index. The Importance of Tongue Fat. American journal of respiratory and critical care medicine, 201(6), 718–727.



 

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