Obesity and sleep apnea

Obesity means excess fat. People who are obese are unhealthy and have increased risks of diabetes, high blood pressure, cardiac disease, stroke, arthritis and premature death. Obesity can be measured by Body Mass Index (BMI) and waist circumference. For Indians, the normal BMI is 18-22 Kg/M2. People are considered to be obese if the BMI is more than 25 Kg/M2. In severe (morbid) obesity, the BMI is more than 37.5 Kg/M2.

What is sleep apnea?

In sleep apnea, people stop breathing for short periods of time (at least 10 seconds) during sleep. Central sleep apnea is due to a malfunction in the brain due to a stroke or brain damage and is not being discussed here. In obstructive sleep apnea, blockage of the breathing passages occurs during sleep, not while the person is awake, partly because the muscles in the airway relax during sleep.

What is the significance of obstructive sleep apnea?

Frequent episodes lead to numerous brief awakenings and to sleepiness during waking hours. This leads to tiredness and difficulty in concentrating during the day, and can also result in life-threatening situations including high blood pressure, stroke and heart failure.

How are obesity and sleep apnea related?

More than two-thirds of patients with sleep apnea are obese. The prevalence of sleep apnea among those who are morbidly obese is 12-30 times more than in the general population. Breathing is made difficult by excessive body fat around the neck or on the chest. This narrows the air passages, causing short interruptions in breathing during the night.

What are the treatments available for sleep apnea?

Specific treatment can be advised after complete investigation of the cause of sleep apnea. Tests include a sleep study, to determine how severe the problem is, and a study of the air passages. All treatment is aimed at widening the air passages during sleep to prevent obstruction from occurring.

Does the sleeping position affect sleep apnea?

Sleeping on the back tends to make sleep apnea worse because the tongue may fall back over the airway and the airway muscles may collapse and block the air passages. Try to avoid sleeping on the back.

Does alcohol affect sleep apnea?

Consumption of alcohol and some medications like pain killers, sleeping tablets and muscle relaxants, close to bedtime, can worsen sleep apnea. The muscles in the airways relax further, and the respiratory drive may be reduced.

How does Continuous Positive Pressure Airway help in preventing sleep apnea?

Continuous Positive Pressure Airway (CPAP) works by blowing pressurised room air through the air passage at a pressure high enough to keep the throat open. At night, the patient wears a mask that is connected to a machine that delivers pressurised air. The machine settings can be adjusted to deliver air at sufficient pressure to keep the airway open and prevent sleep apnea.

Does losing weight affect sleep apnea?

A 10 per cent reduction in weight results in more than 50 per cent reduction in episodes of sleep apnea, as well as improvement in kidney function and high blood pressure. In extreme cases, bariatric operations may be suggested, but such individuals will need to continue using other methods like CPAP to avoid sleep apnea. They will also need to strictly follow a diet and exercise plan so that they do not gain the lost pounds.