Sleep Apnea and Obesity
INTRODUCTION
A healthy lifestyle requires a night of good and sound sleep, allowing one to wake up fresh and energetic the next day. After a disturbed sleep, a person remains fatigued and is not able to enjoy his whole day. Therefore, a good night’s sleep for adults on average of 6-8 hours is essential. The typical adult respiratory rate during sleep is slow and regular at the rate of 12-20 times per minute. According to WHO, Obstructive sleep apnea syndrome is defined as a clinical issue set apart by continuous stops in breathing during rest, generally joined by uproarious wheezing. These frequent pauses do not allow adequate oxygen supply and the removal of carbon dioxide from your body. Your brain senses this and rouses you up; your airway opens, and breathing restarts. These episodes may occur many times during the night and cause interrupted sleep. You have headaches and concentration problems during the day, and at night, loud snoring is a common symptom.
According to studies, the prevalence of Obstructive sleep apnea in adults is 25%, while in individuals with obesity, it is 45%. This suggests that obesity largely predisposes to sleep apnea. Not only adults but pediatric clinical studies suggest sleep apnea in 46% of children suffering from obesity when compared to the general pediatric population.
Relationship between Sleep Apnea and Obesity
Obesity is a significant independent risk factor for the development of sleep apnea. The mechanism in which obesity causes sleep apnea is not very difficult to understand. With excess weight, there is an increased amount of fat deposition in the neck and abdominal regions. Pharyngeal fat deposits in the neck block the upper airway during sleep when the airway is already relaxed. Also, a considerable fat accumulation in the abdomen compresses the chest wall below, impairs the full lung expansion, and decreases the lung volume. Both of these reasons cause the collapse of the airway during sleep, along with the symptoms of snoring. Body mass index is closely related to the risk of obstructive sleep apnea because, with even a 10% weight gain, there is a six-fold rise in sleep apnea risk.
HOW DOES SLEEP APNEA CAUSE OBESITY?
Not only is there a one-way relationship between obesity and sleep apnea, where obesity is a risk factor for obstructive sleep apnea, instead there is a reciprocal relation too. Sleep apnea is considered a risk factor for producing obesity. Obstructive sleep apnea disturbs the whole night sleep of an individual. This also alters the hormonal balance. The two essential hormones that control our appetite are Ghrelin and Leptin, functions of both being the opposite. Leptin is an appetite-suppressing hormone that represses our hunger, and Ghrelin is an appetite-stimulating hormone that increases food cravings. Obstructive sleep apnea causes increased levels of Ghrelin and decreased levels of Leptin in our body. This predisposes an individual to overeat and eventually gain weight.
DOES WEIGHT LOSS HELP APNEA?
Obesity is directly related to sleep apnea. Overcoming obesity allows one to improve their symptoms of obstructive sleep apnea. This is because of reduced fat in the neck and abdominal region, and the airway is less likely to be collapsed during sleep. According to studies, with weight loss of 10-15%, there has been a 50% reduction in sleep apnea symptoms in moderately obese patients. Bariatric surgery has been known to improve or cure 78% patients with sleep apnea. Although losing weight and acquiring a healthy lifestyle dramatically improves one’s condition, still definitive treatment for sleep apnea is required.
COMPLICATIONS OF SLEEP APNEA
Some important worth mentioning complications of sleep apnea include hypertension, heart attack, stroke, nocturnal angina, heart failure, abnormal heart rhythm, diabetes, and gastroesophageal reflux disease. In addition, daytime sleepiness and headaches, along with depression, are caused. The cause of complications is related to increased levels of stress hormones due to low oxygen levels. This causes increased heart rates and worsening symptoms of heart failure.
DIAGNOSIS AND MANAGEMENT
Sleep apnea is diagnosed through polysomnography, a method of measuring one’s body activity during sleep. Your brain activity, along with heart, lung, arms, and legs’ activity, is noted. This device also measures your breathing patterns. A pulse oximeter is another device to measure your oxygen saturation during sleep to ensure whether all your body organs are well oxygenated or not.
In case of abnormal test results, you require proper treatment. The most commonly recommended treatment option is continuous positive airway pressure or CPAP for moderate to severe symptoms. This device is designed to offer you constant oxygen through a well-fitted face mask during sleep. In case some people find it uncomfortable to use, another option of BiPAP is available, which supplies bi-level positive airway pressure.
SUMMARY
Obstructive sleep apnea is one of the associated conditions of obesity. This is a very troublesome condition for an individual, as he is unable to enjoy a good night’s sleep. His mind is not relaxed, and he remains in a bad mood the whole day. Overcoming obesity greatly reduces the severity of symptoms of sleep apnea. A refreshed mind enables one to stay mentally and physically fit.
