Weight Loss and Sleep Apnea
As a lifestyle choice, weight loss can be one of the most beneficial changes an individual with Sleep Apnea can make. Studies relate severity of Sleep Apnea, Cardiac problems and nocturnal blood oxygen desaturation with obesity.
In a study (VALENCIA-FLORES et al. Obes Res) designed to determine the prevalence of Sleep Apnea in obese patients and its relationship with cardiac arrhythmias, ninety-eight percent of the patients had Sleep Apnea, and 33% had Severe Sleep Apnea with severe blood oxygen desaturation. Cardiac abnormalities were present in 31% of the patients and were associated with both Apnea Severity and oxygen desaturation.
The authors concluded that there is a high prevalence of Sleep Apnea in obese patients and that the risk for cardiac arrhythmias and blood oxygen desaturation increases with Apnea Severity.
A reduction in body weight through diet or exercise has long been associated with a reduction in the severity of Snoring and Apnea. Regular exercise and achieving an ideal body weight should always be a component of the initial therapy for these disorders. A recent study indicates that even a very modest level of regular exercise can lead to improvement in the severity of sleep apnea.
In a study designed to determine if physical exercise in sleep apnea patients is safe and/or influences Apnea Severity Giebelhaus et al (Sleep and Breathing); 11 moderate to severe apnea patients began a six-month supervised exercise program involving 2 hours of exercise twice a week. A sleep study was conducted without CPAP both before and after this exercise program.
The results of the regular exercise program demonstrated no adverse effects. There was no significant change in body weight, blood oxygen saturation or fitness level. No adverse cardio-pulmonary effects were observed. However, there
was a decrease in Apnea Severity from 32.8 to 23.6 (p<0.05), without any significant changes in total sleep time or sleep architecture.
The authors concluded that a prescription for mild to moderate exercise is safe in the management of sleep apnea, and that even in the absence of an improvement in fitness, a meaningful decrease in Apnea was experienced without a change in sleep architecture.
Airway Orthotic Therapy has been demonstrated to be effective at all levels of Apnea Severity. However, studies have demonstrated that the % success rate is considerably higher at lower levels of severity. A regular exercise program could reduce a patient’s severity and increase the likelihood of success with an Airway Orthotic.
Regular modest exercise, even in the absence of an improvement in the level of fitness, can reduce Apnea Severity and increase the likelihood of success with an Airway Orthotic.
Sleep Quality Related to Weight Gain
Van Cauter et al. (J Am Med Ass) found that as men age, they typically get less deep sleep. With less deep sleep, there is less bodily production of “growth hormone”, which is associated with “increased fat tissue and abdominal obesity, reduced muscle mass and strength, and reduced exercise capacity”.
Individuals with Sleep Apnea experience a decrease in deep sleep due to constant interruption in normal sleep architecture. Since growth hormone has been shown to increase with an increase in deep sleep, it follows that by treating sleep apnea and re-establishing a normal sleep architecture, appropriate growth hormone production may be re-established reducing the tendency to gain weight with age.
As a lifestyle choice, exercising at least 20 minutes three or four times a week has also been associated with an increase in deep sleep; weight loss, treatment of sleep apnea and quality of sleep all remain closely related.
John Viviano B.Sc. DDS Diplomate ABDSM; obtained his credentials from U of T in 1983, he provides conservative therapy for snoring and sleep apnea in his Clinic Limited to the Management of Breathing Related Sleep Disorders. A member of various sleep organizations, he is a Credentialed Diplomate of the American Board of Dental Sleep Medicine, and has lectured internationally regarding management of Sleep-Disordered Breathing and the use of Acoustic Reflection. Dr Viviano has also conducted original research, authored articles and established protocols on the use of Acoustic Reflection for assessing the Upper Airway and its Normalization.