Posted by Captin Cannuck on May 02, 2008 at 07:17:23:In Reply to: Re: Effect of weight loss on sleep apne posted by seattlebill on May 01, 2008 at 20:28:16:
Thanks for your comments. I have a couple of reactions.
1. THE VICIOUS CYCLE
Basically, people are caught in a cycle. They are too tired to exercise, so they gain weight. They gain weight, so their apnea gets worse and worse. It is a dilemma. People are spiraling in a nose dive. They need to break the cycle. CPAP is seen as being the key to breaking the cycle by suspending the occurance of events and giving the person an opportunity to exercise.What you wrote about Gastric Bypass is also true and a good point. In the Dr. Pascualy's opinion "weight loss surgery is a radical way to lose weight. It is not a conservative treatment". His using the word *radical* makes me think that it would be somewhat risky.
2. STUDIES
About weight loss through exercise, we have to know that studies are saying that people typically improve by 25 to 50%. Most of the studies are saying that AHI stat drops by about 25%. This means that if a person is severe with an AHI of 30, he might drop eight points by dieting and exercising. It would put him in a better position for sure, but he would still be using CPAP. On the other hand, if a person with an AHI of say, 12 or 15 lost 25%, the improvement would put him close to a cure.3. JAPANESE SURGEON'S OPINION ABOUT AIRWAY WIDENING EFFECT OF WEIGHT LOSS
The surgeon that I saw in Tokyo at Toranamon Hospital put great stock in people losing weight. He even estimated that for every kilogram a person lost, that the airway would become roughly one millimeter wider. Of course, that was in Japanese people and sometimes body types are different. Generally people in Japan are much less obese than in North America, so he may have seen many people who were less obese but who had apnea. In other words, people who were close to that threshold.4. GASTRIC BYPASS - VERY REAL RISKS. BUT POSSIBLE CONSEQUENCES FOR ACTON AND ALSO FOR INACTION
I do not know much about gastric bypass. I only know of one individual who went ot our church when I was a young boy. He was morbidly obese. After several years away from the community, I returned. I hadn't seen This man for a long time. One day I walked into church and saw that he was about half the size. I found out that he had had his stomach stapled. The effect on him was tremendous. He was very much rejuvinated. He bought himself a new pair of sneakers and started going for daily walks, which he could not do before (except for huffing and puffing to go a few yards). Generally I would say that he was feeling very good about life. I don't know what happened to that guy. Of course, that is very subjective. I only know of one case. I believe that you come from a medical background. Probably you are able to see the forest for the trees more than I can in that regard. To be clear, the risk of death exists and is real. Other undesirable effects are risks which should not be taken lightly by anyone who is obese with apnea and who is considering this course of action. Of course, OSA is killing them anyway, but in a slow and gradual way. A person would have to weight the potential of positive improvements against the risk for adverse results. They would have to really research it and make a decision based on careful thought.
- Re: Effect of weight loss on sleep apne seattlebill 12:23 5/02/08 (1)
- Re: Effect of weight loss on sleep apne Captin Cannuck 04:04 5/06/08 (0)