There have been a few interesting stories involving Sleep Apnoea over the last couple of weeks, so here’s a quick round-up of what’s been going on.
Probably the most important news is the story we covered in our last blog entry; that of an Australian Sleep Clinic showing a direct link between weight and Sleep Apnoea. After studying 20 years of records, they found unquestionable correlation between increasing weight and more severe Sleep Apnoea. Although the link has long been made, it’s the first time that it has had some hard statistics to prove it.
On a similar note, there was a story in the Daily Mail last week about a girl who has been diagnosed with Sleep Apnoea and has vowed to lose 5 stones in the next year. Doctors had warned her that her condition could kill her – which may sound a little over the top as to many it just results in snoring and being tired during the day. It is very easy to forget that Sleep Apnoea itself can be fatal, and for a girl who weighs 16 stone at just 14 years of age that risk is very apparent.
A study by the Walter Reed Army Medical Centre in America, a respected hospital for ex-service people, has conducted a study which showed that weight-loss surgery does not eliminate Sleep Apnoea. 24 patients were from an average BMI of 52 down to an average of 32 but only 1 had their Sleep Apnoea “cured” after the gastric-band operation. It is worth noting that a BMI of 32 is still considered obese so it is perhaps not surprising that they still had OSA, but it is an interesting study nevertheless.
Although Sleep Apnoea itself can be fatal, as mentioned above, the major problem with it is that it can lead to other health problems. A recent study has shown that Sleep Apnoea sufferers are 58% more likely to develop heart disease. This is most likely due to the increased strain placed on the heart when an apnoea occurs. So your CPAP therapy is not only helping you sleep soundly, it could also be reducing your chances of developing heart disease – a win-win situation if ever there was one!
Those who drive while tired are risking their insurance policies according to a report. A study of 800 drivers conducted by Direct Line found that one in ten people admitted to driving while tired at least once a week, with 74% having done so at least once over the last year. Daytime tiredness is one of the main Sleep Apnoea symptoms, so if you feel tired all the time then it is worth getting it checked out – especially if you still feel tired after 8 hours sleep.
All of these news stories were broadcast via our Twitter account shortly after they first broke. If you follow us on Twitter, then you can be kept up to date with the latest Sleep Apnoea stories as soon as they happen. We’ll do a fortnightly round up on this blog so that we can keep all of you up to date with what’s happening in the world of Sleep Apnoea. If you come across an interesting news story that you’d like us to publicise, drop us a comment on our CPAP Blog or on our Intus SDB Twitter and we’ll spread the word!
A study by a sleep clinic in Newcastle has shown that the severity of their patients’ sleep apnoea was directly linked to their weight. After examining 20 years of records it became clear that as their patients gained weight and increased their BMI, the frequency of their apnoeas increased.
There has long been a link between sleep apnoea and being overweight, but it is interesting to find a study that shows the link between the two so directly. On average men put on 10kg and women 12kg from when they first visited the clinic, but while no specific reason was named for why they put on the weight, the increase in the severity of their sleep apnoea was a clear consequence.
Weight and Sleep Apnoea are closely linked
“As body weight goes up, Sleep Apnoea gets worse”
Dr Jeffry Pretto, who did the analysis of the clinic’s data, said: “How many times each hour people actually stop breathing, or slow their breathing down significantly - that marker is very much linked to body mass index. As people’s body weight goes up, the severity of their sleep apnoea gets worse. The other interesting finding is the instance of severe obesity - that is if they have a body mass index of over 40. Back in 1987, only 3 per cent of people that were referred to us for sleep studies we’d classify as having morbid obesity. In 2007, that went up to 15 per cent. It’s gone up by a factor of five.”
Without successful treatment for sleep apnoea it can become a vicious cycle. Sleep apnoea makes you tired during the day, giving you less energy to be active and do exercise. This leads to you gaining weight, increasing the severity of your apnoea, making you even more lethargic. The cycle goes on and on. Some people also blame increase carbohydrate cravings on tiredness, which leads to weight increase.
To break the cycle, you first need to get treatment for your sleep apnoea. CPAP therapy, the most successful and widely-adopted treatment for sleep apnoea, will alleviate or greatly reduce the frequency of apnoeas, giving you the energy and enthusiasm during the day to allow you to be more active and to exercise.
From there, the circle repeats itself in the opposite direction, more energy, more exercise, lose weight, fewer apnoeas, more energy, etc. It takes determination, will power and patience, but by losing weight you can reduce the severity of your sleep apnoea and, in some cases, alleviate it completely.
Lifestyle changes are difficult - but not impossible
While easier said then done, if you are suffering from sleep apnoea then it is important to try to at least maintain your current body weight if possible, and ideally look to gradually lose weight. One of the major problems with sleep apnoea is that it usually gets diagnosed very late, on average after around seven years of suffering, by which time most people are over 40 and a change of lifestyle becomes very difficult to implement.
One of our forum members, scourserpaul, has just started using the Atkins Diet to reduce his weight. You can follow his progress in his Sleep Apnea And Dieting thread.
Losing weight when you have sleep apnoea is far from easy, but it gets easier as you go along as the positive cycle mentioned earlier begins to take effect. The health benefits are not only confined to reduced sleep apnoea, so it is certainly worth making a concerted effort towards.
If you are known to snore loudly, then it could be more than simply a source of irritation for your partner - it could actually be a sign that you’re suffering from a serious medical problem. Snoring is one of the most obvious symptoms of sleep apnoea, a condition that causes you to stop breathing in your sleep as your airways become obstructed – and one that an estimated 24% of men suffer from1. Sleep apnoea itself can be fatal, but can also lead to further health issues. For example, a study this week found that people with sleep apnoea were 58% more likely to develop heart disease2. Worryingly, it is thought that 90% of those with sleep apnoea have not been diagnosed. The good news? Once you have been diagnosed, almost every case can be treated through therapy. Two of the main symptoms of sleep apnoea are snoring and tiredness during the day. If either or both of these symptoms sound familiar to you, either through yourself or a partner, it may be worth reading on.
Symptoms
According to the NHS3, the symptoms of Sleep Apnoea include:
feeling very sleepy during the day
waking up with a sore or dry throat
poor memory and concentration
headaches (particularly in the morning)
irritability and a short temper
anxiety
depression
lack of interest in sex
in men, impotence (inability to get or maintain an erection)
Additional symptoms include snoring, non-refreshed sleep, restless sleep, gasping or choking during the night, reduced ability to handle stress, frequent toilet visits during the night and high blood pressure4.
The effects of sleep apnoea are wide ranging. As well as the tiredness and increased risk of heart disease, as mentioned above, it also leads to a lack of concentration, higher risk of accidents at work and while driving, anxiety, short temper, as well as leading to problems in your personal life due to depression, irritability and a lack of sex drive.
What can I do about it?
If you think you may have sleep apnoea, there are three main routes to follow – either getting diagnosed and treated by the NHS, privately, or at home. It all depends on how long you are prepared to wait, and on the expense.
You can be diagnosed and treated for sleep apnoea by the NHS. While this is free, the time frame can be quite drawn out. In June this year there were 4,461 people on the NHS waiting list for a Sleep Study, 16% of which had been waiting for over a month already5. Once you actually receive a Sleep Study, you then have to wait for your results, a consultation, and then there is another waiting list to actually get the equipment you need. It is not uncommon for the process to take several months from seeing your doctor initially to being given your CPAP equipment. Please be aware that once you are diagnosed with sleep apnoea, you will not be able to drive until you are shown as being compliant with your therapy. Failing to report a diagnosis to the DVLA can result in a £1,000 fine. Therefore if you drive, the waiting time between getting diagnosed and getting treatment on the NHS can simply be too long, so you may want to consider one of the other, much faster, alternatives.
Alternatively, you can go to a private sleep clinic. There they will assess you, give you a sleep study, and provide you with the appropriate equipment. Prices vary from clinic to clinic, but expect to pay between £1,000 to £2,000 for everything. The difference in waiting time is stark – it is often less than a month from consultation to therapy. The price may put people off, but it is a considerably faster yet more comprehensive solution. For those looking for a similar level of speed but with a much lower cost, then the third option may be the solution.
Your third choice is to simply rent a Sleep Study for use at home. You can rent one for as little as £99, and you get the results within a fortnight, and often within a week. With those results you can then go to the NHS to join the equipment waiting list, or you can order the equipment online and begin your therapy almost immediately. With machines starting at £450 and masks at £54, the whole process costs as little as £600 and you can be getting therapy within three weeks. There is not the same level of consultation or advice as you would get from a Sleep Clinic, but if you’re prepared to do your own research and use your initiative, it can be a much better value alternative.
Stop snoring, start sleeping, start living
Whichever path you choose, you will be well on your way to improved health and wellbeing, it’s just a question of time frame and expense.If you need any further information about sleep apnoea, sleep studies or CPAP, feel free to browse our website, cpap.co.uk for more articles and advice, or browse our forums at forums.cpap.co.uk, where you will be able to ask any questions you want and get advice from those currently undergoing therapy.
Whatever you do, if you have any of the symptoms of sleep apnoea, we strongly recommend that you get tested, as the effects of untreated sleep apnoea can be very serious. The important thing to remember is that diagnosis and treatment can be very quick and incredibly effective, so you could be enjoying a better quality of life within a month.
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