CPAP Blog

Labour Party leader Ed Miliband’s operation a few weeks ago to cure his Obstructive Sleep Apnoea has raised the awareness of OSA. Intus Healthcare saw a big rise in people enquiring about sleep studies and well as the number of visitors to their OSA-based websites. “Having such a leading figure put Sleep Apnoea on the front pages has raised the awareness of the condition dramatically, if what we have seen is anything to go by” said Intus Healthcare’s Tim Barker.

“As it is estimated around 75% of those with the condition are undiagnosed, it is excellent to see it being brought to the attention of the public and getting more people to get themselves tested for OSA themselves”. However it would appear that Mr Miliband’s operation was not a success which unfortunately comes as little surprise; as many as two thirds of operations to treat OSA are unsuccessful.

Obstructive Sleep Apnoea was also in the newspapers this week thanks to Dr Keith’s advice in The Sun on August 18. Dr Keith’s “excellent” advice to those with OSA was to lose weight, and then listed surgery as the first choice treatment – despite the success rate being as low as around 1 in 3 and CPAP being effective in all cases. It is not the first time Dr Keith has shared his views on OSA – back in 2008 he claimed that the way to treat OSA was simply “losing weight and ditching alcoholic nightcaps”.

A recent study also showed that OSA in older women significantly increases the chances of them developing cognitive impairment or dementia than those who sleep normally. OSA has long been linked with an increased risk of heart failure or stroke, and this study now further highlights the risk of leaving OSA untreated. The study was conducted by a team from the University of California led by Dr Kristine Yaffe, and comprised of 300 women with an average age of 82 who did not have dementia. The four year study showed that those diagnosed with OSA were 50% more likely to develop these further health conditions.

Another study at the University of Brescia this month suggested that wearing compression stockings can lower snoring and OSA by a third. There have been studies into the relationship between rostral fluid shift and sleep previously, so the result may not be as surprising as it first appears. However the study was comprised of just twelve patients, all of whom were attending a CVI Clinic rather than a Sleep Clinic which arguable skews the results further. Nonetheless, the findings are interesting and research of a larger, more “natural” sample would make for fascinating reading. A few members of the UK CPAP Forums are currently trialling this method and it will be intriguing to see how they get on.

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.