Snoring And Apnoea Blog

Snoring Leads To Weight Gain

Posted on Tue, Jul 05, 2011

Overweight people are known to be more likely to suffer from a sleep disordered breathing (SDB) condition because of the build up of fatty deposits in the soft tissue of the tongue, soft palate and pharyngeal walls.  The enlarged tissues encroach on the upper airway, causing restriction or blockages. 

But it is NOT just a matter of ‘Fat people snore.”  More and more research is pointing to the fact that “Snoring people get fat.”

 Worse still, there is clear evidence that sleep disordered breathing is a significant contributor to hypertension (high blood pressure) and type 2 diabetes.

In one extremely well written paper, by Dr Ralph Pascualy of the Swedish Sleep Medicine Institute, the link between the conditions is explained thus:

 “…several clear relationships have been shown between sleep deprivation and metabolic abnormalities.  Sleep debt strongly affects glucose utilization as well as circadian cycles of thyrotropin, cortisol, growth hormone, and other physiological variables.   

Sleep debt alone is reported to result in impaired glucose effectiveness similar to that found in non-insulin-dependent diabetics.  Severe OSA significantly influences plasma insulin and glycemia and may increase the risk of diabetes independently of obesity. Not all OSA patients are obese; however, insulin resistance is found in both obese and non-obese OSA patients. Blood pressure and fasting insulin correlate closely with both BMI and the severity of OSA. Thus, both the sleep debt and the sympathetic activation that accompany OSA may speed the deterioration of glucose tolerance. Insulin resistance and hyperinsulinemia lead to further sympathetic activation, thus completing the circle of obesity, diabetes, hypertension, and the related metabolic abnormalities.”

In simple terms:  sleep disordered breathing leads to reduced blood oxygen levels and increased blood pressure.  As a result, the body’s metabolism is retarded – which makes it easier to gain weight, and harder to lose it.

Failure to treat a sleep disordered breathing condition puts a sufferer on a downward spiral — because the SDB leads to weight gain, which makes the SDB worse, which makes the weight gain worse … and so on. 

The full article is available in the ‘Research’ section of this website.

Tags: snoring, OSA, weight gain

OSA - What Is It?

Posted on Thu, Mar 03, 2011

OSA stands for obstructive sleep apnoea, or obstructive sleep apnea, depending on which part of the world you come from.

OSA is one of a constellation of disorders referred to generally as 'sleep disordered breathing'.

As the names suggest, OSA and sleep disordered breathing relate to conditions where the sufferer's airway is compromised during sleep.  Milder (but still serious) forms of sleep disordered breathing, such as snoring, allow the sufferer to breathe while asleep.  That said, the noise of snoring is a loud signal that the airway is constricted and consequently the airflow is not natural and effortless.

Think of it this way:  If you saw someone who was wide awake, but they were breathing like a snorer, you'd be worried about them and concerned for their health.  Yet when we see a person snoring and thus exhibiting the same laboured breathing while asleep, we tend to think of it as normal.  The truth is, snoring and other forms of sleep disordered breathing are very common, but they are certainly not normal or healthy.

OSA is a more severe form of sleep disordered breathing.  In patients suffering from OSA, the tissue of the soft palate (i.e., the soft part of the roof of the mouth), the uvula (the droopy flap of tissue at the back of the soft palate), the tongue and the pharyngeal walls (i.e., the airway above the windpipe or trachea, where there is no rigid structure to hold the airway open) tend to collapse into the upper airway, preventing inhalation. 

Patients with OSA are frequently unaware of the existence of their condition, because they are asleep while it is happening.  Often the first notice they get of the condition is when their sleeping partner nudges them awake to get them breathing again.  Diagnostic sleep studies (polysomnograms) are used to monitor and record exactly what happens while the patient is asleep and to determine the degree of severity of any OSA. 

OSA does not typically self-resolve, meanining some form of treatment or intervention will be required.  Treatment of mild OSA is commonly done via oral appliance therapy, which involves the custom fitting of dental devices which typically hold the lower jaw and connected tissue clear of the airway.  In more severe cases of OSA, the best treatment is continous positive airway pressurisation (CPAP).  CPAP works by feeding gently pressurised air into the patient's airway, to create an 'air splint' which holds the walls of the upper airway apart. 

Common consequences and co-morbidities associated with OSA include hypertension, gastro oesophageal reflux disease (GERD, or acid reflux), ischemic heart disease, depression, obesity, type 2 diabetes, loss of libido and impotence ... plus much more. 

OSA should be treated, not tolerated.  The numerous negative consequences can be avoided or more successfully treated once the OSA has been resolved. 

Tags: obstructive sleep apnoea, obstructive sleep apnea, OSA

Neck Size Is Key Indicator For Sleep Apnoea

Posted on Sat, Dec 04, 2010

A study of the ‘Predictors and Prevalence of Obstructive Sleep Apnoea and Snoring in 1001 Middle Aged Men’ has found that neck circumference and alcohol consumption were most closely correlated with the existence of obstructive sleep apnoea (OSA).   There was a clear correlation with age and obesity, but this was not as well defined. 

An abstract of the full article can be found at:

http://thorax.bmj.com/cgi/content/abstract/46/2/85

Tags: apnoea, OSA, apnea, neck circumference, neck size