Comment by DanBC | Hacker News Reader

Comment by DanBC | Hacker News Reader

Parent Full thread

People are complaining about the length of time it takes to get treatment, and the cost of treatment, and that treatment is a racket.

All that stuff is true. All that stuff is avoided by losing weight.

Your comment appears to be overly sensitive to a calm, non-judgemental bit of information.

EDIT: Here's the link to the CDC page which lists overweight as a cause of sleep apnea: http://www.cdc.gov/healthyweight/effects/index.html

It's really easy for people, especially men, to hit a BMI of 30 and not realise that they are obese. Especially in obesogenic societies where very many people are obese, morbidly obese or even super obese. This carries a range of health risks, most of which are helped by losing weight.

It's weird the source article doesn't mention weight, since it is caused by lack of sleep (especially in children and young people) and causes lack of sleep (in adults).

http://www.cdc.gov/sleep/about_sleep/chronic_disease.htm

> Laboratory research has found that short sleep duration results in metabolic changes that may be linked to obesity. Epidemiologic studies conducted in the community have also revealed an association between short sleep duration and excess body weight. This association has been reported in all age groups—but has been particularly pronounced in children. It is believed that sleep in childhood and adolescence is particularly important for brain development and that insufficient sleep in youngsters may adversely affect the function of a region of the brain known as the hypothalamus, which regulates appetite and the expenditure of energy

> People are complaining about the length of time (...) All that stuff is avoided by losing weight.

I strongly disagree on the point of time. It is important to realize how slow actual weight loss is. By my naive googling, losing 1kg of fat per week will require quite a lot of calorie restriction, and it is not achievable easily. If you are say 20kg overweight, you will need at least 20 weeks to lose that weight, likely more as nobody is perfect and stress factors here as well.

I am stressing this point as I would like to encourage anyone who suffers from sleep apnea to start both treatment and losing weight. Telling yourself "I don't have to seek treatment, I'll just lose weight" may lead you into several weeks of diminished productivity (as a PhD student with apnea, when not getting enough sleep my scientific productivity is close to zero).

I am not claiming any of the original commenters suggest this, but still: "I'll just suffer until I lose enough weight" is a terrible decision.

> It is important to realize how slow actual weight loss is

That's a good point.

> I am not claiming any of the original commenters suggest this, but still: "I'll just suffer until I lose enough weight" is a terrible decision.

Well, yes, but treatment will change as weight changes. Why go through risky surgery if weight loss might help? Why go through the hassle of sleep studies and waiting for machine fitting if weightloss will help? The alternative to weightloss is not "instant cure", there's still time delays built in.

Worst case it doesn't help your sleep and only improves the other million things that being overweight is bad for. Darn.

/working on it

I lose about 3lbs of fat per week on the ketogenic diet. High fat, moderate protein, low carb (under 20g a day of carbs). I eat all of the cheese, meat, and vegetables that I want. You learn to love eggs if you don't already.

Losing weight is not hard. Change your diet and start walking (just walking) 30-60 minutes a day.

https://www.reddit.com/r/keto/wiki/faq

Weight loss is slow, but there are other benefits that might make it more palatable. I'm 5'9, currently 230, was 240+ (weighed myself after I started losing, so maybe 245), just those 10-15lbs have helped my sleep enormously. I have about 60lbs more to go until I'm at a comfortable weight, and this will take a long time (Should reach my goal by Feb '16). At my weight though, 3lbs of loss a week isn't that uncomfortable. I still eat 1500-1800kcal a day which, depending on what I eat that day, fills me up quite nicely.

I agree with your other points, but I'd say that getting a CPAP is probably a good idea, but that losing weight could make that unnecessary down the road and there are a myriad of other benefits.

Also I would argue it's much harder to lose weight with untreated apnea for a couple reasons. 1. you're constantly over tired, and working out or even walking when you've been woken up hundreds of times per night is hell. Someone with apnea can have 30 or more breathing "pauses" every hour, and all of those times, the brain wakes up in some capacity. You can go with years of that condition untreated. Imagine trying to work out every week with that amount of sleep deprivation.

2. The metabolism and appetite changes drastically. Instead of getting a break and waking up in the morning after a good night of sleep not needing food, you are constantly sugar crazy 24/7. You never get a break from the appetite and blood sugar mayhem. This makes it really difficult to change eating behavior.

The best solution is to get as many people as possible a CPAP machine so they can feel well rested and reset their system, and then they will have a much better starting point for losing weight. And yeah, you can be skinny as hell and still have sleep apnea, a bunch of people do.

I am one of those skinny people awaiting my sleep study results.

And for the past several years, I felt the exact same symptoms - falling asleep behind the wheel (or on the subway); craving for food; episodes of sleep paralysis (thankfully not too frequent).

> People are complaining about the length of time it takes to get treatment, and the cost of treatment, and that treatment is a racket.

> All that stuff is true. All that stuff is avoided by losing weight.

No, its not.

For one thing, because if you are overweight and have OSA, "losing weight" can be more difficult if you don't get the OSA treated.

For another thing, healthy weight loss of an amount that is likely will significantly OSA is a longer process than getting treatment for OSA, even with all the problems that can involve.

Firstly, if you are obese, losing weight will indeed ameliorate or eliminate a very wide range of common health problems. High blood pressure and metabolic precursors to type 2 diabetes are, in particular, very responsive to weight loss.

But even if no-one were obese, obstructive sleep apnea would still exist. Anyone who snores could have it. The person may have a deviate septum. They might have swollen tonsils or adenoids. They might have a congenitally narrow airway. Maybe even a particularly long uvula.

And then there are the non-obstructive (worse) sleep apneas, such as those caused by defects in the nervous system, where the brain is unable to tell the diaphragm to move.

Being thin is not a perfect defense against sleep apnea. Nevertheless, it appears that the vast majority of apneas are worsened by obesity, and obesity is worsened by sleep deprivation. That is a vicious cycle.

With my foil hat on, I suspect that safe and effective treatments for reducing body fat in obese individuals are not being researched for public health reasons (esp. as preventative measures against heart disease and diabetes), because an non-curing treatment for fatness would make ten times more money than boner pills, especially in the US. And this is why you get people doing DIY fecal transplants from thin friends in their own kitchens, or buying and injecting barely-tested research peptides (like cyclized CKGGRAKDC-GG-D(KLAKLAK)2 HCl salt) from Chinese synthesis labs. The health care system wants all the money, and the people who need the treatments most just don't have enough of it. When the flow of cash takes priority over patient well-being, people start to do crazy things out of desperation, and a sense that the doctors are acting as drug pushers instead of trying to help them get well.

> People are complaining about the length of time it takes to get treatment, and the cost of treatment, and that treatment is a racket.

> All that stuff is true. All that stuff is avoided by losing weight.

As that is not true in 100% of cases of sleep apnea as you implied, you are being an asshole and misleading, fyi.

http://www.mayoclinic.org/diseases-conditions/sleep-apnea/ba...

> Excess weight. Fat deposits around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight. Thin people develop this disorder, too.

Not everyone who has sleep apnea has weight issues. It's common, but not universal.

> All that stuff is true. All that stuff is avoided by losing weight.

STRONGLY disagree. My doctor says that IN MY CASE, losing weight should be enough. We're talking 10kg (~22 pounds) from the ideal weight.

Is this true for the general population? No idea. There are several other possible causes. And that includes central sleep apnea, or problems in the airways.

We are in agreement that losing weight should be the first thing one should try. But one would think that doctors would point that out too (as they did with me).

How are you going to STRONGLY disagree, then say "That's what I was told to do", and then "I have no idea how this applies to the population at large"?

I strongly disagreed with the generalization.

Reply on news.ycombinator.com