Lost weight, but sleep apnea is worse!!

Hi everyone,

I visited this board a few years ago when I first got on CPAP, and everyone was really helpful. Now I have a weird situation, and I'm a wee bit scared.

Over the past year and a half I've lost 25 percent of my body weight, and since I know that often cures sleep apnea (or makes it better), I decided to have a sleep study done. (for reference, I'm a 32 yo female) But the results were terrifying!! An apnea-hypoapnea index thingy of 52! And even when they put me on a cpap machine in the lab, they put me up to 9, and I still had 38 episodes in an hour! (I hope I'm remembering all this correctly from the report). My cpap has been at 7, and that's what they put me on when I was 75 lbs heavier!!

Any thoughts? Sounds like my sleep really has been worse than I realized. I guess you just get used to being tired all the time.

Thank you everyone; I really appreciate your help.

Jen

Hi Rocky. Sorry to hear that your OSA has gotten worse despite the weight loss. Yes, losing weight can help in terms of OSA severity but it's not always the case and varies from person to person. Increased fat deposition is not the only contributor to OSA.

What was your original apnea-hypopnea index (AHI)? Not everone is the same and there could be several reasons as to why your OSA got worse:
1) Muscles become weaker with age. When did you have your first study done? Maybe not so relevant if it was only about a year ago.
2) AHI varies from night-to-night
3) AHI varies throughout sleep stages (worse during stage 1 and 2, even more so in REM)
4) AHI generally varies with posture (commonly worse in supine than lateral)

In regards to points 3 and 4, how much time was spent in each sleep stage in both studies and how much time was spent supine vs lateral in each study? Differences in AHI maybe attributed to these differences.

Nevertheless, CONGRATS on the weight loss!! You should be happy with that

And maybe you were tried with a badly fitted mask that leaked all over. It would help if you could fill in your 'profile' so we know what you are using at home, including pressures. I take it you don't have the software or machine with a smart card to track your own progress day to day?

rockymountainsleeper wrote:Any thoughts? Sounds like my sleep really has been worse than I realized. I guess you just get used to being tired all the time.

You may have hit the nail on the head, there, Jen, that it is not your sleep-disordered breathing that is the issue, but rather sleep itself.

Can you post all of the results that you have?

Muffy

how did things go at the sleep study? Did you sleep well, did the mask fit good, did you have mask leaks.

What kind of machine do you have and is it data capable?

Their are all kinds of variable? How did you feel after losing that weight? Did you feel rested in the morning?

Have you seen an ENT? You said you lost a lot of weight, was that weight distributed evenly on your body? Was your neck much thicker with that extra weight than other parts of your body?

Gerry

First of all......Congratulations on losing the weight.

A number of people have previously reported the same thing......needing higher pressure after they lost weight.

However, if your first study was flawed, your previous pressure may not have been correct.
I'm guessing that you don't have a data-capable machine or the software to help monitor your therapy. (that would really help)


Den

Muffy wrote:. . . Can you post all of the results that you have? . . . Muffy

Rockymountainsleeper, those are words I would particularly note.

I love it when Muffy says that to someone. The person always finds out valuable things to consider. And I get to learn.

jeff

You guys are incredible! Sad to say, I didn't get my sleep study results from the first study a few years ago. All I know is that I was put on a Respironics Remstar at 7 cm, with a regular-type mask over my nose. It doesn't leak. The night of the sleep study, they put me on a Swift nose pillow mask, and it was great. No leaks. I slept like a rock on my back for the rest of the night. (until then, I laid in bed for two hours, unable to fall asleep) Or, at least, I thought I slept like a rock. The results say they tried different cpap levels on me, from 5 cm to 9 cm, and even at 9, I had 38 apnea-hypoapnea incidents per hour. I think that's right. Anyway, the result said I need to go back for titration, since they didn't have enough time during the night. For my first study, they titrated me that very night.

Also, the report said that this time, I only had hypoapeanic episodes -- the kind where you don't completely stop breathing? NOt sure if that's correct. And my oxygen saturation went down to 85 percent. I do live at 6500 feet, if that makes any difference (Colorado).

I'm sorry I'm not so great at providing information here! I am very interested to learn about other people who've lost weight and required higher pressures. Is there more I can read about that? I think that's very strange.

Also, I never had a really fat neck, and now it's even less fat

Oh yeah -- I did experiment last night and increased my pressure to 10, and I slept very well. I'm thinking about inching it up and seeing how I feel. I really don't want to go back for the titration, just because of the money thing. But if I'm really sleeping that badly, I want to get it fixed!

Thank you again everyone.

rockymountainsleeper wrote: Also, I never had a really fat neck, and now it's even less fat

"It is not the size of the neck, it is the size of the airway in the neck."

Typically obstructive sleep apnea is caused by narrow recessed jaws. During our developmental years, due to our modern diet, we do not do enough chewing of food. Little chewing means the jaw skeleton doesn't develop depth and width. This is why we have crooked teeth, orthodontics, and wisdom tooth removal.

With narrow recessed jaws, the soft palate and tongue can easily block the airway while sleeping.

rockymountainsleeper wrote: Also, I never had a really fat neck, and now it's even less fat

I think you better get over the "I don't fit this catagory" anymore.
Loosing 25% of you body weight has got to cause some major changes.
Who could even know what those would be?
Are you thinking, WOW, I lost all this weight, I can sell the cpap thingy?

I was sent for a sleep study....even though "you don't fit the profile" for OSA.
I had no weight to loose.....well, maybe a few pounds....but nothing to write home about.

I live in Co at 5.6K'. I don't think that makes any difference.

We are all individuals.
You, me, JNK, Wulfman...etc,etc.....don't fit a profile.
We are what we are.

I would suggest you continue your education.
Get data capable so you can see what is happening w/your therapy.

The same thing happened to me; I needed a higher pressure after losing 60 lbs. Not very comforting, maybe, but you're not alone.

Sometimes sleep apnea causes weight gain, and not the other way 'round.

You know, that "narrow, recessed jaws" is only applicable to some patients, not all, and it can be more complicated, with either other anatomic features being a problem, or other medical/metabolic ones. I'd be careful about putting all the diagnostic eggs in that one basket.

rockymountainsleeper wrote: . . . I didn't get my sleep study results from the first study a few years ago. . . .

See if you can now.

rockymountainsleeper wrote:. . . I do live at 6500 feet, if that makes any difference . . .

Yep. For sleep, sure can.

rockymountainsleeper wrote: . . . I did experiment last night and increased my pressure to 10, and I slept very well. I'm thinking about inching it up and seeing how I feel. . . . .

I would not experiment until I had data in hand.

If Muffy asked to see my data, I would make the call to wherever and to whomever to get it right away, myself. But hey, that's just me.

jeff

Julie wrote:You know, that "narrow, recessed jaws" is only applicable to some patients, not all, and it can be more complicated, with either other anatomic features being a problem, or other medical/metabolic ones. I'd be careful about putting all the diagnostic eggs in that one basket.

That's why I said "typically", Julie.

BTW, if you have a good basket, it is a great place to put all your eggs. But suit yourself.