From Our 2014 Archives
A Little Weight Loss May Ease Sleep ApneaBy Steven Reinberg
Latest Sleep News
Finnish researchers said losing as little as 5 percent of body weight seems to lead to significant improvement in the condition -- in which breathing pauses frequently while people are asleep, resulting in disrupted sleep and daytime fatigue.
"Being overweight is considered the most important risk factor for obstructive sleep apnea," said lead researcher Dr. Henri Tuomilehto, an adjunct professor at the University of Eastern Finland's Oivauni Sleep Clinic, in Kuopio.
Being moderately overweight increases the risk for obstructive sleep apnea by 10 times, Tuomilehto said. "It has been estimated that around 70 percent of all patients with obstructive sleep apnea are obese," he said.
Based on this and other studies, Tuomilehto said, a weight-reduction program with lifestyle counseling should be a part of the routine treatment for all obstructive sleep apnea patients who are obese.
"We believe it represents the first-line treatment in the early phases of the disease and has a good chance of curing the disease or at least preventing the progression," Tuomilehto said.
For the study, his team randomly assigned 57 moderately obese people with mild sleep apnea to a yearlong supervised program of diet and exercise designed to get them to lose weight. Others in the study were given general information on diet and exercise.
During four years of follow-up, those who lost at least 5 percent of their body weight (an average of 11 pounds) saw dramatic improvement in their sleep apnea, the researchers found. Those who maintained their weight loss saw an 80 percent reduction in progression of their condition, compared to those who didn't lose weight.
Tuomilehto said many people who suffer from the condition don't know they have it.
"Obstructive sleep apnea is a highly prevalent disease and untreated it is a major burden for our health care systems," he said. "Unfortunately, 80 percent to 90 percent of those with obstructive sleep apnea are undiagnosed and do not know or even suspect that they have it."
"If daytime performance and vitality is not what you would expect, do not blame your age first," he said. "Suspect something else, such as obstructive sleep apnea, until proven otherwise."
The report appeared in the Feb. 11 issue of the journal Sleep Medicine.
Dr. Harly Greenberg, head of sleep medicine at Long Island Jewish Medical Center in New Hyde Park, N.Y., said obesity is linked to sleep apnea because fatty tissue accumulates around the neck and narrows the airway, making it more susceptible to obstruction during sleep.
The consequences of the condition include increased risk for high blood pressure, hardening of the arteries, heart attack and stroke, Greenberg said. In addition, sleep apnea may contribute to the development of type 2 diabetes.
Weight loss alone won't be enough to help everyone with the condition, Greenberg said.
"While a weight-loss program is appropriate for overweight sleep apnea patients, it should not be relied upon as the sole therapy for those with moderate to severe sleep apnea who are at risk for cardiovascular consequences and for patients with any severity of sleep apnea who suffer from daytime sleepiness that adversely affects daytime function," he said.
"Those patients should be treated with therapeutic interventions such as continuous positive airway pressure (CPAP) or oral appliances that can produce more immediate improvement in symptoms and relief of daytime sleepiness while waiting for weight loss to occur," he said.
Another expert welcomed the new study findings.
"It is always wonderful when the take-home message is that so much of our health is under our control," said Dr. Lisa Liberatore, an otolaryngologist at Lenox Hill Hospital in New York City.
"Our approach to treating obstructive sleep apnea is always to address any weight issues. We have many examples of when patients lose weight their snoring and apnea reduces significantly," Liberatore said. "A proactive approach is even better. Telling and showing patients how weight gain -- even modest amounts -- can and will lead to sleep apnea is a powerful message."
Although the new study showed a connection between weight loss and improved sleep apnea symptoms, it did not prove a cause-and-effect link.
SOURCES: Henri Tuomilehto, M.D., Ph.D, adjunct professor, Oivauni Sleep Clinic, University of Eastern Finland, Kuopio; Lisa Liberatore, M.D., otolaryngologist, Lenox Hill Hospital, New York City; Harly Greenberg, M.D., director, sleep medicine, Long Island Jewish Medical Center, New Hyde Park, N.Y.; Feb. 11, 2014, Sleep Medicine