Losing Weight with Sleep Apnea
Frankie Roman, MD
What are the typical behavioral and psychological factors that contribute to weight gain?
Everything revolves around food. Every time we celebrate, every time we have a meeting it revolves around food. A lot of it is our sedentary lifestyle. Another part of the behavioral problem is that we misinterpret some of our basic needs. We may be thirsty or sleepy, yet we interpret that as being hungry. Many people use food as a coping mechanism as well. We have also become a society where we drive everywhere and we sit too much. There's resistance to walk up one flight of stairs or walk one block to a store.
What health problems might contribute to weight gain, or make it difficult to lose weight?
We now know that with obesity there is a higher chance of insulin resistance or glucose intolerance which results in patients developing type-2 diabetes. There is a higher chance of high blood pressure, sexual dysfunction, headaches, and depression. Now there is also a sense that as we get older we experience more frequent fatigue. Studies suggest that it's not necessarily our chronological age that makes us so tired or fatigued, but it could be related to obesity, not necessarily obstructive sleep apnea (OSA), just obesity. It's a vicious cycle where we sleep poorly, we are less motivated to increase physical activity, and so we gain more weight, which leads to obesity related issues including sleep apnea.
How many of your sleep apnea patients are overweight? If they are overweight, should they automatically ask their primary care doctor to screen them for sleep apnea?
The majority of our patients are obese. There seems to be a relationship between obesity and obstructive sleep apnea; however, we have to point out that not every obese patient by body mass index has obstructive sleep apnea. There are patients who have normal body mass indexes who are diagnosed with obstructive sleep apnea. Persons who are obese should undergo a general physical examination for obesity related health issues. A good test to do is to measure neck circumference. In men,