Sleep Apnea and Weight Gain

Apnea in Greek means 'without breath'. Sleep apnea is a breathing disorder that is caused due to frequent 'pauses' in breathing. These pauses (lasting anytime between seconds or minutes), only occur when the patient is sleeping, which is why he is usually unaware of it. The pauses can occur as many as 30 or more times within the interval of an hour. This happens when the airway gets blocked due to reasons like structural irregularities, large tongue, enlarged tonsils, medical conditions, or simply small size of airways.

It is a disorder that can have serious consequences if left untreated. Also, if left untreated, it increases the risk of high blood pressure, diabetes, heart failure, impotency, memory issues, and daytime sleepiness, leading to the individual being sleepy and accident prone.

The symptoms of sleep apnea are sometimes so subtle in their manifestation, that it is difficult to realize one is suffering from it. Sleep apnea is of three types:

• Central Sleep Apnea
• Obstructive Sleep Apnea
• Mixed Sleep Apnea (mixture of the above two types)

Every time a pause occurs, the person is awakened enough for him to resume breathing, due to which sleep is disturbed. Sleep apnea is a chronic condition and it is characterized by choking sounds and gasps. Usually a family member or sleeping partner is the first one to realize if someone is suffering from this disorder.

Sleep apnea and weight gain form a vicious cycle. People who are overweight tend to be more at risk, and people who have sleep apnea tend to put on weight. Sleeping less (due to disturbed sleep) and over sleeping (sleeping more to make up for disturbed sleep) can both lead to weight gain. The level of a protein called leptin, which is present in the body is affected by lack of sleep or disturbed sleep.

Leptin is responsible for controlling appetite. Low levels of leptin lead to an increase in appetite and high levels lead to a decrease in appetite.

Lack of sleep causes the leptin levels in the body to decrease which makes the person feel hungry, leading to overeating and consequently, weight gain. The only way to break this cycle is to exercise and have a healthy diet to keep your weight in check.

Weight gain can lead to the respiratory tract being blocked due to deposition of fatty tissues. This causes the size of the opening to reduce leading to blockages during breathing. Also, the muscles tend to become weak due to these fatty deposits, causing the apnea attacks. Conversely, less sleeping can cause tiredness, leading a person to eat more. This in turn, can cause weight gain leading to increase in risk.

AHI (Apnea-Hypopnea Index) is calculation of the average of the total apnea hypopnea episodes occurring on an hourly basis. Studies reveal that people with an AHI of 15 or more showed an increase of 0.52kg/m² in BMI (Body Mass Index), as compared to the 0.22kg/m² increase in BMI shown by people with an AHI of less than 15, thus establishing a direct relationship between weight gain and sleep apnea.

Besides being related to weight gain, there is also a relationship between so who is susceptible to sleep apnea? If we can tell whether we are prone to it, then we can be alert and try to prevent this from happening. Before that we need to know what factors contribute in making a person more susceptible.

 The following have been noted to be the major influencing factors:

• Gender is an important issue. Males are more prone to it than females.
• Females are more at risk during pregnancy and menopause.
• Age is another issue. As age increases, so does a person's chance of suffering from it. Usually the risks increase after the age of 65.

• Obese people are more at risk than physically fit people. Keeping your weight under check helps reduce the risk considerably.
• Physical deformities due to medical complications and genetic conditions like small size of nasal passage or airways can put you more at risk.

• The race affects the risk factor to some extent with Hispanics and African-Americans being more prone to it than Caucasians.

• There are many machines available which help to physically keep the airways in the throat open, like CPAP and BiPAP machines.
• Sleeping on your side instead of your back helps to open airways.

• Keeping a check on your weight, avoiding habits like smoking and consuming alcoholic drinks helps significantly as well.
• If your condition is really severe, then the last option would be surgery. It can be done to reduce the size of the tongue, increase the size of the airways, remove tonsils, and to counter excess tissue growth in the throat.

Sleep apnea in children can cause slowed growth and ADHD, and in adults it can cause serious problems like Polycystic Ovarian Syndrome (PCOS), atherosclerosis, atrial fibrillation, renal failure and diminished libido to list a few. Timely treatment is the best solution to get rid of this condition and lead a healthy life.