If you are obese, then there is a good chance that you also suffer from a syndrome of Obstructive Sleep Apnea (OSA), especially if you:
- Feel tired and sleepy; fight against sleepiness when driving, sitting in business meetings or watching TV.
- Live with chronic fatigue.
- Have "brain fog" and difficulty with concentration.
- Have bad mood and depression.
- Have type 2 diabetes.
- Have problems with heart.
- Have high blood pressure.
- Suffer from headaches (especially in mornings).
- Sweat at night even when it is not hot.
- Go to washroom at least once per night.
- BMI 35-39.9 - 71%
- BMI 40-49.9 - 74%
- BMI 50-59.9 - 77%
- BMI 60 or more - 95%
You want to get rig of OCA (it's easy - keep reading!) not only because of all the listed problems, but also because it prevents weight loss! How? It will be explained soon.
WHAT IS THAT?
When you are sleeping at night, your brain goes into deep sleep and loses control over internal tissues of your mouth. They collapse under their own weight and block the airway:
Each suffocation event can last as long as 1 and even 2 minutes! When the blood oxygen saturation decreases critically, the brain, bombed with SOS signals, slightly wakes up and saves the situation, raising the collapsed tissues. Air passage is restored, the brain falls back into a deep sleep, and... the story repeats itself in an endless loop:
The person spends half a night (or even more - sometimes 5 hours of 8!) not breathing - in heavy asphyxia - but, after waking up in the morning, remembers nothing and has no clue what happens at nights and why he/she is suffering many years from obesity and all the problems, listed in the beginning of this page! More explanation of OSA can be found in these videos: 1, 2, 3, 4, 5.
BTW, now you understand why people with OSA "sweat at night even when it is not hot"? When the airway is blocked, the chest is repeatedly, but unsuccessfully, trying to breathe. So, the body is working very hard physically throughout the whole night.
OBESITY CAUSES OSA...
When most people gain weight, they gain it everywhere - including their neck and intraoral organs ("visceral fat"). Fatty tissues in this area can narrow your airway when you lie down. Compare the throats of a slim and a fat person:
In addition, the fat behind the neck (the "beer lover's neck") arches the backbone forward. This narrows the airway as well:
While the weight is increasing, the clearance between the collapsing internal tissues and the neck continues to decrease, and one night the airway is completely blocked...
...AND OSA PREVENTS WEIGHT LOSS!
How exactly? There are a few ways.
- When the sleeping brain finally discovers that the level of oxygen in the blood has fallen to a critical level, it switches to an "emergency mode" and throws into the blood an extra dose of adrenaline and other special biochemistry to save the situation and raise the fallen nasopharyngeal organs. In such an emergency, the body (thanks to evolution!) prepares the body for the worst scenario (perhaps, prolonged hunger) and launches the mechanism for storing fat as a reserve (to survive the hungry period).
- Intermittent sleep in apnea causes a disruption in the production of growth hormone (testosterone) responsible for transforming fat stores to energy, necessary for the normal functioning of the body. As you could read in the page HOW TO START, growth hormone "plays an important role in weight loss - it "opens the fat depot" i.e. enables the use of fat deposits as a source of energy". The sleep of a healthy person consists of two alternating stages: shallow ("fast sleep", or "fast eye movement" phase) and deep ("slow sleep"). Growth hormone is produced mostly in the deep stages of sleep. But as soon as the brain goes into it, apnea occurs and the brain returns to the shallow stage. The lack of growth hormone causes the body to require more and more food to get energy from it, since the stored fat is "locked".
- ОСА causes us to over produce ghrelin. The job of that hormone is to tell us when we need to eat - it stimulates food intake by making us physically feel hunger. So, the link between increased secretion of ghrelin and wight gain is very straightforward. In patients with obesity, after eating, the level of ghrelin does not decrease, for this reason there is no feeling of satiety after eating. Interesting fact: ghrelin is produced in the area of the stomach, which is removed with most bariatric surgeries - this is one of the mechanisms of action (but not the main) of these surgeries, which turn obese into slim. While bariatric surgeries almost stops the production of ghrelin, obstructive sleep apnea - on the contrary, greatly increases.
- ОСА causes us to under produce leptin, and reduces sensitivity to it. Leptin is the hormone which regulates appetite (it tells us to stop eating). Because of the developed resistance to leptin, the body thinks that a person is hungry, even when in fact there is no physical need for food at the moment. That causes two effects: more frequent meals, and overeating during one meal.
- OSA reduces the production of serotonin. Serotonin is a natural suppressant of appetite: that hormone suppresses the feeling of hunger and gives a feeling of saturation, even if the stomach is not full. Thanks to serotonin, the amount of food consumed decreases, and as a consequence, the weight decreases.
- OSA reduces sensitivity to insulin. High levels of insulin (hyperinsulinemia), which are caused by insulin resistance, are associated with central obesity (a massive accumulation of fat in the abdomen): the person can look not very fat in front, but have a large, overhanging belly.
As you see, Obstructive Sleep Apnea causes fat to be stored MORE, then necessarily, and consumed (utilized for energy production) LESS, then necessarily, so nor diets (even the best ones in the world!) nor Intermittent Fasting will help to lose weight seriously and constantly because the fat storage mechanism of OCA has nothing to do with WHAT, HOW MUCH and HOW OFTEN you eat. People can think that you are a lazy glutton who don't want to do sport, but it's not your fault that you are obese - you have a problem (which, fortunately, can be quickly and easily solved - keep reading!).
So, all the just listed reasons cause further weight gain and make weight loss unrealistic. Because the person gets fatter, the degree of apnea becomes even stronger, which leads to an even greater weight gain... and so on, and so on - we have a vicious circle:
Detailed explanation of how OCA prevents weight loss can be found in these videos:
OSA CAN KILL. LITERALLY!
Have you ever heard the phrase that someone died in a dream, although he/she seemed to be healthy? Chances are great that it happened because of apnea. I mean death not from diseases that are consequences of apnea (for example, related to the heart, blood pressure or oncology). I'm talking about death directly from the apnea itself. People are just strangled while sleeping.
The normal level of saturation (oxygen concentration in the arterial blood) is 95-98%. The reduction to 93% is considered clinically insignificant. If the level drops to 90%, it is considered as hypoxemia, and it can lead to hypoxia. The level of oxygen in the blood below 80% can disrupt the functioning of the brain and heart. 70% can lead to cardiac arrest. A decrease in saturation of less than 50% within 2 minutes leads to the onset of necrosis (death) of neurons in the cerebral cortex. The following video shows how OCA leads to a drop in the oxygen level in the blood to 53%. The brain at the last moment woke up and saved the situation, but not everyone was so lucky:
HEART PROBLEMS AND SLEEP APNEA
The heart begins to suffer and be damaged from lack of oxygen quicker than many other organs including the brain. Please google.
HIGH BLOOD PRESSURE AND SLEEP APNEA
If you know somebody with hypertension, advise them to go to a sleep disorder specialist NOW!!! Please google.
DIABETES AND SLEEP APNEA
For diabetes and sleep apnea, glucose intolerance and insulin resistance are two terms you should become familiar with. Insulin is a hormone released by your pancreas (a gland in your abdomen behind your stomach that plays a role in hormone production and digestion) to help you store and use the sugar and fat from the food you eat.
When you suffer from sleep apnea, you periodically stop breathing many times a night — as many as hundreds of times a night if your sleep apnea is severe. When your body is deprived of oxygen, your fat cells become resistant to insulin and your glucose levels rise. This is referred to as insulin resistance and glucose intolerance. When this happens, your body may not respond to insulin. For more details, read this article.
HOW TO GET RID OF OSA?
The treatment is very quick and easy - CPAP (continuous positive airway pressure) device, or "sleeping machine", a high-tech computerized compressor that supplies air under pressure through the face mask:
A modern Automatic CPAP (aka APAP) has a smart algorithm which tries to keep the pressure lower for your convenience, but decreases it in real time when detects air flow limitation or airway blockage, so each time the problem is resolved in seconds, before blood saturation begins dropping.
It's so easy to begin new life without all the problems, listed above! Believe or not, but CPAP-therapy removes sleep apnea (but not it's reason) immediately, not after a few months or even days, so you will start feeling much-much-much better (I would say, begin your new life) next morning after the first night of the therapy. In fact, it will be your first night with good sleep and no suffocation for many years! It's like a fairy tale, but there are no miracles - physics only: the air pressure, produces by the "sleeping machine", mechanically keeps the tissues from collapsing and closing the airway. Voilà - no suffocation and its terrible effects anymore! Of course, it takes time to get used to the face mask (for example, I stopped feeling discomfort after 1.5 weeks, and stopped paying attention at all after 1.5 months), and you will not lose weight after just a few nights with CPAP, but the obstacle, which didn't allow you to lose weight, is removed literally immediately! In the following videos, people share their impressions in the first day after beginning CPAP therapy: 1, 2.
WHAT SHOULD YOU DO TO BE DIAGNOSED?
Ask your family doctor to write a referral to a sleep disorder specialist ("sleep doctor") which will send you to a sleep test (polysomnography) to define if you have OSA. If you do, the sleep doctor will prescribe a CPAP. In many places it's covered by insurance. For example, SunLife insurance in Canada covers 90% of the CPAP-related costs (including masks). If you live in Ontario and have no extended insurance: Assistive Devices Program covers 75% of the basic device price (you pay the rest; but don't buy a basic one, buy only a modern AUTOMATIC CPAP, or APAP!!!). Google similar programs in other provinces/states/countries.
IF YOU ARE SURE THAT YOU HAVE SEVERE SLEEP APNEA...
...BUT YOU WILL SEE A SLEEP DISORDER SPECIALIST (AND HAVE A CPAP) ONLY AFTER A WHILE, YOU CAN PERFORM SOME STEPS RIGHT NOW TO PARTIALLY SAVE THE SITUATION:
- Do not drink alcohol, especially in the second half of the day! OSA is all about brain loosing control on muscles, and alcohol contributes to that loosing a lot, so obstruction events come quicker. Also, alcohol increases reaction time of the brain when it gets signals about low level of oxygen in the blood, so suffocation lasts longer and is more dangerous (the lower blood saturation - the more chances to die). How Alcohol Affects Sleep Apnea and Snoring by Relaxing Airway Muscles
- Do not take sedatives or sleeping pills, especially in the second half of the day. They increase the reaction time of the brain in the same way as alcohol. Also, they contribute to obstruction events. Sleeping pills relax the mind and the body so you can fall asleep. But in the process of relaxing the body, the mouth muscles become relaxed as well, and the tissues tend to block the airway quicker and more frequently.
- Try sleep sitting up in an armchair. If the backrest is low, put your pillow ON it. Use an airplane neck pillow (buy it in a tourism/travelling store or department). Sleeping up will not totally remove OSA, but can improve the situation (maybe, you will even say: "It was my best sleep in years!" - even though sleeping in an armchair is pretty inconvenient). Also try the anti-snore/anti-apnea oral device (a.k.a. sleep apnea mouth guard). It slightly moves your lower jaw ahead, thus opening the airway (and prevents it from falling down while sleeping). You can buy it in any pharmacy. Usually, it's useless at all with severe apnea, but who knows - it may help in combination with sleeping up.
- If you fail to sleep sitting up, buy a bed wedge. By elevating the person's upper body, the position helps keep the upper airway open and prevent weak tongue muscles from collapsing to block the airway, hence promotes better air-flow and prevents snoring as well as mild sleep apnea:
Buy a wedge with height at least 9 inch (that info always appears on the product or in the description if you buy online). Also, watch this video (it's an ad, but explains the principle).
- Stop smoking.