When we treat patients with obstructive sleep apnea we offer multiple treatments options to improve their symptoms such as snoring, disrupted sleep, tiredness, difficulty staying alert on the job as well as alleviate the cardiovascualar risks of sleep apnea. Typically people receive treatment with positive airway pressure (CPAP) because of its high rates of success in treatment, safety, and easy tolerability. However, other treatment methods are used as well. These include surgery by an ear, nose and throat surgeon to open the airway. Also the patients may do well with an oral device which is an acrylic piece like a mouth guard that is built and fitted by a specialist dentist to keep the jaw from sinking back and the tongue from collapsing the airway.
One treatment we mention but usually does not get immediately implemented is weight loss. Obstructive sleep apnea is often caused by obstruction worsened with excessive weight in and around then neck tissues. Losing weight can have a dramatic responses on the severity of sleep apnea. Many have been able to reduce their CPAP pressures. Others have been retested and their tests no longer detect sleep apnea and they no longer need treatment.
As exciting as a complete cure from sleep apnea would be, a significant weight loss is a long and difficult challenge. We do not tell patients with sleep apnea that they should lose weight and expect their efforts will suddenly get easier. They will still need another treatment for sleep apnea while they tackle the weight problem. However, if someone is serious about losing weight, there are several approaches that can be helpful and have data to support their greater level of success.
Organized approaches work better than general approaches. Programs requiring meetings, appointments with a trainer, etc. are better than trying to follow good intentions.
Record-keeping is highly effective. Now there are very easy online record keeping software systems that not only have huge food catalogs already in them but they remember what you eat so you just have to click on coffee, cereal, grapefruit and you have entered your usual breakfast. To make this even better, some of these are even available on iPhone/iPod Touch and other handheld platforms. You enter your exercise in the same way. By using software you know when you have done well and when you did... less well. It helps you realize which decisions make a significant impact.
I recommend "FitDay" and "My Fitness Pal"
Exercise is critical. Daily exercise. It is okay to have a few days per week of hard work at the gym with a trainer or whatever your choice of harder exercise. On the other days there needs to be some sort of activity to keep up your metabolism. A shorter walk, a shorter time on the exercise machine, an easier yoga session. Whatever you chose it needs to be something.
Dietician: I strongly encourage people to see a dietician. Almost every morbidly obese patient looks at me and says, "I know how to eat. I don't need to be taught." The irony of their statement is completely lost on them. When we need to learn something, it is time to go to the person who can teach us.
Bariatric Medicine and Surgery: Bariatric medicine is a specialty in medicine in which there is more than a dietician needed. The person needs a doctor who specializes in the body's metabolism. They work on directing the metabolic processes and the patient to work more effectively and when they do, the weight goes down. People who follow the program have excellent results.
Bariatric Surgery is a field of medicine which changes the gastrointestinal system by surgical means to promote weight loss. It is highly effective and has become a standard in the care and management of obese patients who have failed other approaches.
In our clinic when we see patients who have lost a significant amount of weight we often find they no longer need CPAP. They also often tell us they have stopped other medicines, as they no longer need diabetes pills, cholesterol medicines, etc.
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