Sleep Apnea

WHAT YOU NEED TO KNOW

What Is Sleep Apnea?

Sleep apnea is a condition where breathing is repeatedly interrupted during sleep. These interruptions (called apneas) can happen many times per hour, affecting your sleep quality and overall health.

Main Symptoms Include:

  • Interrupted breathing during sleep
  • Daytime sleepiness
  • Poor quality sleep
  • Difficulty concentrating
  • Mood changes
  • Morning headaches

The Truth About Weight and Sleep Apnea

Despite what you may have been told, the relationship between weight and sleep apnea is not simple:

  • Sleep apnea affects people of all sizes
  • The old theory about abdominal fat pressing on blood vessels has been disproven
  • Some research suggests the condition itself might contribute to weight changes, not the other way around
  • Many factors like hormones, metabolism, and inflammation play a role
  • Changes blamed on weight could be caused by weight stigma, weight cycling, and chronic stress

What About Weight Loss as Treatment?

The evidence for weight loss as a treatment for sleep apnea is surprisingly weak:

  • Most studies show no clear link between weight loss and improved symptoms
  • Weight loss attempts can cause additional stress and potentially worsen symptoms
  • Medications like CPAP have been shown to improve symptoms regardless of weight
  • The focus on weight loss often delays or prevents people from getting effective treatment

How Weight Stigma Affects Your Care

Weight stigma in healthcare can seriously impact sleep apnea treatment:

  • Effective treatments may be delayed or denied while focusing on weight loss
  • You might be pressured into dangerous very-low-calorie diets
  • The stress of forced weight loss attempts could make your symptoms worse
  • Important symptoms might be dismissed or blamed on weight
  • Without a diagnosis, you may have an increased risk of complications during anaesthesia

Weight Inclusive Treatment

Your Rights as a Patient

You deserve healthcare that:

  • Treats your symptoms effectively
  • Doesn’t delay proper treatment by focusing on weight loss
  • Considers all available treatment options
  • Respects you and takes your concerns seriously
  • Uses evidence-based treatments like CPAP

Getting Good Care

If your doctor is only focusing on weight loss:

  • You can refuse consent to discuss weight or weight loss during consultations
  • Ask about evidence-based treatments, especially CPAP
  • Request a sleep study on the basis that sleep apnea puts you at risk of serious health conditions
  • Seek a second opinion if needed

Evidence-Based Treatment Options

CPAP (Continuous Positive Airway Pressure)

CPAP is the most effective treatment for sleep apnea, regardless of body size:

  • Provides pressurized air through a mask
  • Keeps your airway open during sleep
  • Prevents breathing interruptions
  • Improves quality of life
  • Reduces health risks
  • Works for people of all sizes

Alternative Treatments

Other evidence-based options include:

  • Oral appliances that move the jaw forward or hold the tongue
  • Treatment of nasal congestion
  • Position therapy
  • Management of other health conditions

Important Considerations for Surgery

If you have or might have sleep apnea:

  • Insist on proper screening before any surgery
  • Don’t let weight concerns delay necessary screening
  • Make sure your surgical team knows about your sleep apnea
  • Request appropriate monitoring during and after surgery
  • Know that proper treatment (like CPAP) significantly reduces surgical risks

When to Seek Help

Contact your healthcare provider if you:

  • Experience excessive daytime sleepiness
  • Have been told you stop breathing during sleep
  • Wake up gasping or choking
  • Have morning headaches
  • Feel unrested despite sleeping
  • Have difficulty concentrating during the day

Summary

Remember: You deserve evidence-based care that treats your actual symptoms, not just advice about weight loss. Sleep apnea is a serious but treatable condition, and effective treatment options like CPAP work regardless of body size.

Effective Sample Script

You can use this script with healthcare providers:

“I am aware of the association between sleep apnea and higher weight. I have done my research regarding the benefits and risks of intentional weight loss for sleep apnea. I have decided that I do not wish to pursue this avenue. I therefore do not consent to discussing my weight or weight loss during this or any future consultation. Any attempts to do so will only serve to stigmatize me further.”

 

This information is provided by Dr. Asher Larmie, The Fat Doctor. For more detailed information and resources, check out his masterclass.