Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
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Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#2I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device.
I would also like to point out that I see an incredible amount of fat-shaming that is rooted in a drumbeat of research that (correctly) shows lower health risks in many areas when BMI is lowered. In reaction to that, it is important to understand that for many people weight loss is neither practical nor maintainable and for that reason it is critical that we continue to advance our treatment of things like sleep apnea.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#3I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…
Nobody who fat shames has shown me research about the efficacy of fat shaming on weight reduction. That's not necessarily because the research doesn't exist, it's because they just don't care.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#4When I was in my 20s, I weighed around 165 and never snored. By the time I was in my early 40s, I weighed about 225 and snored like a bandsaw and was diagnosed with sleep apnea. I improved my diet and started exercising 5 days a week. By the time I dropped back down to about 175 my snoring and apnea were both totally gone. At least in my case, the snoring and apnea were definitely weight related.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#5I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…
I understand what you are saying but, economically, treating the symptom rather than the cause is expensive; somehow there needs to be some way to create a cost high enough to encourage people to attack the cause of the problem; and shame can be a useful way to increase the cost. So "fat shaming", although politically incorrect these days, should not be thrown out as a way to encourage behavior that benefits society as a whole and the person as whole. If there was a high enough cost to being fat then you would see it would become practical and maintainable.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#6Always profile before optimization.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#7I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…
I understand what you are saying but, economically, treating the symptom rather than the cause is expensive; somehow there needs to be some way to create a cost high enough to encourage people to attack the cause of the problem; and shame can be a useful way to increase the cost. So "fat shaming", although politically incorrect these days, should not be thrown out as a way to encourage behavior that benefits society…
If literally not being able to breathe isn’t enough, people being dickheads probably isn’t going to do it.
Please think harder.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#8I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…
>In reaction to that, it is important to understand that for many people weight loss is neither practical nor maintainable and for that reason it is critical that we continue to advance our treatment of things like sleep apnea.
Sorry, but I have to call BS on that. Having lost ~50 lbs last year (after my blood pressure started getting scary), I can tell you it's all about planning and self-discipline. You plan a diet that fills your stomach and provides the major types of nutrients, yet gives less calories that your body burns every day, and you stick to it for a couple of months. No bullshit, no cheat days, no "let me just have that 500cal chocolate bar as an exception". And it works like clockwork, solving a bunch of health problems on the way.
As a matter of fact, I would call it very unethical to comfort people into an unhealthy lifestyle associated with major health risks and shorter life expectancy just to get an extra buck from treating numerous symptoms, instead of giving them a strong motivation to resolve the underlying cause.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#9I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…
> In reaction to that, it is important to understand that for many people weight loss is neither practical nor maintainable and for that reason it is critical that we continue to advance our treatment of things like sleep apnea.
Thank you for this comment! I'd like to emphasize this point in particular. It took me a long time to come to this realization on my own, and I regret putting my brother under so much pressure to lose weight out of my own concern for his health. I likely did more harm than good with my efforts, only worsening his mental and physical health.
While losing weight solves a lot of problems, the decision to do so is one's own, and for some, it's an unreasonably difficult task. Not everyone is like you, and not every body is like yours. The best you can do to help someone suffering the consequences of excess weight is to be compassionate and supportive. Feel free to offer solutions and perspectives, but leave your emotions out of it. Respect the dignity and autonomy of others.
Re: Effect of Weight Loss on Obstructive Sleep Apnea: The Importance of Tongue Fat
#10I'm a dentist who regularly treats OSA with dental appliances; they work by posturing the mandible forward with a maxillary and mandibular (two-arch) device as a way to increase the cross sectional area of the posterior airway, reducing apneic events -- but it is important to know that the gold standard remains the positive airway pressure (CPAP) device. I would also like to point out that I see an incredible amount…
I'd just like to chime in as someone who has lost and kept off about half his bodyweight, that yeah, losing significant amounts of weight is a very demanding undertaking. It requires a significant lifestyle change, large investments of time, is emotionally and cognitively draining, and to top it all off does not positively impact your quality of life nearly as much as is touted. To be successful at it requires a level of obsession that qualifies as an eating disorder in its own. I track every calorie I eat, and weigh myself everyday. I have to hate seeing those numbers go up. I have to feel shame at overeating and not allow myself to make excuses for it, lest I become complacent. I can't keep food in my house. I avoid social gatherings because there's almost always food involved. You might think you can just not partake but it doesn't work like that, your brain thinks you're starving and has all sorts of ways to wear down your will and convince you it is ok to eat. It's kind of a living hell.
Based on personal experience, I am quite confident that physicians have absolutely no idea how to give actionable advice in this area, and nutritional specialists are only slightly better. None of them care about your suffering, because that isn't something they measure.
I guess what I'm saying is that yeah, it is possible for anyone to lose and keep off significant amounts of weight, but basically none of you have any idea what it really takes.