Sleep apnea means stopping breathing during sleep. One of the most common types of sleep apnea is obstructive sleep apnea (OSA), which occurs due to airway obstruction. Obstructive sleep apnea affects 10 to 30 percent of the population in the United States. The estimated prevalence in North America is approximately 15–30% in males and 10–15% in females.
Research shows that obesity increases the risk of obesity diseas such as breathing problems such as asthma, obstructive sleep apnea (OSA), and obesity hypoventilation syndrome. Due to the obvious connection between obesity and sleep apnea, weight loss surgery can help to solve this problem in cases where it is necessary. Since only obstructive sleep apnea is associated with obesity and can be controlled by weight loss surgery, this article deals with this type of sleep apnea.
What is obstructive sleep apnea and what are its complications?
“Obstructive sleep apnea” means “interruption of breathing due to obstruction during sleep”. This condition is usually caused by airway obstruction during sleep. The tissues that help keep the airway open naturally relax after a person falls asleep. Although this loosening does not affect breathing in most people, it can narrow or even block the narrow airway in obese people or people with other risk factors for obstructive sleep apnea.
People with mild airway narrowing may snore at night, while people with significant narrowing stop breathing during periods of sleep, in other words, they have obstructive sleep apnea. Obstructive sleep apnea causes a person to wake up frequently during the night, as well as fluctuations in their blood oxygen and carbon dioxide levels, both of which increase the risk of various health complications. If this obstructive apnea occurs repeatedly and in the long term, it can cause irreparable consequences to a person’s health. Heart damage and eventually heart failure is one of these problems. Sleep apnea increases the pressure in the blood vessels around the heart and some cavities of the heart and puts pressure on this organ and eventually causes damage to the heart muscle. Depression and irritability are other results of sleep apnea.
Dr. Zandi, a bariatric surgeon, treats your sleep apnea with his knowledge. Treating your apnea will help those around you to sleep well as well.
What does obesity have to do with sleep apnea?
The risk of developing obstructive sleep apnea increases with the increase of a person’s BMI or body mass index. Obesity can reduce the diameter of the airways, decrease the capacity of the lungs and increase the possibility of loosening of the tissues of the throat and blocking of the airways.
Although obesity increases a person’s risk of developing obstructive sleep apnea, some experts believe the opposite may also be true. That is, having sleep apnea may increase the risk of obesity. The reason is that apnea can affect the hormone leptin. Leptin is a hormone that helps the body to recognize when it is full and when it is hungry; Therefore, the change in leptin hormone can cause obesity by changing the amount of food intake and some other mechanisms. In addition, sleep apnea may cause the body to become resistant to increased levels of leptin. The reason is that breathing disorders at night cause the release of cortisol, which affects the body’s resistance to leptin. People with leptin resistance feel less full, which leads to increased food intake and weight gain.
Continuous positive airway pressure (CPAP) can also cause weight gain. CPAP is the most common treatment for sleep apnea and is effective in reducing symptoms in most people with sleep apnea. Doctors aren’t sure why some people gain weight after starting treatment; However, the treatment cannot be stopped to prevent overweight.
How does bariatric surgery affect sleep apnea?
Treating obesity can help prevent or reduce complications associated with high BMI, including obstructive sleep apnea. Although exercise and diet are always the first and most important steps to lose weight, in some cases, weight loss surgery is necessary.
Weight loss following bariatric surgery reduces nocturnal respiratory obstructions, improves blood pressure, and improves overall health.
Of course, as mentioned in the introduction, you should keep in mind that these positive effects are only observed when sleep apnea is of the obstructive type. Also, you should consider that weight loss surgery is not a complete treatment for obstructive sleep apnea, but it helps to a large extent to resolve it.
There are three types of sleep apnea: obstructive sleep apnea (OSA), central sleep apnea (CSA), and mixed sleep apnea. Obstructive sleep apnea is the most common and accounts for 84% of sleep apnea diagnoses. Therefore, there is a high possibility that sleep apnea is of an obstructive type and its severity will decrease with weight loss.
Which bariatric surgery has the most effect on the treatment of respiratory apnea?
Two common gastric procedures recommended by bariatric surgeons to treat obesity, resulting sleep apnea, and other obesity-related problems such as type 2 diabetes and high blood pressure: Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy (gastric sleeve).
It can be said that it is not the surgeries themselves that have an effect on the improvement of sleep apnea, but actually weight loss does this. The type of surgery is determined by the doctor according to your condition.
How long does sleep apnea improve after weight loss surgery?
Obese patients lose between 50 and 80% of their excess body weight during the first two years after surgery. By losing weight, the fatty tissue around the throat also decreases and as a result the airway expands. The reduction of this fat causes the sagging of loose tissues during sleep to be reduced and obstructive sleep apnea is improved.
With the explanations given, it is clear that the patient will witness the improvement of sleep apnea at the same time as he experiences weight loss, and since the greatest weight loss is in the first two years after surgery, you can hope that sleep apnea will improve to a large extent during this period.
Conclusion
Sleep apnea means stopping breathing during sleep, which may last for several seconds and cause various problems for a person’s health. The most common type of sleep apnea is obstructive sleep apnea, in which loose tissues in the throat block the airways. In obese people, there are more of these tissues, and as a result, the airway becomes blocked more easily. In cases of obstructive sleep apnea in obese people, bariatric surgery can reduce the fat and loose tissue around the airways by helping to lose weight and help prevent these airways from becoming blocked.
For more information, refer to Dr. Zandi, a specialist in weight loss surgery and general surgery and minimally invasive surgery fellowship from England.
