4 ms·

That's a very simplistic view of apnea. You don't have to be fat to experience it, and this misconception is a bit part of why it's underdiagnosed.

BenjiWiebe 3y ago
It is definitely highly correlated, as the commenter said.
- neffy 3y ago
  It's correlated, but the causality may be reversed. That is to say, sleep apnea probably causes and certainly doesn't help, obesity. There is a strong relationship between not getting enough sleep, and appetite control. There are also a lot of other causes of sleep apnea, physiology being a big one, also obstructions in the nasal canal.
behringer 3y ago
he's clearly not talking about the people with apnea who are not overweight in that particular example...
deleted 3y ago
[deleted]
appplication 3y ago
Agree. While sleep apnea risk does increase with obesity, it has a fairly high baseline. Sleep apnea is one of the most diagnosed conditions in service members separating or retiring from the military, and that is by definition not an obese group. I have sleep apnea and am one of the most fit people I know. When I was in the military, I encouraged many of my friends who sleep poorly to get a sleep test and many of them - fit and young - were surprised to learn they also had it. I would not be surprised if some significant portion of the population has it and is just unaware. At anything short of severe levels, many people would never even suspect they have it.
- throwaway2037 3y ago
  Sleep apnea is one of the most diagnosed conditions in service members separating or retiring from the military Woah. Why? Is there something specific about the (US?) military that causes it? Or do doctors measure/monitor for it more closely -- similar to the "explosion" of ADHD diagnoses in the last 20 years.
  - appplication 3y ago
    It is possible there are legitimate links (I lived and worked near the burn pits and those for sure messed up my respirstory system). But maybe more likely is because you get an automatic 50% disability rating from the VA when you’re diagnosed in service. It’s automatically presumed that if you had no diagnosis before that it is service connected. I.e. you developed it as a result of your service and therefore the VA will compensate you for it. This means an extra $1-2 thousand per month for life in most cases. So there is this natural experiment where we have a population with a very high incentive to get tested compared to the baseline population.
    - CobaltFire 3y ago
      This is no longer the case as of a year or two ago; they lowered it quite a bit. Even then it was quite hard to fake it; it just encouraged everyone to get tested.
    - nonameiguess 3y ago
      It's not like you can just fake sleep apnea. The VA makes you get a sleep study. But it does raise the question of whether it's more common than we think for people to develop it between 20 and 50 or so and we simply don't realize it for non-veterans because they're less likely to get tested.
  - CobaltFire 3y ago
    As someone who retired after 22 years in the US Military: Because the toll that way of life takes on your body is at least a magnitude more than most civilians realize. Years of little sleep in poor condition while under constant low level stress, being in unfamiliar conditions where you never quite feel safe sleeping, constant interruptions because the military activities don't stop while YOU sleep, poor temperature control (hot or cold), poor hygiene availability, poor sleeping surfaces, odd work schedules, short sleeping schedules... Those are just the factors that you deal with for decades that relate to sleep. I wasn't a grunt; I did do a lot of move fast and don't break things or people die stuff (Nuclear Power, SAR Aviation, Amphibious Operations) and that was just how life was. We had a few overweight people, but they were the exception. Those of us who were more senior were just all broken in so many ways. I don't THINK I have sleep apnea, but I do have trouble sleeping from the pain I'm in every night from a back injury and multiple autoimmune issues that cause flareups and pain. The cost on those that serve is absolutely astounding. I don't recommend service to anyone.
roody15 3y ago
“ Interactions Between Obesity and Sleep Apnea Among the risk factors for OSA, obesity is probably the most important. Several cross-sectional studies have consistently found an association between increased body weight and the risk of OSA.16 Significant sleep apnea is present in ≈40% of obese individuals,17 and ≈70% of OSA patients are obese. Furthermore, in a population-based prospective study of 690 randomly selected Wisconsin residents, a 10% weight gain was associated with a 6-fold increase in the odds of development of sleep apnea (Figure 4).18 In the same study, a 10% weight loss predicted a 26% decrease in the apnea-hypopnea index (Figure 4). Similarly, in several other case-control studies, weight loss in OSA patients led to a significant decrease in apnea frequency.1” https://www.ahajournals.org/doi/full/10.1161/01.hyp.0000101686.98973.a3 https://www.ahajournals.org/doi/full/10.1161/01.hyp.00001016...
- schwartzworld 3y ago
  > In the same study, a 10% weight loss predicted a 26% decrease in the apnea-hypopnea index This isn't as earth shaking as you imagine. The minimum AHI for diagnosis (in the US) IS 5. 20ahi (meaning you stop breathing 20 times per hour on average), is pretty mild. Some people have ahi over 100. Meaning a 26% decrease isn't actually doing much for you. What I can tell you is that I know several people who seem to have sleep apnea, complaining about the symptoms, who were told by their PCP that they don't need a sleep study because they weren't fat. When your partner complains about you choking in your sleep all night, you probably should a get it checked out regardless of your BMI. I honestly believe that doing a sleep study once every couple of years should be considered routine for everyone. We check our eyes, blood pressure, testicles, skin... Why not check for sleep quality prophylactically? I'm not saying you're wrong, but the OP using the condition as proof of societal causes of sleep issues is way off the mark. Skinny people can experience it. Children experience it. Bodybuilders are quite prone to it. As tissues loosen and sag with age across the body, old people are prone to it.
mensetmanusman 3y ago
I believe that your view and the OP's are correct simultaneously.
tibbydudeza 3y ago
The increasing incidents of removal of wisdom teeth seems to indicate the human jaw is getting smaller due to our dietary changes since we moved on from hunter gatherers to pastoral farming. Sleep apnea is not because you have fat in your neck obstructing your airway but your tongue relaxing at night and the area below the uvula falling backwards then obstructing your airway.
m0llusk 3y ago
In particular sleep apnea is extremely common among weightlifters. It turns out that even modest weightlifting tends to increase muscle throughout the body and even a small increase in the size of the muscles of the neck can fundamentally change breathing during sleep.

BenjiWiebe 3y ago

It is definitely highly correlated, as the commenter said.

neffy 3y ago
It's correlated, but the causality may be reversed. That is to say, sleep apnea probably causes and certainly doesn't help, obesity. There is a strong relationship between not getting enough sleep, and appetite control. There are also a lot of other causes of sleep apnea, physiology being a big one, also obstructions in the nasal canal.

behringer 3y ago

he's clearly not talking about the people with apnea who are not overweight in that particular example...

deleted 3y ago

[deleted]

appplication 3y ago

Agree. While sleep apnea risk does increase with obesity, it has a fairly high baseline. Sleep apnea is one of the most diagnosed conditions in service members separating or retiring from the military, and that is by definition not an obese group. I have sleep apnea and am one of the most fit people I know. When I was in the military, I encouraged many of my friends who sleep poorly to get a sleep test and many of them - fit and young - were surprised to learn they also had it. I would not be surprised if some significant portion of the population has it and is just unaware. At anything short of severe levels, many people would never even suspect they have it.

throwaway2037 3y ago
Sleep apnea is one of the most diagnosed conditions in service members separating or retiring from the military Woah. Why? Is there something specific about the (US?) military that causes it? Or do doctors measure/monitor for it more closely -- similar to the "explosion" of ADHD diagnoses in the last 20 years.
- appplication 3y ago
  It is possible there are legitimate links (I lived and worked near the burn pits and those for sure messed up my respirstory system). But maybe more likely is because you get an automatic 50% disability rating from the VA when you’re diagnosed in service. It’s automatically presumed that if you had no diagnosis before that it is service connected. I.e. you developed it as a result of your service and therefore the VA will compensate you for it. This means an extra $1-2 thousand per month for life in most cases. So there is this natural experiment where we have a population with a very high incentive to get tested compared to the baseline population.
  - CobaltFire 3y ago
    This is no longer the case as of a year or two ago; they lowered it quite a bit. Even then it was quite hard to fake it; it just encouraged everyone to get tested.
  - nonameiguess 3y ago
    It's not like you can just fake sleep apnea. The VA makes you get a sleep study. But it does raise the question of whether it's more common than we think for people to develop it between 20 and 50 or so and we simply don't realize it for non-veterans because they're less likely to get tested.
- CobaltFire 3y ago
  As someone who retired after 22 years in the US Military: Because the toll that way of life takes on your body is at least a magnitude more than most civilians realize. Years of little sleep in poor condition while under constant low level stress, being in unfamiliar conditions where you never quite feel safe sleeping, constant interruptions because the military activities don't stop while YOU sleep, poor temperature control (hot or cold), poor hygiene availability, poor sleeping surfaces, odd work schedules, short sleeping schedules... Those are just the factors that you deal with for decades that relate to sleep. I wasn't a grunt; I did do a lot of move fast and don't break things or people die stuff (Nuclear Power, SAR Aviation, Amphibious Operations) and that was just how life was. We had a few overweight people, but they were the exception. Those of us who were more senior were just all broken in so many ways. I don't THINK I have sleep apnea, but I do have trouble sleeping from the pain I'm in every night from a back injury and multiple autoimmune issues that cause flareups and pain. The cost on those that serve is absolutely astounding. I don't recommend service to anyone.

roody15 3y ago

“ Interactions Between Obesity and Sleep Apnea Among the risk factors for OSA, obesity is probably the most important. Several cross-sectional studies have consistently found an association between increased body weight and the risk of OSA.16 Significant sleep apnea is present in ≈40% of obese individuals,17 and ≈70% of OSA patients are obese. Furthermore, in a population-based prospective study of 690 randomly selected Wisconsin residents, a 10% weight gain was associated with a 6-fold increase in the odds of development of sleep apnea (Figure 4).18 In the same study, a 10% weight loss predicted a 26% decrease in the apnea-hypopnea index (Figure 4). Similarly, in several other case-control studies, weight loss in OSA patients led to a significant decrease in apnea frequency.1” https://www.ahajournals.org/doi/full/10.1161/01.hyp.0000101686.98973.a3 https://www.ahajournals.org/doi/full/10.1161/01.hyp.00001016...

schwartzworld 3y ago
> In the same study, a 10% weight loss predicted a 26% decrease in the apnea-hypopnea index This isn't as earth shaking as you imagine. The minimum AHI for diagnosis (in the US) IS 5. 20ahi (meaning you stop breathing 20 times per hour on average), is pretty mild. Some people have ahi over 100. Meaning a 26% decrease isn't actually doing much for you. What I can tell you is that I know several people who seem to have sleep apnea, complaining about the symptoms, who were told by their PCP that they don't need a sleep study because they weren't fat. When your partner complains about you choking in your sleep all night, you probably should a get it checked out regardless of your BMI. I honestly believe that doing a sleep study once every couple of years should be considered routine for everyone. We check our eyes, blood pressure, testicles, skin... Why not check for sleep quality prophylactically? I'm not saying you're wrong, but the OP using the condition as proof of societal causes of sleep issues is way off the mark. Skinny people can experience it. Children experience it. Bodybuilders are quite prone to it. As tissues loosen and sag with age across the body, old people are prone to it.

mensetmanusman 3y ago

I believe that your view and the OP's are correct simultaneously.

tibbydudeza 3y ago

The increasing incidents of removal of wisdom teeth seems to indicate the human jaw is getting smaller due to our dietary changes since we moved on from hunter gatherers to pastoral farming. Sleep apnea is not because you have fat in your neck obstructing your airway but your tongue relaxing at night and the area below the uvula falling backwards then obstructing your airway.

m0llusk 3y ago

In particular sleep apnea is extremely common among weightlifters. It turns out that even modest weightlifting tends to increase muscle throughout the body and even a small increase in the size of the muscles of the neck can fundamentally change breathing during sleep.