Individuals who struggle with obstructive sleep apnea (OSA) should pursue weight loss in addition to continuous positive airway pressure (CPAP) as a form of initial therapy, new recommendations from the American College of Physicians (ACP) state.
More than 18 million Americans suffer from sleep apnea, of which OSA is the most common type. OSA causes the airway to collapse or become blocked, resulting in shallow breathing or pauses that can last anywhere from a few seconds to minutes.
Besides being the leading cause of daytime fatigue, sleep apnea increases the risk of high blood pressure, heart attack, stroke, heart failure and diabetes. OSA in particular has been linked to increasing rates of obesity nationwide.
"Obesity is a risk factor for obstructive sleep apnea and the evidence indicates that intensive weight loss interventions help improve sleep study results and symptoms of OSA," Dr. Molly Cooke, the president of ACP, said in a statement.
"Plus, losing extra weight is associated with many other health benefits," Cooke added.
For those who prefer it or do not tolerate CPAP well, the ACP further recommends a mandibular advancement device (MAD) as an alternative.
"The evidence shows that a mandibular advancement device can effectively improve sleep study results and sleepiness," Cooke said. Though, she notes, in studies "CPAP more effectively raised the minimum oxygen saturation compared to MAD."
Finally, the recommendations stress that physicians "stress the importance of compliance with treatments, especially CPAP. Doctors should weigh patient preferences and the likelihood of therapy adherence against costs before initiating CPAP treatment."
OSA, though more common in people who are overweight, can affect anyone, with risk increasing with age.
Common signs of OSA include chronic snoring, morning headaches, memory and learning problems, mood swings, depression, waking up with a dry mouth and irritability, among other things.