Question:
Do all "morbidly obese" or "super obese" people have sleep apnea?
I am posting this anonymously because I do not want it to interfere with my surgery preparations and I know my doctor and others checks this sight often. I just got back from seeing the sleep study doctor. I went into his office, not as a pre operative requisite but because I am having a horrible, horrible time breathing at night. I have always had a terrible snoring problem but at least God blessed me with a man who could sleep through a train wreck, it bothers him very little. As soon as the man walked in, he looked me dead in the eye and told me what I had been "charged" with, making it all a 'fun' joke. You've been charged with "excessive loud noises from your snoring, leg twitches, irritablility and restless sleeping" - "how do you plea". I said "guilty as charged". My partner had to fill out his part of the questionaire and it asked specific questions - the only part he left out was the part about and you've gained 70 pounds over the coarse of 2-years. As he examined my throat, he told me what I was told 10-years ago by a ENT (ear/nose/throat) Dr. - they said the opening to my throat never developed past the age of 10 years old. Since I've snored even at my most thin weight, this MIGHT be a reason, huh? Or so I thought. Without even handling the overnight sleep study, he has diagnosed me with sleep apnea although myself, my husband and my daughter state that we've notice no break in my breathing pattern. He said that he's been studying bariatric patients since the early 1980's and not one single patient of his who is morbidly obese was NOT diagnosed with sleep apnea. He told me to go into this surgery without an oxygen mask could be extremely dangerous to me. I guess my question is this ~ and I'm looking for answers or simple comments: (1) does anyone else think it is somewhat weird to diagnose sleep apnea without watching the person sleep and be monitored with 1800 little gadgets attached to your body as I was shown in the video (2) do you think it is an assumption to believe that ALL obese patients have sleep apnea? (3) maybe I have the wrong definition for sleep apnea? Please help, if you can. — [Anonymous] (posted on February 27, 2002)
February 27, 2002
It is very common for even obese (not necessarily MO)people to have sleep
apnea. When he 'charged' you with the irritability, loud snoring, leg
twitches, restless sleeping, those are all signs of sleep apnea. Part of
the reason for having the study is for them to put you on a CPAP machine
and then monitor you to see what pressure is best for you. When I was
diagnosed, I had been divorced for a few years, so no one noticed the
snoring. However, I was dog tired ALL the time. I could get so sleepy at
work that I would go into the bathroom, close the stall door and rest my
head against the back wall of the stall. I could sleep there for 15 or 20
minutes. I almost fell asleep driving a couple of times. As for your
needing an oxygen mask during surgery, the anasthesiologist will take care
of that for you. That's his job, to monitor your breathing, oxygen levels,
blood pressure, heart rate and so on, while your surgery is going on.
— garw
February 27, 2002
1) does anyone else think it is somewhat weird to diagnose sleep apnea
without watching the person sleep and be monitored with 1800 little gadgets
attached to your body as I was shown in the video
*** no. There is a "look" to apnea victims. My pulmo also
labeled me, then sent me to the clinic to get the treatment started ASPS
& he was right. Mine was critical.
(2) do you think it is an assumption to believe that ALL obese patients
have sleep apnea?
*** no, it's very reasonable. MOST of us do, but it goes undiagnosed. Not
all, but MOST. Good chance.
(3) maybe I have the wrong definition for sleep apnea?
*** you're thinking you stop breathing for a significant period. An
"apnea" can be short, just often. Or it can be any number of
things. My mom was treated just with oxygen, not a CPAP.
I understand you being sort of freaked with a dx on looks alone, but we all
have a certain "look" to us. I can see it in us, too, but that
doesn't make it a true dx. Since he didn't sent you to a clinic, he is
going to treat you "as if", sounds like? That means, "with
kids gloves, more intense respiratory care"? So, that's not a bad
thing.
— vitalady
February 27, 2002
5'9 and 358 and I do not have sleep apnea. but my father who is not
overweight does
— [Anonymous]
February 27, 2002
No, not all morbidly ibee people havs sleep apnea. Both my husband and I
had weight loss surgery - we are (were) obese, though he more significantly
than I, and neither of us had sleep apnea. Perhaps someone could tell this
doctor that believing every obese person has sleep apnea is as erroneous as
believing that all doctors are as obnoxious as he! Let's just hope he is a
very excellent physician (which one can be although falling short in the
human being department) and that all will go superbly well with you and
you'll send him a picture of your svelte, healthy, glowing self. Lots of
luck and success in all. Nancy
— Nancy Z.
February 27, 2002
I weighed 435 and I DID NOT have sleep apnea . My mother says I have snored
since day 1, which was 36 years ago. I did have a doctor tell me I had to
have it at my size, he shut up after I had the test.
— [Anonymous]
February 27, 2002
I was 410 with no sleep apnea. My husband is maybe 20 lbs overweight and
has sleep apnea. while it can occur more often in obese people, and be
brought on by obesity, it doesn't just effect the obese.
— Becky K.
February 28, 2002
I weighed 350 and I did not have sleep apnea. My husband used to tell me I
was so quiet he didnt even know I was there. I even took tests (My doctor
recommended)they did not show any sign of sleep apnea. In fact they
thought I slept to good. Is there any such thing??? Well anyway the docs
a quack if he can give you a sound opinion without any tests.
— [Anonymous]
February 28, 2002
I have to respond to the people who question whether the doc could make the
diagnosis without a test. The answer is pretty much yes. He mentioned the
most common symptoms to the original poster and she said she had them all.
She also mentioned that the opening in her throat did not develop properly.
Another reason for having sleep apnea is for the little hanging piece of
skin (and I have no idea what it is called) to inhibit your ability to
breath. In fact, one of the treatments for sleep apnea, besides using a
CPAP, is to have that piece of tissue removed surgically. I think the
doctor made a very good guess. Could he be wrong? Yes. Is he? Probably
not.
— garw
March 1, 2002
I weigh 268 pounds and I do not have sleep apnea. I don't believe all MO
people have it, but I think your doc probably knows what he is doing.
— emilyfink
March 1, 2002
I weighed 402 and did NOT have sleep apnea.... Yes you can have all the
classic symtoms and be diagnosed.. but what I wonder is how do they know
what settings to use for the CPAP machine if they did not do a sleep
study??????
— Pamela W.
March 3, 2002
I am the author of this one ~ just wanted to add the the sleep study doctor
is not my doctor. My surgeon, in fact, didn't think the sleep study was
necessary due to all the other tests that I have had to do. He said the
anesthesiologist will use oxygen anyway during surgery.
It bothered me that I was diagnosed through visiting. It bothered me that
even at my smallest weight (140), I couldn't breath properly because of
this small opening in my throat that may have to be surgically corrected.
Thanks for all who responded though.
— [Anonymous]
April 8, 2005
Not all obese people have sleep apnea. My BMI is 41 and I did not need a
CPAP or BIPAP machine. ENT's are qualified to diagnose sleep apnea based on
the airway's structual assessment and patient symptoms. Typically obese
people put more weight on the airway when it is already relaxed while you
sleep, so it can cause apnea events, but that is not always the case. There
are several non-obese people who use CPAP machine because of the structure
of the airway. There are many factors involved. I agree that the best form
of diagnoses would be to have a sleep study because many factors can cause
you to feel daytime fatigue. During a sleep study, they measure your
breathing events in apneas, hyponeas, and upper airway disturbances. They
also monitor periodic limb movements, and oxygen saturation levels.
Usually they can do EKG monitoring as well. Keep in mind that just because
you snore, it does not mean that you have apnea. In fact people who have
the surgery to repair the resistance in the airway or those on a CPAP/BIPAP
machine can still snore. It is unlikely but could be normal in some cases.
If you are someone who is concerned with this diagnoses, schedule a consult
with a board certified sleep specialist.
— Tiffany W.
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