One in 15 Americans has sleep apnea, but we don’t talk about it. It’s practically a taboo subject, possibly because apnea is correlated with fatness (though there’s no proven causation).
One of the consequences of us not talking about it is that 80% of people with sleep apnea are undiagnosed. That’s a lot of people whose health and lives are in danger in part because the condition is so highly stigmatized.
When people in larger bodies are diagnosed with sleep apnea, their weight is often blamed for the condition. Some doctors push “solutions” that aren’t reliable in the long term, like intentional weight loss, while others deliver a heaping helping of shame along with a dental appliance or CPAP machine.
But what does the science say about these factors?
- Sleep apnea causes and symptoms
- Body size and risk factors
- Evidence-based and effective sleep apnea treatments
- Whether weight loss or weight loss surgery help with sleep apnea in the long term
Here are seven resources on sleep apnea and body size, from the easily understandable to the academic. Use them as part of your Health at Every Size® journey, or show your doctor.
Never forget: You are worthy of gentle, weight-neutral, equitable healthcare, no matter your body size or weight.
The Big Fat Science Sleep Apnea Series: A summary
“Exercise can decrease apnea episodes and symptoms of obstructive sleep apnea. But CPAP therapy is by far the best treatment. When used regularly, CPAP therapy completely eliminates apnea episodes – and snoring! CPAP therapy also reduced sleepiness, improves blood pressure, insulin resistance, and metabolic syndrome.”
Persistence of Obstructive Sleep Apnea After Surgical Weight Loss
“Surgical weight loss reduces the apnea-hypopnea index, but many patients have residual obstructive sleep apnea one year after bariatric surgery.”
Is bariatric surgery really a cure for sleep apnea?
“Sleep apnea is one of the criteria used to support the ‘medical necessity’ of bariatric surgeries. To qualify for insurance coverage by many major insurers and the Centers for Medicare and Medicaid, and, for many years, to have surgery covered through Medicare disability, even those with moderate obesity (BMI≥35) could be a candidate if their surgeon said they had a “serious obesity-related morbidity, such as obstructive sleep apnea.”
“But Everything Is Supposed to Get Better After Bariatric Surgery!” Understanding Postoperative Suicide and Self-injury
“While some medical illnesses temporarily improve following bariatric surgery, postoperative patients can experience a recurrence of ailments with which they struggled preoperatively. In a meta-analysis, Peterhansel observed that many diseases, including sleep apnea and diabetes, tended to reemerge and even worsen long-term following WLS”
Do No Harm: Weight Stigma in the Medical Field
“I have been diagnosed with sleep apnea, despite never even complaining about symptoms related to sleep apnea to my doctor. I’ve gone to offices where the scale stops at 300 pounds and I could not be weighed. (This has not spared me from any lectures, though.) I’ve had doctors recommend exercise to me as a treatment for my depression. Really, the stories I have are endless. I leave nearly every medical appointment with a new one.”