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This is new to me. never before on sleepguide have any of my statements been so disliked. It has been fun. I have to go to a meeting on billing at the hospital, then I am going to start celebrating my birthday. have a great weekend everyone! I know I will. I wish all of you good health and an uneventful night's sleep.
Thomas,
Sleep apnea is a world wide problem. The incidence in Asians is 24%, Hispanics and Afro-Americans 15-16%, Caucasians 9%.
Dr Christian Guilleminault and coworkers at Standford have done tissue biopsies in the upper airways of patients with OSA and find evidence of neuromuscular pathology. In one of his first reports, I believe from the early 90's, he wasn't certain of the cause. Was it due to the trauma of longstanding vibrations from snoring or was there some as yet undetermined source of the pathology? More recent studies, show the same pathological changes again with no obvious cause. The trauma theory had fallen out of favor, if I remember correctly. So the cause is still unknown.
OSA, the result of pathological collapse of the tissues and musculature in what may already be an anatomically small upper airway, causes obesity and obesity narrows the airway even more. This magnifies the problem, i.e., OSA causes itself to get worse. Loosing the excess weight reduces the AHI, but rarely eliminates all apneas. There are a few cases reported in which the AHI is 0 after dropping to a normal BMI. The assumption here is that the obesity caused their OSA.
Why does OSA cause obesity? The sympathetic nervous systems surges (the "fight or fright mechanism") with each apnea results in elevated levels of many hormones including cortisol which drive the appetite center in the hypothalamus. There is a drop in leptin and a surge in ghrelin, both contributing over stimulation of the appetite center. Treat OSA and these hormone level drop and weight tends to be much easier to lose (some have found their weight drops without even trying).
Twenty percent of OSA patients in the US are not over weight nor obese presumably because of their genetic makeup (look at the Asians). You can be skinny and have an AHI of over 100. There is no fat surrounding the upper airway; there airways were made small and the collapsing tissues have no fat.
Loosing weight is simple. I've done it many times. It is calories in and calories out. One pound of fat contains 3500 calories. Metabolize or use up 3500 calories and you have lost one pound of fat. Because the strong drive for food is part of our instinctual brain located in the hypothalamus, hunger triggered by cortisol, etc., easily overrides the prefontal cortex's control center. But because we are rational and intelligent beings, we have found many inventive ways to overcome this hypothalamic over-stimulation. Portion control works for me. The bottom line: Stop going to the service station when your tank is full.
How do you explain OSA in dogs and cats? And who knows what other animals? I guess when we discover the cause in humans we will have the answer in animals or vice versa.
This is new to me. never before on sleepguide have any of my statements been so disliked. It has been fun. I have to go to a meeting on billing at the hospital, then I am going to start celebrating my birthday. have a great weekend everyone! I know I will. I wish all of you good health and an uneventful night's sleep.
HAPPY BIRTHDAY, ROCK!! Anyone who's had much contact with you knows how deep your commitment is to helping apnea patients. You've been an enormous source of help to me for nearly 4 months now. I can say the same about jnk from personal experience with his level of support as well.
This kind of dialogue is part of what's so important about SleepGuide. Someone further back said "We're all in this together". He was right, and everyone who frequents this website knows it. Sometimes it feels like it's us against the world. But here everyone can say what they think and, like you and jnk, even get into spirited debates (some of which are driven by you guys for the sheer love of it!, now be honest!!), and some of it, from where I sit, has to do with different communication styles. Everyone sees things through their own set of lenses--it doesn't make anyone right or wrong necessarily as long as respect is maintained. You guys have made it clear that you DO respect and care about each other.
There's a very complex conversation happening on this particular thread. It's important, my opinion only!, that we maintain a spirit of support even as we sometimes disagree or misunderstand, temporarily, what someone else is saying. It always seems to work itself out in the end. Again, the magic of SleepGuide. Like Mike says, "Bringing Power to the People". There IS a sense of lost power having a life-threatening illness of any kind, so I say more power to all of us, with all the respect and empathy we can muster. We ALL need it, if we're gonna get straight-up honest about it. I've found no better place to meet that need than here with all of you on SG.......
There you have the rambling of an old woman who's been there, done that, bought the t-shirt, and sold it in a garage sale. For 50 cents!!!!!!
Let's just keep on keepin' on, y'all. This is where it's at.
Susan McCord (:-p)
Rock Hinkle said:This is new to me. never before on sleepguide have any of my statements been so disliked. It has been fun. I have to go to a meeting on billing at the hospital, then I am going to start celebrating my birthday. have a great weekend everyone! I know I will. I wish all of you good health and an uneventful night's sleep.
I hope you are not worried about me and Rock Hinkle, 99. He and I go way back and couldn't get genuinely mad at each other if we had to. Rock is always begging me for a debate, so once in a while I humor him with one.
He is a good man.
Giving him a hard time just makes him better.
:-)
jeff
99 said:a lot of truth has been mentioned hear but please no bulling as i did start it all off as a genuine inquiry so as to better my education into OSA and not to cause arguments among friends who can help us in our hour of need. sometime we need something like this to get to the bottom of thing with our friends yes they are you friends also and they are truly remarkabe friends to have when problems arise let us solve them together for benefit of the many let us kiss and make up we are in this together
Mack, I find this kind of specific info VERY helpful in trying to conceptualize the multitude of apnea issues. I'm surprised and wondering what's up with the Asian population having a much higher % of apnea patients than other groups. Asians are most typically either slender or normal weight, rarely obese. What thoughts do you have about that?
Susan McCord
Mack D Jones, MD, SAAN said:Thomas,
Sleep apnea is a world wide problem. The incidence in Asians is 24%, Hispanics and Afro-Americans 15-16%, Caucasians 9%.
Dr Christian Guilleminault and coworkers at Standford have done tissue biopsies in the upper airways of patients with OSA and find evidence of neuromuscular pathology. In one of his first reports, I believe from the early 90's, he wasn't certain of the cause. Was it due to the trauma of longstanding vibrations from snoring or was there some as yet undetermined source of the pathology? More recent studies, show the same pathological changes again with no obvious cause. The trauma theory had fallen out of favor, if I remember correctly. So the cause is still unknown.
OSA, the result of pathological collapse of the tissues and musculature in what may already be an anatomically small upper airway, causes obesity and obesity narrows the airway even more. This magnifies the problem, i.e., OSA causes itself to get worse. Loosing the excess weight reduces the AHI, but rarely eliminates all apneas. There are a few cases reported in which the AHI is 0 after dropping to a normal BMI. The assumption here is that the obesity caused their OSA.
Why does OSA cause obesity? The sympathetic nervous systems surges (the "fight or fright mechanism") with each apnea results in elevated levels of many hormones including cortisol which drive the appetite center in the hypothalamus. There is a drop in leptin and a surge in ghrelin, both contributing over stimulation of the appetite center. Treat OSA and these hormone level drop and weight tends to be much easier to lose (some have found their weight drops without even trying).
Twenty percent of OSA patients in the US are not over weight nor obese presumably because of their genetic makeup (look at the Asians). You can be skinny and have an AHI of over 100. There is no fat surrounding the upper airway; there airways were made small and the collapsing tissues have no fat.
Loosing weight is simple. I've done it many times. It is calories in and calories out. One pound of fat contains 3500 calories. Metabolize or use up 3500 calories and you have lost one pound of fat. Because the strong drive for food is part of our instinctual brain located in the hypothalamus, hunger triggered by cortisol, etc., easily overrides the prefontal cortex's control center. But because we are rational and intelligent beings, we have found many inventive ways to overcome this hypothalamic over-stimulation. Portion control works for me. The bottom line: Stop going to the service station when your tank is full.
How do you explain OSA in dogs and cats? And who knows what other animals? I guess when we discover the cause in humans we will have the answer in animals or vice versa.
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