"please keep me updated about oximeters "
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When was sleep apnea first identified or reported?
Thomas Roger Williams posted this question to "articles" section instead of here, so reposting here:
"i want to know is this a western phenomina cause by poor diet?
and any interesting investigations as to why it is so previlent
and what can we do to prevent problems before they occur
is it cause by vitamin B deficency and the like"
"i want to know is this a western phenomina cause by poor diet?
and any interesting investigations as to why it is so previlent
and what can we do to prevent problems before they occur
is it cause by vitamin B deficency and the like"
Views: 152
Replies to This Discussion
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Permalink Reply by Jan on
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And wishing you a happy, healthy and fun birthday! It is all a learning experience :-) Enjoy!
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.
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Permalink Reply by Mack D Jones, MD, SAAN on
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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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Permalink Reply by RockRpsgt on
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Thank you Judy. Yeah 99, jnk and I our fine. I love that man. He is sexy when he talks sleep. This was one of our better debates. It is hard to find things to debate over when you agree on almost everything. You had some friends this time jnk.
For the record I did make some bad decisions in my 20s. I let my body and my health go unchecked. My body was mine and many others palyground. It was not until I got into the medical field that I decided to be healthy. Now I am fighting apnea, my weight, and the backwards schedule of a sleep tech. My body is hormonoly crazy right now. I was a smoker for years. There are alot of factors working against us in the battle to be healthy. if you choose to be healthy keep fighting and eventually you will be. I'll get you next time you crazy New Yorker. Dr. Mack thank you for your input. Always a pleasure sleepguide.
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Permalink Reply by susan mccord on
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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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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.
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HAPPY BIRTHDAY AGAIN, ROCK! Is the Guitar Hero party in honor of your birthday???? Have fun!!!
McCord :-)
susan mccord said: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.
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:-) to you, Jeff.......
Susan McCord
j n k said: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
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Permalink Reply by Jerri Lynn on
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Not directed at anyone on here, but I abhor everything being blamed on obesity. However, I also believe that in the majority (note I said majority, not ALL) of obese individuals, the condition is a choice. I've weighed as much as 324 and as little as 140. I currently weigh 198 and am 5'9". I've been morbidly obese about 35% of my life, overweight about 35% and at a normal healthy weight about 30%. My highest weight was 11 months ago @ 324. I made the choice to lose. And most people can do the same. I did it alone and without any assistance. The motivating factor was fear of heart disease. As far as the OSA, I was told many years ago while in the hospital for a jugular blood clot, that they suspected sleep apnea because the nurse's would frequently find me not breathing normally. At that time I weighed about 150. I ignored them as it wasn't a concern to me at the time.
While I believe obesity can play a mitigating factor in many health conditions I also feel it's an easy way out for physicians to blame an individuals health disorders on obesity.
I have lots more to say but am in a hurry to meet up with some friends and family.
I LOVE THIS SITE AND THE PEOPLE ON IT......THANKS SO MUCH TO WHOMEVER STARTED IT!
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This is definately one of the grey areas of medicine jerri. My point in this conversation was to ignite a fire under some people. when we allow ourselves to become defined by our disorders we become complacent. In dealing with both of my parents ailments (brain cancer, and hep c) motivation was the key to their survival. Alot went into that motivation. First they got complacent. This complacency almost killed them both. I remember finding my father lost in his own yard thinking of suicide because he just went with the flow. Next I got them angry. I mean they hated the site of me. i was constantly in their faces, reading their reports, and making them go to their appointments. From this anger came motivation. At first it might have just been to get rid of me, but it soon turned into survival. Today both of my parents our healthy and will be attending my birthday party this evening. We did not allow them to be defined by their disorder, rather we defined and isolated their disorder. They won by not giving up. As did you Jerri. and susan, adn Judy, and Jan,and Vicki, and gordon, and even TIM. LOL He about shut me up!
Susan I do love a good debate. I do not always enjoy being the devils advocate though. Sometimes it has to be done so that we can see both sides of the coin. OK I like it a little.
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Oooooh! Rock. Sometimes you like it a little rough, do you? You naughty boy!! Tsk, tsk. *wicked grin*
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The only explanation I have read is that Asians tend to have small upper airways, but that doesn't really explain why the muscles collapse during sleep. Could it be that we all tend toward some degree of muscular relaxation during certain phases of sleep, but have no problem unless that relaxation occurs in an airway that is already too small and/or too narrow say, for example, from obesity.
Histological examinations have shown neuromuscular pathology within these muscles, but the cause has not been determined. One theory is that the trauma from snoring causes the pathology, but that leaves us to ask what caused the snoring, i.e., what caused the tissues to get loose and flabby in the first place? The last I heard is that heads are still being scratched.
susan mccord said: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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