Tired all the time? Struggling to lose weight? You could have sleep apnoea — a condition that affects 9 per cent of women and 25 per cent of men. HFG helps you sleep tight.
We’ve all experienced a bad night’s sleep (or three!). You wake up feeling tired, struggle to concentrate at work and find yourself reaching for a sugar hit come 3pm.
If you feel like you eat more when you’re tired, you’re not imagining it. When you’re sleep deprived, your hunger and satiety (fullness) hormones are thrown out of balance, which drives you to eat more food. If this happens once in a blue moon, it’s no big deal— but if you’re constantly tired, it could be a reason behind unwanted weight gain.
More often than not, you’ll know what caused your restless slumber — perhaps you were mentally compiling tomorrow’s to-do list, nursing a crying bub, or being distracted by technology. But what if you can’t put your finger on it? Enter, sleep apnoea.
What is obstructive sleep apnoea?
Obstructive sleep apnoea (OSA) is a condition where your airways relax and close over while you’re asleep. This stops you breathing — and you don’t even realise it. These episodes can last a matter of seconds or for more than one minute, and can occur hundreds of times a night. They don’t always wake you up, but you do stir — and they can have some serious knock-on effects.
Firstly, you are unable to breathe, causing your oxygen levels to fall, which then creates a stress response in the body. Your heart rate and blood pressure rise, and you release the hormone adrenaline. Essentially, your body thinks that itis being suffocated.
If this happens many times a night, it can lead to tiredness, morning headaches, difficulty concentrating, memory issues and grumpiness — but that’s not all sleep apnoea does.
People with OSA are up to seven times more likely to develop heart disease, and they are two-and-a-half times more likely to have a car accident. OSA is also a risk factor for insulin resistance. It’s a serious health issue.
Calculate your risk
Do you snore loudly?
Do you regularly feel tired during the day?
Has anyone ever noticed that you stop breathing or gasp while you’re asleep?
Do you have high blood pressure?
Is your Body Mass Index (BMI) over 25?
Are you 50 or older?
Are you male?
If you’re male, is your neck circumference greater than 43cm? If you’re female, is your neck circumference greater than 41cm?
If you answered yes to two questions or less, your risk of OSA is low. If you answered yes to five or more, you’re at high risk.
How do you know if you have OSA?
The signs and symptoms of OSA can be subtle, especially in women. A typical sleep apnoea patient is described as an overweight middle-aged man who snores loudly and gets tired during the day. You can see why the condition is often overlooked in women.
Women often present with an unexplained fatigue and tiredness, headaches and lowered mood, as well as waking frequently overnight. Research also reveals that menopause greatly increases the risk of sleep apnoea.
One of the main causes of OSA is obesity, especially excess fat carried around the neck. Others include alcohol consumption, some medical conditions and certain medications. Sometimes it’s physical bone or muscle structure that’s the root of the problem.
Signs & symptoms
OSA can be tricky to diagnose — because the main symptoms occur when you’re asleep. Here’s what you should look out for:
Gasping for air when asleep
Waking up thirsty or with a dry throat
Excessive daytime sleepiness
High blood pressure
What’s the treatment?
The first port of call to treat OSA is usually lifestyle intervention. Weight loss is a top priority, along with cutting back on alcohol. That’s particularly important in the evening, as alcohol relaxes the muscles around the throat, which can contribute to apnoea. Quitting smoking is also beneficial, as smoking leads to fluid retention in the airways, which narrows them.
Sleeping on your side is recommended, too, as the effect of gravity can cause your tongue to block your airway when sleeping on your back.
Other interventions for OSA include a Continuous Positive Airway Pressure (CPAP) machine, or perhaps a specifically designed mouthguard. In extreme cases, surgery may be required.
If you suspect you have sleep apnoea, or if you have any related symptoms — even if you aren’t sure that you snore — speak to your GP for a referral to a sleep specialist for further investigation.
Real-life case study: Sleep apnoea
"Like many people with sleep apnoea, I didn’t know I had it.."
Dan, 53 from Sydney, lost 19kg
Although sleep apnoea can stop you breathing, it doesn’t actually wake you up at night. I was at my GP’s for an annual check-up, when, perhaps because of my weight and age, he suggested this was one of the tests I should take — even though I didn’t display the usual sleep apnoea symptoms of drowsiness during the day.
The doctor referred me to a local sleep apnoea centre for a sleep study test. I had the choice either of staying overnight in hospital, or hooking up the eight or so ‘bells and whistles’ myself to my face and upper body at home one night. I chose the cheaper DIY option. A few weeks later the clinic rang me with the results. Five or less apnoea ‘events’ (which includes breathing cessation and airway narrowing) an hour is normal. Over 30 events is severe. I had 37.
The clinic proposed that I trial one of their CPAP (Continuous Positive Air Pressure) machines, with a view to buying one for approximately $3000.
I asked if weight loss would also fight sleep apnoea. They said it could, but the machine was clearly their preferred solution. I was sitting around 95kg, so I decided to lose weight and trial the machine.
The CPAP machine — about the size of a school bag — sits at the side of your bed and plugs into the wall. A tube connects to a mask you place over your mouth and/or nose, and it blasts air down your throat all night to keep your air passage open and prevent apnoeas. It’s not for everyone — approximately 50 per cent of those who try the machines give them up — and after three months I decided it wasn’t for me. If anything, the machine was stressing me out, making it harder to sleep!
However, I did decide to persevere with my weight loss goal. I already exercised a fair bit, so I concentrated on healthy eating. For me it was mainly low-GI foods. I start the day with rolled oats and blueberries, and to avoid hunger pangs during the day I snack on mixed nuts, raw carrots, and fruit. Lunch is mainly salads, vego meals, or a small chicken and salad multigrain wrap. For dinner I have salad and salmon, with plain yoghurt and berries for dessert. Plus a small piece of dark choc or a hot chocolate for supper. I hardly ever feel hungry or deprived. And I’ve cut right back on bread, beer and weekend takeaways.
The result? I’ve dropped 19kg in six months, which is good for my health on every possible level. Is my sleep apnoea getting better?
Every instinct says yes, but I won’t know for sure until I do a second home test in a few months’ time. Regardless of that result, do I feel fitter and healthier? You bet!
5 tips to lose weight, sleep better!
Keeping portions in check is key for successful weight management. Around 6300kJ (or 1500cal) per day is recommended for the average adult seeking to lose weight. Smaller plates, bowls and cups can help reduce portion sizes.
Alcohol, soft drink and juice contribute a significant amount of kilojoules to your diet, which can lead to weight gain over time. A glass of wine, for example, has 590kJ (140cal), and a 600ml bottle of soft drink has 1048kJ (251cal). It pays to make the switch to water!
Rather than sticking with the traditional meat-heavy way of eating, it’s time to shift the focus to vegies. That doesn’t mean you have to cut out meat altogether. Instead, make plant foods— such as colourful veg, beans and legumes — the main event.
There’s no need to eliminate carbohydrates to lose weight. Aim to swap refined, processed carbs for sensible portions of high-fibre, slow-burning carbs. That might be half a cup of rolled oats at breakfast, or a slice or two of wholegrain bread as part of your sandwich for lunch. Most highly refined carbs, like cake and hot chips, are loaded with added sugar and fat — and when they are consumed in excess, can lead to weight gain.
Being physically active helps you burn calories, build muscle, and speed up your metabolism. So, start small with an activity you enjoy, like walking or swimming, then build up your fitness.
Improve your sleep routine
Whether you have sleep apnoea or not, try these five relaxing tips to help you get a better night’s sleep and boost your energy levels!
Set yourself a regular sleep and wake time.
Dedicate the bedroom to sleeping and intimacy only. Studying, working and watching TV should be done in another room.
Put away your phone, power down your laptop and turn the TV off at least one hour before bedtime. Take the time to relax and unwind.
Eat dinner at least two hours before you go to bed, so you don’t go to sleep weighed down with a full stomach.
If you’re not asleep in 20 minutes, leave your bedroom and spend quiet time in another room. Return to your bed once you feel tired.
What does apnoea mean? A complete cessation of breathing, often lasting 10 seconds or longer
Melissa is an Accredited Practising Dietitian with a love of healthy, delicious food. She is passionate about helping others to lead healthier lives and teaching people to use nutrition to better their health.