With rates of life-threatening sleep apnea increasing, the American College of Physicians (ACP) has unveiled new guidelines stipulating that weight loss should be the first choice for relief, reported Medpage Today on September 23.
Highlights of the new guidelines include:
- After a patient is diagnosed with sleep apnea, physicians should first focus on weight loss to alleviate the condition.
- If weight loss does not suffice to relieve the problems, continuous positive airway pressure (CPAP) should be the first choice.
- As an alternative, mandibular advancement devices can be utilized.
ACP issued the new guidelines because of the increase in obstructive sleep apnea, which the guidelines link to "escalating obesity rates." Concerned that more people are apt to seek help, the organization determined that new guidelines were required.
Why the emphasis on dieting rather than devices? The guideline committee cited evidence that getting overweight and obese patients who have obstructive sleep apnea to lose weight is the key to "effectively reduce signs and symptoms of (obstructive sleep apnea) in obese patients with or without diabetes."
Among the symptoms of obstructive sleep apnea:
- apnea-hypopnea index (AHI)
- daytime sleepiness
- oxygen saturation.
The obvious question: What happens if the patient isn't overweight or if attempts to shed pounds fail? The committee recommends CPAP as the secondary choice.
As for surgery and medications, the committee feels neither is worth the risks. Drug therapies attempted in the past include mirtazapine (Remeron), xylometazoline and fluticasone (Flonase). As for surgical interventions, the inconsistent results made "it difficult to ascertain the benefit of surgery," the committee reported.
Learn more about the link between sleep and weight by using the links below: