Losing Weight Improves Sleep Apnea

The Simple Steps One Man Took to Reclaim His Health

Three years ago, Robert Sorin weighed 333 pounds. His wife was concerned he seemed to be walking around in a fog. Even after a few close calls driving, Bob refused to believe there was anything wrong. Undeterred, his wife brought him to HCGH to see pulmonologist and sleep specialist Carmen Salvaterra, M.D., who admitted Bob to the intensive care unit (ICU) where he was placed on a respirator and spent weeks recovering. Final Diagnosis: obesity hypoventilation syndrome and severe sleep apnea.

“Because of Bob’s obesity, he couldn’t breathe deeply. His abdominal fat was pushing up on his lungs making it difficult for him to take a deep breath,” says Dr. Salvaterra. “His ongoing hypoventilation caused him to chronically retain carbon dioxide. To make matters worse, he also had undiagnosed sleep apnea, which complicated his condition further. He was a very sick man.”

What is Sleep Apnea?

The National Sleep Foundation estimates that nearly 18 million Americans have sleep apnea, a condition often found in overweight people. According to Dr. Salvaterra, those with sleep apnea experience one or more pauses in breathing or shallow breaths while sleeping. These breath pauses can last several seconds to minutes and reoccur numerous times in an hour. In some cases, the brain’s only safety net for obtaining a normal breath is by waking the person up; this usually occurs with a loud snort or choking sound. The ongoing stress of repeated drops in oxygen and retention in CO2 is believed to be the explanation why sleep apnea is associated with an increased risk for stroke, heart failure, abnormal heart rhythms, mood disorder, and poorly controlled diabetes and hypertension.

Often patients with sleep apnea have problems with daytime sleepiness, fatigue, difficulty concentrating and increased irritability. Some patients complain of insomnia. “Having sleep apnea made me feel like I was drunk,” says Bob. “It isn’t so foggy that you pass out; your reactions just slow down. You think it is safe to drive but it isn’t.”

Embracing Change

“There is nothing like being in the ICU and almost dying to make you face reality,” says Bob. When I got out of the hospital, I had a sleep study and was prescribed a continuous positive airway pressure (CPAP) mask so I could get a good night’s sleep.  I also made lifestyle changes.” Bob had been overweight since he was 13 and had type 2 diabetes for decades. “All my diets had been compete successes and total failures at the same time. I lost weight and then gained it back plus some,” says Bob. But, for the two years after his diagnosis, he watched what he ate and exercised. He lost 155 pounds and has kept his weight down for the past year. He no longer has sleep apnea and is not diabetic.

What Worked

According to Bob, the following were vital to his weight-loss success:

  • Don’t lose weight too fast – it won’t last.
  • Explore new foods – I discovered it was fun to eat new things.
  • Get familiar with the spice rack – spices add great flavor without calories.
  • Exercise can be social – do it with friends.
  • Roast vegetables – My mother boiled veggies and ruined the taste for me. Cook them the right way, and you can eat a lot of them.
  • Exercise – cycle, yoga, lift weights, walk on Columbia’s pathways – they are free!
  • Teamwork – getting better is a team effort. I had ongoing help from a trainer, nutritionist, family and physician.

“The key is to find a way to enjoy the food and the workout,” notes Bob. “Discipline with me only goes so far. I have made things enjoyable. If they weren’t, I wouldn’t have made it this far.”

Seeking Treatment for a Sleep Disorder

Sleep specialists at the Johns Hopkins Center for Sleep, located on the HCGH campus, can diagnose and treat a wide range of sleep disorders in adults and children including sleep apnea, insomnia and restless legs syndrome.