Study looks at how obesity, reflux, sleep apnea are linked

The Oklahoman
December 28, 2010
By Sonya Colberg
Copyright © 2010, The Oklahoma Publishing Company

Before he adopted the Darth Vader look, Roger Scott always felt tired and rather grumpy.

Little did he know that several factors had come together to create a battle of galactic proportions in his body. Scott had put on extra pounds over the years and had developed indigestion. His wife noticed that he snored.

“I thought I was sleeping eight hours a night, but the following day, I’d be really tired and irritable. I couldn’t figure out what was happening,” said the 56-year-old Oklahoma City resident.

Scott finally went in for a sleep study and learned he had obstructive sleep apnea, a disorder characterized by potentially life-threatening pauses in breathing while sleeping.

He stopped breathing 30 times per hour each night, the test showed.

“You sleep less than two minutes before you wake up again. It’s amazing,” Scott said.

At bedtime now, Scott and his wife and fellow sleep apnea sufferer, Terri, don special CPAP (continuous positive airway pressure) masks that cover much of the face and generate air pressure to keep the throat open during sleep to prevent pauses in breathing.

“We look like something out of ‘Star Wars,’ ” Scott said.

Lack of sleep affects ability to lose weight
He is participating in a new study on sleep apnea, indigestion and obesity coordinated by Kelly Shepherd, a research fellow from Australia, working in the sleep disorders division at the nonprofit Lynn Health Science Research Institute in Oklahoma City.

Shepherd said she is looking for more study participants in her effort to help people with sleep apnea.

“Many people think they just sleep badly and wake up feeling terrible the next day. Many don’t know why,” said Shepherd, 31.

Studies show obesity is the main cause of sleep apnea, primarily because obese people have larger tonsils and tongues which interfere with air flow during sleep. Obese people make up 70 percent of sleep apnea patients and about 40 percent of obese men and women have obstructive sleep apnea.

Shepherd said sleep apnea patients can stop breathing from five to 130 times per hour.

Scott said at times during the past five years he would practically fall asleep at stop signs and routinely fell asleep in front of the TV after work.

He now wears a pacemaker. He thinks he may have had years of damage caused by the undiagnosed disorder. Indeed, sleep apnea patients are at risk for heart attacks, car wrecks, depression and lost work productivity caused by daytime sleepiness.

“It’s incredibly underdiagnosed,” Shepherd said.

Sleep apnea strikes an estimated 20 percent of adults yet is diagnosed in only about 5 percent of adults in western countries, she said. Also, more sleep apnea sufferers have reflux problems complicating the situation.

Her work in Australia, focusing on indigestion or reflux and sleep apnea, put Shepherd in the spotlight and helped earn her invitation to the United States. She found three times more people with severe sleep apnea had reflux during sleep than those with mild sleep apnea.

Reflux during sleep is far more likely to result in long-term problems than reflux during the day because of decreased swallowing at night, she said. Reflux is linked to asthma and other respiratory disorders and esophageal carcinoma, which is often not detected until it has advanced to the incurable stage.

Scott encourages others to participate in the study or get a sleep analysis to help break the vicious cycle between sleep apnea, reflux and obesity.

“It makes a difference in your ability to lose weight. If you don’t get enough sleep, you’re tired, and the last thing you want to do is get up and get some exercise. Then you feel bad about yourself. Then you start nervous eating,” he said. “If you can get your sleep … you don’t sit around and eat chips and watch TV. You go walk the dog.”

He said now that he gets his sleep, he’s lost 20 pounds and is feeling much better. His wife has noticed.

“It made a huge difference in how gripey I was,” he said. “She wishes we’d done this a long time ago.”

Sleep apnea study
To be considered for participation in the Lynn institute sleep study conducted by Kelly Shepherd, call 447-8839 or go to Participants will receive $275 in compensation. Shepherd is looking for 60 people: 20 who are overweight and have sleep apnea, 20 who are overweight and have no sleep apnea and 20 people of normal weight who have sleep apnea.