Thank you to the crew of CityTV for a wonderful segment on Sleep and Sleep Apnea. A most special thanks to Dr. Alan Hoffman for taking the time away from his busy schedule to help us continue our efforts to educate our community about the different sleep disorders that people may suffer from. I hope everyone enjoys the link of the video segment below!
Guest Speakers: Dr. J.M. FitzGerald, Dr. S. Lam, Dr. S. Kwan, Dr. S. MacDonald, Ms. Maria Li, RRT
Sunday, Feb. 27, 2011
12 pm – 4 pm
Chinese Cultural Centre
50 E. Pender St., Vancouver BC
Well I’m sure that I can list 125 reasons why losing weight would be beneficial to all of us but I was inspired once again by another patient “BB” who lost 125 pounds and improved her Obstructive Sleep Apnea significantly. Her OSA has improved so much that there are no more traces of drop in her blood oxygen levels that would be of any cardiovascular risk. So is she “cured” of OSA, well I’m not one to make that conclusion and she would need further testing however I can say that I am so proud of her because using CPAP to improve her sleep quality and the way she feels upon waking is now a choice and not a necessity.
I’m sure there are many more people like her… imagine 2 people who I have known for years and who have struggled with moderate to severe OSA have all but received a clean bill of health with regards to their OSA. If that doesn’t inspire you, then nothing will. Losing 125 pounds is not easy for anybody and I personally would need to lose less than that to achieve an ideal weight and body mass index (BMI); that’s even more a reason why I know I can do this over a realistic time frame of a year.
Since starting this program I switched to using an Auto CPAP to track my trends for titrated* CPAP pressures and Apnea/ Hypopnea Indexes. I started with a 90th percentile pressure** of around 14 cmH2O and an AHI of around 2.5 events per hour. A recent download of my data has shown that my pressures have now been reduced to around 10.1 cmH2O and an AHI slightly elevated to 3.2 events per hour. More importantly , I feel just as good upon waking and I exhibit no sign of a degrading sleep quality.
If there was one change in my exercise routine that I had last week was that I had a personal training session. Let me tell you that was 1 hour of pure effort and exhaustion. If I was not motivated, I probably would’ve quit 20 minutes into it! Guess what I made it through. Even after days of aches and pains, I proved to myself that I’m getting there. Its the little achievements that’ll keep us going. Whether it be a lower CPAP pressure or survival of an extreme workout, at the end of the tunnel will always be “NO MORE OSA”
* Titrate: The adjusted pressure that is ideal for managing one’s OSA to keep the Apnea/ Hypopnea index below 5 events per hour.
** 90th Percentile Pressure: The CPAP pressure determined by an Auto-CPAP that will eliminate at least 90% of Apneas and/or Hypopneas over a period of time.
One the most interesting revelations throughout these past few weeks is how much the simple things around me has helped me cope with the challenges of this endeavor. For anyone who has tried to lose weight, you know it isn’t easy. Most of all it isn’t easy to stay motivated. Just as in my previous post regarding the holidays, there are obstacles everyday that impede my progress to achieve the ultimate goal. This past week, i was thrown another curve ball that I’m sure everyone faces at this time of year… I developed a cough and cold! Now that made it tough to just do my everyday tasks and made it even tougher to convince myself to go to the gym. The first thought I had was that it would be another reason to miss days and further push me behind in my program after the “holiday hiatus”. Guess what came to the rescue… the Nintendo Wii!
My kids had received the Wii and a game called the Wii Fit Plus from their grandmother as a Christmas gift. So here I sat sniffling and coughing away thinking, “I guess I gotta skip today” when out of boredom I thought of making a Mii character (this is what they call the character that you make to play the different games on the Wii). But the interesting thing was that the Wii Fit Plus game actually tries to make an accurate model of myself and asks to take measurements such as BMI and Weight that it will track daily and place on a graph. More importantly, it asks me to create a goal to achieve over a catered time frame. Sure enough the measurements indicated that I was “obese” and need to lose weight. Next it had some exercises to perform and estimates calorie consumption after the exercise is done; I did some of exercises or games and lets just say it got me going.
Since that day, I use the Wii to measure my progress instead of a scale just because it’s more visual and interactive. I don’t exercise on it much except to play with the kids but I gotta say the whole thing prevented me from slacking off that one day and the next day I was back on schedule. I’m not suggesting that everyone should get a Nintendo Wii, rather I think there are simple motivations around us, you just got to find one for yourself.
UPDATE: So how is my obstructive sleep apnea today? Well I’ve lost about 8% of my bodyweight in 1.5 months but more importantly I lost about 0.25 inches in my neck-size. This I feel is a great simple tool to gauge if there is any improvements to the severity of one obstructive sleep apnea; even more than BMI and Weight alone. As a resource for everyone, here is the formula for the adjusted neck circumference that can be used as a predictor for having OSA.
ANC = (Neck Size in centimeters) + (4 cm) if one has hypertension + (3 cm) if a habitual snorer + (3 cm) if you choke or gasp in the middle of the night
If your size is less than 43 cm you have a LOW probability, 43 to 48 cm you have an INTERMEDIATE probability, and if your ANC is greater than 48 cm you have a HIGH probability.
I was almost certain that starting this program before the holidays would give me ample time to set up a regimen that I could continue even with all the temptations that accompany the festivities of season. Let’s just say I didn’t do too well. Before our offices closed for the holidays on December 23rd, I lost a total of 14 pounds since I started the program. After coming back from a well deserved R&R, I gained 2.5 pounds back. YIKES! Maybe I was disappointed or frustrated but to be honest, I had no one to blame but myself. For the past 11 days, I went to the gym once! True I did some walking and if you consider chasing my kids around a workout than I was not a sedentary as I thought I was but the reality is that it just was not enough.
One thing I realized most through this experience is that it is times like this that can easily throw someone off track. I can even imagine some feeling frustrated enough to the point of giving up. Then I started thinking, there’s nothing wrong with enjoying the holiday season…temptations to rich foods, sweets, and other indulgence is part of life How boring life would be if we did not take these moments to have a little fun and break away from the norm (in my case the “new norm” being the program). So here’s my take on it, If I didn’t lose the weight to begin with, it would simply mean that I would’ve gained 2.5 pounds for the year. This way I still had a net loss of 11.5 pounds so I should be pleased with that… and I AM!
I finally went to the gym this evening and it was tough to even get there. But just like before, once I got started and got into rhythm, I actually felt great. I was pleasantly surprised that my endurance was not really compromised too much but I did notice that I could not get my heart rate as high during my elliptical step workout for 30 minutes. I just hope I don’t wake up sore in the morning because that’s always tough to get over for a few days.
Someone asked me to blog about my experiences more often so I certainly will try to do that. Especially when I have a significant experience both positive or negative that I can share with everyone. My new years resolution started last year and I’m glad to say that I think I am still on track. To the hundreds of followers, thanks for your support! You are all my greatest motivation. Happy New Year and until next time… have a good night’s sleep.
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