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The Sleep Side of Weight Loss: CPAP Therapy on The Biggest Loser Helped Me Shed the Pounds

How do you go from 374 pounds to 191 pounds in just four months? For me, sleep apnea treatment was a secret weapon that worked. When I was a contestant on Season Nine of The Biggest Loser®, I had the opportunity to have a sleep test and receive treatment for sleep apnea. But my own personal journey with the sleep side of weight loss started many, many years ago when I was a six-year-old girl whose mother had to watch her sleep every night to make sure she kept breathing. My stomach would rise and fall, but there would be long periods of time when I stopped breathing at night.

posingThe Biggest Loser host Alison Sweeney (left) strikes a pose with Season Nine Contestant Ashley Johnston.

The doctor had my mother sit up with a stopwatch and time me night after night to see how long those pauses in breathing lasted. He told her he would do something about the situation if I stopped breathing for one minute straight. My mom finally told him that was just ridiculous. Even a few seconds was too long for a child to go without taking a breath. She took me to another doctor, who immediately scheduled a surgery for me to have my adenoids and tonsils removed.

At the time, we felt like that helped. My growth had been stunted earlier in my childhood, but after the surgery, I started growing. Soon I was a chubby kid. Although I swam on the swim team, I didn’t play other sports; and being from the South—we lived in Knoxville, TN—we didn’t have the healthiest diet either. My mom would sometimes make us fried bologna bowls for breakfast, with cheese in the middle. My mother and father were overweight, as well. I came from an obese family.

My father developed melanoma skin cancer when I was 15 and passed away when I was 16. By that time, I was about a size 14–16. I looked overweight for my age, and that affected me in such a hard way. But I didn’t know how to deal with the loss of my dad, so I turned to food. I was an emotional eater. I wanted that comfort, all those carbohydrates that make you kind of sleepy when you get full. I didn’t realize it at the time, but I used that feeling of fullness to cope.

I also branched away from my family and became a party girl. I was trying to find anything I could to help fix the pain within me. I smoked for 11 years on top of everything else. I guess I thought I was invincible. I was eating fast food several times a day. I was staying out late at night with my friends, drinking and living a really dangerous lifestyle. Then I was eating more fast food at three in the morning and then going to sleep—or trying to. I wasn’t sleeping well either. It was like a giant puzzle, and none of the pieces were fitting together.

Ultimately, I ended up weighing 374 pounds and wearing a size 26–28. I could not buckle the seatbelt in my car or sit behind a booth in a restaurant. I would be just sitting on the couch and people would ask me, “Are you OK?” I’d say, “Sure, I’m fine,” and they’d say, “You’re breathing really heavy.”

I was also waking up in the middle of the night unable to catch my breath, and waking up in the mornings with really bad headaches. I didn’t have health insurance at the time, but my mom went to the doctor and asked him if there was anything he could do for me. He ordered a sleep test, and the results showed I had severe sleep apnea. He gave me a donated CPAP machine, but I didn’t receive any instruction on how to use it or any follow-up care. Basically, I went down, picked it up at the office, and they sent me on my way. I had to figure it out for myself.

Unfortunately, the machine was like a dinosaur. It was so loud. I used it for a couple of nights, but it didn’t work for me. Even though I knew I had severe sleep apnea and this machine could save my life, without any instruction or follow-up care, I still could not figure out how to use it properly and make it work in my life.

So, I ended up waking up night after night with the same problems and being tired in the mornings. I was managing an Aveda Spa at the time, and I would find myself falling asleep while I was giving facials. It was very difficult for me to stay awake during normal business hours. It all led to a really poor level of happiness with my life.

A good wake-up call for me came when I woke up one night and honestly had the worst sleep apnea attack I had ever had. I really thought I was having a heart attack. I woke up my mom and told her I thought I needed to go to the hospital. When I finally calmed down, I realized my weight was not just making it hard to fit into cute clothes at the mall or buckle my seatbelt — it was affecting my health. The weight was going to kill me if I didn’t make a change.

I’d been watching The Biggest Loser since Season Three, and I had always wanted to have that moment of busting through that paper and getting my life back. So I looked it up online and got all the information about how to make an audition video. Then I approached my mom and told her I wanted her to do it with me.

After a lot of hard work, there we were, having a weigh-in in downtown Knoxville in front of a large crowd in a sports bra. That was day one. People asked, “How could you appear in a sports bra on national television? Isn’t that so embarrassing?” The answer is, yes, it was awful. But it was also freeing to finally say, “This is the issue, and this isn’t going to happen again. I’m not going to be 374 pounds again. From this point on, my life will be different.”

When we got to the Ranch, we got a real sleep test. Most of the contestants were found to have sleep apnea and, I, of course, still had severe sleep apnea. They brought out our brand new CPAP machines and my first thought was: “Well, OK, here we go again—I’m going to have to use this thing.” But I was excited, too, because I knew it was time for me to start being responsible for my life, and that included my health. I still looked at it as a huge puzzle, and treating my sleep apnea was a huge piece of the puzzle. I knew I couldn’t lose weight without using CPAP because I realized how they were both affecting my health.

cpapAshley and her mom, Sherry, called CPAP their “secret weapon” during the show for its ability to give them the good nights sleep they needed to exercise during the day.

The first night I put it on I slept pretty good. In the beginning I ripped it off a few times in my sleep. It took me a little while to get used to it. But even though the hours I wore it that first night were limited, the next morning I felt like a whole new person. Still 374 pounds—but it was the first good night’s sleep I’d had in 28 years. I felt like I was ready to go to the gym right then. But what followed was a 26-mile ride on a stationary bike. Thank goodness I had the CPAP machine before that event.

As contestants on The Biggest Loser, we have everything we need to maximize our weight loss. We have organic food and nutritionists, and, of course, our trainers. We also have regular follow-up care for our sleep apnea from respiratory therapists who come to the Ranch on a regular basis to see how we are doing and help us with any problems we might be having.

One thing the RTs stressed was the need to be compliant with our CPAP every night, all night. My mother and I were always compliant. In fact, she always won the “CPAP monkey”—a little prize they gave out to the contestant who wore the CPAP the longest—because she was compliant and also because she went to bed a lot earlier than some of the rest of us, myself included.

However, there were many people in the house who were not compliant, and we started noticing how that was affecting the weigh-ins. We started figuring out, yes, we are all working out eight hours a day, we’re burning 6,000 calories. We’re counting every single calorie we put into our bodies. We are doing everything we possibly can. But some people were not using their CPAP and that appeared to be affecting them on the scale. So my mother and I started viewing CPAP as our secret weapon, and that redoubled our resolve to be compliant with the therapy.

cookingAshley and her mom learned healthy eating habits on the show.

Of course, I can’t say that using CPAP is going to help with weight loss. We can’t prove that. But from my personal experience, having the CPAP was a tool to help me lose the weight. I had more energy for those six-to-eight hour-a-day workouts. If I had been in the state I was in before I used the CPAP, working out that long would have been impossible.

There is so much that goes into weight loss. The exercise and nutrition are vital, and so is the mental side of it. That was certainly the case for me, because I had to understand all of the issues that got me to 374 pounds in the first place before I could make the changes I needed to make to lose 183 pounds by the end of the show and set the record for losing more weight than any other female contestant in The Biggest Loser history.

workoutEight-hour-a-day workouts were the norm on The Biggest Loser Ranch, according to Ashley, who spoke about sleep apnea at Congress.

Using my CPAP every night played a big role, as well. I know many people who lose a lot of weight are cured of their sleep apnea and no longer need the machine. That’s not the case for me. I think I’m just genetically made to require that assistance during sleep; and I’ve learned that when I do neglect to pack my CPAP when I travel, I feel the consequences. For me, CPAP is going to be a lifelong treatment.

I’ve made some huge changes in my life since my journey on The Biggest Loser began. I’ve run a marathon. I learned to surf. And I’m a more active, happy person. Treating my sleep apnea has been a big part of that journey, and it still is today.

NBC and “The Biggest Loser” do not endorse the facts, advice, or recommendations made or included in this article. It is a registered trademark and copyright of Reveille, LLC and NBC Studios, LLC. All rights reserved.

© 2014 American Association for Respiratory Care