Weight Loss and Sleep Apnea: What’s the Connection?

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Raj Dasgupta, MD

Maintaining a moderate weight is strongly linked to improved sleep apnea, according to research. Many doctors recommend this for individuals with the condition. A 2020 study in the Journal of Clinical Sleep Medicine supports this. Sleep apnea affects around 22 million Americans, causing breathing interruptions during sleep.

The most common type, obstructive sleep apnea, often relates to excess weight, with about 41% of cases in adults linked to it. This excess weight may lead to airway obstruction due to increased soft tissue, like tongue fat.

To learn more about weight’s impact on sleep apnea and treatment options, continue reading.

Why Excess Weight Causes Sleep Apnea

Weight Loss and Sleep Apnea

Sleep apnea, especially obstructive sleep apnea (OSA), is most common in overweight or obese individuals. Excess weight leads to fat deposits in the neck, known as pharyngeal fat, which can block the upper airway during relaxed sleep, causing snoring.

Moreover, increased abdominal fat can compress the chest wall, reducing lung volume and airflow during sleep, making airway collapse more likely. The risk of OSA rises with higher body mass index (BMI), with even a 10% weight gain associated with a six-fold increase in risk.

While other factors like enlarged tonsils, anatomical features, endocrine disorders, acid reflux, lung diseases, and heart problems can also contribute, overweight or obesity is a predominant factor, affecting roughly 60–90% of adults with OSA.

How Sleep Apnea Causes Weight Gain

Sleep apnea can lead to weight gain through various mechanisms:

  1. Increased Hunger: Lack of sleep can heighten hunger levels, leading to overeating, especially of calorie- and carb-dense foods, which can result in weight gain.

  2. Fatigue and Reduced Activity: Poor sleep quality can cause fatigue, reducing energy levels and motivation for physical activity and exercise. Lower mobility due to fatigue further hinders regular exercise routines.

  3. Impact on Adolescents: Insufficient sleep can particularly affect adolescents, disrupting crucial brain growth and development processes. This can lead to weight gain during this critical developmental stage.

  4. Hormonal Imbalance: Sleep apnea disrupts hormone levels, particularly leptin and ghrelin, which regulate appetite. Elevated leptin levels, along with potential resistance to it, can diminish the feeling of fullness after eating. Meanwhile, increased ghrelin levels can heighten hunger, leading to excessive calorie intake and weight gain.

Health Risks of Sleep Apnea and Excess Weight

Sleep apnea, exacerbated by excess weight, poses serious risks to cardiovascular, metabolic, and pulmonary health. Obese individuals face heightened dangers due to the compounding effects of obesity-related health issues.

  1. Cardiovascular Impact: Sleep apnea strains the cardiovascular system, causing oxygen supply disruptions that trigger increased blood pressure and heart rate. This cycle, repeated throughout the night, can lead to inflammation and atherosclerosis, increasing the risk of heart attacks, stroke, and hypertension.

  2. Metabolic Disruption: Sleep apnea disrupts blood glucose and carbon dioxide levels, impacts the nervous system’s control over heartbeat and blood flow, increases insulin resistance, and alters oxygen-carbon dioxide exchange. Consequently, it’s associated with hypertension, arrhythmias, heart failure, stroke, coronary heart disease, type 2 diabetes, and metabolic syndrome.

  3. Obesity Hypoventilation Syndrome (OHS): OHS often accompanies sleep apnea in obese individuals. Excess weight compresses the chest wall, impeding deep breathing. Nearly 90% of OHS patients also have sleep apnea. OHS can exacerbate cardiovascular issues and elevate the risk of death, particularly in severe cases.

Can Weight Loss Cure Sleep Apnea?

Lifestyle changes, particularly losing weight, are key in treating obstructive sleep apnea (OSA). Shedding excess weight reduces fatty deposits around the neck and tongue, improving airflow and reducing the likelihood of airway collapse during sleep.

It also alleviates OSA symptoms like daytime sleepiness and neuropsychiatric issues, while enhancing cardiovascular health and overall quality of life. Although weight loss may not fully cure OSA, it can significantly lessen its severity.

Effective weight loss methods for OSA patients include dietary adjustments, increased physical activity, medications, and surgery. Behavioral modifications can be as effective as certain surgical procedures. Exercise alone can modestly improve OSA severity, even without substantial weight loss.

Regardless of the chosen approach, OSA improvement correlates with the amount of weight lost. Patients should consult with their doctor to determine the most suitable weight loss strategy based on their individual circumstances, overall health, and OSA severity.

Can Treating Sleep Apnea Help You Lose Weight?

Managing sleep apnea may aid weight loss efforts for some individuals. Studies indicate that levels of ghrelin, a hormone that stimulates appetite, normalize after using CPAP treatment for just two days.

However, long-term CPAP use has been linked to weight gain in some cases, though the reasons are uncertain and further research is needed. It’s essential for overweight patients to understand that relying solely on CPAP therapy or other sleep apnea treatments may not be sufficient for weight control due to the complex nature of weight management and sleep apnea treatment.

For mild cases of sleep apnea, you may use some anti-snoring devices or anti-snoring mouthpieces.

How Much Weight to Lose for Sleep Apnea Relief?

If you’re overweight and have sleep apnea, aiming to shed just 5-10% of your body weight can be beneficial, according to the American Thoracic Society. While this might not completely eliminate your sleep apnea, it can help manage symptoms and enhance your overall health. Discuss with your healthcare team to determine the best weight management approach for you.

Healthy Ways to Lose Weight

Weight loss methods vary for each individual. Sustainable weight loss involves finding the right combination of strategies tailored to your body. To address sleep apnea and improve overall health, consult a healthcare provider for personalized recommendations.

Some strategies that can aid weight loss and benefit sleep apnea include:

  1. Regular exercise
  2. Eating a balanced and healthy diet
  3. Quitting smoking
  4. Limiting alcohol intake

FAQs: Sleep Apnea and Weight Loss

1. Can maintaining a moderate weight cure my sleep apnea?

It varies. While early weight loss may cure mild sleep apnea in some cases, research suggests weight loss typically reduces its severity but doesn’t cure it on its own.

2. Is it harder for people with sleep apnea to lose weight?

Yes, studies suggest sleep apnea may predispose individuals to obesity due to the link between poor sleep quality and weight gain.

3. How much weight should I lose?

There’s no universal answer. Losing 5–10% of body weight may help, but a doctor may recommend a different amount based on individual factors like starting weight and co-existing conditions.

4. Should I consider weight loss surgery?

Weight loss surgery may improve sleep apnea in some severe obesity cases, but it’s not a guaranteed solution and carries risks. Not everyone is advised to undergo this procedure; doctors may suggest maintaining a moderate weight before considering surgery.

Need professional help to diagnose and address your sleep problems? Schedule an online consultation with sleep specialist Dr. Owen Napleton.

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