How Weight Affects Sleep Apnea

Obstructive sleep apnea (OSA) affects 10% to 30% of adults in the U.S., and is caused by repeated blockage or collapse of the airway during sleep. Gaining weight or having obesity can raise the chance of developing OSA, and OSA symptoms may improve or get worse with changes in body weight. 

We explore the relationship between weight and sleep apnea, cover treatment options, and discuss lifestyle changes that may help improve the symptoms of obstructive sleep apnea.

The Relationship Between Sleep Apnea and Weight

Weight gain and obesity are major risk factors for developing obstructive sleep apnea, the most common breathing disorder linked to sleep in the U.S. In fact, as many as 90% of U.S. adults with OSA are also overweight.

Gaining weight can increase the size of the neck and the upper airway’s soft tissues, as fat builds up in the neck and throat. These enlarged tissues in the throat can restrict or block a person’s airway when they sleep, leading to pauses in breathing and sleep disruption. A narrowed airway also causes snoring, a familiar symptom of OSA.

Excessive weight gain also limits the lungs’ ability to take in air. Fat buildup in the chest and abdomen can put pressure on the structures surrounding the lungs, reducing the amount of air the lungs can hold. With less air passing through, the upper airway becomes more likely to collapse.

Additionally, weight gain and obesity may make obstructive sleep apnea symptoms worse for people who have already been diagnosed with the condition.

Does Sleep Apnea Cause Weight Gain?

While experts recognize that weight gain increases the risk of obstructive sleep apnea, some researchers believe that OSA may in turn cause weight gain. This could be due to the effect OSA has on a hormone called leptin. 

Leptin helps regulate fullness cues and how much people eat. Evidence suggests that people with obstructive sleep apnea have high levels of leptin and are more prone to leptin resistance. People with leptin resistance are less likely to feel full after eating, which leads them to eat excessively and gain weight. 

One of the most common types of treatment for OSA, continuous positive airway pressure (CPAP) therapy, may also cause weight gain. Studies have not fully uncovered the reasons why this should be so, and some doctors report that individuals with OSA have lost weight after starting CPAP.

Regardless, because CPAP is effective at reducing the symptoms of obstructive sleep apnea, people should not discontinue the therapy without talking to their doctors first. 

The Risks of Sleep Apnea and Weight Gain

Excess weight, obesity, and untreated obstructive sleep apnea increase the risk of a range of other health issues, including:

• High blood pressure
• Cardiovascular disease
• Pulmonary hypertension
• Insulin resistance
• Type 2 diabetes
• Obesity hypoventilation syndrome
• Fatty liver disease

Obstructive sleep apnea can cause chronic sleep loss, leading to cognitive deficits such as memory loss, drowsiness, and impaired decision-making. Some people with sleep apnea are also at risk for mood disorders, nocturia, and decreased sex drive. 

Is Sleep Apnea Reversible With Weight Loss?

Losing weight may not completely reverse obstructive sleep apnea, but it can help relieve the symptoms. Weight loss can lower the number of breathing pauses a person with OSA experiences while asleep, which can also decrease daytime sleepiness. Losing weight may also reduce blood pressure and improve a person’s overall quality of life. 

The improvement in symptoms that weight loss can bring are surprisingly durable. Some people report that their symptoms remained improved for several years, despite regaining up to 50% of the weight they’d originally lost.

However, while weight loss effectively relieves symptoms in mild and moderate OSA, it is less effective in more severe cases.

Talk to Your Doctor About Your Options

Speak with your doctor early to prevent excess weight gain, decrease obstructive sleep apnea symptoms, and lower the risk of developing other health problems. Your doctor can provide information about the different treatment options for sleep apnea, as well as give you personalized advice for managing your weight.

Positive Airway Pressure (PAP) Therapy

After diagnosing OSA, your doctor may discuss positive airway pressure treatment. Because obstructive sleep apnea develops because of a narrow or blocked airway, PAP treatment uses air pressure to keep the airway open during sleep to reduce the symptoms of sleep apnea.

The two most common types of PAP therapy are continuous positive airway pressure (CPAP) and auto-adjusting positive airway pressure (APAP). These small machines deliver filtered air through a hose into a mask that covers the nose or both the nose and mouth. 

The goal of PAP therapy is to improve sleep and reduce daytime tiredness by decreasing the signs and symptoms of sleep apnea.

Lifestyle Changes for Sleep Apnea

Some lifestyle changes can potentially help sleep apnea. In combination with PAP therapy, these home remedies may help improve the symptoms of obstructive sleep apnea. 

• Sleep on your side: If you sleep on your back, consider side sleeping to keep your tongue from falling into your airway. 
• Elevate your head: Using extra pillows, a wedge pillow, or an adjustable mattress to raise your head can help keep your airway open.
• Avoid alcohol and sedatives: Before bedtime, reduce or avoid sedatives, including alcohol, since these substances can temporarily loosen your muscles and contribute to airway narrowing. 
• Get exercise regularly: Exercise combined with weight loss strategies like a healthy diet, drug therapy, or bariatric surgery can help improve sleep apnea, daytime sleepiness, and cardiovascular health.

Depending on your lifestyle and preferences, other sleep apnea treatments could include oral appliances or surgery. Your health care provider can discuss the best treatment for your individual needs and help you weigh the pros and cons of each option.