Are you living with sleep apnea or increased body size, or both? You may be wondering what the connection is between weight and sleep apnea. Does sleep apnea cause weight gain, or does weight gain cause sleep apnea? This page will give you the answers you need.
What is sleep apnea and how does it affect the body?
Sleep apnea is a common condition in which breathing repeatedly stops or becomes very shallow during sleep. Each of these pauses lasts at least 10 seconds, and often longer
There are two main types of sleep apnea, plus a third that combines features of both:
- Obstructive sleep apnea: Your airway becomes blocked or partially obstructed during sleep, which may be triggered by multiple factors and conditions. When most people think of sleep apnea, this is the type of apnea that comes to mind.
- Central sleep apnea: Your brain doesn’t send the signal that your body needs to tell you to keep breathing, which ultimately leads to apnea episodes.
SIDE NOTE: Exact estimates vary, but many studies suggest that approximately 25-30% of men and 9-17% of women in the US have obstructive sleep apnea.
If left untreated sleep apnea may lead to health changes that increase your risk of several issues occurring, such as:
- Type 2 diabetes
- Cardiovascular disease
- Extreme daytime fatigue
- Memory or concentration issues
- Higher risks of anxiety and depression
- Liver scarring and/or metabolic dysfunction–associated steatotic liver disease
The link between sleep apnea and weight gain
The biggest contributing factor to sleep apnea in relation to weight gain is the fact that it adds further soft tissue to your neck, walls of your throat, tongue, and/or soft palate, so that when you’re lying down (especially on your back), it’s easier for gravity to pull those tissues down, block your airway, and cause apnea episodes.
Additional body mass around your abdomen also makes it harder for your lungs to fully expand when you’re lying down, which makes airway collapses more easily occurring. Sleeping on your back adds to the risks of airway collapse, since your airway is more narrow in that position.
There are other ways that weight gain may impact conditions that also connect to or worsen sleep apnea symptoms, such as acid reflux, but researchers are still trying to determine exactly how much these conditions contribute/compound one another.
But weight isn’t the entire contributing factor here, because things like size and shape of your jaw, tongue, and airway are all inherited, which is why some people can develop sleep apnea without carrying any extra weight.
Getting poor-quality sleep at night is also known to trigger changes in your hormones, which can lead to further weight gain and, in turn, affect the severity of sleep apnea symptoms. This is because broken or poor-quality sleep affects hormones that control hunger/fullness, increase cortisol levels, as well as reduce insulin sensitivity – all of which can make it easier to gain weight.
Over time, this can lead to a vicious cycle where weight gain worsens your sleep apnea symptoms, and the disrupted nightly sleep makes it harder for you to manage your weight.
Can weight loss improve sleep apnea symptoms?
Yes, it can, but that doesn’t mean that it will.
This is very unique to each person: the specific reasons behind why they’re experiencing sleep apnea include many things like their family history, genetics, and biological factors.
Exact estimates vary between studies, but overall a decrease in body size often leads to a decrease in apnea-hypopnea index (AHI). A meta-analysis showed that a decrease of around 20% in body mass through weight loss was shown to reduce apnea-hypopnea index (AHI) numbers by around 57%. For most people, this means substantial improvements to the severity and/or frequency of their apnea episodes.
In some cases, losing weight may improve sleep apnea symptoms, due to the fact that tissues in the throat become less thick when body mass shrinks, reducing the opportunity for that to be the specific cause of sleep apnea episodes. However, the biggest benefits from weight management come in other areas of life, such as:
- Improved health goals
- Better cognition
- Reduced daytime fatigue
- Improved blood pressure
- Better sleep quality
- Mood improvements
These all play a role in shaping your daily quality of life, and together, these can help improve both your overall well-being and happiness.
Why is decreasing body size challenging for people with sleep apnea?
Genetic and biological factors play a huge role in the size and shape of our bodies, which is because increased weight is a chronic medical condition that frequently requires medical treatments.
It’s extremely important to remember that each person’s weight management and metabolic health journeys are going to be unique to them.
A weight management treatment that works wonders for one person’s health goals may not be helpful for someone else. This isn’t a personal fault; it’s a simple matter of the complicated science of our bodies.
The fatigue and disrupted sleep caused by sleep apnea can also affect metabolism and energy regulation, creating additional barriers to weight loss. The irony of this is that some studies show that aerobic exercises may help some patients reduce the severity of their sleep apnea.
Is sleep apnea reversible with weight loss?
Yes, it can be, but this is an infrequent scenario. There are many factors that lead to having sleep apnea, and certain conditions are associated with OSA (i.e., liver scarring, acid reflux, etc.), but these aren’t causes of sleep apnea. They’re conditions associated with OSA.
With that in mind, even without complete reversal of sleep apnea, decreasing body size frequently improves AHI. In fact, many studies have shown that weight changes have been able to help predict AHI changes over time, which may function as a gauge for apnea improvements.
How to know if sleep apnea is affecting your weight
Weight affecting your sleep apnea is not at likely as sleep apnea affecting your weight. While losing weight has been shown to reduce AHI, the impact of sleep apnea on weight is indirect, triggered by things like daytime fatigue, changes in appetite hormones, and/or reduced activity, which is not something that CPAP treatments can reliably reverse.
While the ability to pinpoint the cause of weight gain may be challenging, if you have a BMI of 30 or higher (or 27-30 and you’re living with weight-related health issues), you may be eligible to consider weight loss treatments to assist with reducing your overall body mass.
When this is the case, it’s time to involve your healthcare team for support and guidance.
When should I talk to my healthcare practitioner about sleep apnea?
If you have concerns about your sleep and are interested in seeing if sleep apnea may be affecting your health, then it’s time for you to contact a healthcare practitioner at Felix and have a virtual consultation with them.
They can assess your health and sleep concerns in order to determine if a sleep study or sleep apnea treatment is appropriate for you, so that you can start sleeping better and work towards your health goals.
With Felix in your corner, you can find the guidance and support you need to move towards your health and well-being goals, so you can get back to living life on your terms – the way it should be.
FAQs about sleep apnea and weight loss:
Why does sleep apnea cause weight gain?
Technically speaking, sleep apnea itself isn’t what causes weight gain. Most of the time, there are many different things that interact and lead to sleep apnea.
In fact, weight gain is more likely to cause sleep apnea than vice versa. However, sleep apnea does often promote weight gain for some people through hormonal changes, increased cortisol, reduced physical activity, and metabolic alterations etc.
How do I know if sleep apnea is affecting my weight?
If you’ve noticed that as you’ve gained some weight over the last several months and that in tandem with this, your sleep patterns and daytime fatigue have been worse, or that you’ve been waking more throughout the night to use the bathroom, it could be time to talk to your healthcare practitioner about whether this could be related to your sleep apnea.
In some cases, this may include getting a sleep study performed and/or weight loss treatments that can aid you in reducing your size to assist with decreasing the frequency or severity of your apnea episodes.
REMEMBER: Without a sleep study, you will not be able to get a diagnosis for sleep apnea, so if you haven’t gotten a diagnosis yet, start by discussing a sleep study referral or assessment from your healthcare practitioner.
Many regions across Canada offer home sleep testing, but eligibility will be dependent on the patient, their location, as well as any medical comorbidities they’re experiencing.
