How Your Weight Affects Sleep Apnea

The general population often sees snoring as synonymous with sleep, undoubtedly because so many people experience it in one way or another. Snoring in adults is so common that some might not give it a second thought.

The truth is, snoring is the result of blockage in the upper respiratory pathways, which is indicative of a number of conditions of varying severity. If you or someone you know snores frequently, consider asking your doctor if you might suffer from sleep apnea.

Sleep expert Professor Dagmara Dimitriou says, “Snoring can cause frequent night wakings leading to poor sleep quality. It is well-established that sleep fragmentation is associated with poorer cognitive and behavioral functioning during the day. Thus increasing our understanding about sleep will be beneficial to our wellbeing and mental health status.”

Sleep apnea is a Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source common condition that affects a wide variety of people. It is estimated that over three million people a year report suffering from it. Sleep apnea affects a person’s ability to breathe normally while s/he sleeps.

There are two distinct types of sleep apnea, Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source less common is Central Sleep Apnea, or CSA, which is a neurological condition caused by miscommunication between the brain and respiratory system. Obstructive Sleep Apnea (OSA) is mechanical in nature and is caused by the physical blockage of airways when the body’s muscles relax during sleep.

Technically there’s also complex sleep apnea, which has symptoms of both central sleep apnea or obstructive sleep apnea. However, we will focus on OSA and how your body weight impacts it.

Obstructive sleep apnea and weight have been found to be intrinsically linked. Obstructive sleep apnea, sometimes shortened to OSA, is both the result and cause of excess body fat, which can lead to further complications and conditions associated with sleep apnea and obesity.

A study from the University of Wisconsin School of Medicine found that people who experience a small, 10% increase in weight are six times more likely to develop obstructive sleep apnea.  Conversely, weight loss has been proven to reduce or completely remove the effects of sleep apnea.

Are you drowsy/sleepy during the day? Do you snore loudly and frequently? Do you find yourself waking up multiple times throughout the night? Do you suffer from obesity or have you recently gained excess body weight?

If you say yes to these questions, you may be at risk for obstructive sleep apnea. This article will explore the link between body weight and sleep apnea, as well as the steps you can take to treat both issues.

About Obstructive Sleep Apnea

When you lay down to sleep and relax your muscles, excess pressure on your neck and chest can greatly restrict the flow of air through your upper airways. This is the underlying cause of OSA. In less severe cases, this can lead to snoring and slightly restless sleep. If the upper airways are completely obscured so no air is able to get through, the body will be forced to wake itself up to compensate for the lack of oxygen. Lapses in breath can last up to 10 seconds and occur up to 30 times per night in the worst cases.

These lapses cause a spike in blood pressure, only remedied when one wakes up and is able to breathe clearly again. Constant blood pressure fluctuations like this can lead to further complications like hypertension, heart disease and failure, stroke, diabetes, joint pain, and various mobility challenges.

The cycle of oxygen levels going up and down can trigger inflammation, potentially leading to atherosclerosis (a buildup of plaque in the blood vessels), which is connected to heart attacks, stroke, and high blood pressure. Obstructive sleep apnea makes a person wake up many times during the night, causing changes in the levels of oxygen and carbon dioxide in their blood. Both of these changes raise the risk of additional health problems.

Sleep medicine is a specialized field, focusing on the diagnosis and treatment of various sleep disorders, with particular attention to conditions like sleep apnea that can significantly impact an individual’s overall well-being. 

These are all conditions that are also associated with excess body weight and obesity. In a recent study related to this, Schwab discovered that ethnicity might influence how severe sleep apnea is. His research team compared the upper airway anatomy of Chinese and Icelandic patients with sleep apnea. They observed that, in comparison to Icelandic patients, there were differences in sleep apnea severity among the Chinese patients.

More directly, obstructive sleep apnea can lead to sleep deprivation. Since the body uses sleep to rest, recover, and reset, sufferers of sleep apnea may experience daytime drowsiness, depression, difficulty concentrating, and an appetite imbalance. This can potentially lead to excessive weight gain and further exacerbate the problem.

Obstructive sleep apnea in children can also occur and should be cause for increased concern due to the importance of sleep in a child’s development. It can be the result or cause of childhood obesity and lead to a lifetime of further complications including cardiovascular conditions and hormonal imbalances.

As a sleep disorder, obstructive sleep apnea is more common in men than in women. 4-5% of men report suffering from it compared to only 2-3% of women. 30% of the obese population suffers from OSA, compared to over 50% of the morbidly obese population. In addition, 60-90% of those who suffer from obstructive sleep apnea are obese.

While obesity is not a prerequisite for the condition, there is a well-established link between weight, obesity and sleep apnea. It should also be noted that the loss of weight has been found to reduce or completely cure the effects of sleep apnea signifying a direct correlation.

If you’re curious and want to know how to tell if you have sleep apnea, we recommend filling out one of these questionnaires:

• Epworth Sleepiness Scale test Verified Source Harvard Health Blog run by Harvard Medical School offering in-depth guides to better health and articles on medical breakthroughs. View source
• Berlin Sleep Questionnaire Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source
• STOP-BANG test Verified Source Harvard Health Blog run by Harvard Medical School offering in-depth guides to better health and articles on medical breakthroughs. View source

The results can help you decide if you need to ask your doctor about testing for sleep apnea.

How Your Weight Affects Sleep Apnea

Studies have directly linked sleep apnea as both a result and cause of excess body weight. Obesity leads to an increase in pharyngeal fat around the neck. Upon relaxation, pharyngeal fat presses down on the airways and greatly restricts or even prevents the back and forth movement of air when you breathe.

According to guidelines from the World Health Organization (WHO), if your body mass index (BMI) is ≥25, you’re considered overweight, and if it’s ≥30, you’re classified as obese. Following these criteria, the rates of overweight and obesity are very high, almost like reaching an epidemic.

This issue is compounded Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source by increased weight in the chest, which causes a similar effect in the lungs: the fat presses down and reduces the amount of air that can be taken in at a time. In tandem, these issues can result in the previously mentioned snoring and the reduction of oxygen intake.

Experimental evidence suggests that chronic oxidative stress caused by obesity might be linked to endothelial dysfunction and hypertension. Identifying diagnostic predictors for obesity-hypoventilation syndrome becomes crucial in patients with suspected sleep-disordered breathing. These predictors aid healthcare professionals in accurately assessing and addressing respiratory challenges associated with obesity and sleep disturbances. 

 

In a longitudinal study examining moderate weight change and sleep-disordered breathing, researchers tracked individuals over time to understand how even slight weight changes could impact sleep-related breathing issues. This comprehensive investigation sheds light on the long-term relationship between weight fluctuations and disturbances in breathing during sleep.

Obstructive sleep apnoea syndrome serves as a risk factor for hypertension. If the condition is severe, someone who suffers from sleep apnea will wake up during the night to balance oxygen and reduce blood pressure.

New research hints that the connection between excess weight and sleep apnea goes both ways. In a study from the Annals of Internal Medicine, they discovered that individuals diagnosed with obstructive sleep apnea gained about 16 pounds in the year before getting diagnosed, showing how excess weight can be a significant risk factor in both directions.

According to a study published by the American Medical Association, a mere 10% weight gain is linked to a six-fold increase in the risk of obstructive sleep apnea. Another study was conducted with 67 participants who were obese and had mild to severe obstructive sleep apnea (with a body mass index greater than 30.0) took part. They managed to shed almost 10 percent of their body weight, on average, in six months through diet or weight loss surgery. 

The overall sleep apnea scores of the participants improved by 31 percent following the weight loss intervention. Therefore, maintaining a healthy body weight , increasing physical activity, and a balanced diet with calorie restriction are crucial for patients with sleep apnea. 

Sleep apnea actively raises carbon dioxide and glucose levels in the blood, disturbs the nervous system controlling heartbeat and blood flow, increases insulin resistance, and changes the flow of oxygen and carbon dioxide which needs critical care medicine.

The resulting sleep deprivation causes an imbalance of hormones in the body, including those related to your appetite. When you sleep, your body releases hormones and chemicals to manage your appetite and weight. If this is disrupted by obstructive sleep apnea, you will feel less sated by food.

Sufferers of obstructive sleep apnea will find themselves eating more to compensate for the body’s lack of energy, which results in a vicious cycle of weight gain and the further complication of sleep apnea-related side effects. Moreover, having excess weight around the upper body (android obesity), particularly when there’s an increase in visceral fat, is more strongly connected to hypertension than having excess weight around the lower body (gynoid obesity).

There is much crossover between the side effects associated with obesity, weight gain and sleep apnea. Many of these are heart-related conditions: the most significant being high blood pressure, also known as hypertension. This is when the circumference of your arteries and the amount of blood your heart pumps increases and causes excess force on the artery walls, putting you at risk for stroke or heart attack.

Hypertension could also be indicative of metabolic syndrome, Verified Source American Heart Association (AHA) Funds cardiovascular medical research and promotes awareness about heart health. View source another disorder commonly found in sufferers of obstructive sleep apnea. Metabolic syndrome is an umbrella term that includes conditions such as high blood sugar, cholesterol imbalances, and an abnormally large waist, which also increases pressure on the lungs.

While it can be hard to initially lose and maintain a healthy weight while suffering from sleep apnea, the good news is that the benefits compound exponentially. Weight loss has been shown to improve the effects of obesity, of course, but also greatly reduce and even completely resolve obstructive sleep apnea. See also our guide to good sleep and weight loss.

Treating Sleep Apnea

The most common treatment for obstructive sleep apnea involves the use of a Continuous Positive Airway Pressure (CPAP) Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source machine. A CPAP machine forces air through your air passages and reduces or completely resolves obstructions to allow continuous, uninterrupted breathing.

There are reports of the use of CPAP machines resulting in Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source weight loss. While more research is needed to determine if and why this is the case, some OSA sufferers report a decrease in fat around the neck and chest—although no weight loss is directly attributed to the CPAP machine itself.

This positive effect is likely the result of the improved sleep granted by a CPAP machine. Verified Source Medline Plus Online resource offered by the National Library of Medicine and part of the National Institutes of Health. View source The reduction or resolution of sleep deprivation results in more balanced hormone and appetite levels in the body, making it easier to lose weight.

During adolescence, when the brain is undergoing vital growth and development, young adults require ample high-quality sleep to support this process. Insufficient sleep can negatively impact the growth of the hypothalamus, a brain region responsible for regulating appetite and energy expenditure. 

Weight loss reduces the risk of obstructive sleep apnea and its ensuing side effects. Much in the same way OSA causes a cycle of untreatable weight gain, treating OSA causes a positive snowball effect that reduces negative results of both the sleep apnea itself and effects related to obesity.

When most people gain weight, it happens all over, including the neck. Extra weight in this area can make your airway narrower when you lie down. The reduction of body fat in the chest and neck leads directly to better airflow while the associated muscles are relaxed during sleep. 

This will result in a fuller, more fulfilling night’s sleep, increased energy levels, better mood, and increased focus. Sleepers can tone their muscles in this are with mouth and throat exercises.

Weight may not be the only focus, though. For example, allergies and sleep apnea are often linked together, so you may need to treat allergies to relieve sleep apnea. Other lifestyle changes may need to be made for full relief.

In short, while the negative side effects of OSA and obesity are potentially severe, the benefits of treatment are significant and compound in a short time.

Frequently Asked Questions

Will losing weight help sleep apnea?

Losing weight is often recommended as a way to alleviate sleep apnea. For some people, shedding extra pounds can help their sleep apnea symptoms disappear completely. However, losing weight isn’t necessarily the only way to relieve sleep apnea, nor is it always helpful.

People with healthy body weights can still experience sleep apnea due to other factors. These sleepers should speak with their doctor about ways to manage their sleep apnea symptoms.

What are the warning signs of sleep apnea?

If you have sleep apnea, you’re likely to do more than just loudly snore. You may have moments where you stop breathing as you sleep, or you may suddenly wake up gasping and choking. It’s also worth noting that it’s possible to have sleep apnea and not snore, though the two do frequently overlap.

These symptoms can be difficult to spot on your own, so you may have to ask your partner to watch you sleep. Alternatively, you may find it easier to note the daytime effects of sleep apnea. People with sleep apnea often wake up with a headache, have difficulty concentrating and overall experience excessive daytime sleepiness.

Can I test myself for sleep apnea?

Yes, you can fill out the Epworth Sleepiness Scale test or the Berlin Sleep Questionnaire to gauge if you have sleep apnea. There’s also the STOP-BANG test, which consists of four yes-or-no questions about sleep apnea and four more questions to determine your risk of developing sleep apnea.

These evaluations are meant to help you determine if you need to seek a specialist’s help and cannot replace an official diagnosis. A sleep specialist may have you conduct an at-home test or they may arrange for you to spend a night in a sleep center to determine if you have sleep apnea.

What happens if sleep apnea is left untreated?

The effects of untreated sleep apnea can be long-lasting, primarily due to the way it prevents a person from fully recovering while they sleep. Untreated obstructive sleep apnea can lead to heart complications, overall increasing a person’s risk of death.

This is why it’s important to speak with your doctor if you suspect you have sleep apnea. It’s also essential to take steps to reduce the effects of sleep apnea once you have a diagnosis.

Is sleep apnea caused by weight?

While weight can be a factor when it comes to sleep apnea, the condition is not solely caused by obesity. It’s perfectly possible for a thin individual to experience sleep apnea and feel fatigued the next morning. Aside from weight, other risk factors for sleep apnea include aging, a narrow airway, diabetes, hypertension, asthma, and chronic nasal congestion.

Conclusion

Next time your friend or partner complains about your loud snoring, it’s best not to laugh it off as a common side effect of sleeping that everyone experiences! It could be indicative of obstructive sleep apnea, a potentially severe condition that affects your ability to breathe while you sleep. This can lead to further conditions including high blood pressure, stroke, heart attack, diabetes, and even affect your everyday performance with depression, anxiety, and daytime drowsiness.

If you think you may be affected by sleep apnea, keep a careful eye on your weight. Obesity can result in excess weight around the neck and chest, further increasing pressure on your upper airways and obscuring the smooth passage of air to your lungs.

The reduction of this will help you see huge improvements across your life. Typically, your sleep will improve and this will result in a more balanced appetite, increased focus and mood, higher energy levels, and low risk for the aforementioned cardiovascular conditions.

Talk to your doctor or primary care specialist if you think you may be suffering from obstructive sleep apnea. You could be just around the corner from the most satisfying night’s sleep you’ve had in a while.