Sleep Apnea and Obesity: How They Are Connected and What You Can Do About It

If you have trouble sleeping at night, you may be suffering from a condition called sleep apnea. Sleep apnea is a disorder that causes your breathing to stop and start repeatedly while you sleep, often causing loud snoring, gasping, or choking sounds. Sleep apnea can affect anyone, but it is more common in people who are overweight or obese.

In this article, we will explain how obesity can cause or worsen sleep apnea, what are the health risks of having both conditions and what you can do to improve your sleep quality and overall well-being.

What is Sleep Apnea?

Sleep apnea is a type of sleep-related breathing disorder that affects about 10% to 30% of adults in the United States. There are three main types of sleep apnea, but the most common type and the type that can be affected by obesity is obstructive sleep apnea, or OSA.

OSA occurs when the muscles in your throat relax too much during sleep, causing your airway to narrow or collapse. This prevents enough air from reaching your lungs, leading to low oxygen levels and high carbon dioxide levels in your blood. Your brain senses this imbalance and wakes you up briefly to restore normal breathing. This can happen hundreds of times per night, disrupting your sleep cycle and making you feel tired and groggy the next day.

Obesity and Sleep Apnea: How does weight impact OSA?

Obesity is a disease that affects your metabolism and body weight regulation. It is defined by having a body mass index (BMI) of 30 or higher. BMI is a measure of your body fat based on your height and weight. Obesity can increase your risk of developing many health problems, such as diabetes, high blood pressure, heart disease, cancer, and osteoarthritis.

Obesity is also a major risk factor for OSA, the most common type of sleep apnea. About 60% to 90% of adults with OSA are overweight or obese. There are several ways that excess body fat can contribute to OSA:

Fat deposits in your neck: When you have excess fat in your neck area, called pharyngeal fat, it can put pressure on your upper airway and make it more likely to collapse during sleep. This reduces the size of your airway and makes it harder for air to flow through it.

Fat deposits in your chest: When you have excess fat in your chest area, called visceral fat, it can compress your chest wall and reduce your lung volume. This means that you have less space for air to enter and exit your lungs, which lowers the airflow in your airway and makes it more prone to collapse during sleep.

Hormonal changes: When you have obesity, you may also have hormonal imbalances that affect your appetite, metabolism, inflammation, and stress levels. Some of these hormones, such as leptin and ghrelin, can also affect your breathing patterns during sleep. For example, leptin is a hormone that suppresses your appetite and stimulates your breathing. When you are obese, you may have leptin resistance, which means that your brain does not respond well to leptin signals. This can lead to overeating and reduced breathing during sleep.

What Are the Health Risks of Having Sleep Apnea and Obesity?

Having both sleep apnea and obesity can increase your risk of developing serious health complications that can affect your quality of life and shorten your lifespan. Some of these complications include:

Cardiovascular disease: Sleep apnea and obesity can both cause high blood pressure, which increases the strain on your heart and blood vessels. This can lead to heart attack, stroke, heart failure, arrhythmia, or sudden cardiac death.

Metabolic syndrome: Sleep apnea and obesity can both cause insulin resistance, which means that your cells do not respond well to insulin signals. Insulin is a hormone that helps regulate your blood sugar levels. When you have insulin resistance you may go on to develop type 2 diabetes.

Decreased quality of life: The combination of sleep apnea and obesity can lead to chronic fatigue, mood disorders, and reduced overall quality of life due to poor sleep quality and health-related concerns.

How are Sleep Apnea and Obesity Diagnosed?

If you suspect that you have sleep apnea or obesity, it is important to seek medical attention as soon as possible. Here are some of the ways that these conditions can be diagnosed:

Sleep apnea:

The most definitive way to diagnose sleep apnea is by undergoing a sleep study, which is a test that records your breathing, heart rate, oxygen levels, and brain activity during sleep. A sleep study can be done in a specialized sleep center or at home with a portable device, like the Lofta at home sleep test. The results of the sleep study will determine the type and severity of your sleep apnea, and the best treatment options for you.

Obesity:

The most common way to diagnose obesity is by calculating your BMI, which can be done by using a simple online calculator or by measuring your weight and height. You can also consult a sleep apnea bmi chart. However, BMI is not always accurate, as it does not take into account your muscle mass, body fat distribution, or other factors that can affect your health. Therefore, it is also recommended to measure your waist circumference, which can indicate the amount of visceral fat around your organs. A waist circumference of more than 40 inches for men and 35 inches for women is considered high risk for obesity-related health problems. Additionally, you may also undergo some blood tests to check your cholesterol, blood sugar, and other markers of metabolic health.

How can obesity and sleep apnea be treated?

Addressing sleep apnea and obesity requires a multifaceted approach that includes lifestyle changes, medical interventions, and possibly surgical options:

Weight management: Losing weight is one of the most effective ways to reduce the severity of sleep apnea for overweight individuals. Even a modest weight loss can improve sleep quality and reduce the frequency of apnea events​​.

Continuous Positive Airway Pressure (CPAP): CPAP therapy remains the standard treatment for moderate to severe OSA. It involves wearing a mask that delivers continuous airflow to keep the airways open during sleep​​.

Learn more about CPAP therapy

Exercise and diet: Regular physical activity and a healthy diet can aid in weight loss and improve sleep apnea symptoms. Consultation with a dietician or a physical trainer may be beneficial​​.

Surgical options: In some cases, surgical interventions to remove or reduce tissue blocking the airway might be considered, especially for individuals who do not respond to CPAP therapy​​.

There are also positive lifestyle changes you can make to combat the impact of obesity and sleep apnea. For example, quitting smoking, avoiding alcohol and sedatives, and practicing good sleep hygiene are key strategies for improving sleep apnea symptoms and overall sleep quality.

Smoking can exacerbate sleep apnea by inflaming and irritating the airways, while also heightening the risk for cardiovascular diseases and cancer; thus, cessation improves breathing, blood pressure, and oxygen levels. Assistance from medical professionals or smoking cessation programs can support this process.

Alcohol and sedatives, by relaxing throat muscles and disrupting brain-controlled breathing, worsen apnea episodes and sleep quality, making it advisable to limit alcohol intake and use sedatives only under a doctor's guidance. Good sleep hygiene—maintaining a consistent sleep schedule, ensuring a sleep-conducive environment by minimizing noise and light, and avoiding caffeine and heavy meals before sleep—fosters better sleep, establishing a stable circadian rhythm and enhancing overall well-being.

Learn more about sleep hygiene

FAQs

Will sleep apnea go away if I lose weight?
Weight loss can significantly improve, and in some cases, eliminate sleep apnea symptoms, especially in cases of obstructive sleep apnea (OSA) where excess weight is a major contributing factor. While not everyone may completely overcome sleep apnea through weight loss alone, reducing body weight can decrease the severity of symptoms by reducing fat deposits around the neck and improving respiratory function. It's important to approach weight loss under medical supervision to ensure it's done safely and effectively.

What is the life expectancy with someone with sleep apnea?
Sleep apnea can impact life expectancy by increasing the risk of serious health conditions such as cardiovascular disease, hypertension, diabetes, and stroke. The degree to which life expectancy is affected depends on the severity of the sleep apnea, the individual's overall health, and the effectiveness of the treatment plan. Early diagnosis and effective management, including the use of CPAP therapy, lifestyle changes, and addressing underlying health issues, can significantly mitigate these risks and improve quality of life and potentially life expectancy.

What are three symptoms of sleep apnea?
Three common symptoms of sleep apnea include:

1. Loud snoring:While not everyone who snores has sleep apnea, loud and persistent snoring is a hallmark symptom, especially if it's accompanied by silent pauses, gasping, or choking sounds.

2. Excessive daytime sleepiness: Difficulty staying awake during the day, feeling unrefreshed after a full night's sleep, and unintentionally falling asleep during activities are indicators of the disrupted sleep patterns caused by sleep apnea.

3. Observed episodes of breathing cessation during sleep: Partners or family members may notice periods where the individual stops breathing for several seconds, often followed by a loud snort or choking sound as breathing resumes.

How long will it take to reverse damage from sleep apnea?
The time it takes to reverse damage from sleep apnea varies depending on the severity of the condition, how long it went untreated, and the individual's response to treatment. Some health improvements, such as reduced blood pressure and improved oxygen levels, can be seen relatively quickly after starting CPAP therapy or making lifestyle changes. However, reversing the long-term effects on cardiovascular health or cognitive function may take longer and depends on comprehensive management of both sleep apnea and any coexisting conditions. It's crucial to maintain ongoing treatment and follow-up care to manage symptoms and mitigate potential health impacts effectively.

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