Can losing weight help sleep apnea? – What we know and how best to do it
By Jason Wooden, PhD | September 6, 2022
As many as 40% of adult obstructive sleep apnea cases have been linked to weight. Studies show that losing as little as 10% of your body weight can improve sleep apnea symptoms. Other things to consider include lifestyle changes, avoiding alcohol and sedatives, seeing a doctor, and various other remedies.
1) Why you’re thinking weight loss
2) The link between sleep apnea and weight
3) Can weight loss REALLY help? (Answer)
4) How much weight do I need to lose?
5) Can sleep apnea cause weight gain?
6) Other causes for your sleep apnea
7) Weight loss tips for sleep apnea sufferers
8) Other things besides weight loss that can help
9) Why you should still see a doctor
Why you’re thinking weight loss for sleep apnea
Sleep apnea can leave you feeling miserable and desperate, so anything that can make it better is worth a look.
It’s a condition in which breathing is repeatedly interrupted while during sleep. As you become more oxygen deprived, your brain arouses you out of deep sleep into a lighter sleep to resume breathing.
Unfortunately, the loss of deep sleep means you’re missing out on the restful sleep your body needs to replenish and restore itself.
This is why you wake up feeling as if you haven’t slept at all…
And struggle with pounding headaches, extreme fatigue, poor focus, irritability, and all the other nagging symptoms of sleep apnea.
So, what’s got you thinking losing weight could help your sleep apnea?
Maybe you only started to notice sleep apnea symptoms after putting on some pounds…
Or perhaps you heard about it from someone you knew…
Regardless, you’re likely not the first to consider this. After all, sleep apnea is thought to affect to varying degrees somewhere around a billon people worldwide.
(Yes, you read that right.)
We’re going to take a look at what we know about the sleep apnea connection to weight and what you can do about it.
What’s the link between sleep apnea and weight?
It turns out there’s a strong connection between weight gain and obstructive sleep apnea (OSA), the most common sleep apnea type. It happens when air flow to the lungs is physically restricted because the muscles in the throat relax too much or there’s excessive tissue fat.
OSA is most common in patients who are overweight or obese.
In fact, results from the Wisconsin Sleep Cohort study suggest that as many as 41% of adult cases are linked to weight. One study found that even a 10% increase in weight was associated with a six-fold increase in OSA risk.
If you’re curious how the extra weight could trigger sleep apnea symptoms, it’s believed to result in fat deposits in the neck which can block the airway during sleep. Also, weight-related increases in abdominal girth is thought to compress the chest wall and decrease lung volume.
Based on this, it’s not too crazy to think that losing weight might make a difference
Can weight loss REALLY help sleep apnea?
So, now we finally get to what you really want to know, whether shedding pounds can really make a difference for sleep apnea sufferers.
It should be obvious by now that the answer is yes for people with obstructive sleep apnea.
One study tracked 2968 participants over a period of 5 years and found that modest changes in weight could lessen symptoms. Other studies have shown that putting patients on weight loss programs involving lifestyle and behavioral changes can improve symptoms.
Even losing tongue fat has been found to help some people.
Finally, if you’ve already started treatment with CPAP, weight loss can still make a big difference. A recent study in Spain found that overweight men with moderate or worse OSA had their symptoms significantly improved after an 8-week weight loss and lifestyle program. Even better, 45% of the participants in the intervention group no longer required CPAP therapy!
How much weight do I need to lose to help my sleep apnea?
It’s generally believed that losing as little as 10% of your body weight can help improve obstructive sleep apnea symptoms:
- A Penn Medicine study found that patients who loss around 10% of their body weight over 56 months had their symptom scores improve by 31%
- A 10-15% weight loss can reduce symptoms by 50% in moderately obese patients
In some cases, losing weight may even cure sleep apnea. I’ve already mentioned the study in Spain where some patients no longer needed their CPAP therapy.
Can sleep apnea cause you to gain weight?
Yes, evidence is growing that sleep apnea can cause weight gain. This shouldn’t be surprising what sleep apnea does to wreck your sleep and what poor sleep does to people.
For starters, you’re less likely to exercise due to low motivation. You’re also more tempted to eat unhealthy foods at the wrong time such as right before bed.
Also, sleep deprivation is associated with lower levels leptin, an appetite-suppressing hormone, and higher levels of ghrelin, an appetite-stimulating hormone. This can increase your cravings for calorie-dense foods.
So, if you’re not careful, you can get into a spiral where your weight gain is worsening your sleep apnea and your poor sleep is causing you to gain more weight.
Other reasons beside weight gain you have sleep apnea
Weight isn’t the only thing to think about. There could be other things at play causing or worsening sleep apnea symptoms.
After all, slender people get sleep apnea too.
Other risk factors and causes for sleep apnea include:
Anatomical features – a naturally narrower airway, enlarged adenoids or tonsils, and retruded jaw
Ethnic features – sleep apnea is more common African-Americans, Hispanics, and Pacific Islanders
Size – smaller build and more narrow airway in slender women may increase the risk
Athletes – may have thicker and more muscular necks
Alcohol, sedatives – they relax the muscles in the throat
Smoking – may irritate and inflame the airway
Allergies – you’re more likely develop sleep apnea if you have difficulties breathing through nose
Edema – excess fluid in the larynx from smoking, alcohol, or gastroesophageal reflux
Medical conditions – hypothyroidism, growth hormone irregularities
Other conditions – people who’ve had heart failure or a stroke are more at risk for central sleep apnea
Weight loss tips for sleep apnea sufferers
If you’re going to try losing weight to help your sleep apnea, there’s a right way and a wrong way to do things.
In general, for weight loss it’s recommended that you:
- Eat regular meals
- Plan your meals
- Cook your own food
- Choose grilling or baking over friend foods
- Avoid late meals
- Avoid frequent snacking
- Control your portions
- Avoid refined carbs and processed foods
- Increase your fruits and vegetables
- Limit snacks
- Stay hydrated
- Get more active
It’s also a good idea to work with a doctor, especially if you’re symptoms are serious and you’re dealing with other health complications. They can make sure your weight loss program is safe for you and refer to you a weight loss specialist.
How to Lose Weight and Keep It Off (HelpGuide.org)
29 Easy Ways to Lose Weight Naturally (Healthline)
7 Steps to Permanent Weight Loss (EatingWell)
Other things that will help your sleep apnea
Good news – there’s plenty of things you can do to help your sleep apnea since weight loss is only one piece of the recovery puzzle.
Many of the things you’ll find listed below are geared towards people with obstructive sleep apnea, since that’s the most common type. (You can learn more about your treatment options for central sleep apnea here.)
Some are pretty simple and quick to get going on, others will take time to bear fruit.
Among the things besides weight loss you can do to are:
1) Sleep hygiene
Your everyday habits can make or break sleep. Also, poor sleep hygiene can sabotage the other things you do to treat your sleep apnea.
For better sleep hygiene, you should:
- Wake up and go to bed at the same time every day
- Avoid large meals, alcohol, and stimulants such as caffeine before bedtime
- Maintain a bedtime routine
- Avoid electronics (TVs, tablets, smartphones) near bedtime
- Keep your bedroom dark, cool, quiet, & relaxing
3) Sleep on your side
Did you know that over half of obstructive sleep apnea sufferers have symptoms that are “position-dependent”? Their symptoms are worse if they sleep on their back.
Depending on the severity of your sleep apnea, sleeping on your side instead of your back may help keep your throat more open and improve symptoms. Some people even claim that sleeping upright in a recliner helps.
Besides helping with weight loss, physical activity is known to promote deeper sleep and there’s evidence it can help reduce sleep apnea breathing disruptions.
Figure out something that will work for your situation whether it’s swimming, bicycling, jogging, or getting out for a walk. If you’re dealing with other health issues, be sure to check with a doctor so you don’t overexert yourself.
5) Healthy eating
Eating healthier can help with weight loss and keep you from eating foods in the evening that may come back to wreck your sleep.
A low carb anti-inflammatory diet may also help since sleep apnea has been connected to inflammation. (Patients with obstructive sleep apnea, the most common sleep apnea type, have upper airway and systemic inflammation.)
Oral appliances are used to reposition the lower jaw and tongue so that the airway stays more open. They may work best for mild cases of sleep apnea.
7) Mouth and throat exercises
Various exercises using your mouth and throat may help strengthen your airway and surrounding muscles. This can help the airway stay more open and improve sleep apnea symptoms.
In fact, a recent study found that performing mouth exercises 3 times a day significantly reduced snoring and improved symptoms for patients with moderate OSA.
Mouth And Throat Exercises to Help Stop Snoring and Improve OSA (sleepfoundation.org)
Video: Throat exercises for snoring and sleep apnea
Why it’s still worth seeing a doctor
While losing weight can help sleep apnea, it may take a while and if your symptoms are pretty serious you need to get treated sooner rather than later. Untreated sleep apnea can increase your risk for serious life threatening health complications.
Also, weight gain my not be the only thing you’re dealing. Things like chronic pain, heartburn, asthma, and medications also can cause problems for sleep.
A doctor can check for other underlying health issues, other sleep apnea risks factors, and make sure you’re doing the right things to get your sleep apnea under control.
You may also be interested in:
Is sleep apnea bad? – 5 ways it can wreck your life
Does sleep apnea reduce life expectancy?
Does sleep apnea get worse over time?
Yes, skinny women get sleep apnea too
More treatment options:
9 Things to try to treat sleep apnea yourself
The Latest Sleep Apnea Devices and Treatment Options ( Complete List)
Can acupuncture help sleep apnea?
Can sleep counseling help sleep apnea?
Sleeping upright with sleep apnea – What we know and 3 things to try
Foods that help sleep apnea – 5 to try for better sleep
1. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis, Lancet Respir Med. 2019 Aug; 7(8): 687–698.
2. How Weight Affects Sleep Apnea, 2022, sleepfoundation.org
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4. Longitudinal Study of Moderate Weight Change and Sleep-Disordered Breathing. JAMA. 2000;284(23):3015-3021.
5. Progression and regression of sleep-disordered breathing with changes in weight: the Sleep Heart Health Study. Arch Intern Med. 2005 Nov 14;165(20):2408-13.
6. Losing Tongue Fat Improves Sleep Apnea, 2020, Penn Medicine News
7. Effect of an Interdisciplinary Weight Loss and Lifestyle Intervention on Obstructive Sleep Apnea Severity. JAMA Netw Open. 2022;5(4):e228212.
8. Weight loss, breathing devices still best for treating obstructive sleep apnea, 2013, Harvard Health Publishing
9. Why does sleep apnea cause weight gain?, resmed.com
10. Brief Communication: Sleep Curtailment in Healthy Young Men Is Associated with Decreased Leptin Levels, Elevated Ghrelin Levels, and Increased Hunger and Appetite. Ann Intern Med. 2004 Dec 7;141(11):846-50.
11. Obstructive sleep apnea syndrome in non-obese patients. Sleep and Breathing volume 26, pages 513–518 (2022)
12. 4 Reasons Why You Could Be Thin and Have Apnea, My Sleep Device
13. Weight Loss and Sleep Apnea, Am J Respir Crit Care Med Vol. 201, P5-P6, 2020
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