One of the questions we get asked the most here at Alaska Sleep Clinic is how weight contributes to sleep apnea.
Because weight is one of the biggest contributors to sleep apnea, and one of the most frequently cited risk factors for developing the condition, we decided to delve into the relationship between sleep apnea and weight, as well as whether weight gain can worsen the condition, and weight loss can reduce it.
Sleep Apnea and Weight
There are many contributing factors to obstructive sleep apnea including age, smoking, alcohol consumption, anatomical hereditary features (thick neck, round face, narrow airway, etc.), and even enlarged tonsils or adenoids. However, of all the contributing causes, an individuals weight is often the most likely contributing factor.
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which either the throat muscles collapse, the tongue falls back into the airway, or enlarged tonsils and/or adenoids impede air flow. When the airway becomes cutoff, the brain has to wake itself to signal the respiratory system to kick back into gear. This often leads to breathing resuming with loud gasps, snorts, or body jerks that may wake you from your slumber and disrupt your sleep.
Patients who are overweight or obese are much more likely to have sleep apnea than patients maintaining a healthy body weight. In the adult population the prevalence of OSA is roughly 25% of the population, but can be as high as 45% in overweight or obese patients. Men with neck circumferences greater than 17 inches, and women with neck circumferences greater than 16 inches are at higher risk for having OSA.
Overweight and obese patients are more likely to have excessive fatty tissues found throughout the body including the throat. These soft, fatty tissues can make the airway narrower, and when the patient is sleeping, these soft tissues collapse more readily into the airway and impede or pinch-off airflow leading to apnea events.
Can weight loss improve sleep apnea?
We always encourage our patients to lose weight while they are on CPAP therapy to treat their sleep apnea. For patients with sleep apnea, weight loss sometimes, but not always, results in a complete resolution of the disorder. However, even though a patient's sleep apnea probably won't go away entirely, it can lead to lower pressure settings, which can make CPAP therapy much more tolerable.
On the other side of the coin, increased weight gain can also lead to needing higher pressure settings, which can make CPAP therapy more difficult to tolerate. The more tissues found in the throat impeding airflow, the higher the pressure needed to keep these tissues from collapsing into the airway. High pressure settings is often one of the most cited reasons patients abandon CPAP therapy altogether, which can be detrimental to their overall health.
Both sleep apnea and obesity share many common health risks including high blood pressure, coronary heart disease, stroke, diabetes, heart attack, heart failure, and decreased quality of life. Losing weight not only improves tolerable pressure of a CPAP device, but also reduces patient risk for severe health conditions.
Patients with untreated sleep apnea often find themselves in a vicious cycle:
Poor sleep caused by sleep apnea, leads to decreased energy during the day, which in turn leads to a more sedentary lifestyle devoid of healthy activities and exercise.
Decreased quality of sleep also contributes to unhealthy food cravings for sugary foods and foods high in carbohydrates.
Untreated OSA decreases metabolism making weight loss more difficult.
Patients who find themselves using CPAP therapy to treat sleep apnea get better quality sleep at night. This in turn leads to higher energy levels during the day, making exercise to reduce their weight much easier to perform. Patients who continue to maintain healthy lifestyle choices can end up with less apnea events each night leading to lower pressure settings on their CPAP, or even become candidates for dental appliances used in treating sleep apnea patients with mild to moderate symptoms.
If you believe that you may have sleep apnea, and are ready to get proactive about it. Contact The Alaska Sleep Clinic by clicking the link below, and a sleep educator will contact you for a free 10-minute phone consultation to discuss your symptoms and determine if a sleep study is right for you.