Understanding the Link Between Obesity and Sleep Apnea

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Obstructive sleep apnea (OSA) is a disorder that’s becoming increasingly prevalent around the globe, with approximately one in five people affected in the United States. One of the primary conditions linked to sleep apnea is obesity—along with type 2 diabetes, hypertension, and hypercholesterolemia. Research has shown that being obese increases the risk of developing several respiratory conditions, such as asthma, OSA, and obesity hypoventilation syndrome. 

By learning more about the relationship between obesity and sleep apnea, you can better understand your risks, as well as when to see a doctor about your quality of sleep and nighttime breathing. 

What is Obstructive Sleep Apnea?

There are several different types of sleep apnea, but obstructive sleep apnea is the most common. With OSA, an individual’s throat muscles intermittently relax while they sleep, causing the airway to become blocked. A person with OSA may stop and start breathing multiple times while sleeping and have low oxygen levels throughout the night 

Obesity is directly related to OSA because it can cause fat deposits to develop in the upper respiratory tract. These deposits narrow the airway and decrease muscle activity When this happens, the amount of oxygen available in the body for the tissues and blood vessels decreases—a condition called hypoxia, one of the main contributing factors of atherosclerosis (the primary risk factor for heart disease). 

What Are the Symptoms of Sleep Apnea?

It’s very common for patients with sleep apnea to snore loudly and experience excessive sleepiness throughout the day. While these are certainly unpleasant, the more concerning issue is that sleep apnea is linked to many other medical conditions, including high blood pressure, heart attack, and stroke. Other symptoms of obstructive sleep apnea include:

  • Periods of stopped breathing while sleeping
  • Waking up abruptly while gasping or choking
  • Morning headaches
  • Mood changes, like depression or irritability
  • Difficulty concentrating throughout the day
  • Decreased libido
  • High blood pressure

In some cases, you may not be aware of breathing issues while you sleep, so it’s important to talk to a doctor if your partner or other family members mention that you’re snoring loudly, gasping for air, or have other breathing disturbances throughout the night. 

Risk Factors for Sleep Apnea

There are a number of risk factors for developing sleep apnea, but the most important ones are related to age, sex, and weight. The risk of sleep apnea increases with age but generally tends to level off around the age of 60 or 70. Men are two to three times more likely of developing sleep apnea; however, the risk of sleep apnea goes up for women after menopause. Being obese (having a BMI of 30 or higher) also increases the risk. 

Other risk factors include

  • A naturally narrow airway
  • Enlarged tonsils or adenoids
  • High blood pressure 
  • Chronic nasal congestion
  • Smoking 
  • Diabetes
  • Asthma
  • A family history of sleep apnea

Neck and waist circumference, as well as waist-to-hip ratio, are also important considerations when assessing the risk of sleep apnea. A neck circumference of 17 inches or more for men and 16 inches or more for women, for example, raises the risk of both obesity and sleep apnea. The greater a person’s hip-to-waist ratio, the higher the chances of developing sleep apnea or other obesity-related health conditions. The way fat is distributed also plays a role; a high amount of fat in the abdomen is a greater risk factor than having a higher fat accumulation on the hips and thighs. 

Interestingly, it’s also thought that sleep apnea itself can cause weight gain, although no studies have proven this definitively. OSA increases the amount of leptin in the body, a hormone that’s responsible for helping the body recognize when it’s full. Nighttime breathing disruptions trigger the release of the stress hormone cortisol, which in turn affects the release of leptin. Over time, this can contribute to leptin resistance, which causes patients to feel less satiated and want to eat more. 

Another factor that can cause weight gain is the use of a continuous positive airway pressure (CPAP) machine, one of the most common treatments used for obstructive sleep apnea. Although it’s not clear why CPAP therapy causes some people to gain weight, many doctors believe the benefits of the treatment outweigh the risks. 

Treatment for Sleep Apnea

CPAP Machine

There are numerous treatments for obstructive sleep apnea, including oral devices, CPAP machines, and even surgery. However, many patients find the long-term use of CPAP machines and oral devices cumbersome and uncomfortable; likewise, many patients want to avoid more invasive treatments like jaw surgery or tissue removal. 

Fortunately, many lifestyle changes are very effective for milder cases of sleep apnea—and some of them have the benefit of also reducing weight. These include:

  • Maintaining a healthy weight
  • Regular exercise
  • Drinking alcohol moderately (if at all) and avoiding alcoholic drinks hours before going to bed
  • Quit smoking
  • Using a nasal decongestant or allergy medications
  • Sleeping on your side or stomach rather than your back
  • Avoiding sedatives, like anti-anxiety drugs or sleeping pills

If you’re overweight or obese, losing as little as 5-10% of your body weight has been shown to help reduce the severity of sleep apnea, and in some cases, prevent it from developing. Weight loss helps reduce breathing obstructions, improves blood pressure, and enhances overall health. 

Get Professional Guidance for Obstructive Sleep Apnea and Obesity

If you’ve been having trouble breathing at night or you struggle to maintain a healthy weight, you may benefit from a medical weight loss plan. Dr. Jennifer Hubert offers personalized weight loss plans that take a holistic approach to your health and weight loss challenges using behavior modification, nutritional counseling, and medical monitoring. Over the years, she has helped countless patients improve their health and overall sense of well-being through sustainable lifestyle changes. Schedule a consultation today at 707-575-THIN (8446)