Sleep Apnea and Body Weight

There are numerous influencers on the development of sleep apnea; although certain relationships are unclear, what is clear is that weight loss can help improve symptoms.
Sleep Apnea and Body Weight

Obstructive sleep apnea is found in two to three percent and four to five percent of middle-age women and men.1 As weight increases, so does the likelihood of having sleep apnea. In fact, according to one study, more than one third of obese and half-to-nearly all of morbidly obese adults have sleep apnea.1 While there are other risk factors such as aging and a small airway in the mouth and throat, obesity is a strong predictor for the development of sleep apnea. The good news is that weight loss can reduce the severity of the condition.

What is the relationship between obesity and sleep apnea?
With regard to obesity and sleep apnea it is unclear which condition leads to the other; does weight gain precede the development of sleep apnea or do the consequences of sleep apnea lead to weight gain?

Research has shown that excess weight can contribute to the development and worsening of sleep apnea. One reason is that as weight accumulates, fatty tissue can block air passage and weaken the muscles in the area. Sleep apnea can lead to weight gain because it causes sleep deprivation (for more information on weight and sleep deprivation, read the Science Center library article, Sleep and its Role in Weight Management) and daytime drowsiness. Tiredness can then result in excessive snacking or overeating and little to no desire to exercise, which can all contribute to weight gain.

Studies also suggest that sleep apnea affects the way the body breaks down glucose, therefore increasing the risk of developing type 2 diabetes2. Ultimately, further research is needed to evaluate the complex relationship between obesity, sleep apnea and diabetes.

Another area of active investigation is the link between inflammation, obesity and sleep apnea. Since elevated inflammatory levels are linked to both obesity and sleep apnea, it is possible that the effects of one disorder could impact the development of the other, but there are still areas that need additional research.3

Weight loss and sleep apnea
Weight loss of five to 10 percent of body weight has been shown to improve the symptoms of sleep apnea. One well-designed study evaluated the effects of a weight-loss program with or without nasal continuous positive airway pressure (CPAP), the usual treatment for sleep apnea, on the symptoms of the disorder. Participants lost 14 percent and nine percent of their original body weight after six and 24 months. At six months, 61 percent of patients had a 50 percent decrease in their symptoms of sleep apnea, and these results were still seen in 42 percent of patients at 24 months. Adding CPAP in the initial phase of weight loss did not have a significant impact on results4, therefore weight loss cannot be attributed to using CPAP.

Bottom Line: More research is needed to better understand the risks and consequences of sleep apnea, but what is clear is that a weight loss of five to 10 percent can make a big difference in reducing the symptoms.

This content is reviewed regularly. Last updated December 17, 2011.

1 Pillar G, Shehadeh N. Abdominal fat and sleep apnea: the chicken or the egg? Diabetes Care. 2008 Feb;31 Suppl 2:S303-9.

2 Tasali E, Mokhlesi B, Van Cauter E. Obstructive sleep apnea and type 2 diabetes: interacting epidemics. Chest. 2008 Feb;133(2):496-506.

3 Mehra S, Redline S. Sleep apnea: a proinflammatory disorder that coaggregates with obesity. J Allergy Clin Immunol. 2008 May;121(5):1096-102.

4 Kajaste S, Brander PE, Telakivi T, Partinen M, Mustajoki P. A cognitive-behavioral weight reduction program in the treatment of obstructive sleep apnea syndrome with or without initial nasal CPAP: a randomized study. Sleep Med. 2004 Mar;5(2)125-31.

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