Sleep apnea and weight loss: what's the connection?

Written on April 19, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What is sleep apnea?
• Weight loss and sleep apnea
• Strategies for weight loss in sleep apnea
• The next step is speaking with a healthcare provider
• Related content

Getting a good night’s sleep is critical for health and well-being.[1] Healthy sleep is vital for various body functions such as cognitive ability, mood, and mental, cardiovascular, and metabolic health. Sufficient amounts of good sleep quality are integral in reducing the risk of accidents and injuries from lack of sleep and fatigue. Inadequate sleep is associated with an increased risk of death and can contribute to other chronic diseases, including diabetes, obesity, and cancer. Survey data report that about 33% of United States adults fail to get enough sleep regularly.[1] A condition that affects how well and how long you sleep is called sleep apnea.[2]

What is sleep apnea?

Sleep apnea is a disorder where you stop and restart breathing while you sleep.[2,3] “Apnea” is a word that has its origin in the Greek word for “breathless."[3] This irregularity in breathing prevents your body from getting enough oxygen and can be detrimental to your sleep and, ultimately, your body.

Causes of sleep apnea

Sleep apnea may have a genetic component since it has been found to run in families.[2] There are three main types or causes of sleep apnea [2-4]:

• Obstructive sleep apnea (OSA): OSA is the more common type of sleep apnea. It occurs when the muscles in your head and neck relax during sleep and cause the surrounding tissues to push onto your windpipe, obstructing or blocking the airflow.
• Central sleep apnea (CSA): Your brain normally manages your breathing pattern while you sleep. In CSA, there is an issue in your brain that hinders the signals to help regulate the muscles related to breathing. CSA occurs for many reasons and may involve:
  • Heart failure
  • Nervous system damage
  • Initial treatment with continuous positive airway pressure (CPAP) for OSA (typically resolves with continued CPAP use)
  • Nervous system conditions like amyotrophic lateral sclerosis (ALS)
• Mixed or complex sleep apnea: Mixed or complex sleep apnea is the combination of OSA and CSA.

Symptoms of sleep apnea

Sleep apnea has a variety of symptoms.[3,4] The symptomology between OSA and CSA may be similar, making it difficult to discern between the two types.[4] Symptoms of sleep apnea include [3,4]:

• Fatigue when waking up, even after a whole night’s sleep
• Sleeping or drowsiness during the day
• Snoring
• Mood changes, such as irritability, depression, and anxiety
• Brain function disruptions manifesting as memory loss or issues concentrating
• Waking up multiple times during the night
• Pauses in breathing and unusual breathing patterns during sleep
• Headaches when waking up
• Insomnia
• Night sweats and restlessness
• Sexual dysfunction
• Shortness of breath when waking up
• Dry mouth when waking up

Diagnosis of sleep apnea

For a sleep apnea diagnosis, you will typically see a healthcare provider and share your symptoms and medical history. [3,4] The healthcare provider will ask you questions on additional signs and symptoms. If they suspect sleep apnea, they will order testing to help diagnose it. Common tests for sleep apnea are an overnight sleep study and a home sleep apnea test. An overnight sleep study will consist of you sleeping overnight in a medical facility or sleep lab. The facility will have the equipment to monitor your heart rate, breathing, oxygen levels, and brain waves while you sleep. A home sleep apnea test is conducted at your home and is not as accurate as the overnight sleep study since it does not diagnose CSA. The home sleep apnea test also does not measure your brain waves.

Treatment for sleep apnea

Once diagnosed, your healthcare provider will go over treatment options with you. Common treatment options include airway pressure and adaptive ventilation devices, oral mouthpieces, nerve stimulators, and surgery.[3,4] Medications are also available for CSA treatment. Aside from these therapies, there are also nonmedical treatment options available. Nonmedical or conservative therapies include changes in sleep positions, nasal sprays or adhesives, medication changes, treatment of underlying conditions, and weight loss. Discussing your sleep apnea condition and treatment options is essential in selecting the appropriate therapy for you.

Weight loss and sleep apnea

Wight loss is a therapeutic option for sleep apnea and has been recommended as a supplementary treatment, especially if you struggle with obesity.[5] The most common risk factor for OSA is obesity. Even losing 10% of your body weight can improve sleep apnea when you are overweight or obese.[3] Sometimes sleep apnea can even be resolved by achieving a normal weight, but it may reappear if that weight is regained.[4]

Evidence for weight loss and sleep apnea management

Though weight loss is often recommended as a supplementary sleep apnea treatment for those who are overweight or obese, the relationship between weight loss and sleep apnea can be complex. [5] A small study of 89 overweight or obese men with moderate to severe OSA found that weight loss and lifestyle modifications significantly improved OSA severity after eight weeks.[6] At six months, 62% of patients who underwent weight loss and lifestyle changes no longer required CPAP therapy. A systematic review and meta-analysis assessing the impact of weight loss on measures of OSA showed improvements in these measurements.[7] An extended follow-up study included 264 adults with obesity, type 2 diabetes, and OSA who received either intensive lifestyle interventions for weight loss or diabetes support and education.[8] The researchers reported that participants with OSA and type 2 diabetes receiving intensive lifestyle intervention for weight loss had reduced OSA severity at ten years.[8]

Strategies for weight loss in sleep apnea

Losing weight is beneficial for managing many chronic diseases, including sleep apnea. A healthy weight loss goal is around 1 to 2 pounds per week. A complete lifestyle intervention program with a restricted calorie diet, increased physical activity, and behavioral therapy are essential to losing weight.[9]

On average, total caloric intake should be limited to 1200 to 1500 calories per day for females and 1500 to 1800 calories for males for at least six months for safe and effective weight loss.[9] Your diet should be composed of healthy, well-balanced choices and food intake tracking. Recommendations to promote a healthy diet include [9,10]:

• Eating three meals per day and not skipping meals
• Controlling your portion sizes
• Planning your meals ahead of time
• Drinking water and limiting beverages like juices and soda
• Choosing meals high in fiber and complex carbohydrates and low in sugars
• Limiting foods high in fat

Increasing your physical activity and exercise helps to achieve and maintain a healthy weight.[9,10] Ways to increase your activity:

• Use the stairs when possible
• Take breaks to walk throughout the day
• Get an exercise buddy

Behavioral therapy is recognized as integral in helping people achieve and maintain weight loss.[9] Additionally, as part of your weight loss journey, it’s essential to commit to losing weight, evaluate where you are, set realistic goals, find resources and support, and revisit your goals to assess your progress.[10]

The next step is speaking with a healthcare provider

If you are having trouble sleeping throughout the night or waking up tired, it is a good idea to speak with your healthcare provider. These could be symptoms of sleep apnea. If you are already diagnosed with the condition and wondering if weight loss should be part of your treatment, then speaking with a clinician is also a good idea. Before beginning any weight loss therapies, be sure to consult with a healthcare provider.

At Everlywell, you can speak with a certified healthcare provider about your health and weight concerns through the telehealth weight loss option. You can schedule a consultation from the comfort of your own home. The clinician will help to address your questions and concerns and develop a care plan for you. They may suggest additional testing and follow-up based on the initial discussion.

Related content

Understanding the connection between thyroid health and weight loss

Pregnancy and obesity: what you need to know

Weight loss and improvement in comorbidity

References

1. Ramar K, Malhotra RK, Carden KA, et al. Sleep is essential to health: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2021;17(10):2115-2119. doi: 10.5664/jcsm.9476. URL.
2. What is sleep apnea? National Heart Lung and Blood Institute. URL. Accessed April 18, 2023.
3. Sleep apnea: What it is, causes, symptoms & treatment. Cleveland Clinic. URL. Accessed April 18, 2023.
4. Sleep apnea. Mayo Clinic. URL. Published April 6, 2023. Accessed April 18, 2023.
5. Patel SR. The complex relationship between weight and sleep apnoea. Thorax. 2015;70(3):205-6. doi: 10.1136/thoraxjnl-2014-206484. URL.
6. Carneiro-Barrera A, Amaro-Gahete FJ, Guillén-Riquelme A, et al. Effect of an interdisciplinary weight loss and lifestyle intervention on obstructive sleep apnea severity: the INTERAPNEA randomized clinical trial. JAMA Netw Open. 2022;5(4):e228212. doi: 10.1001/jamanetworkopen.2022.8212. URL.
7. Araghi MH, Chen YF, Jagielski A, et al. Effectiveness of lifestyle interventions on obstructive sleep apnea (OSA): systematic review and meta-analysis. Sleep. 2013 Oct 1;36(10):1553-62, 1562A-1562E. doi: 10.5665/sleep.3056. URL.
8. Kuna ST, Reboussin DM, Strotmeyer ES, et al; Sleep AHEAD Research Subgroup of the Look AHEAD Research Group. Effects of weight loss on obstructive sleep apnea severity. Ten-year results of the sleep AHEAD study. Am J Respir Crit Care Med. 2021;203(2):221-229. doi: 10.1164/rccm.201912-2511OC. URL.
9. Coaker MA, Hudgel DW, Patel SR. Weight loss and sleep apnea. Am J Respir Crit Care Med. 2020;201(3):P5-P6. doi: 10.1164/rccm.2013P5. URL.
10. Losing weight: Getting started. Centers for Disease Control and Prevention. June 3, 2022. URL. Accessed April 18, 2023.